The Great Influenza | John M. Barry

Summary of: The Great Influenza: The Story of the Deadliest Pandemic in History
By: John M. Barry

Introduction

Embark on a chilling journey through the deadliest pandemic in history as John M. Barry’s ‘The Great Influenza’ uncovers the harrowing details of the 1918 flu outbreak. This book explores the American medical landscape leading up to World War I, highlighting the important breakthroughs that took place in fields such as germ theory and the public health system. As the devastating strain of influenza arrives, readers bear witness to the far-reaching effects on society and the valiant efforts of the scientific community in their search for an answer. Within this summary, you’ll discover the birth of modern medicine, the shocking consequences of military involvement in the pandemic, and the insidious nature of the virus itself.

Revolutionizing American Medicine

The book explores the evolution of American medicine from the outdated practices of bloodletting to becoming world-class medical science. The transformation started with Johns Hopkins University in Baltimore, which recruited graduates from the finest German medical universities, instantly gaining credibility. The Hopkins and Rockefeller institutes raised the bar for American medical schools, making American doctors as good as, if not better than, their European counterparts by the outbreak of World War I. In 1918, Hopkins inaugurated a school for public health aimed at preventing diseases. Welch presided over a close-knit group of brilliant, curious researchers who revolutionized the American medical field.

The Lurking Danger of Influenza

Influenza is a virus that is highly efficient in mutating and finding new hosts. Each molecule of the virus can multiply into thousands of new proteins, thus making it extremely contagious. Influenza encodes its genes in RNA, which doesn’t have proofreading mechanisms, increasing the chances of mutations that can make the virus more dangerous. When a particular mutation is effective, the virus finds maximum host individuals to challenge the immune system. Influenza adapts to humans, causing pandemics as human immune systems haven’t learned to respond to the new strains. Our immune system has dendritic white blood cells that teach other white blood cells which enemies to target. Knowing the lurking danger of influenza, we need to take care and practice preventive measures.

The Unseen Enemy

In 1918, the world was ravaged by World War I. President Woodrow Wilson committed the US to the war effort, and a draft was instated, leading millions of men to gather at military camps, each with slightly different disease immunity. The war also gave the medical research community an injection, leading to the first use of medicine as a weapon. However, the conditions created by the war effort were perfect for the spread of a virus. Non-combatants also joined the war effort by producing military matériel in factories, leading to inadequate housing and overcrowding. The Army’s budget for medical research increased massively, and a serum was developed to alleviate pneumonia, but the surgeon general failed to anticipate the potential for a pandemic as the influenza virus hit full force.

Deadly Waves

The winter of 1917 in Haskell County Kansas, marked the origin of the influenza pandemic that became known as the Spanish Flu in its first wave. The virus later mutated, leading to a second wave, which was deadlier and more gruesome. The virus caused victims’ skin to turn blue then black, rendering its victims helpless. The US army continued troop movements, leading to the virus’ rapid spread worldwide. Despite the scientific urge to find a solution, William Welch, the Head of Public Health at Johns Hopkins, failed to help and later contracted the flu himself.

The Deadly 1918 Influenza Outbreak in Philadelphia

In 1918, a deadly flu virus hit Philadelphia, sickening 600 soldiers and threatening to engulf the overcrowded city. Despite warnings from doctors, Philadelphia’s public health director, Wilmer Krusen, denied the threat and took no action. A massive city parade was held, attracting over 200,000 people, and within days, all the city’s hospital beds were filled with dying patients. City officials and Army commanders failed to respond effectively to the crisis. At Camp Grant in Illinois, the commanding officer refused to limit troop training exercises, resulting in over 1,800 troops reporting ill in a single day. The deadly outbreak was exacerbated by bungled responses from authorities.

The Deadly 1918 Flu

The 1918 influenza was a lethal and gruesome strain that mostly impacted young and healthy individuals, causing vigorous immune system responses that filled lungs with fluid and dead cell debris. The victims were doubly dead in that they died young and in agonizing pain, with symptoms such as subcutaneous emphysema and delusions. The flu killed more US military personnel than the entire Vietnam War, but Americans were less affected, with symptoms leading to pneumonia in only 10-20% of cases. In contrast, isolated areas such as jungle villages and Pacific islands witnessed up to 22% of deaths due to the flu.

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