The Great Influenza

by John M. Barry

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Part 7: The Race Summary

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Last Updated on June 8, 2022, by eNotes Editorial. Word Count: 1158

Chapter Twenty-Two

As the virus spread around the world, the struggle of scientists to save lives began. Barry writes, “In the United States that struggle would be fought by Welch, Gorgas, Cole, and their colleagues, as well as by the institutions they had built and the men and women they had trained.” Three important questions lay before the scientists. First, they needed “to understand the epidemiology of influenza, how it behaved and spread.” Second, they needed to learn the disease’s pathology—“what it did within the body, the precise course of the disease.” Third, they needed to identify the pathogen that caused the disease.

In answer to the first question, most scientists accepted, correctly, that influenza was airborne. They understood aspects of how the disease incubated and how it spread from person to person. Unfortunately, no scientist had the power to enforce the strict isolation that preventing the disease seemed to require.

In answer to the second question, scientists were learning “too well” the pathology of influenza. Although deaths from ARDS could not be prevented, some measures helped stop the deaths that were occurring from the pneumonias caused by “secondary invaders.”

The third question would be the key to discovering any cure for the disease. In response, the scientific community at large contributed to the cause.

William Welch himself was struck down by the disease. Although he recovered, he was bedridden for weeks. Flexner and Gorgas arrived in Europe “just as influenza erupted in America.” These men were part of “the generation who had transformed American medicine.” In the fight against influenza, their intellectual successors—not themselves—would be the key players.

In pursuing the problem, it was necessary to proceed in an orderly way. Scientists “understood the basic principles of the immune system”: how to manipulate it, how to make vaccines, and how to utilize the specificity of the immune system’s attacks.

It was necessary to understand the pathogen that caused influenza. Richard Pfeiffer—a renowned German medical researcher—had declared, with certainty, that he had discovered the relevant pathogen during the 1889-1890 pandemic. The bacteria was commonly known as “Pfeiffer’s bacillus,” and most scientists trusted Pfeiffer’s reputation enough to accept “the validity of his discovery.”

For scientists exploring the unknown, “courage to accept—indeed, embrace—uncertainty” is required. A fundamental requirement of any scientific discovery is that it is reproducible and expandable. In science, “the distinguishing element… is not intelligence but judgement.” Or perhaps, Barry muses, “it is simply luck.”

Scientists like Thomas Rivers succeeded in their work because they first questioned notions that “everyone believed.” Richard Pfeiffer was so certain that he had found the cause of influenza—naming the bacteria Bacillus influenza—and “his reputation gave his finding tremendous weight.”

Chapter Twenty-Three

Across the world, “desperate investigators” focused on the study of influenza. In Europe, particularly, laboratories suffered shortages due to the war effort. The United States, now armed with some of the best medical scientists in the world, was not “exhausted” the way Europe was.

Many American doctors and scientists began to search for a solution. Arguably the most influential in this fight were Oswald Avery, William Park and Anna Williams, and Paul Lewis.

In New York City, the political situation was volatile. For political reasons, “the best municipal public health department in the world” was turned over to the leadership of Royal Copeland, a man who was not even an M.D.

Working in this turmoil, William Park remained “untouchable” but now had the burden of defending his laboratory department. While Copeland reassured New York citizens and was slow to act against the disease, William Park and Anna Williams were well aware of the danger and began “devoting all their energies to the disease.” Park and Williams were long-time collaborators who “complemented each other perfectly.”

There were no other laboratories that had the resources and abilities of Park’s laboratory. The laboratory was able to “focus all resources on one question” and also had the ability to “produce serum and vaccines in industrial quantities.”

While Park began his study of influenza filled with both confidence and disdain for the “sloppiness” of other investigators, the “disease began to overwhelm the department” and “humbled him” to the point that he focused only on finding the pathogen.

As the disease spread and the death toll rose, the pressure mounted. Park, usually meticulous, was “maddened” by his inability to find B. influenzae, Pfeiffer’s bacterium. Anna Williams was able to locate it consistently, and she “perfected her technique.” While Park reported that B. influenzae appeared to be the cause of the disease, he knew that his methods had been less precise than they should have been.

Subsequent experiments with B. influenzae, on animals and humans, were inconclusive.

Chapter Twenty-Four

In Philadelphia, the accomplished and capable Paul Lewis was also searching for answers in the fight against influenza. Like every other scientist, the urgency of the pandemic gave him little time to work through the problem. While Lewis allowed others to focus on experiments using “whole blood and serum of survivors of influenza,” he spent his time on four things. 

First, he “tried to develop an influenza vaccine using the same methods he had used against polio.” Second, he and his laboratory staff discovered techniques for finding B. influenzae more regularly. The third area of focus “involved shifting his dye experiments from trying to kill tuberculosis bacteria to trying to kill pneumococci,” but he quickly turned away from this and back to efforts that could produce more immediate results. His laboratory, and others, also focused on producing large quantities of vaccines, even if these vaccines were not proven with certainty to be functional.

Finally, Lewis also began working on “a serum that could cure the disease.” Flexner, along with Martha Wollstein, had tried to develop such a serum but had failed for years. Lewis  hoped that a serum was possible to fabricate.

Chapter Twenty-Five

After William Welch left Devens, one of the men he called was Oswald Avery, whom “he hoped… could identify the pathogen” of the disease. Avery immediately went to Devens and began laboratory tests.

Avery found “several possible pathogens.” Like other scientists, he “had initial difficulty but began to find Pfieffer’s bacillus.” While other scientists announced that the disease was caused by B. influenzae, Avery himself was not convinced. While he “pushed himself to work, he would not push himself toward a conclusion.”

Unlike other scientists, Avery refused to yield to the pressure of the pandemic. Despite the frenzied activity of other investigators, “he would not be rushed.”

Avery “poured his energies into perfecting the tool, to find ways to make it easier to grow B. influenzae.” He made progress, and the “recipe” he published made it possible for any “reasonably competent scientist” to identify the bacteria. Still, Avery considered B. influenzae as only a possibility in the search for a pathogen; he did not consider it a conclusion.

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