Sunday, November 22, 2009

Shades of 1918

The other night, I was enjoying an evening stroll near my home. As I passed a walk-in medical clinic, a figure in hospital garb, complete with face mask, stepped outside and put a sandwich board on the sidewalk. It proclaimed in bold red letters 'H1N1 FLU SHOTS AVAILABLE HERE'.

I have not been vaccinated yet, although I plan to be. My immune system has always been excellent, but if the 1918-19 flu epidemic is an accurate indicator, that could be a liability.

I am currently reading John Barry's The Great Influenza, an account of the Spanish flu devastation that wiped out millions. In early 1918, when World War I was at its height, a contagious and lethal influenza A virus of the H1N1 subtype exploded in a Kansas army camp and migrated east, its first step in a global journey that claimed an estimated 100 million victims. Modern science's most illustrious practitioners struggled to understand and contain the epidemic, which killed more people in one year than the Black Death consumed in a century.The tragedy was amplified by the fact that the majority of victims were in the prime of life: children lost their parents, newlyweds were cruelly separated, and aging parents lived to see their adult children precede them in death. A few survivors have been in the news this past year, recalling those days of isolation, loss, and terror.

I often heard my grandmother talk about her two aunts who died when the flu reached Nova Scotia: one had just turned thirty while the other was only thirty-two. Both were strong-willed, vivacious women who had plenty to live for, something I appreciated even as a child. I remember poring over my grandmother's photo album, looking at the youthful faces of her aunts Clarice and Eva and trying to understand WHY.

Barry's book has helped me understand why, at least from a medical and scientific standpoint. The 1918 flu virus was the most lethal to young adults because their strong immune systems overreacted (a process known as a 'cytokine storm') and ravaged the body as mercilessly as the virus itself. Children and seniors reacted less intensely and therefore recovered. It was a twisted reversal of Darwin's theory, and caused people to live in fear. No wonder: in some cases mere hours transpired between the first flush of fever and the last dying gasps. You could never say "See you later" to anyone and be sure that you actually would.

The Great Influenza is a monumental study of the Spanish flu epidemic. A reviewer for Newsweek called it "Terrifying.... the lessons of 1918 couldn't be more relevant." Judging from the fact that people are lining up everywhere to get the H1N1 vaccine and hand sanitizer dispensers are in most public places now, the lessons appear to have been learned.