Andrew Knox

HIST&137 – Research Plan #1

January 26th, 2011

Part I: Introduction (619 words)

I chose the 1918 Influenza Pandemic as my topic because I had never learned much about it in

grade school, which, looking back, seems extremely odd. The Flu Pandemic was one of the worst

disasters to ever strike America, or the entire world for that matter. Approximately 675,000 Americans

died, and about 28% of the population was infected at one time or another. Worldwide, mortality was

so high and corpses were destroyed so quickly that estimates for a death total range from 20 to 100

million. Since the virus killed by instigating an immune system over-response, people between ages 20

and 40 suffered greater mortality rates than young children and the elderly, who naturally tend to have

weaker immune systems.1 This fact, coupled with the massive slaughter of young men in World War I,

led to the phenomenon of the Lost Generation, an age cohort that had become disillusioned with the

path America had gone down in their lifetimes.2

Like the Bubonic Plague that ravaged Medieval Europe, the Middle East and Asia, and killed

indiscriminately from peasant to king, the 1918 Pandemic's extreme lethality meant that no one in

society was safe from the disease. Woodrow Wilson, Franklin D. Roosevelt, Ethiopian Emperor Haile

Selassie and Walt Disney all caught the flu at some point. Due to popular nicknames like “Spanish

Flu” and “La Grippe,” it is generally accepted that the flu came to America with soldiers returning

victorious from the wretched battlefields of World War I Europe. While the pandemic officially lasted

from June 1917 to December 1920, in the year 1918, the virus swept over the planet in three waves.

The first wave hit America in March 1918. The far deadlier second wave struck from September to

November, survivors of the first wave were immune, but the rest faced a far more lethal strain. The

1 Billings.
2 Tripodi.

1
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

third wave was much more subdued, passing meekly through the winter and into early 1919.3

The third wave was less deadly than the others because, by this point, the public health

departments of many developed nations were finally prepared to contain and quarantine further

outbreaks. These prevention measures were implemented with exceptional speed because the war had

made many governments of Europe and North America heavily nationalist, and, consequently, more

authoritarian. The prevailing mindset of wartime society “led to the relatively calm response of the

public and application of scientific ideas. People allowed for strict measures and loss of freedom during

the war as they submitted to the needs of the nation ahead of their personal needs. They had accepted

the limitations placed with rationing and drafting. The responses of the public health officials reflected

the new allegiance to science and the wartime society.”4 Since society was largely passive to quick

suspension of freedom due to the war, the government was able to implement containment measures

that may have saved millions of lives. Thank goodness for war?

Since the pandemic took place during the chaotic couple years following World War I, lasted so

briefly and moved through communities in as little as three weeks, the survivors tried to forget the

horrors of the era and start anew. In the public consciousness, the flu dead were an extension of the

war dead. Seventy-five years of national amnesia passed and the 1918 Influenza Pandemic faded from

memory. Only when new contagious viruses like SARS, Bird Flu and Swine Flu, reared their heads

with the threat of another global megadeath did news articles reminding the fearful populace of the

“forgotten pandemic.” Public consciousness of the outbreak has risen in recent years, but still falls far

behind the reverence it deserves: America's first and worst national disaster ever.5

3 Morens.
4 Billings.
5 United States.

2
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

Part II: Primary Sources (233 words)

The two physical archive institutions I found with possible information caches related to the flu

pandemic are the National Museum of Health and Medicine in Washington, D.C., and at various

branches of the National Archives and Records Administration around the country. The National

Archive's Flu Pandemic collection is very spread out, so I have provided the contact information for the

Seattle office and the Main Archives in Washington, D.C..

National Museum of Health and
Medicine
6900 Georgia Avenue, NW,
Building 54
Washington D.C. 20307
202-782-2200
nmhminfo@afip.osd.mil
Seattle National Archives Office
6125 Sand Point Way NE
Seattle, Washington 98115-7999
206-336-5115
seattle.archives@nara.gov
National Archives and Records
Administration
700 Pennsylvania Avenue, NW
Washington, D.C. 20408-0001
202-357-5000
http://www.archives.gov/

I chose the National Museum of Health and Medicine because of the great variety of pictures

and documents in their online exhibit.6 I figured that a military museum focused on health and

medicine will likely have important primary sources about soldiers with the disease. There are photos

of the emergency hospitals, army regimented treatments and even the shriveled lungs of autopsied flu

victims. I chose the National Archives because my research pointed to the administration being the

primary authority on cataloging this history that nobody wants to remember.7 The National Archives

also has a convenient location near my house that I have confirmed has primary sources from the era on

its premises.

