Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It

Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It

by Gina Kolata


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Product Details

ISBN-13: 9780743203982
Publisher: Atria Books
Publication date: 01/28/2001
Pages: 352
Sales rank: 424,958
Product dimensions: 5.50(w) x 8.43(h) x 0.90(d)
Lexile: 1160L (what's this?)

About the Author

Gina Kolata is a science reporter for The New York Times and the author of Clone: The Road to Dolly and Sex in America. She lives in Princeton, New Jersey.

Read an Excerpt

Chapter One


This is a detective story. Here was a mass murderer that was around 80 years ago and who's never been brought to justice. And what we're trying to do is find the murderer.

—Jeffery Taubenberger, molecular pathologist

When the plague came, on those chilly days of autumn, some said it was a terrible new weapon of war. The plague germs were inserted into aspirin made by the German drug company Bayer. Take an aspirin for a headache and the germs will creep through your body. Then your fate is sealed.

    No, the plague came in on a camouflaged German ship that had crept into Boston Harbor under cover of darkness and released the germs that seeded the city. Boston, after all, was where the plague started. There was an eyewitness, an old woman who said she saw a greasy-looking cloud that floated over the harbor and wafted over the docks.

    No, it was started by Germans who slipped into Boston Harbor on U-boats and then sneaked ashore, carrying vials of the plague germs with them. They let the germs loose in theaters and among crowds gathered for those interminable Liberty Bond rallies. Lieutenant Colonel Philip S. Doane, head of the Health Sanitation Section of the Emergency Fleet Corporation, said so, and he certainly was in a position to know. It was on page one of the Philadelphia Inquirer.

    Soon the plague was everywhere. And no one was safe.

    The sickness preyed on the young and healthy. Oneday you are fine, strong, and invulnerable. You might be busy at work in your office. Or maybe you are knitting a scarf for the brave troops fighting the war to end all wars. Or maybe you are a soldier reporting for basic training, your first time away from home and family.

    You might notice a dull headache. Your eyes might start to burn. You start to shiver and you will take to your bed, curling up in a ball. But no amount of blankets can keep you warm. You fall into a restless sleep, dreaming the distorted nightmares of delirium as your fever climbs. And when you drift out of sleep, into a sort of semi-consciousness, your muscles will ache and your head will throb and you will somehow know that, step by step, as your body feebly cries out "no," you are moving steadily toward death.

    It may take a few days, it may take a few hours, but there is nothing that can stop the disease's progress. Doctors and nurses have learned to spot the signs. Your face turns a dark brownish purple. You start to cough up blood. Your feet turn black. Finally, as the end nears, you frantically gasp for breath. A blood-tinged saliva bubbles out of your mouth. You die—by drowning, actually—as your lungs fill with a reddish fluid.

    And when a doctor does an autopsy, he will observe your lungs lying heavy and sodden in your chest, engorged with a thin bloody liquid, useless, like slabs of liver.

They called the plague of 1918 influenza, but it was like no influenza ever seen before. It was more like a biblical prophecy come true, something from Revelations that predicted that first the world was to be struck by war, then famine, and then, with the breaking of the fourth seal of the scroll foretelling the future, the appearance of a horse, "deathly pale, and its rider was called Plague, and Hades followed at its heels."

    The plague took off in September of that year, and when it was over, half a million Americans would lie dead. The illness spread to the most remote parts of the globe. Some Eskimo villages were decimated, nearly eliminated from the face of the earth. Twenty percent of Western Samoans perished. And no matter where it struck, the virus went after an unusual group—young adults who generally are spared the ravages of infectious diseases. The death curves were W-shaped, with peaks for the babies and toddlers under age 5, the elderly who were aged 70 to 74, and people aged 20 to 40.

    Children were orphaned, families destroyed. Some who lived through it said it was so horrible that they would not even talk about it. Others tried to put it behind them as another wartime nightmare, somehow conflating it with the horrors of trench warfare and mustard gas. It came when the world was weary of war. It swept the globe in months, ending when the war did. It went away as mysteriously as it appeared. And when it was over, humanity had been struck by a disease that killed more people in a few months' time than any other illness in the history of the world.

    When we think of plagues we think of strange and terrible illnesses. AIDS. Ebola. Anthrax spores. And, of course, the Black Death. We worry about horrifying symptoms—pustules, or fountains of blood gushing from every orifice. Or young men, who had had the bodies of gods, reduced to skeletal figures, hobbling down the street on withered limbs, leaning on canes, shivering with cold. Today we worry about germ warfare—a new virus made of a combination of smallpox and anthrax or smallpox and Ebola. Or we worry that a terrifying new disease is brewing somewhere, in a hot zone, and that it is poised, prepared, with the disruption of ancient forests, to break out and kill us all.

