Review: New books revisit the influenza pandemic of 1918 that killed millions

Published: 12/20/2018 10:08:34 AM

 “Influenza: The Hundred-Year Hunt to Cure the Deadliest Disease in History” by Dr. Jeremy Brown; Touchstone (258 pages, $26.99)

“Pandemic 1918: Eyewitness Accounts from the Greatest Medical Holocaust in Modern History” by Catharine Arnold; St. Martin’s Press (357 pages, $27.99)

 

Exactly a century ago, a virulent, highly contagious flu infected an estimated one-third of the globe. Somewhere between 50 and 100 million people died. The 1918 influenza took more lives in 15 months than AIDS has claimed in 40 years and buried more than the bubonic plague killed in a century.

A submicroscopic virus composed of just eight genes would turn out to be the killer, wiping out “more humans than any other disease in a period of similar duration in the history of the world,” as historian Alfred W. Crosby put it.

Very few witnesses remain among us, but a tower of books — including Crosby’s influential 1989 “America’s Forgotten Pandemic” — has sought to document the scale of the horror.

British schoolchildren slumped dead at their desks, and German furniture vans hauled bodies scattered in the streets to the cemeteries. Panicked South Africans threw dying miners from trains to expire along the tracks.

Sometimes in days, sometimes in hours, the flu would start with a dull headache or burning eyes, followed by chills and fever. Almost all the infected would live, but for an unlucky 2.5 percent, the lungs filled with a reddish fluid, the lips and ears would turn dusky blue and the victim’s feet would turn black.

The struggle for air produced a hellish cough that mimicked a duck’s quack. Doctors couldn’t stop it or treat it or even pinpoint its cause.

Jeremy Brown, a London-trained emergency room physician who now directs the NIH Office of Emergency Care Research, turns indignant in his new book, “Influenza: The Hundred-Year Hunt to Cure the Deadliest Disease in History,” at the quackery his field once perpetrated. His first chapter, “Enemas, Bloodletting, and Whiskey,” unpacks the nonsense — and harm — that physicians threw at their patients, including killing many of them with aspirin overdoses.

“The flu is still a serial killer,” Brown notes, adding that it “is certainly not ‘the emperor of all maladies,’ as cancer was described by the oncologist Siddhartha Mukherjee, but it is the malady of all empires. It has been with us since the dawn of time, and it has afflicted each civilization and society in every corner of the globe.”

A second Brit, journalist Catharine Arnold, has timed her own flu retrospective to the centennial. “Pandemic 1918: Eyewitness Accounts from the Greatest Medical Holocaust in Modern History” is not above a lurid subtitle, but its psychologist author picks a better opener for her book.

She begins in an English churchyard 10 years ago, where an Oxford don is exhuming the body of Sir Mark Sykes, a prime-of-his life British diplomat felled as he helped negotiate the peace in Paris after World War I. Buried in a lead casket, which delays decomposition, the corpse, it was hoped, retained enough soft tissue to enable scientists to extract the virus. (It didn’t work, as the coffin had cracked.)

Grave excavations provide colorful anecdotes in both books. Most led to disappointments, but one, in Alaska, hit pay dirt in 1997 when a 73-year-old Swedish scientist returned to the far-North permafrost. He found that the extra fat on an obese flu victim preserved enough of the 1918 virus in one of the four samples he culled from her body to help unlock the virus’ RNA pedigree.

Brown tells this story with a welcome scientific crispness, but Arnold supplies the telling human details: The Swedish scientist names the silent donor “Lucy” in a nod to the famous hominid unearthed in Ethiopia.

The covers of both books feature the same striking 1918 photograph: a cavernous, crowded emergency ward of stricken U.S. soldiers at Camp Funston in central Kansas. This photo also illustrates an excellent 2017 Smithsonian Magazine article on the pandemic from historian John M. Barry.

Readers wanting a briefer foray should find it online. A longer read — “The Great Influenza,” Barry’s 2004 book — is better written than either of the two new volumes. So is “Flu” by science journalist Gina Kolata.

The new works, then, must make fresh information their justification. Here Brown’s book is superior to Arnold’s meander through the archives. He depicts the shortfalls of big data in flu tracking, the pitfalls in our annual flu vaccinations and the scandalous medical politics bedeviling Tamiflu and similar treatments.

A century on, we know more — towns with teams in the Super Bowl will see an 18 percent jump in elderly deaths due to football-party-spread virus — but scientists still can’t prevent or cure the flu.

The shadow of this pandemic dogs us still.

 

 




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