6 NMHM.
7 NARA.

3
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

Part III: Secondary Sources (1095 words)

The first book I found was The Great Influenza: The Epic Story of the Deadliest Plague in

History by John Barry. It was written with the intent of wide appeal, interesting to medical students

and history majors alike. I selected a review by Peter Palese from The Journal of Clinical

Investigation to determine the book's quality. Palese was clearly impressed by Barry's concise writing

style, as he wrote, “the writing is facile and gripping at the same time, and the author does an

extraordinarily good job of creating a fluent narrative from historical research.” The reviewer

commended the author in laying out an extensive background on the context of society, politics and

medical technology in the early 20th century. This book was also cited in many reviews of other books

I found as an authoritative standard work on the topic.

The second book was America’s Forgotten Pandemic: The Influenza of 1918 by Alfred Crosby.

The thesis of this book is that following World War I and the Flu Pandemic, many Americans were

more than willing to forget all the pointless death. The review was written by Sandra M. Tomkins of

Christ's College, Cambridge. It turns out that America's Forgotten Pandemic is actually a reworking of

Crosby's 1976 book, Epidemic and Peace, that even contains the original typos. The only change,

according to the reviewer, is a four-page epilogue about the AIDS epidemic. It seems it was re-released

with a new title to correspond with the burgeoning return of interest in the topic in the 1990's. The

reviewer seems to disagree with many parts of the original work, as well. She says that some of

Crosby's claims about the impact of the epidemic are overblown, others even dubious.

Another book was Hunting the 1918 Flu: One Scientist’s Search for a Killer Virus by Kirsty

Duncan of the University of Toronto. A retired geriatric physician named Fred Charatan wrote a review

4
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

for the book that was published in the British Medical Journal. This book seems different from the

others because it focuses on the author's first-hand research on the 1918 flu virus by trying to recover a

sample of it from frozen preserved corpses in Spitzbergen, Norway in an attempt to study it and

sequence its DNA. The book chronicles the author's 1998 expedition's setbacks and regulatory hurdles,

eventually achieving its goal of retrieving samples of the virus, but ultimately failing to come to a

scientific conclusion. The reviewer seems to admire the attempt, but regret the adversity Duncan's

team had to fight through to do their research. He says, “this book is either a cautionary tale or a

medical detective story about a gallant effort by a team of intrepid researchers.”

The next book I found was Influenza 1918: The Worst Epidemic in American History by Lynette

Iezzoni. This book was reviewed in the New England Journal of Medicine by Margaret K. Hostetter,

M.D., of Yale University School of Medicine. Hostetter admired the book's resemblance to “a modern

newscast, with rapid cutting from one scene to the next and brief but memorable sound bites from

witnesses.” The reviewer's main criticism was that the book is too complicated for most readers

without medical expertise and should explain more of the clinical terms to make the book more

accessible. The mixed review went on for a while critiquing many of the unanswered questions the

book leaves in the casual reader.

The fifth book I found, Flu: The Story of the Great Influenza Pandemic of 1918 and the Search

for the Virus that Caused It by Gina Kolata, was reviewed by Andrew Noymer of University of

California at Berkeley. In the review, I was surprised to learn the origin of the nickname, “Spanish

Flu.” Apparently, due to World War I, most countries at war heavily censored their newspapers, and

thus suppressed coverage of the pandemic. In neutral Spain, however, the uncensored newspapers ran

wild with flu stories that inexorably led to the pandemic being closely associated with Spain at the

5
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

time. The reviewer enjoyed the book, as he called it “interesting and very readable.”

Another book was Spanish Influenza Pandemic of 1918-19: New Perspectives, edited by

Howard Phillips and David Killingray. I found a review for it by Margaret Humphreys, a history

professor at Duke University. Humphreys both complimented the coverage of an “impressive array of

localities... [including] New Zealand, Japan, China, India, Europe, Africa, northern Canada and Great

Britain” and bemoaned the gaps in coverage of the epidemic in places like Middle and South America,

Russia and the Middle East. Essentially, the same story plays out in each location, the virus silently

appearing and quickly decimating the population. The reviewer highly regards this book, saying,

“there can be no doubt that this book is now the appropriate starting place for anyone interested in the

1918 story.”

The seventh book I found was A Cruel Wind: Pandemic Flu in America by Dorothy A. Pettit

and Janice Bailie. It was reviewed by Anne Sealey of Ohio State University. A trend I've seen in these

reviews is that reviews of newer books seem to be more glowing and positive than those of older

books, and I attribute this to the increase in paranoia regarding the possibility of another deadly

pandemic striking the world again. As in this review, where the reviewer praises the authors for

“vividly painting the picture of a world in which public masks were common, anti-influenza

propaganda existed alongside the anti-German, and the healthiest young adults, those between 18 and

40, were most likely to die of influenza.” Sealey had some small criticisms regarding the book's

organization, but still hailed it as “a valuable service.”

