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The Great Influenza: The Story of the Deadliest Pandemic in History Revised Edition

4.2 out of 5 stars 465 customer reviews
ISBN-13: 978-0143036494
ISBN-10: 0143036491
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Editorial Reviews

From Publishers Weekly

In 1918, a plague swept across the world virtually without warning, killing healthy young adults as well as vulnerable infants and the elderly. Hospitals and morgues were quickly overwhelmed; in Philadelphia, 4,597 people died in one week alone and bodies piled up on the streets to be carted off to mass graves. But this was not the dreaded Black Death-it was "only influenza." In this sweeping history, Barry (Rising Tide) explores how the deadly confluence of biology (a swiftly mutating flu virus that can pass between animals and humans) and politics (President Wilson's all-out war effort in WWI) created conditions in which the virus thrived, killing more than 50 million worldwide and perhaps as many as 100 million in just a year. Overcrowded military camps and wide-ranging troop deployments allowed the highly contagious flu to spread quickly; transport ships became "floating caskets." Yet the U.S. government refused to shift priorities away from the war and, in effect, ignored the crisis. Shortages of doctors and nurses hurt military and civilian populations alike, and the ineptitude of public health officials exacerbated the death toll. In Philadelphia, the hardest-hit municipality in the U.S., "the entire city government had done nothing" to either contain the disease or assist afflicted families. Instead, official lies and misinformation, Barry argues, created a climate of "fear... [that] threatened to break the society apart." Barry captures the sense of panic and despair that overwhelmed stricken communities and hits hard at those who failed to use their power to protect the public good. He also describes the work of the dedicated researchers who rushed to find the cause of the disease and create vaccines. Flu shots are widely available today because of their heroic efforts, yet we remain vulnerable to a virus that can mutate to a deadly strain without warning. Society's ability to survive another devastating flu pandemic, Barry argues, is as much a political question as a medical one.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.

