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The Greats Wine Flu Epidemic Of 1918
June 1976 | Volume 27, Issue 4
In earlier outbreaks influenza, like other respiratory diseases, had tended to take the lives of the weak and the old. Pneumonia, for example, has commonly been called the old man’s friend because it carries off the elderly quickly, almost painlessly. But the plague of 1918 had a cruel twist. Like the war it paralleled, the Spanish influenza killed off mostly the young and the strong. The disease felled young fathers and mothers in droves. In one week in October, 19 out of 42 women in a San Francisco maternity ward died of influenza. Yet during the outbreak the death rate among those aged forty-five to seventy-four tended to remain where it had been before the epidemic.
In the years just preceding the epidemic, the influenza and related pneumonia death rate among white men between twenty-five and thirty-four had been about 80 deaths per 100,000. In 1918 that rate rose to nearly 2,000, or 2,400 per cent. For white women death struck hardest at those between twenty and twenty-four, raising the influenza death rate by 2,500 per cent over the previous period. Influenza deaths also rose among blacks, though the rate was only about one fourth of that for whites.
Army doctors noted a curious distinction early in the outbreak at Fort Dix. Men from tough big-city neighborhoods seemed almost immune, while brawny farm boys from the blue-skied wide-open spaces fell like tall trees. The doctors concluded that men with large, well-developed chests breathed in more germs than their slighter comrades. They reasoned further that their strong constitutions also unleashed a massive counter-attack that killed off the invading organisms too swiftly and thus somehow proved overwhelming to the human system. The stronger the body, the swifter seemed its collapse.
Not knowing the true identity of the enemy, medical scientists were hard pressed to devise a vaccine in defense. Some people were inoculated with a mixture of organisms from influenza patients. Some were vaccinated with diphtheria antitoxin and antitetanus and antimeningitis sera. Doctors at a Boston naval hospital injected patients with a mixed vaccine that included Pfeiffer’s bacillus, the germ believed to have caused an influenza epidemic in 1890. This experiment produced some encouraging results. A few other successes with vaccines were also reported. On the whole, however, the results of vaccination were inconclusive, since they were used on an infinitesimal number of the total population. A committee of pathologists appointed by the Massachusetts State Board of Health, either unaware of or unable to duplicate the results of the Boston naval hospital experiment, reported that “the evidence at hand convinces the board that the vaccines we have considered have no specific value in the treatment of influenza.”
Even attempts to verify the way the disease spread were frustrated. On a parade ground at the naval prison in Boston Harbor’s Deer Island, Dr. Joseph Goldberger, a public-health physician, stood before a thousand deserters, insubordinates, brawlers, and other delinquent sailors. The doctor needed volunteers for an influenza experiment. The epidemic had stricken nearly a quarter of the total personnel and was on its way to taking the lives of 5,000 men.
Goldberger was blunt. Volunteers would first have to inhale a pure culture of Pfeiffer influenza bacillus into their nostrils. If this did not infect them, they would be injected with matter from the lungs of dead influenza victims. Volunteers would next have secretions from influenza patients sprayed into their nostrils and eyes and swabbed inside their throats. Finally each volunteer would be assigned to a seriously ill influenza patient who would cough directly into his face.
In exchange for running this gauntlet with death all surviving volunteers would be pardoned and restored to active duty. Three hundred men volunteered; Goldberger took 62 of them for his experiment.
A week after the sailor guinea pigs had sniffed, been injected, had their throats swabbed, and 10 of them had inhaled the coughs of influenza victims, not one man had contracted the disease. Their escape may be explained by the fact that the epidemic had already passed through Deer Island before the experiment had started, and these particular volunteers may have possessed natural immunity. Ironically, the doctor in charge of the quarantine station where the experiment was conducted did contract influenza and died during the study. But as for the experiment itself, it failed to verify the one point that the doctors previously had thought they were sure of—how the disease was transmitted.