    But influenza never makes the list of deadly plagues. It seems so innocuous. It comes around every winter and everyone gets it sooner or later. There is no good treatment once a person becomes ill, but no matter. Nearly everyone gets over it, few are the worse for the experience. It is just an inconvenient illness that inflicts, at most, a week or so of misery. Influenza is not supposed to be deadly, at least for young adults, who have little reason to fear death or disease.

    Even its name, "influenza," hints at its usual pattern of coming around each winter. "Influenza" is an Italian word that, one hypothesis has it, was coined by the disease's Italian victims in the middle of the eighteenth century. Influenza di freddo means "influence of the cold."

    Flu also, however, seems unavoidable. It is spread through the air and there is little that can be done to prevent being infected. "I know how not to get AIDS," says Alfred W. Crosby, a historian of the 1918 flu. "I don't know how not to get the flu."

    And yet perhaps because the flu is so familiar, its terrors in 1918 were all the more dreadful. It is like a macabre science fiction tale in which the mundane becomes the monstrous.

    When the illness was first observed, doctors were reluctant even to call it the flu. It seemed to be a new disease, they said. Some called it bronchopneumonia, others called it epidemic respiratory infection. Doctors suggested it might be cholera or typhus, or perhaps it was dengue fever or botulism. Still others said it was simply an unidentified pandemic disease. Those who used the term "influenza" insisted on enclosing it in quotation marks.

    One way to tell the story of the 1918 flu is through facts and figures, a collection of data whose impact is numbing and whose magnitude is almost inconceivable.

    How many became ill? More than 25 percent of the U.S. population.

    What about servicemen, the very young and healthy who were the virus's favorite targets? The Navy said that 40 percent of its members got the flu in 1918. The Army estimated that about 36 percent of its members were stricken.

    How many died worldwide? Estimates range from 20 million to more than 100 million, but the true number can never be known. Many places that were bludgeoned by the flu did not keep mortality statistics, and even in countries such as the United States, efforts at tabulating flu deaths were complicated by the fact that there was no definitive test in those days to show that a person actually had the flu. But still, the low end of the mortality estimates is stunning. In comparison, AIDS had killed 11.7 million people through 1997. World War I was responsible for 9.2 million combat deaths and around 15 million total deaths. World War II for 15.9 combat deaths. Historian Crosby remarks that whatever the exact number felled by the 1918 flu, one thing is indisputable: the virus "killed more humans than any other disease in a period of similar duration in the history of the world."

    How lethal was it? It was twenty-five times more deadly than ordinary influenzas. This flu killed 2.5 percent of its victims. Normally, just one-tenth of 1 percent of people who get the flu die. And since a fifth of the world's population got the flu that year, including 28 percent of Americans, the number of deaths was stunning. So many died, in fact, that the average life span in the United States fell by twelve years in 1918. If such a plague came today, killing a similar fraction of the U.S. population, 1.5 million Americans would die, which is more than the number felled in a single year by heart disease, cancers, strokes, chronic pulmonary disease, AIDS, and Alzheimer's disease combined.

    But the raw numbers cannot convey the scenes of horror and misery that swept the world in 1918, which became part of everyday life in every nation, in the largest cities and remotest hamlets.

    Some tell of their personal epiphanies. Historian Crosby, a friendly bear of a man with snow-white hair and a short bushy beard, was at Washington State University one day, gazing at a wall of world almanacs. On a whim, he picked up an almanac from 1917 and looked up the U.S. life expectancy. It was, he recalls, about fifty-one years. He then turned to the almanac from 1919. The life expectancy was about the same. Then he looked at the 1918 almanac. The life expectancy was thirty-nine years, he says. "What the hell happened? The life expectancy had dropped to what it had been fifty years before." Then he realized what the explanation must be. It was the influenza epidemic, the flu his own father had lived through but had not spoken about to Crosby. "When you talk to people who lived through it, they think it was just their block or just their neighborhood," Crosby noted. The flu's enormous, almost unthinkable impact somehow had escaped attention. Crosby applied for a grant from the National Institutes of Health to study the 1918 flu and soon became the world's expert on that almost forgotten period of history.

    No one knows for sure where the 1918 flu came from or how it turned into such a killer strain. All that is known is that it began as an ordinary flu but then it changed. It infected people in the spring of 1918, sickening its victims for about three days with chills and fever, but rarely killing them. Then it disappeared, returning in the fall with the power of a juggernaut.