From The New England Journal of Medicine

The connection among public health, epidemic disease, and politics can be seen throughout history, from the responses to the Black Death in Italian cities in 1348 to the response -- or lack thereof -- to the resurgence of tuberculosis on the part of the New York City Department of Health in the 1980s. John M. Barry spells out this connection in fascinating detail in The Great Influenza. In his meticulous description of the dire consequences that resulted when short-term political expediency trumped the health of the public during the 1918 influenza pandemic, Barry reminds his readers that the government response to an epidemic is all too often colored by the politics of the moment. Barry is neither a scientist nor a professional historian, and some of the details he gives on virology and immunology are clearly targeted at a nonmedical audience, but physicians and scientists will find this book engrossing nonetheless. The influenza pandemic of 1918, the worst pandemic in history, killed more people than died in World War I and more than the tens of millions who have died, to date, in the AIDS pandemic. Barry focuses only on what was occurring in the United States at the time, and he tries to place this unprecedented human disaster both against the background of American history and within the context of the history of medicine. He is right to try to acquaint the reader with the state of American medicine at the turn of the last century, focusing on the dismal status of medical education and laboratory research, particularly as compared with that in Europe at the same time. Much of his discussion centers on "great men" (and an occasional great woman), however, and the picture given of their lives and professional careers is superficial and occasionally repetitious, and it distracts from the main events. His point, presumably, is to convey the futility of all the efforts of these brilliant minds, and he begins and ends the book with anecdotes about Paul Lewis, a scientist who had helped to prove that poliomyelitis is caused by a virus and then developed a highly effective simian vaccine. Lewis is the symbol of the best and the brightest of the scientific establishment, and we follow him as he weaves in and out of the story. He, like all scientists of his time, failed to grasp the fact that influenza was caused by a virus, believing it to be caused by Pfeiffer's bacillus, and he was therefore unable to develop a successful vaccine or to halt the devastation. The book becomes riveting once Barry begins to describe the origins and early weeks of the epidemic. The fact that it was wartime and that hundreds of thousands of men were being called up, placed in overcrowded camps, and packed like sardines into ships to be delivered as efficiently as possible to Europe enabled influenza to spread rapidly among recruits. From the military camps, the virus spread into the civilian population in the United States and from the United States to France. Barry describes the first catastrophe at Camp Devens, in Massachusetts, in the late summer of 1918, where thousands of previously healthy men in their prime suddenly became critically ill, overwhelming the inadequate camp hospital, infecting the medical staff, and dying by the hundreds, apparently with acute respiratory distress syndrome. The smartest and most hardworking scientists, physicians, and nurses, both military and civilian, were stunned by the rapidity of the disease progression and the inexplicable death toll among the youngest and strongest. (Figure) Barry provides a fascinating picture of the response of the government -- both federal and local. The former was sluggish at best and secretive and dishonest at worst, desperate to keep the war effort going and the public calm and to minimize the severity of the disease. In one of the more gripping chapters, Barry focuses on Philadelphia and tells us of the backwardness of its social infrastructure, the lack of a functioning health department, and the power of the local political machine. Dr. Wilmer Krusen, a political appointee who was the director of the Philadelphia Department of Public Health and Charities, deliberately ignored warnings against allowing a Liberty Loan parade to proceed, even though influenza had devastated the local Navy Yard and begun to spread into the civilian population. Within 72 hours of the parade, every bed in Philadelphia's 31 hospitals was filled. Within 10 days the epidemic exploded from a few hundred civilian cases to hundreds of thousands and from a daily rate of one or two deaths to hundreds. The horror is most vivid in the dilemma surrounding the disposal of bodies. The city morgue had hundreds of bodies stacked up, which produced an unbearable stench, and undertakers rapidly ran out of coffins. Hundreds of bodies lay in homes exactly where they had been at the time of death; burial quickly became impossible, since there were not enough people to dig graves. Whether anything might have been done differently, and if it had, whether this would have made a difference, are questions that Barry leaves unanswered. His tone is often irritatingly and unnecessarily sensationalist. But his indictment of the public authorities for their dishonesty and deliberate minimization of the damage and dangers is particularly chilling in today's climate of bioterrorism, in the midst of a war whose damages and dangers have been similarly minimized. Barry makes it all too easy to imagine a similarly devastating epidemic with a similarly inadequate response. I highly recommend this book to all. Karen Brudney, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an out of print or unavailable edition of this title.

Product Details

  • Paperback: 546 pages
  • Publisher: Penguin Books; Revised edition (October 4, 2005)
  • Language: English
  • ISBN-10: 0143036491
  • ISBN-13: 978-0143036494
  • Product Dimensions: 5.4 x 1.2 x 8.4 inches
  • Shipping Weight: 1.2 pounds (View shipping rates and policies)
  • Average Customer Review: 4.2 out of 5 stars  See all reviews (465 customer reviews)
  • Amazon Best Sellers Rank: #19,391 in Books (See Top 100 in Books)

More About the Author

I was born in... Nah, let's not start that far back. Let's just say after dropping out of graduate school in history I became a football coach-- in fact, the first story I ever sold was to a coaching magazine, about a way to change blocking assignments at the line of scrimmage, and I was on the staff of a guy who was named national coach of the year. I quit coaching to write, first as a Washington journalist covering economics and national politics, then I finally began doing what I always intended and wanted to do: write books. Two of those books have in turn led me into active involvement in a couple of policy areas. Anyway, here's the more formal version of my bio:

John M. Barry is a prize-winning and New York Times best-selling author whose books have won several dozen awards. In 2005 the National Academies of Science named The Great Influenza: The story of the deadliest pandemic in history, a study of the 1918 pandemic, the year's outstanding book on science or medicine. In 1998 Rising Tide: The Great Mississippi Flood of 1927 and How It Changed America, won the Francis Parkman Prize of the Society of American Historians for the year's best book of American history. His latest book is Roger Williams and The Creation of the American Soul: Church, State, and the Birth of Liberty, which has been named a finalist for the Los Angeles Times Book Prize, to be awarded late spring 2013. ( Scroll down for more about this book, including a syndicated op ed based on it.)

