Plague of the Century

By R.Z. Sheppard

Even a hard-core pessimist must agree that things are looking up when the most immediate worry at the end of the 20th century is that computers won't know what time it is just after midnight, Dec. 31. Or that the threat of a genuine apocalypse has been downgraded from a swift nuclear winter to the palmy dangers of slow global warming.

If you are still not convinced of a general improvement in the human condition, pick up a copy of Gina Kolata's Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It (Farrar, Straus & Giroux; 329 pages; $25). Kolata, a science writer for the New York Times, resurrects a year when the worst could and did happen: at least 20 million and possibly more than 40 million people throughout the world took sick and died.

In the U.S., the epidemic first appeared on Army bases. Strapping recruits began the day in the pink and ended it drowning in their own secretions. The bug jumped quickly to the civilian population. Abroad, similar outbreaks spread until entire continents were stained by infection. The scourge remains, hands down, the biggest single disaster in human history. Strangely, it is also a chapter that has been largely forgotten. Kolata suggests that the lapse is due to the magnitude of the horror--in short, mass denial. Another diagnosis could be that the epidemic was conflated with the carnage of World War I, memories of which have also faded as its last survivors succumb to extreme old age.

Those familiar with previous accounts of the 1918 contagion (Richard Collier's The Plague of the Spanish Lady or Alfred Crosby's America's Forgotten Pandemic) may be surprised to learn that science has yet to discover what made that particular flu virus so deadly. Though no longer a threat, the mass killer is, so to speak, still at large.

Kolata's medical detective story is packed with new information and astonishments. She explains, for example, that it is now believed the epidemic killed mainly strong adults between ages 20 and 40 because healthy immune systems overreacted. Both invader and defender flooded the lungs, the only organ in the body with the enzyme needed to replicate the virus.

In this era of big science, most of the research on the 1918 virus has been done on shoestring budgets by determined individuals. Kolata celebrates the obscure scientists who did the scut work, which included collecting tissue samples from bodies moldering in permafrost for eight decades. Dr. Jeffrey Taubenberger of the Armed Forces Institute of Pathology in Washington didn't have to go far. While searching through the institute's museum of diseased body parts ("a Library of Congress of the Dead," says Kolata), Taubenberger found a lung scrap from an Army private who died on Sept. 19, 1918.

Only a genetic "footprint" of that plague year has been found. Yet Kolata has made the most of the ongoing mystery. She has produced not only a chilling read but also a book that, like Paul de Kruif's classic Microbe Hunters, could jump-start a new generation of medical researchers.

--By R.Z. Sheppard