The Great Influenza

The Great Influenza

The Epic Story of the Deadliest Plague in History

eBook - 2005
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Publisher: New York : Viking, 2005, c2004
ISBN: 9780786586516
0786586516
9781429501927
1429501928
Call Number: EBOOK OVERDRIVE
Characteristics: 546 p. : ill. ; 24 cm

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PineSisken02
Jun 07, 2020

"Closing saloons and theaters and churches meant nothing if significant numbers of people continued to climb onto streetcars, continued to go to work, continued to go to the grocer. Even where fear closed down businesses, where both store owners and customers refused to stand face-to-face and left orders on sidewalks, there was still too much interaction to break the chain of infection. The virus was too efficient, too explosive, too good at what it did. In the end the virus did its will around the world."

"It was as if the virus were a hunter. It was hunting mankind. It found man in the cities easily, but was not satisfied. It followed him into towns, then villages, then individual homes. It searched for him in the most distant corners of the earth. It hunted him in the forests, tracked him into jungles, pursued him onto the ice."

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jimg2000
May 17, 2020

Epidemiological evidence suggests that a new influenza virus originated in Haskell County, Kansas, early in 1918. Evidence further suggests that this virus traveled east across the state to a huge army base, and from there to Europe. Later it began its sweep through North America, through Europe, through South America, through Asia and Africa, through isolated islands in the Pacific, through all the wide world. In its wake followed a keening sound that rose from the throats of mourners like the wind.
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All subsequent quotes are excerpts from the updated 2009 AFTERWORD:

But in 1997, an H5N1 avian influenza virus, the so-called bird flu, killed six of eighteen people in Hong Kong. Millions of fowl were slaughtered in an unsuccessful effort to wipe it out, and it reemerged with a vengeance in 2003.

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jimg2000
May 17, 2020

Since then, H5N1 and more recently an H7N9 avian virus have been infecting humans at previously unknown rates. Between 2003 and 2017 — the latest numbers as I write this — these viruses have infected 2,342 people and killed 1,053 of them — a case fatality rate of 44.9 percent.
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In 1918 such a virus did infect humans. Since the original publication of this book, scientists have found evidence (the question is not settled) that seven of the eight segments of the 1918 virus are of avian origin, and the virus jumped species to humans probably after a reassortment (see 112) with another virus in which it acquired a human hemagglutinin gene — the gene which allows the virus to bind to and thus infect cells. And even that eighth segment had recent avian roots. This reassortment would have occurred when the avian virus infected a mammal — human, horse, pig, whatever — that was simultaneously infected by another influenza virus carrying that gene.

j
jimg2000
May 17, 2020

In 1918, the world population was 1.8 billion, and the pandemic probably killed 50 to 100 million people, with the lowest credible modern estimate at 35 million. Today the world population is 7.6 billion. A comparable death toll today would range from roughly 150 to 425 million.
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Chiefly because antibiotics would slash the toll from secondary bacterial infections, if a virus caused a 1918-like pandemic today, modern medicine could likely prevent significantly more than half of those deaths — assuming adequate supplies of antibiotics, which is quite an assumption — but tens of millions would still die. And a severe influenza pandemic would hit like a tsunami, inundating intensive-care units even as doctors and nurses fall ill themselves and generally pushing the health care system to the point of collapse and possibly beyond it. Hospitals, like every other industry, have gotten more efficient by cutting costs, which means virtually no excess capacity

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jimg2000
May 17, 2020

— on a per capita basis the United States has far fewer hospital beds than a few decades ago. Indeed, during a routine influenza season, usage of respirators rises to nearly 100 percent; in a pandemic, most people who needed a mechanical respirator probably would not get one. (The strain influenza puts on health care was driven home to me in a personal way on my book tour.
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In Kansas City, a flare-up of ordinary seasonal influenza forced eight hospitals to close emergency rooms, yet this was only a tiny fraction of the pressure a pandemic would exert.) This and similar problems — such as if a particular secondary bacterial invader is resistant to antibiotics, or shortages of such seemingly trivial items as hypodermic needles or bags to hold IV fluids (a severe shortage of these bags is a major problem as I write this) — could easily moot many medical advances since 1918. Disease impact would also ripple through the economy to disastrous effect.