    In retrospect, medical experts talk of the two waves of the 1918 flu. The first was banal, and easily forgotten. No one mentioned plagues or germ warfare when the influenza epidemic first arrived. But when it came back, in the second wave, it had become something monstrous, bearing little resemblance to what is ordinarily thought of as the flu.

    The earliest traces of the first wave of the 1918 flu are lost in the sands of time, a warning that only afterward seemed dire. The disease seemed trivial at the time, coming as it did in the midst of the disruptions and terrors of war. But for one of the first towns to be hit by the flu, the disease was not easily dismissed—not because it was so deadly but because it was so infectious.

    It was February and the tourist season was in full swing in San Sebastián. The sunny town on the northern coast of Spain seemed a world apart from the dismal, dreary fighting just over the border in France. San Sebastián in the winter of 1918 was a place where you might forget the trenches and the wet, cold, muddy battles. You could escape the talk of mustard gas, that deadly green haze, that horrible new German weapon of war. You could find respite in a country that was still unaligned, where the days were warm and the nights soft and fragrant. You might forget that the rest of Europe was bogged down in an exhausting war to end all wars.

    Then the flu came to town. It was nothing alarming—just three days or so of fever, aches, and pains. But it certainly was contagious. It seemed that nearly everyone who was exposed to the disease became ill about two days later. And the disease seemed to strike young, healthy adults, often sparing the old people and the children, who usually are the first to be felled by influenza.

    What to do? If the world knew about the flu in San Sebastián, the tourist season would be finished. Who would want to go on vacation only to be laid up with the flu? Maybe the illness could be hushed up, the town's officials reasoned. Yet the word spread—San Sebastián was a place to be avoided.

    At nearly the same time, some soldiers were becoming ill, although there was as yet no clear pattern of the disease's spread. Influenza arrived in March in the 15th U.S. Cavalry traveling to Europe.

    Two months later, it seemed that everyone was getting sick. In Spain, eight million people were ill, including King Alfonso XIII. One-third of Madrid was sick with the flu, forcing some government offices to close. Even the trams stopped running. And this time, Spain was not alone—the first wave of the flu had spread widely.

    The troops called it "three-day fever," according to some who suffered from it. One, Sergeant John C. Acker of the 107th Ammunition Train, 32nd Division, American Expeditionary Force, writing from France that April, said: "They started calling it the 'three-day fever' here, but couldn't camouflage it with a name when it runs its course in a week or more. It hits suddenly and one's temperature nearly chases the mercury thru the top of the M.D.'s thermometer, face gets red, every bone in the body aches and the head splits wide open. This continues for three or four days and then disappears after considerable perspiration, but the 'hangover' clings for a week or two."

    But in the rest of the world, the illness came to be called the Spanish flu, to Spain's consternation. After all, the other countries of Europe, as well as the United States and countries in Asia, were hit too in that spring of 1918. Maybe the name stuck because Spain, still unaligned, did not censor its news reports, unlike other European countries. And so Spain's flu was no secret, unlike the flu elsewhere.

    Nonetheless, the scope of the epidemic remains unclear. There were no requirements in those days to report cases of influenza—that became a practice in the United States only after, and as a consequence of, the second wave of the 1918 flu. And there was no reason in those days of war to keep track of what seemed like a minor illness. Reports on the flu's reaches were sporadic, reflecting mostly the practices of organizations such as prisons, the military, and some industries, which simply recorded absentees. There was no systematic attempt to track an epidemic.

    There are records noting that at the Ford Motor Company more than 1,000 workers called in sick with the flu in March. In San Quentin prison, 500 of 1,900 prisoners became ill in April and May. On March 4, the flu came to Camp Funston (now Fort Riley) in Kansas, a training camp for 20,000 recruits. That month and the next, it also arrived at more than a dozen other Army camps, but no eyebrows were raised. After all, colds and flu were to be expected in training camps where thousands of men were brought together, mingling and passing viruses among themselves.

    In April 1918, the epidemic appeared in France, laying waste to British, American, and French troops stationed there, as well as the civilian population. The next month, it was in England, where King George V got the flu. The epidemic crested in England in June; at the same time, it cropped up in China and Japan. In Asia, it also was called the "three-day fever" or, sometimes, "wrestler's fever."

    Not surprisingly, the epidemic affected the war effort. Soldiers trying to fight in World War I were laid up by the flu in such numbers that some commanders complained that the disease was hindering their ability to fight.

    King George's Grand Fleet could not even put to sea for three weeks in May, with 10,313 men sick. The British Army's 29th Division had planned to attack La Becque on June 30, but had to put off the operation because so many of its men were sick with the flu.

