Most Helpful Customer Reviews
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14 of 14 people found the following review helpful:
5.0 out of 5 stars
A well-written social history of the horrific flu pandemic that killed almost 700,000 Americans between 1918 and 1920..., July 30, 2008
A careful, well-written and thoroughly documented academic study of the flu pandemic that ravaged America from 1918 to 1920. Includes numerous illustrations, tables and photographs, chapter notes, an extensive classified bibliography, and an excellent index.
Taking a much-different approach than the several other books available on the 1918 Influenza Pandemic, the authors -- Pettit, a former Medical Technologist with a Ph.D. in American History, and Bailie, holding a Ph.D. in Biochemistry -- take a "social history" approach and weave the stories of individuals who lived and died during this harrowing time, in with informed scientific discussion of the virus and clinical perspectives of the healthcare professionals who tried to save them.
The numbers are shocking -- Pettit and Bailie cite pandemic influenza data indicating that "25%-30% of the world's population" had "clinically apparent illnesses" with a resulting "mortality rate of 2.5 % to 5 %." And, though the pandemic is usually only briefly mentioned in -- or, often even left out of many world and/or American history books -- it was truly a catastrophic event. The authors estimate that somewhere between 50,000,000 and 100,000,000 people died of this particular, virulent strain of the flu worldwide during those two years.
In the opening chapter, "The Riddle of Influenza," we're introduced to the distinguished neurosurgeon, Harvey Cushing, of Johns Hopkins University, who describes his battles with influenza in 1906 and 1918. The authors then discuss how the virus was typically diagnosed at the time, describes the viral invasion, replication and the body's attempts to defend itself; then, goes on to discuss bacterial complications, and traces the disease through the history of mankind. Closes the chapter with a discussion of research conducted by Simon Flexner of the Rockefeller Institute on epidemic encephalitis and Richard E. Shope's work on Hog Flu and the peculiar characteristics of this particular strain, noting that: "About fifty percent of those who died were between twenty and forty years of age. [And,] influenza and pneumonia death rates for 15 to 34 year-olds were more than 20 times higher in 1918 than in previous years; they were people in the prime of life, a group that usually has a very low death rate from influenza."
Chapter two, "The Silent Foe," focuses on the impact of the flu pandemic on the millions of American soldiers mobilized to fight in France during World War I. Describes efforts by Secretary of War Newton D. Baker, Army Surgeon General William C. Gorgas and others to improve sanitary conditions in the training camps, to identify and weed-out unfit doctors, and their unsuccessful efforts to prevent the spread of the flu to major cities. Offers useful data that describes this spread by date and city location (46 cities), through the Navy ships and shipyards, through the Army camps and over into France, China and around the world. Focuses on descriptions of the virus in China and closes with a brief discussion of the impact on Austrian-German forces.
Chapter 3, "A Kind of Plague," focuses on the impact of the Flu on the allied forces in France, discusses the establishment of the Pneumonia Commission in the United States during July 1918 and describes their work at Camp Pike in Arkansas, Camp Funston in Kansas, and Camp Devens in Massachusetts. Closes the chapter with discussion of the plight of specific individuals, the horrific death rates, the shortages of coffins in major cities, the effect on the political elections, and bans on gatherings.
Chapter 4, "One War Ends," discusses the economic impact of the flu pandemic during September-October, 1918 through the stories of individuals involved, how the pandemic "was a boon to the life insurance industry," the shortages of healthcare personnel, U.S. Public Health Service efforts to help communities fight the disease, how pandemic-related poverty cases overwhelmed the social agencies of the time, and the misery of the many thousands of children who had lost one or both parents.
Chapter 5, "The Paris Cold," focuses on the impact on the work of the Diplomatic Corps in Paris who fought influenza virus while trying -- at the same time -- to address and write the peace treaty and associated documents to end the war. Refers to cases of one prominent individual after another -- Dr. Raymond Pearl with the U.S. Food Administration, Willard Straight who was an investment banker and founder of New Republic Magazine, Joseph Grew of the State Department, economist Clive Day, Colonel Edward M. House, and finally the battle to save the life of the President himself, Woodrow Wilson, are all narrated and implications on the American Peace Delegation are drawn.
