The Great Influenza


John M Barry




Date Reviewed:

March 10, 2007

his book is a fascinating account of the influenza plague that erupted in 1918 and killed millions of people around the world. However, this book is much more than just an account of the epidemic, it also tells interesting information about the scientists and politics which played such a crucial part of the story.

The opening section of the book gives a detailed account of the state of medicine in the United States at the time. Medicine was primitive superstition, "doctors" got degrees without ever performing a disection or studying anatomy, bleeding was still believed to be a helpful treatment. A few men, led by a brilliant man named Welch, transformed American medicine, founding the John Hopkins institute, emphasizing research and scientific approach to health. John Hopkins is famous, but I never really knew why until I read this book. Reading about these men almost made me wish I had gone into medicine as a career; they changed America from a backwater to the world leader, even better than the best institutes in Europe.

Just before the influenza breakout, America joined the Allied side in World War I. It was amazing to read the all out effort that President Wilson directed when he committed our nation to the war. Civil liberties were violated, no one was permitted to speak ill of the war effort or American policy. Strict rationing was enforced "voluntarily", people were exhorted to buy Liberty bonds, one out of eight women in the entire country belonged to a chapter of the Red Cross. Unfortunately, the single minded focus of the government on the war effort resulted in complete lack of focus on health issues, so there was no attempts to stop the influenza epidemic as it got started. Censorship blocked any word of the devastating disease, this fear of "hurting morale" by reporting the truth led to complete distrust by the civlian population of all the happy talk about "only influenza".

The influenza plague apparently began with a mutated strain in the American heartland, arriving at an army camp with a young soldier. The camps were densely packed, with thousands of men streaming in and out, ideal breeding grounds for the lethal strain. Unfortunately, the military command failed to react immediately to advice about quartantines, so Barry tells some horrifying stories about troop trains and ships jammed with soldiers that turned into charnel houses as dead piled up everywhere.

The book explains how lethal and contagious this disease was. The worst aspect was it seemed to kill the healthiest people - young adults seemed to die the quickest. The influenza strained provoked such a devastating counterattack by the human immune system that stricken people had their lungs fill with blood, pus, white blood cells - they literally drowned as their lungs filled with fluid. Since the healthiest adults had the most vibrant immune systems, their response was the strongest, and thus they were most likely to die. Barry describes people turning dark blue as their bodies starved for oxygen.

Barry describes how poorly the cities reacted to the influenza bug. Philidelphia held a long planned parade to encourage people to buy war bonds, despite the fact the medical authorities pleaded that the parade be cancelled. But the parade was held, and within days the city was filled with dying citizens.

The book spends several chapters describing the attempts of the science and medical community to find a cure, or even the cause of the epidemic. These men fail, the epidemic ends when the strains mutates into a more benign form, but even after the epidemic has past, the men continue to investigate diseases, viruses - the research community we take for granted today became institutionalized back then. One hero of the book is a man named Avery, who persistently spends his entire career trying to deduce how the influenza strains can pass different genetic information between them. Ultimately, Avery proves that a molecule called DNA was responsible for passing genetic information - Watson and Crick discovered the structure of DNA, but it was Avery who first showed what DNA does.

One of the most interesting chapters describes how Woodrow Wilson caught influenza while in Europe negotiating the peace process. Barry explains how people recovering from influenze exhibit reduced mental capacity, some people never recover their previous personalities. Prior to his infection, Wilson had pressed George (English prime minister) and Clemenceau (French) for a just and sustainable peace treaty. But the other Allied leaders wanted revenge on Germany and Austria for World War I. After Wilson "recovered" from his bout of influenza, he acted like a different man, and in the end gave up all his principled positions (except the League of Nations) - England and France got the vengeful treaty they wanted, and 20 years later the world got World War II.

This is a long book, I had to renew it from the library several times to finish. But the good parts are very informative, I learned a lot from reading it.