Flu Week/Book Review: Flu, by Gina Kolata

Flu‘s full title is Flu: The Story of the Great Influenza Pandemic of 1918.  It does not deliver what it promises, but what it does deliver is pretty neat.

From the title, I expected it to be about the biology and/or social effects of the 1918 flu pandemic.  I would have been perfectly fascinated by either of these.  The 1918 pandemic is one of very few plagues that was more deadly to healthy young adults than children and the elderly.  The only other disease I can think of that does that is HIV, and in that case it’s caused by the mechanism of transmission.  Both children and the elderly breathe, so that’s not the issue with the flu.  On a sociological level, the 1918 flu killed 3-5% of the world’s population, wiped entire villages off the map, and complicated the logistics of WW1.  How did people react to that?  How did it change society?  Flu talks a lot about how little the pandemic was talked about in the early aftermath, but nothing about how it affected society.

On the biological level, Flu raises several interesting mysteries. One, how did infections go from 0 to everyone so fast?  Even accounting for rapid transit, the disease seemed to spontaneously generate in multiple cities simultaneously.  Two, why did most of the victims suffer from an additional bacterial infection.  Was in opportunistic?  A co-infection that led to especially devastating outcomes?  She even hints that the answers may be related, but never returns to either.  My inner epidemiologist was heartbroken.

What Flu does talk about is how scientists have investigated these questions.  The anti-body work to demonstrate it was probably pig flu.  The ingenious methods of finding samples from a disease that died out 30-80 years ago.  Some of the politics of handling potential modern epidemics.  These are all fascinating, and important, and really hard to do well.  Demonstrating how science progresses is in many ways more valuable than any given scientific fact, which has a 50% chance of being proven wrong   I do wish Kolata hadn’t gotten my hopes up so high with the medical mysteries, but I would have happily read a book that promised exactly what this one delivered.