Chapter 6, "The Aftermath (1919)," offers an assessment of the impact of the pandemic on both individual lives and on America's public institutions. Suggests that it: forced the U.S. Government to offer financial support for medical research; pointed out to social workers, how essential it is for communities to offer services to safeguard the health of citizens; how health is as much a public concern as it is a private concern; forced a reassessment of the mission and role of the American Red Cross, the New York City Health Commission and the growth of Public Health Nursing; and, promoted efforts by bacteriologists and other noted scientists of the day to find the cause of the infection and spread of influenza.
Chapter 7, "A Tired Nation (1920)," describes the continued impacts of the pandemic on the American public. Discusses the deaths of more prominent individuals, efforts to limit the spread, the hoarding and profiteering that took place, the resulting mental disorders of many of the victims, and how the nation struggled during this "sad and sickly" time.
Chapter 8, the closing chapter, "The Battle Continues," concludes that the flu pandemic of 1918 was a truly "humbling experience." Discusses how the great strides that scientists had made in bacteriology during the previous 50 year had given many a "false sense of security." Cites the pandemic as kindling a vigorous crusade against the disease, with the Rockefeller Institute spending hundreds of millions of dollars in post-pandemic research and being instrumental in creating focus and interest on public and community health and preventative medicine. Offers a detailed discussion of the theories of origin of the pandemic, followed by a wide-ranging discussion of the research and findings of a number of present-day researcher, including: Jeffrey Taubenberger, Terrence Tumpey, Johan Hultin, Mark J. Gibbs, Adrian J. Gibbs, Neil M. Ferguson, Ira Longini, Jr., Pascale Wortley, and David Morens.
Bottom line of the authors? "We must treat this microscopic mass murderer with the utmost respect and never doubt its exceptional ability to adapt, take advantage of permissive conditions where it can, and overcome adverse conditions to develop resistance to treatments [designed] to destroy it when it must."
And, as stated on the back cover: "Because many experts believe that it is not a matter of IF the world will encounter another 1918-like flu pandemic, but WHEN...[this] should be considered essential reading for those interested in learning what worked -- and didn't--during that grim time."
Highly recommended; this book belongs in the collection of EVERY college, university and public library. It should also be seriously considered for inclusion in secondary school collections where students are encouraged to write term papers.
In addition, medical and public health decision-makers in government office worldwide, and individuals practicing in the fields of nursing, public health, medicine, and teaching in the history of medicine and in the life-sciences will find it thought-provoking and useful reading.
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6 of 6 people found the following review helpful:
5.0 out of 5 stars
Pandemic Influenza: Can it happen again?, August 19, 2008
A Cruel Wind: Pandemic Flu in America, 1918-1920,
Dorothy Pettit, Ph.D, and Janice Bailie,Ph.D., Timberlane Press, 2007
Reviewer: Chris Holmes, M.D., M.S.P.H.
Why should we worry about the flu? It's just a minor, 3-day illness, right? Well, not exactly. For 15% of the world's citizens (500,000 U.S.) who get sick from it each year, or the 250-300,000 (30,000 U.S.) who die from it, it's not "minor." Nor is its economic impact: $167 billion annually in the U.S., which includes the cost of 70 million doses of vaccine. If you multiply these numbers by about 200, you approach the rates for the 1918 pandemic. So maybe we should be a little worried.
In this well written and thoroughly researched book, the authors -- a biochemist and an historian -- trace in detail the American course of this outbreak and its impact on every aspect of U.S. life: economic, political, military and public health. Even the entertainment industry was affected: movie theaters closed, stages darkened. The epidemic also highlighted America's woefully inadequate health care system. The book's numerous illustrations, tables and figures, and extensive references and bibliography ground, illuminate and clarify the viral and historical concepts.
The story begins with a review of basic influenza virology and immunologic classification. The concepts of antigen drift (minor surface antigen changes requiring a new vaccine annually) and antigen shift (major, 10 year-or-so changes which signal the start of pandemics like the 1957 Asian flu (2 million deaths worldwide) and the 1968 Hong Kong flu (700,000 deaths).
The authors then confront several vexing questions about the 1918 pandemic: First, where did it originate. Two competing theories have emerged: that it spontaneously erupted in Europe, Asia and North America; or it began in U.S. Army recruit camps in Kansas then spread to Europe as soldiers headed for WW I. Neither theory emerges a winner. But it seems plausible, wherever it began, that this particular strain also infected animals (swine). Another intriguing question is why this epidemic was so deadly (mortality close to 30% overall), especially in healthy young adults (50% mortalty in 20-40 year-olds). The authors find no definitive answer to this question either, though they examine all sides clearly.