His writing has received not only formal awards but less formal recognition as well. In 2004 GQ named Rising Tide one of nine pieces of writing essential to understanding America; that list also included Abraham Lincoln's Second Inaugural Address and Martin Luther King's "Letter from Birmingham Jail." His first book, The Ambition and the Power: A true story of Washington, was cited by The New York Times as one of the eleven best books ever written about Washington and the Congress. His second book The Transformed Cell: Unlocking the Mysteries of Cancer, coauthored with Dr. Steven Rosenberg, was published in twelve languages. And a story about football he wrote was selected for inclusion in an anthology of the best football writing of all time published in 2006 by Sports Illustrated.

He has had considerable influence on both pandemic policy and flood protection. Both the Bush and Obama administrations sought his advice on influenza preparedness and response, and he was a member of the original team which developed plans for non-pharmaceutical interventions to mitigate a pandemic. The National Academies of Science asked him to give the keynote speech at its first international scientific meeting on pandemic influenza, and he was the only non-scientist on a federal government Infectious Disease Board of Experts.

In the area of water resources, he has been equally active. In 2006 he became the only non-scientist ever to give the National Academies annual Abel Wolman Distinguished Lecture, a lecture which focuses on some aspect of water. After Hurricane Katrina, the Louisiana congressional delegation asked him to chair a bipartisan working group on flood protection, and he now serves on the board overseeing levee districts in metropolitan New Orleans and on the Louisiana Coastal Protection and Restoration Authority, which is responsible for the state's hurricane protection. Barry has worked with state, federal, United Nations, and World Health Organization officials on influenza, water-related disasters, and risk communication.

Barry sits on advisory boards at M.I.T's Center for Engineering Systems Fundamentals and the Johns Hopkins Bloomberg School of Public Health as well as on the board of the Society of American Historians and American Heritage Rivers.

He has also been keynote speaker at such varied events as a White House Conference on the Mississippi Delta and an International Congress on Respiratory Viruses, and he has given talks in such venues as the National War College, the Council on Foreign Relations, Harvard Business School, and elsewhere. He is co-originator of Riversphere, a $100 million center being developed by Tulane University; it will be the first facility in the world dedicated to comprehensive river research.

His articles have appeared in such scientific journals as Nature and Journal of Infectious Disease as well as in lay publications ranging from Sports Illustrated to The New York Times, The Washington Post, Fortune, Time, Newsweek, and Esquire. A frequent guest on every broadcast network in the US, he has appeared on such shows as NBC's Meet the Press, ABC's World News, and NPR's All Things Considered, and on such foreign media as the BBC and Al Jazeera. He has also served as a consultant for Sony Pictures and contributed to award-winning television documentaries.

Before becoming a writer, Barry coached football at the high school, small college, and major college levels. Currently Distinguished Scholar at the Center for Bioenvironmental Research of Tulane and Xavier Universities, he lives in New Orleans.

Barry's latest book focuses on the development of both the idea of separation of church and state and the first expression of individualism in the modern sense. These two issues-- how we define the relationship between church and state and between the individual and the state-- have opened fault lines which have divided America throughout our history up to today. Here is an op ed syndicated by The Los Angeles Times February 5, 2012 :

A Puritan's `War Against Religion.'

In January, while conservative Christians and GOP presidential candidates were charging that "elites" have launched "a war against religion," a federal court in Rhode Island ordered a public school to remove a prayer mounted on a wall because it imposed a belief on 16-year-old Jessica Ahlquist. The ruling seems particularly fitting because it was consistent not only with the 1st Amendment but with the intent of Roger Williams, who founded Rhode Island expressly to provide religious liberty and who called such forced exposure to prayer "spiritual rape."

