Weight o f Numbers

89

untouched population which has not acquired natural defences, the result is a catastrophic epidemic. MacNeill thinks, and he may well be right, that the pandemic of 1348 which we call the Black Death and which ravaged virtually the whole of Europe, was the result of Mongol expansion which reactivated the silk routes and made it easier for pathogens to travel across continental Asia. Similarly, when the Europeans at the end of the fifteenth century unified the trade routes of the world, pre-Columbian America was in turn struck a terrible blow by diseases previously unknown there, which the Europeans brought with them. In return, a new form of syphilis struck Europe and reached China in record time, by the early sixteenth century, whereas maize and sweet potatoes which were both American in origin did not arrive in the Far East until the last years of the century.194 Nearer home, a similar biological drama occurred in 1832, when cholera from India arrived in Europe. But it is not only a question of mans greater or lesser vulnerability, or greater or lesser immunity to infection, in these cases of diseases which first attack then retreat. Historians of medicine have suggested, rightly in my view, that every pathogenic agent has its own history, which runs parallel to that of its victims, and that the evolution of diseases largely depends upon changes, and sometimes mutations, in the agents themselves. Here lies the cause of the complicated advances and retreats of disease, the surprise appearances or epidemic outbreaks, and the quiescence and sometimes complete disappearance of certain illnesses. One example, with which we are today familiar, of mutations in a microbe or virus, is that of the disease we call grippe, or influenza. The word grippe, denoting a disease which seizes or takes hold of its victims, may only date from the spring of 1743.195 But the illness itself is known, or thought, to have existed in Europe since the twelfth century. It was one of the diseases unknown in the Americas, and it decimated the Indian population there when it arrived. In 1588, it laid low (but did not kill) the entire population of Venice, to the point where the Grand Council was empty - something that never happened during outbreaks of plague; and the epidemic did not stop there, but spread to Milan, France, Catalonia and the Americas.196 Influenza or grippe was already the disease that spreads like wildfire, just as it is today. Voltaire, on i o January 1768 wrote: The grippe, on its way round the world, has passed through our little Siberia (Ferney, near Geneva) and has attacked my old and sickly face a little. But a multitude of symptoms are covered by the generic name: to mention only the most famous outbreaks, the so-called Spanish influenza of 1918 - which caused more deaths than the First World War - was not at all the same disease as the Asian flu of 1957. In fact, there are several different strains of influenza, and if vaccines against them are not entirely reliable, it is because the influenza virus is undergoing constant and rapid mutation. The vaccines are almost always one epidemic behind. Indeed in some laboratories, in order to get ahead in the race against time, efforts have been made to make current flu viruses mutate in test tubes, so as to combine in a single vaccine all the possible mutants