    German General Erich von Ludendorff, the leader of the country's acclaimed offense, complained that the flu, or the Flanders fever, as the Germans called it, was thwarting his battle plans. It was not enough that the fighting men were hungry and cold and wet, trying to slog their way through fields of mud that could swallow a tank. Now there was this flu which, Ludendorff said, was weakening his men and lowering their morale. The flu, he added, contributed to the failure of his July offensive, a battle plan that nearly won the war for Germany.

    He also groused about his staff's complaints about the flu. "It was a grievous business having to listen every morning to the Chiefs of Staff's recital of the number of influenza cases, and their complaints about the weakness of their troops."

Table of Contents



  1. The Plague Year
  2. A History of Disease and Death
  3. From Sailors to Swine
  4. A Swedish Adventurer
  5. Swine Flu
  6. A Litigation Nightmare
  7. John Dalton's Eyeballs
  8. An Incident in Hong Kong
  9. From Alaska to Norway
  10. Mysteries and Hypotheses




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Flu 3.5 out of 5 based on 0 ratings. 26 reviews.
Guest More than 1 year ago
If I were to rate this book from 1-10 with 10 being the best, I would give it a 10 ½ if it existed. It was an excellent book about the history of the flu and the pandemic that ripped the world with its devastating influence. Gina Kolata really caught my attention throughout the whole book. She exposed me to the history of the event as if I was there living through it. I enjoyed flipping through the fascinating facts I learned. I want to recommend this book to all students or anyone who seeks to pursue medicine because it is a wonderful adventurous story that takes the reader through the path of a researcher and a medical doctor. The book puts the reader in the spotlight and portrays the event so explicitly to intrigue its readers
Guest More than 1 year ago
This book is one of the most interesting books I have read in a decade. It isn't an exhaustive history of the epidemic; but it shows why one needs to be written. It doesn't explore the effects of the epidemic on the subsequent economic chaos and rise of totalitarianism, but it shows that this exploration needs to be done. It shows that one of the most important historical events of the past century has been overlooked both by historians and by the media. Perhaps some of the criticism about this book being superficial has merit. However, it is a book that will undoubtably cause others to ask the deeper questions and cause more intense historical studies to come about. I would recommend this book to anyone without question. Now I will read Crosby's book too. I would never have heard of it if it weren't for this excellent work.
gregory_gwen on LibraryThing 10 months ago
my biggest issue was that it was written in 1999 so it didn't cover the last few years of scientific work. I guess I need to read a newer book on this topic!
LTFL_JMLS on LibraryThing 10 months ago
my biggest issue was that it was written in 1999 so it didn't cover the last few years of scientific work. I guess I need to read a newer book on this topic!
AlexTheHunn on LibraryThing More than 1 year ago
Kolata describes the Flu epidemic following World War I. She relates scientists' efforts to locate living strains of the virus for study.
Anonymous More than 1 year ago
Flu by Gina Kolata was a quick and exciting read. The book did an excellent job at explaining how the influenza virus works as a whole and explains in detail the strains and why exactly there are so many out there. She covers not only the epidemic in 1918 but also goes into the swine flu outbreak and the Hong Kong flu outbreak that happened later on in history. The only critique I have of the book is that because it was heavily research based, it was not so much the mystery solver story I had anticipated. Nevertheless, the story as a whole was thoroughly comprehensive, answering the why, when, and how of an epidemic that took the lives of millions. Kolata’s facts are coherent and cohesive and she covers not only the history but also dives into modern times, tying it full circle. Her personal reactions can be seen in her prose and she is incredibly knowledgeable of the different theories and origins. The takeaway lesson from the book as a whole is this: the 1918 influenza epidemic changed the way we dealt with precautions for the influenza virus, how we paid attention to viruses, and how we react. It paved the way for vaccination campaigns and changed the public sentiments. The 1918 flu epidemic is still an unsolved-medical mystery as is its virulence with the search for the true origin still taking place. Overall, the book is a worthy read, especially for those with limited virology knowledge. Kolata’s writing is thorough and enthusiastic as she navigates her way through the theories behind the 1918 flu epidemic.
Anonymous More than 1 year ago
Hi <_> gays
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gabietrust10 More than 1 year ago
It didn't even feel like I was reading a book, it felt like I was watching a really good movie because of how detailed and thrilling it was. Not only was it a good book to read, but it was based on the true story of the flu and the pandemic that ruined the world and devastated many people. I learned so much from this book and it was very interesting to read. The first seven or so chapters were interesting and full of detail pertaining to the flu of 1918. There was what seemed like short stories throughout the beginning of the novel that made me want to keep reading the story the author was telling. There were also a lot of interesting facts and bits of information that were attention grabbers that I would have never learned without reading this book. Discoveries that were told about the flu were very harming and hard to read. It was said reading about all the awful things that were happening to the innocent people. Also it was hard to read about all the soldiers getting sick as well because all they were doing was fighting in the wars and they all ended up getting the flu, which ended in the death of most of them. The author definitely wrote this novel to engage all the readers and inform them of an awful plague that has changed the world, and she did a great job doing it. I would really recommend this book to anyone who wants a book full of facts, but not only that also a book that will keep you engaged with learning them.
