Influenza: a lesson from history's worst plague

April 04, 2004|By Clare McHugh | Clare McHugh,Special to the Sun

The Great Influenza: The Epic Story of the Deadliest Plague in History, by John M. Barry. Viking. 546 pages. $29.95.

Perhaps if the worldwide flu epidemic hadn't coincided with the last months of World War I -- itself a horrific and up-until-that-moment unparalleled event in human history -- the impact of a deadly outbreak of infectious disease that carried away more than 40 million souls in a single year would have been more enduring. As it is, the influenza pandemic gets lumped into the general ghastliness of the era -- and the long-term implications of what scientists and doctors learned from it too easily brushed aside.

Author John M. Barry clearly wants to change that. His lengthy new history of the flu explains how the disease spread, plus what the experts knew and when they knew it. He starts his account in the last decades of the 19th century, when American medicine emerged from primitivism into the age of science. The biological causes of disease were mapped out, most effectively by William Henry Welch, a founder of the Johns Hopkins Hospital and the Johns Hopkins Medical School.

By 1918, doctors may not have mastered illness, but they had greater confidence in managing it. New anti-toxins had been developed for diphtheria and tetanus, and germ theory had been widely accepted, even by country doctors like Loring Miner, a physician in Haskell, Kan. In late January 1918, Miner began seeing a flu of uncommon intensity sickening dozens of otherwise strong, young adults. He contacted the U.S. Public Health Service, which offered neither help nor advice. But by mid-March, the community had bounced back, and no new infections were reported.

Haskell is located in an isolated part of western Kansas, and in earlier years a flu that broke out there might have died there. In 1918, however, men from Haskell were going back and forth to Camp Funston in eastern Kansas, a huge army camp built to train soldiers for the world war America had entered in 1917. By the end of March, 1,100 men at Funston had been hospitalized with flu. From Funston, soldiers went to camps elsewhere in the country and overseas. It seems probable that the Haskell flu strain, mutating and growing stronger as it swept through large groups of men living in confined conditions, sparked the pandemic.

The country's medical establishment, including Welch, didn't detect the vicious new flu until September 1918, when they were summoned to Camp Devans, outside Boston. Young men were dying at the rate of 100 per day, coughing up blood, turning blue and perishing in some cases within hours from the onset of symptoms. Welch was badly shaken by what he saw, and before taking to his own sick bed instructed several of his associates to identify the agent and develop countermeasures. Welch recovered, but the flu epidemic had faded away before meaningful strides were made in modern virology, an infant science in 1918.

The takeaway for the modern reader is clear: Get your flu shot every year. Barry explains that the 1918 strain was highly efficient at invading the lungs, prompting the body to launch a massive counterattack of secretions. For millions of young, healthy adults with strong immune systems, that robust response was fatal.

A chilling scenario, and one that could happen again. But exposure to earlier, weaker strains of flu turned out to be protective in 1918 -- just as it would be today. Another vital ingredient in fighting flu is worldwide openness about reporting disease -- something that China proved incapable of during the early months of the SARS outbreak. A tiny virus can be very powerful, especially when helped along by human mendacity.

Clare McHugh, founding editor of the men's magazine Maxim, is now an editor at Time Inc. She has served as editor-in-chief of New Woman and executive editor of Marie Claire.

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