Finally come the most important questions: How likely is the 1918 outbreak to happen again? And are we prepared for it if it does. The Influenza virus can cross the species barrier (as it appears to have done in 1918), and in 2006-2007 275 human cases of avian influenza (H5N1) were documented in Asia, a majority in Thailand. The great worry is that if a human host is infected with both the H5N1strain and a human influenza strain at the same time, he or she could become a mixing bowl for the reassortment and emergence of a new, deadly strain. That thought should scare the collective pants off us!
I highly recommend this book to students and researchers interested in the history of medicine and science, to practitioners and academic professionals (including university and public libraries) in medicine, nursing, public health and infectious disease, as well as to the general interested reader. There is no better example than this book of why we must learn history or are doomed to repeat it.
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7 of 8 people found the following review helpful:
4.0 out of 5 stars
The Not So Forgotten Epidemic, September 8, 2008
The global influenza pandemic of 1918-1920, which epidemiologists estimate was responsible for the deaths of between 50-100 million people worldwide, was one of the most deadly events in human history. More people died during the pandemic, which lasted a little over two years, than during all four-years of the Black Death (although the world population was by 1918 far larger than during the Middle Ages). Arriving during the closing phase of World War I, the pandemic had a significant impact on mobilized national armies. Half of U.S. soldiers who died in the "Great War," were victims of influenza not of enemy bombs and bullets. It is estimated that almost ¾ of a million Americans died during the pandemic. The impact of the epidemic was so harsh that the average life span in the U.S. fell by 10 years in the second decade of the 20th century. Among those struck was President Woodrow Wilson, who became ill early in 1919 while in Versailles negotiating the treaty to end the world war. As noted in a letter from Wilson's physician included in the book:
"The President was taken violently sick last Thursday. The attack was very sudden. At three o'clock he was apparently all right; at six he
was seized with violent paroxysms of coughing, which were so severe
and frequent that it interfered with his breathing" (p. 171).
Notably, the pandemic was truly global in its impact, showing up in almost all heavily populated areas but in sparely populated Arctic settlements and in remote Pacific islands as well. In this respect, the pandemic exposed the early stages of the most recent wave of globalism and its reconstruction of the modern world as a socially smaller more integrated place.
Although it has been called the "forgotten pandemic," publication of A Cruel Wind: Pandemic Flu in America is one of a number a number of signs that the pandemic of 1918-1920, is once again on people's minds. The reason for this is not obscure. With AIDS, SARS, and many other new infectious diseases in the news, the whole issue of contagions, old and new, has become a topic of widespread concern and interest. Especially for those who are fascinated by the intersection of disease and history, and the impact of disease on society, Dorthy Pettit and Janice Bailie's book will be a fascinating read.
The book, which tells the tale of the influenza pandemic in full historic and biological detail, is introduced by way of a series of riddles (actually uncertainties about the nature of the pandemic), many of which are still unresolved, including just what caused the dramatic impact and unique expressions of the so-called Spanish influenza, which was the number one public health problem just before the take off of the roaring twenties (which contained an exuberance that might well be read as a national celebration that pandemic was finally over). The pandemic came without warning, took an enormous toll, disproportionately killed people in the prime of life, caused prolong illness, and even among survivors left enduring after-affects. Moreover, it was not solely humans who were victims. Pigs and many other animals also got sick.
As the authors of this book make clear, an important part of the death toll was caused by viral pneumonia characterized by extensive bleeding in the lungs resulting in suffocation. Many victims died within 48 hours of the appearance of the first symptoms. In fact, it was not uncommon for people who appeared to be quite healthy in the morning to have perished by sunset. Even before the pandemic, researchers were confused about what caused the grippe, as the disease was then known. Some thought that the source might be a bacterial infection. At the time, virology had not emerged as a discipline but bacteriology was already a flourishing field. Ultimately, it was confirmed that the pandemic was caused by a virus, specifically influenza A virus of the H1N1 subtype Yet among people who survived the first several days of viral infection, many subsequently died of secondary conditions. Most notable was bacterial pneumonia, and it was this adverse interaction of two different diseases that made the pandemic so deadly, and from the perspective of both history and the future of human health (which, because of global warming and the movement of old diseases to new places) something there is tremendous need to understand better. While questions remain, this book helps to gain a much better understanding of just what happened 90 years ago in the biosocial world of human disease that still holds important lessons for us today.
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