Mvp1295 More than 1 year ago
I thought Gina Kolata&rsquo;s Flu: the Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It was well written, easy for me to follow. Many of the chapters read like separate articles that could stand independently, which I not very novel like. The technicalities of microbiology were explained to the point where anyone could follow the explanation and fully understand how it worked.  I thought that it was interesting how she told the history of not just the 1918 influenza pandemic but she also told the back stories of many professors and scientists that worked with the patients and how they found many of the symptoms to be linked to other things. The back stories of the scientists made you want to support their success.  I also found the detailing of a flu scare that happened in Hong Kong with a jump from chickens to humans a very interesting story and how that particular scare and the research that went into studying it and comparing that to the 1918 ordeal was fascinating. I did read the chapter or two on the 1976 flu and I found it kind of irellivent to the 1918 influenza uunless it is seen as the link between the influenza outbreaks. It was also slowed down with its political ramifications and how she went through the story of the 1976 influenza outbreak. I could not bear the slogging through that mess and I wanted to just skip over it. Otherwise, a quick read with many interesting facts and implications for the future study of the mystery of the 1918 influenza pandemic. The last 10 pages describe some of the scientist's insights into how this virus might have become so lethal. The very brief discussion of these theories provides the reader with some food for thought. It is a shame that the author included so little material of this type throughout the book.
Anonymous More than 1 year ago
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Good read
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JEB50 More than 1 year ago
Easy read, goes fast. Good picture of the history and current situation of H1N1, plus you learn what H and N mean! This was a book club read for me, nothing I would have read by choice. But I was intrigued by the topic and enjoyed learning about the flu. I recommend!
Hermione2007 More than 1 year ago
This is a good research about Flu and history of the flu which covers both false and true beliefs about it and reviews the epidemics and pandemics. If you want to know more about the Flu, wether you are a professional or just interested for your own information, this is a very good book.
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Guest More than 1 year ago
Overall, Flu by Gina Kolata was a good book. The first seven or so chapters were interesting and full of detail pertaining to the flu of 1918. There was what seemed like short stories throughout the beginning of the novel that hooked me and kept me interested in the story she was telling. There were also a lot of interesting facts and tid-bits of information that were attention getters. The last few chapters in the novel, however, seemed like ramblings in between biographies of scientists working to break the mystery of the 1918 flu. It seemed that Kolata began filling the pages with useless information about scientist¿s personal lives. The end of the novel lacked a great deal of information about the actual flu of 1918. Although there was some information about influenza and some outbreaks that occurred after 1918, there wasn¿t enough information about it compared to the mass amounts of information on scientist¿s lives not dealing with this main issue at hand. In general, the pace of the novel was consistent and the novel was an overall easy read. Initially I really enjoyed the book, but by the time I finished it, I was disappointed with the author¿s lack of enthusiasm and consistency in her writing.
Guest More than 1 year ago
A fascinating story about the quest to find and decode the 1918 influenza virus. It's a bit outdated now, thanks to advances in science, but still a good and informative read. I only had two complaints: I wished for footnotes, rather than the endnotes that weren't easy to reference without superscript numbers, and I wished Kolata's telling was more of a time line rather than individuals' stories. The first is rather minor, but the second would have made it easier to keep track of the narrative and just when certain events happened.
Guest More than 1 year ago
I picked this book off the shelf at a library for a last minute project- I had no idea I would enjoy it so much or get so caught up in the mystery of the little known Spanish flu. I now find myself wanting to do research and find out more about this horrible event. I recommend it highly!
Guest More than 1 year ago
Though a bit dated as discoveries about the influenza virus that caused the 1918 pandemic have advanced well beyond the end of the book's narrative, still a readable work on the search for that virus. Also, Kolata's perspective may color the narrative and skew it slightly off of a true neutral presentation (if such is even possible), but not to a degree that makes it patently unfair. A good book and should be read in combination with Barry's 'The Great Influenza'