As Williams' nearly 400-year-old comment demonstrates, the conflict over the proper relationship between church and state is the oldest in American history. The 1st Amendment now defines this relationship, but understanding the full meaning of the amendment requires understanding its history, for the amendment was a specific response to specific historical events and was written with the recognition that freedom of religion was inextricably linked to freedom itself.

The church-state conflict began when Puritans, envisioning a Christian nation, founded what John Winthrop called "a citty upon a hill" in Massachusetts, and Williams rejected that vision for another: freedom. He insisted that the state refrain from intervening in the relationship between humans and God, stating that even people advocating "the most Paganish, Jewish, Turkish, or Antichristian consciences and worships" be allowed to pray -- or not pray -- freely, and that "forced worship stinks in God's nostrils."

Yet Williams was no atheist. He was a devout Puritan minister who, like other Massachusetts Puritans, fled religious persecution in England. Upon his arrival in 1631 he was considered so godly that Boston Puritans had asked him to lead their church. He declined -- because he considered their church insufficiently pure.

Reverence for both Scripture and freedom led Williams to his position. His mentor was Edward Coke, the great English jurist who ruled, "The house of every one is as his castle," extending the liberties of great lords -- and an inviolate refuge where one was free -- to the lowest English commoners. Coke pioneered the use of habeas corpus to prevent arbitrary imprisonment. And when Chancellor of England Thomas Egerton said, "Rex est lex loquens; the king is the law speaking," and agreed that the monarch could "suspend any particular law" for "reason of state," Coke decreed instead that the law bound the king. Coke was imprisoned -- without charge -- for his view of liberty, but that same view ran in Williams' veins.

Equally important to Williams was Scripture. Going beyond the "render unto Caesar" verse in the New Testament, he recognized the difficulty in reconciling contradictory scriptural passages as well as different Bible translations. He even had before him an example of a new translation that served a political purpose. King James had disliked the existing English Bible because in his view it insufficiently taught obedience to authority; the King James Bible would correct that.

Given these complexities, Williams judged it impossible for any human to interpret all Scripture without error. Therefore he considered it "monstrous" for one person to impose any religious belief on another. He also realized that any government-sponsored prayer required a public official to pass judgment on something to do with God, a sacrilegious presumption. He also knew that when one mixes religion and politics, one gets politics. So to protect the purity of the church, he demanded -- 150 years before Jefferson -- a "wall of separation between the garden of the church and the wilderness of the world."

Massachusetts had no such wall, compelled religious conformity and banished Williams for opposing it. Seeking "soul liberty," he founded Providence Plantations and established an entirely secular government that granted absolute freedom of religion. The governing compact of every other colony in the Americas, whether English, French, Spanish or Portuguese, claimed the colony was being founded to advance Christianity. Providence's governing compact did not mention God. It did not even ask God's blessing.

Williams next linked religious and political freedom. It was then universally believed that governments derived their authority from God. Even Winthrop, after being elected governor in Massachusetts, told voters, "Though chosen by you, our authority comes from God."

Williams disputed this. Considering the state secular, he declared governments mere "agents" deriving their authority from citizens and having "no more power, nor for longer time, than the people ... shall betrust them with." This statement sounds self-evident now. It was revolutionary then.

The U.S. Constitution, like Providence's compact, does not mention God. It does request a blessing, but not from God; it sought "the blessings of liberty," Williams' "soul liberty." As Justice Robert Jackson wrote, "This freedom was first in the Bill of Rights because it was first in the forefathers' minds; it was set forth in absolute terms, and its strength is its rigidity."

Eight years after the Constitution's adoption, the Senate confirmed this view in unanimously approving a treaty. It stated: "[T]he government of the United States is not in any sense founded on the Christian religion."

Yet the argument continues. Presidential candidates and evangelicals ignore American history and insist on injecting religion into politics. They proclaim their belief in freedom -- even while they violate it.

