Table of Contents:



I. Storm Gathering

1. 1918

2. Master of Metamorphosis

3. H5N1

4. Playing Chicken

5. Worse Than 1918?

6. When, Not If

II. When Animal Viruses Attack

1. The Third Age

2. Man Made

3. Livestock Revolution

4. Tracing the Flight Path

5. One Flu Over the Chicken's Nest

6. Coming Home to Roost

7. Guarding the Henhouse

III. Pandemic Preparedness

1. Cooping Up Bird Flu

2. Race Against Time

3. Tamiflu

IV. Surviving the Pandemic

1. Don't Wing It

2. Our Health in Our Hands

3. Be Prepared

V. Preventing Future Pandemics

1. Tinderbox

2. Reining in the Pale Horse


References 1-3,199

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—Albert Camus, The Plague39
Percentage dying

In 1918, half the world became infected and 25% of all Americans fell ill.40 Unlike the regular seasonal flu, which tends to kill only the elderly and infirm, the flu virus of 1918 killed those in the prime of life Public health specialists at the time noted that most influenza victims were those who “had been in the best of physical condition and freest from previous disease.”41 Ninety-nine percent of excess deaths were among people under 65 years old.42 Mortality peaked in the 20- to 34-year-old age group.43 Women under 35 accounted for 70% of all female influenza deaths. In 1918, the average life expectancy in the United States dropped precipitously to only 37 years.44

Calculations made in the 1920s estimated the global death toll in the vicinity of 20 million, a figure medical historians now consider “almost ludicrously low.”45 The number has been revised upwards ever since, as more and more records are unearthed. The best estimate currently stands at 50 to 100 million people dead.46 In some communities, like in Alaska, 50% of the population perished.47

The 1918 influenza pandemic killed more people in a single year than the bubonic plague (“black death”) in the Middle Ages killed in a century.48 The 1918 virus killed more people in 25 weeks than AIDS has killed in 25 years.49 According to one academic reviewer, this “single, brief epidemic generated more fatalities, more suffering, and more demographic change in the United States than all the wars of the Twentieth Century.”50

In September 1918, according to the official published American Medican Association (AMA) account, the deadliest wave of the pandemic spread over the world “like a tidal wave.”51 On the 11th, Washington officials disclosed that it had reached U.S. shores.52 September 11, 1918—the day Babe Ruth led the Boston Red Sox to victory in the World Series—three civilians dropped dead on the sidewalks of neighboring Quincy, Massachusetts.53 It had begun.

When a “typical outbreak” struck Camp Funston in Kansas, the commander, a physician and former Army Chief of Staff, wrote the governor, “There are 1440 minutes in a day. When I tell you there were 1440 admissions in a day, you realize the strain put on our Nursing and Medical forces….”54 “Stated briefly,” summarized an Army report, “the influenza…occurred as an explosion.”55

October 1918 became the deadliest month in U.S. history56 and the last week of October was the deadliest week from any cause, at any time. More than 20,000 Americans died in that week alone.57