Article from Washington Post Weekly Edition
Vol. 9, Num. 21, March 23-30, 1992
The Grim Reaper by Louis Raemaekers
It All Started in Kansas
Reproduced here with permission
by David Brown
The influenza epidemic of 1918-19 killed an estimated 550,000
American, a ghastly toll, but one that, compared to the rest of
the world, seems almost good fortune. New research places
global mortality from the pandemic at 30 million people.
Previously, it was estimated at 21.5 million. In either case,
it ranks as the 20th century's most readily forgotten global
disaster, and almost certainly the deadliest epidemic in recorded
history. Even today, its virulence remains an utter mystery. The
disease swept whole countries in weeks.
An entire port city in Nigeria was infected by fewer than
10 persons. Only American Samoa and portions of northern and
eastern Iceland were able to establish successful quarantines.
Though mortality was high in all age groups, it was highest in
people 20 to 40 years old, exactly the population that usually
would be the hardiest. "I did a history of the influenza
epidemics in the 18th and 19th centuries, and one of the things
I looked for was anything that resembled this age pattern," says
K. David Patterson, a professor of history at the University of
North Carolina in Charlotte. "I found nothing like it. It is
unique." Patterson and colleague Gerald F. Pyle published their
recalculations of the epidemic's mortality last year in
the Bulletin of the History of Medicine. According to the
research, India probably had the highest mortality, between
42 and 67 deaths from influenza per 1,000 population. In
contrast, the death rate in the United States was 5.2 per 1,000.
Though the disease became known the "Spanish flu," the best
evidence is that it broke out March 8, 1918, in Camp Funston,
Kansas. Scientists speculate that it was the result of a dramatic
genetic "shift" in the influenza virus.
Such events occur every 30 or 40 years and usually
usher in a worldwide epidemic of the new strain. This
particular strain, however, traveled faster and was more
dangerous than its predecessors. It arrived in Europe on
American troop ships in early April 1918, and by July it spread as
far east as Poland.
What happened then -- if current theories are correct amounts
to bad luck of almost incalculable proportions. Somewhere on
the Western Front, the virus underwent a second "shift" and the
result was a virus far more lethal than even its lethal parent.
It was that strain that swept round the world, killing millions.
In the spring of 1919, the virus played itself out, and
disappeared. Though there are no samples of the pandemic's
strain, antibody tests of the people who lived through it have
given biologists a guess at the identity of the virus. They
believe the virus, or a close descendant, is now "archived"
in pigs, one of the many non-human reservoirs of influenza, and
one where a virus changes much more slowly than it does in man.
In 1976, an outbreak of influenza at Fort Dix, N.J., killed a
healthy soldier. When laboratory studies showed his virus to be
similar to the one in pigs, virologists feared the deadly 1918
strain had reentered the human population. This led to
production of the controversial "swine flu" vaccine. As it
happened, the Fort Dix strain never reappeared. There is
good evidence, however, that there is an occasional exchange
of virus between animal and human populations, and that these may
be the source of some of the more virulent influenza epidemics.