Chapter Fourteen 

While it cannot be proven that the influenza pandemic began in Haskell County, Kansas, “the circumstantial evidence is strong.” The timing of the outbreaks at Camp Funston “precisely fits the incubation period of influenza.” In the months to follow, other camps experienced outbreaks of influenza “like falling dominoes.” While the disease spread quickly, it was mild.

In the spring, influenza outbreaks occurred in France, Britain, and Germany. While the disease “[undermined] the troops’ ability to fight,” almost every victim recovered. Spain was neutral during the war; unlike other countries, its press was not censored to eliminate anything that “might hurt morale.” When influenza hit Spain, “Spanish papers were filled with reports of the disease.” It is likely for this reason that the disease became called “Spanish influenza” or “Spanish flu.”

The disease spread across Europe and then across the world. While it spread “explosively,” it was so mild that some doctors questioned if it was even influenza. American scientists were still focused on measles but began to pay attention to the influenza outbreaks when they heard of “some worrisome exceptions… hints that the disease wasn’t always so benign.”

Despite these exceptions, many believed that the disease had disappeared. In reality, the virus “had only gone underground… waiting to burst into flame.”

Chapter Fifteen 

The influenza pandemic came in waves. The first wave, in the spring of 1918, was mild. The second wave “would be lethal.” There are three different theories to explain this development.

The first theory is that the waves were caused by different viruses, a theory that most scientists believe is “highly unlikely.”

The second theory is that the milder virus of the first wave encountered a second virus; these two viruses then mixed their genes to create a new version.

The third theory is the most likely, and it “involves the adaptation of the virus to man.” Organisms have an ability to adapt to new environments. When a virus is spread from living animal to living animal, it often “becomes a better and more efficient killer.” This phenomenon is called “passage.”

When the 1918 influenza virus first “jumped” from animals to people, the initial shock may have “weakened it, making it relatively mild.” In time, it became “better and better at infecting its new host.”

In the summer of 1918, a severe form of influenza broke out in Europe and the United States. This time, some doctors questioned that it was influenza “because it seemed too deadly.” Patients had “strange symptoms,” often turning blue and bleeding from the nose.

Like the first bubbles of water boiling in a pot, outbreaks of the second wave appeared simultaneously across the world. By the end of August, “almost simultaneously, on three continents separated by thousands of miles of ocean…the killing, rolling boil was about to begin.” These first outbreaks occurred in Brest, France; Freeport, Sierra Leone; and Boston, USA.

In Boston, “any hopes of containing the disease… collapsed.” Instead, scientists Rosenau and Keegan “turned their attention to bacteriological analysis, seeking the pathogen so they could prepare a vaccine or serum.”

By September, the disease had spread to civilians in Boston, at Harvard, in Cambridge and then at Devens.

Chapter Sixteen 

Thirty-five miles northwest of Boston, Camp Devens was built for a maximum of thirty-six thousand troops. By September 1918, it held over forty-five thousand. With a “virtually empty” hospital, and a “first rate” medical staff, Devens “seemed ready for any emergency.”

In early September, cases of pneumonia and meningitis were diagnosed. At first, the medical staff at Devens “did not connect these various cases to one another or...