Flu is a 1999 nonfiction book by Gina Kolata that examines the history, causes, and outcomes of the 1918 influenza pandemic.
- The 1918 flu, though it is often relegated to a footnote, killed between twenty and one hundred million people across the world.
- Kolata traces the scientific discoveries in the century since the 1918 flu, from the connection between animal and human flu strains to the specific proteins that make up the virus.
- As the book ends, Kolata cautions that people have little way of knowing what the next flu pandemic might look like.
Last Updated on May 13, 2020, by eNotes Editorial. Word Count: 1195
Science writer Gina Kolata constructs the narrative of Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It (1999) as a detective story about “one of history’s greatest conundrums”: the puzzle behind 1918’s deadly flu, which killed millions globally. Kolata traces the work of scientists who painstakingly labored to partially resurrect the genetic code of the 1918 virus. Interviewing historians like Alfred W. Crosby, scientists like molecular biologist Dr. Jeffery Taubenberger, and technicians like Ann Reid, Kolata draws on the past for future lessons in pandemic preparedness.
Kolata notes that the historical and public record of the 1918 influenza epidemic is scanty in the context of the scale of its devastation. Though the flu affected most of the globe and killed between twenty and one hundred million people in 1918, history and science textbooks often sum it up in a paragraph. Historians like Crosby suggest that a prominent reason for this erasure is that, for most people, the flu became enmeshed with the horrors of World War I, and they could not wait to leave it behind. Luckily for everyone, some scientists and doctors through the coming decades were not as ready to forget the deadliest flu pandemic on earth.
Though pandemics—such as the Athens plague of 431 BCE and the Black Death of 1331—often crop up in history, the 1918 epidemic was unexpected because it occurred in an industrialized, modern world and was caused by the flu, a ubiquitous illness. Yet this was a flu like no other, which makes scientists all the more wary about its recurrence.
Kolata follows a trail of discoveries around the flu, beginning with Dr. Richard E. Shope in 1928. The young scientist discovered a key similarity between “hog” or swine flu and human influenza, and set out to further explore the connection. Dr. Shope also wondered if the flu was caused by a virus, a fact that was not yet established. Around the same time, a team of British doctors conducted a similar experiment in London and proposed that swine flu can spread not just among pigs but also among ferrets. Thus, even though the electron microscope was yet to be invented, viruses were yet to be seen, and DNA and RNA were yet to be discovered, the template that the 1918 flu might have been caused by a virus and that the flu virus jumps and changes across species was already suggested in 1928.
Decades of research led to an extraordinary achievement in 1997: Dr. Jeffery Taubenberger and technician Ann Reid used preserved lung tissue samples of two 1918 flu victims to partially resurrect the virus’s genetic code. A third sample was provided by a seventy-two-year-old pathologist named Dr. Johan V. Hultin, who extracted the tissue from a flu victim’s corpse buried in the permafrost in Alaska. This was Dr. Hultin’s second expedition to the region. His first journey to the Arctic, in 1951, yielded many tissue samples but no concrete results.
By telling extraordinary stories of success following repeated failures, Kolata highlights some of the classic elements of science work: hard work, hunches, and elements of serendipity. For instance, it was Dr. Hultin who unexpectedly volunteered for his second expedition in 1997, returning to a quest he had abandoned nearly fifty years earlier after reading about Dr. Taubenberger’s research.
At the time of Flu ’s publication in 1999, Dr. Taubenberger’s work is still ongoing. His team had resurrected one strand of the virus’s genetic material. A tragedy in 1997 ended up providing more clues about the virus. The death of a three-year-old...
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boy in Hong Kong from a flu-like disease prompted an investigation that led to a frightening conclusion. The child had died of a flu strain not previously seen in humans. Labeled H5N1, this was a virus that Dr. Keiji Fukuda of the Centers for Disease Control and Prevention (CDC) described as “pure bird.” But how did a bird flu virus infect a small child? And did this herald a new viral outbreak in a population defenseless against a cross-species strain? A team of researchers—including Dr. Fukuda, Dr. Robert Webster, and Dr. Kennedy Shortridge—were intent on answering these questions.
In Hong Kong, Dr. Shortridge traced the flu to a “wet market” where chickens were slaughtered before customers. Chickens had been falling sick at alarming rates at the market. Dr. Shortridge also learned that most of the chickens had been imported from China. Based on Dr. Shortridge’s findings, almost all of Hong Kong’s poultry was culled to stop the spread of the flu, and imports from China stopped.
The measures seemed to work, though Dr. Shortridge is left with some interesting theories. He proposes that all flu begins as bird flu and mutates in pigs before it can jump to humans. A chance mixing of bird and human flu viruses in an “unfortunate” pig can lead to a new and virulent strain. He also suggests that most flu originates in southern China, where ducks and pigs are farmed in close proximity, making the cross-species jump possible. According to Dr. Shortridge, the 1918 flu virus may have reached Europe through Chinese workers who traveled to France to build Allied trenches.
Not all of Dr. Shortridge’s findings are universally accepted, notes Kolata, though the interspecies jumps he proposes are likely. Even so, and despite the fact that scientists have learned critical information about the structure and nature of the 1918 flu virus, its origin remains cryptic. British virologist Dr. John Oxford proposes that 1918 was not the first outbreak of the deadly flu. In fact, there may have been similar—and undetected—outbreaks in 1916 or 1917, before matters exploded in 1918. Medical literature of the time does mention episodes of deadly respiratory illnesses among British troops in France, but Dr. Oxford’s theory remains a hypothesis. For Dr. Taubenberger, the mystery of the flu’s origin is “very much unsolved.”
The other mystery around the 1918 pandemic is the high death rate among people between twenty and forty years of age. Dr. Peter Palese, who works in the microbiology department of Mount Sinai Hospital in New York, says that almost all flu viruses behave similarly, worsening in severity with each passing decade, with the mildest manifestations in children. However, the 1918 pandemic was atypically less virulent in those above forty years of age. This was because, according to Dr. Palese, those older than forty may have already been infected with the virus in previous years, gaining some immunity to it. One possible source of this immunity could have been the flu pandemic of 1890, a theory which pushes the 1918 flu’s origin even further back.
Though many questions remain around the 1918 influenza pandemic, isolation of its hemagglutinin protein has made it possible to build a vaccine, in case it recurs. However, no one knows what the next “killer” flu will be like. Since viruses evidently mutate quickly and jump species easily, it is hard to make any predictions about the next pandemic. According to Kolata, perhaps while people “grow smug about influenza . . . a new plague is now gathering deadly force.” Hopefully, lessons from past pandemics and advances in modern medicine mean that the next pandemic will be less deadly.