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jimg2000
May 17, 2020

With everyone from air traffic controllers to truck drivers out sick, just-in-time inventory systems would crash, supply chains would collapse, for lack of some part production lines would shut down, while schools and day-care facilities might close for weeks, and an overburdened “last mile” would limit the ability of people to work from home.
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With the emergence of H5N1, the threat of just such a scenario got the attention of large companies and governments; businesses began working on supply chains and continuity plans; government in developed countries began pouring money into pandemic preparedness, including basic research, vaccine production, and stockpiling certain drugs. In addition, since manufacturing and distributing a vaccine would take months at best, and since no antiviral drugs are very effective, they also asked public health officials to devise policies to mitigate the impact of a pandemic using non-pharmaceutical interventions, or NPIs —

j
jimg2000
May 17, 2020

i.e. , what to do without drugs. Since most of these were based on an analysis of events in 1918, I was asked to join in the effort that brought together people with backgrounds in history, laboratory science, public health, international relations, mathematical modeling, and politics. My involvement continued for several years, and I worked with others through the National Academy of Sciences, national security entities, other state and federal agencies, think tanks, and officials in the Bush and Obama White Houses.
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Planners prepared for a Category 5 hurricane. The 2009 H1N1 swine flu pandemic, not even a tropical storm, threw them off-balance. This pandemic, the mildest ever known, taught new lessons, including some that required rethinking NPI policy.

j
jimg2000
May 17, 2020

The 2009 pandemic killed “only” an estimated 150,000 to 575,000 worldwide, with probably about 12,000 U.S. deaths. (However, if one looks at the 2009 pandemic in terms of total years of life lost, not just deaths, it was much more severe: the average age of victims was only forty, and 80 percent of victims were younger than sixty-five. In seasonal influenza, only 10 percent of deaths occur in those under sixty-five.) By comparison, ordinary seasonal influenza kills up to 650,000 people worldwide annually, and in the United States the disease kills between 3,000 and 56,000 a year, depending mainly on the virulence of the virus and to a lesser extent on the efficacy of that year’s vaccine. The 2009 experience should reassure no one. It seems likely that throughout history many such outbreaks occurred but escaped notice; only modern surveillance and molecular biology allowed us to recognize it as a pandemic.

j
jimg2000
May 17, 2020

When the Washington Post asked Tom Frieden, then head of the Centers for Disease Control and Prevention, what scared him the most, what kept him up at night, he replied, “The biggest concern is always for an influenza pandemic. .. [ It ] really is the worst-case scenario.” So where are we now ? What are the lessons ?
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Before addressing those questions, we need to understand the commonalities of the few pandemics we have information about: 1889, 1918, 1957, 1968, and 2009. First, all five came in waves. (A few scientists argue that the difference in lethality between 1918 ’ s first and second waves mean that these were caused by different viruses, but evidence showing otherwise seems overwhelming. For one thing, exposure to the first wave provided as high as 94 percent protection against the second wave, far better protection than the best modern vaccine affords, and that’s just one piece of the evidence that the same virus caused both waves.)

j
jimg2000
May 17, 2020

In fact, some investigators now speculate that the 1918 virus circulated in humans for several years before mutations allowed it to spread easily. If true, this would of course explode the hypothesis that Haskell was the origin. The 1889 pandemic virus did follow this pattern, generating two and a half years of sporadic outbreaks around the world, including in such large cities as London, Berlin, and Paris, before becoming fully pandemic, blanketing the world in the winter of 1891 – 92.
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We also know that every wave of every pandemic has been at least a little different. In 1918, of course, that difference was dramatic, but 1968 may be more puzzling. In the United States, 70 percent of pandemic deaths occurred in the 1968 – 69 influenza season, with the rest in 1969–70. Europe and Asia were the opposite, with few deaths in 1968 – 69 and the overwhelming majority in 1969–70 — even though a vaccine was available by then.

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missjetlagged
Nov 07, 2020

If you're stuck on the waiting list for this one, CPL has some fantastic other options in the meantime! https://calgary.bibliocommons.com/list/share/526108436_missjetlagged/1599953009_spanish_flu_-_books_at_calgary_public_library

m
mlinard
May 24, 2020

Highly recommend if you are interested in 1918 Flu, health fields, history, or pandemics. Well written and interesting.

j
jimg2000
May 17, 2020

Book was published in 2004, a year before the genome of the 1918 flu virus was reconstructed etc. Nonetheless, invaluable past experience to the current COVID-19 (novel coronavirus disease-2019) the disease and SARS-CoV-2 the virus. While the author only included a short paragraph on the 2003 SARS epidemic in the book's main text, the 2018 edition has an updated AFTERWORD that referenced a bit more on the 2003 SARS and the 2009 Swine Flu pandemic. A good informative read about the individuals who combated the Great Influenza at the onset of WWI. Recommend to peruse the photos and the AFTERWORD (Excerpt in Quotes) if short on time.