Customer Reviews

Top Customer Reviews

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In The Great Influenza, John Barry has produced a massive and exhaustively researched description of one of the greatest disasters of human history. At least, from the American point of view. While there are a few glancing references to what was going on in the rest of the world, there is no serious discussion of any attempts to deal with the pandemic in other countries, even in other industrialized countries. On the other hand, Barry has chosen a very specific point of view: the transition of American medicine and medical training from folk wisdom to science. It's a compelling point on which to balance a long and exhaustive (there's that word again) study of how America and, specifically, American medicine confronted an epidemic in which people were dying faster than the technology of the time could handle, an epidemic in which society itself was nearly overwhelmed by death.

As other reviewers have noted, the book's weakness is a tendency towards melodrama, as in the far-too-often repeated tag line "This was influenza. Only influenza." After a while, you think to yourself, "Yes, we get it. Give it a rest."

On the other hand, the book has one of those quirky displays of real brilliance in the last two chapters in which Barry deals with how science is done well (in the case of Oswald Avery) or done poorly (in the case of Paul A. Lewis). These two chapters are so strong that they could stand on their own, and what they have to say about the process of scientific thought itself is fascinating. Avery's story is that of a man who was just relentessly focused, who kept digging deeper and deeper into a single issue until he discovered the source of heredity itself. Lewis's story, on the other hand, is that of a man who simply lost his way.
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A book that recently caught my eye was one by John Barry titled The Great Influenza - The Epic Story Of The Deadliest Plague In History. Now, I generally have a phobia about needles, and have *never* received a flu vaccination, but I think that will change next year. This was scary stuff...
Barry details the Spanish influenza pandemic of 1918 in great detail. He starts by setting the stage of how American medicine was practiced at the end of the 19th century, and how there was little control or respect for the profession. And rightly so... Nearly anyone could call themselves a doctor and do nearly anything. But through the efforts of a few key people, John Hopkins university was formed to bring the medical education up to European standards. Most of this transformation was occuring when the flu pandemic started. This is where the book gets interesting... and frightening.
Because of World War 1, recruits were overcrowded into training facilities that were less than sanitary. When the flu first broke out in one of the army camps in the states, it was quickly transferred to other camps when soldiers transferred. From there, it easily jumped into major cities, decimating large numbers of people. And when these soldiers went overseas, the flu went with them. Being especially contagious, it swept the globe in short order and left, by some estimates, over 100 million dead. That is so hard to comprehend.
When you look at the struggle they had to even identify the cause of the illness, you understand how it could so easily run rampant. One would think that it couldn't happen today, but one would be wrong. SARS, AIDS... diseases that defy attempts to quickly identify the virus, and are resistant to attempts and efforts to treat them. It's not hard to imagine how a pandemic could start so much more quickly today due to the ease of worldwide travel.
Well worth reading to understand how precarious the general health of society could be...
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As an initial, rough draft, this manuscript shows amazing potential as an important look at a terrifying and prescient topic. As a finished work, it is the most poorly edited book I've ever read.

In the acknowledgments, Barry writes the most important thing that the reader needs to know about getting through this book: "This book was initially supposed to be a straightforward story of the deadliest epidemic in human history, told from the perspectives of both scientists who tried to fight it and political leaders who tried to respond to it....Instead....it didn't seem possible to write about the scientists without exploring the nature of American medicine...." He was wrong. Rather than the exploration of American medicine being essential, enlightening, or even remotely relevant, the result is two completely unrelated books in one. One book is a terrifying and page-turning "straightfoward story of the deadliest epidemic in human history." The other book is a mind-numbingly boring list of names of doctors and scientists, descriptions of university politics, and confusing explanations of experiments that have nothing to do with the influenza pandemic. In fact, on page 259 of the book, Barry says that the people who the first 89 pages are about had nothing to do with research or medical breakthroughs regarding the influenza epidemic in any way!

My favorite example of what Barry considered essential to include in this book about the 1918 pandemic is the story of a scientist named Lewis. Barry tracks Lewis's career almost to the minute.
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