The Great Influenza PDF Download Free

John Walker “In the year 1800, the practice of medicine had changed little from that in antiquity. The rapid progress in other sciences in the 18th century had had little impact on medicine, which one historian called “the withered arm of science”. This began to change as the 19th century progressed. Researchers, mostly in Europe and especially in Germany, began to lay the foundations for a scientific approach to medicine and public health, understanding the causes of disease and searching for means of prevention and cure. The invention of new instruments for medical examination, anesthesia, and antiseptic procedures began to transform the practice of medicine and surgery.

All of the resources of the new scientific medicine were thrown into the battle with the disease, with little or no impact upon its progression. The cause of influenza was not known at the time: some thought it was a bacterial disease while others suspected a virus. Further adding to the confusion is that influenza patients often had a secondary infection of bacterial pneumonia, and the organism which causes that disease was mis-identified as the pathogen responsible for influenza. Heroic efforts were made, but the state of medical science in 1918 was simply not up to the challenge posed by influenza.

A century later, influenza continues to defeat every attempt to prevent or cure it, and another global pandemic remains a distinct possibility. Supportive treatment in the developed world and the availability of antibiotics to prevent secondary infection by pneumonia will reduce the death toll, but a mass outbreak of the virus on the scale of 1918 would quickly swamp all available medical facilities and bring society to the brink as it did then. Even regular influenza kills between a quarter and a half million people a year. The emergence of a killer strain like that of 1918 could increase this number by a factor of ten or twenty.

Strains of influenza tend to come in waves, with one HxNy variant dominating for some number of years, then shifting to another. Developers of vaccines must play a guessing game about which you’re likely to encounter in a given year. This explains why the 1918 pandemic particularly hit healthy adults. Over the decades preceding the 1918 outbreak, the primary variant had shifted from H1N1, then decades of another variant, and then after 1900 H1N1 came back to the fore. Consequently, when the deadly strain of H1N1 appeared in the fall of 1918, the immune systems of both young and elderly people were ready for it and protected them, but those in between had immune systems which, when confronted with H1N1, produced antibodies for the other variant, leaving them vulnerable. The Great Influenza PDF.

With no medical defence against or cure for influenza even today, the only effective response in the case of an outbreak of a killer strain is public health measures such as isolation and quarantine. Influenza is airborne and highly infectious: the gauze face masks you see in pictures from 1918 were almost completely ineffective. The government response to the outbreak in 1918 could hardly have been worse. After creating military camps which were nothing less than a culture medium containing those in the most vulnerable age range packed in close proximity, once the disease broke out and reports began to arrive that this was something new and extremely lethal, the troop trains and ships continued to run due to orders from the top that more and more men had to be fed into the meat grinder that was the Western Front. This inoculated camp after camp. Then, when the disease jumped into the civilian population and began to devastate cities adjacent to military facilities such as Boston and Philadelphia, the press censors of Wilson’s war machine decided that honest reporting of the extent and severity of the disease or measures aimed at slowing its spread would impact “morale” and war production, so newspapers were ordered to either ignore it or print useless happy talk which only accelerated the epidemic. The result was that in the hardest-hit cities, residents confronted with the reality before their eyes giving to lie to the propaganda they were hearing from authorities retreated into fear and withdrawal, allowing neighbours to starve rather than risk infection by bringing them food.

As was known in antiquity, the only defence against an infectious disease with no known medical intervention is quarantine. In Western Samoa, the disease arrived in September 1918 on a German steamer. By the time the disease ran its course, 22% of the population of the islands was dead. Just a few kilometres across the ocean in American Samoa, authorities imposed a rigid quarantine and not a single person died of influenza.

We will never know the worldwide extent of the 1918 pandemic. Many of the hardest-hit areas, such as China and India, did not have the infrastructure to collect epidemiological data and what they had collapsed under the impact of the crisis. Estimates are that on the order of 500 million people worldwide were infected and that between 50 and 100 million died: three to five percent of the world’s population.

Researchers do not know why the 1918 second wave pathogen was so lethal. The genome has been sequenced and nothing jumps out from it as an obvious cause. Understanding its virulence may require recreating the monster and experimenting with it in animal models. Obviously, this is not something which should be undertaken without serious deliberation beforehand and extreme precautions, but it may be the only way to gain the knowledge needed to treat those infected should a similar wild strain emerge in the future. (It is possible this work may have been done but not published because it could provide a roadmap for malefactors bent on creating a synthetic plague. If this be the case, we’ll probably never know about it.)

Although medicine has made enormous strides in the last century, influenza, which defeated the world’s best minds in 1918, remains a risk, and in a world with global air travel moving millions between dense population centres, an outbreak today would be even harder to contain. Let us hope that in that dire circumstance authorities will have the wisdom and courage to take the kind of dramatic action which can make the difference between a regional tragedy and a global cataclysm.”