Notes:
1. One of source quoted often is the 1989 book by historian Alfred. W. Crosby, America’s Forgotten Pandemic: The Influenza of 1918. Crosby estimates that it took the lives of 550,000 Americans, a figure that he deems conservative.
2. Suggest to watch the 2006 documentary, originally broadcast in 1998, from PBS Home Video: Influenza 1918 - American Experience. https://sccl.bibliocommons.com/item/show/182851118

k
krober44
Mar 05, 2020

Although this book was written in 2004 it's very timely right now in 2020 with the current virus. I loved learning the real origins of a so-called Spanish flu; it seems the origin was in America's heartland, Kansas, and was unwittingly exported to Europe as our soldiers were deployed to the battlefields. Chilling is the many detailed descriptions of the grisly deaths, the mass burials at sea, the mass burials in trenches, the long-term effects of influenza on the brain, the possible negative effects the flu had on President Wilson's ability to set down the rules of an armistice with Germany (and that flow-on effect). Especially important is how our government dealt with the emergency then and now: ". . . those who occupy positions of authority must lessen the panic that can alienate all with a society. Society cannot function if it is every man for himself. By definition, civilization cannot survive that. . . . Those in authority must retain the public's trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one." (p461) Great read. Thanks SAPL for having this in your collection.

o
OllPuff9
Jul 25, 2017

Absolutely amazing read. I work as an administrative assistant to a pathology team and learning the immune system processes in more detail was fascinating. I also will continue to get my annual "flu shot" and in years when the CDC/NHI/WHO isn't sure they have the routine vaccination "right" (such as winter of 2016-17) I will always opt for the higher-priced quadrivalent vaccine instead (like I did last fall). The organisms' "shift" versus "drift" explanation is also particularly horrifying.

d
DUVIDL
Jun 21, 2017

Point Of Fact: The reason it is called the Spanish Influenza is because Spain, being neutral during World War I, did not censor its papers and news media, which is why the world first learn of this pandemic through the deaths in Spain. It is surmised this nightmare was created when the flu strain that had developed in the New World combined with the flu strain of the Old World, creating a super strain that killed people faster than they could be buried or, in some cases, even have time to realize how sick they were (one woman, as a child of eight, remembers walking down the streets of London while people dropped dead around her mother and her.) Bureaucratic obstinacy created this pandemic as many `top brass` refused to admit there was such a crisis (bad for patriotic morale) and (in the case of the United States) kept stuffing sick soldiers into troop ships and sending them `off to do battle`...until the flood of telegrams reached them reporting arriving ships loaded with nothing but corpses! For an excellent documentary on this unjustly forgotten nightmare, see 'INFLUENZA 1918', a PBS special in the St. Louis City Library`s Film Library - both in DVD and VHS.

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IV27HUjg
Mar 17, 2016

Epidemics fascinate me. This read is very, very long, and I felt confused by the author repeating much of it & thought he jumped around too much. This author was excellent in his research, but he could have used an editor & a proof reader. UPDATE: It has taken me nearly 3 weeks to complete this book, however it took the author 7 years to write it. I highly recommend this work, even if one only reads the last chapter, the importance is of great value.

Some real pearls sprinkled in this history lesson. Lots of technical biology, microbio, etc. For me, it was an eye-opener about W.Wilson decisions, leaving me not on the admiring side of his term in office. Not to belabor the issue, but I kept thinking this is a case of US officials certainly didn't have their act together - while Rome burned Nero fiddled - while thousands died the gov't sat on their thumbs. To give credit, 'we' were incredibly naive & blind. The panic & terror of this pandemic caused untold deaths not so much in the disease, but due to starvation of those infected.

I was not the least bit surprised with the majority belief that is was NOT Spanish Influenza as so commonly referred to. Sound reasoning why it's a misnomer. The number of deaths from this contagion is staggering & frightening. As a companion read at the same time is Last of the Dough Boys - excellent history lesson on The Great War despite the audio is not the voice I prefer.

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