The last book I found was Fever of War: The Influenza Epidemic in the U.S. Army during World

War I by Carol Byerly. As the title states, the book has a focus on the story of U.S. Army doctors and

how their “unprecedented confidence in their ability to keep soldiers healthy” was thrashed by the

6
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

sudden and lethal epidemic. It was reviewed by Christopher Langford of Oxford University. Langford

said that the first two-thirds of Byerly's book were “extremely interesting and largely successful,” but

he considered the last third “less successful.” Apparently, in the third part, several points made about

comparing death rates between white and black Americans contradicted each other. Regardless, the

reviewer highly recommends the book, stating, “Byerly’s book provides a wealth of fascinating detail.

Everyone with an interest in the 1918–19 pandemic will profit from reading it.”

7
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

Part IV: Conclusion (247 words)

When I picked this topic, I had no idea that such a horrific and devastating event could be

forgotten or suppressed from memory, and especially so quickly. Unfathomable events, like what

happened in one Alaskan town, where 85% of the population got sick and died in only three weeks,

became commonplace. If such a deadly plague were to spread in today's world, society would

definitely screech to an immediate halt, if not completely collapse into anarchy when the government

loses control of the situation and the population. These terrifying scenarios may seem fantastical, or

even impossible, but simultaneously, we know that they are all too possible. Past epidemics of

infectious diseases like swine flu, bird flu, SARS, ebola and small pox were largely contained by a

mixture of luck and good timing.

These scary futures make study of the 1918 Influenza Pandemic all the more important. Due to

lack of technology, organization and knowledge of viruses, millions of people may have died unneeded

deaths. We can never know for certain, I suppose, and perhaps our medical advancement since then

could be part of our undoing. Over-use of antibiotic medications to cure a wide variety of bacterial

infections may be causing bacteria to adapt resistance to these medications, giving rise to a new class of

“superbugs.”8 Whoever said those who forget history are doomed to repeat it was right. If we don't

remember and correct our mistakes from 1918, then 2018 could be a rough year.

8 Leung.

8
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

Part V: Works Cited

• Barry, John. The Great Influenza: The Epic Story of the Deadliest Plague In History. New York:
Viking, 2004. Print.
• Billings, Molly. "The 1918 Influenza Pandemic." Stanford University, 5 Jun 1997. Web. 26 Jan
2011. <http://virus.stanford.edu/uda/>.
• Byerly, Carol. Fever of War: The Influenza Epidemic in the U.S. Army during World War I. New
York: New York University Press, 2005. Print.
• Charatan, Fred. "Review: Hunting the 1918 Flu: One Scientist's Search for a Killer Virus."
British Medical Journal, 20 Sep 2003. Web. 26 Jan 2011.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC196410/>.
• Crosby, Alfred. America's Forgotten Pandemic. 2nd ed. Cambridge, UK: Cambridge University
Press, 1990. Print.
• Duncan, Kirsty. Hunting the 1918 Flu: One Scientist's Search for a Killer Virus. Toronto,
Ontario: University of Toronto Press, 2003. Print.
• Hostetter, Margaret. "Review: Influenza 1918: The Worst Epidemic in American History."
Massachusetts Medical Society, 26 Aug 1999. Web. 26 Jan 2011.
<http://www.nejm.org/doi/pdf/10.1056/NEJM199908263410919>.
• Humphreys, Margaret. "Review: The Spanish Influenza Pandemic of 1918-19: New
Perspectives." Journal of the History of Medicine, 19 Jul 2004. Web. 26 Jan 2011.
<http://jhmas.oxfordjournals.org/content/59/3/490.full.pdf+html>.
• Iezzoni, Lynette. Influenza 1918: The Worst Epidemic in American History. New York: TV
Books, 2000. Print.
• Kolata, Gina. Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the
Virus That Caused It. New York: Touchstone Press, 1999. Print.
• Langford, Christopher. "Review: Fever of War: The Influenza Epidemic in the U.S. Army
during World War I.." Oxford Press, 2 Nov 2005. Web. 26 Jan 2011.
<http://jhmas.oxfordjournals.org/content/61/1/92.full>.
• Leung, Rebecca. "Super-Resistant Superbugs." CBS News, 2 May 2004. Web. 27 Jan 2011.
<http://www.cbsnews.com/stories/2004/04/30/60minutes/main614935.shtml>.
• Morens, David. "1918 Influenza: the Mother of All Pandemics." Centers for Disease Control
and Prevention, 22 Dec 2005. Web. 26 Jan 2011.
<http://www.cdc.gov/ncidod/EID/vol12no01/05-0979.htm>.

9
Andrew Knox
HIST&137 – Research Plan #1
January 26th, 2011

• NARA. "The Influenza Epidemic of 1918." National Archives and Records Administration, 21
Jul 2008. Web. 26 Jan 2011. <http://www.archives.gov/exhibits/influenza-epidemic/>.
• NMHM. "Images from the 1918 Influenza Epidemic." National Museum of Health and
Medicine, 12 Oct 2010. Web. 26 Jan 2011.
<http://nmhm.washingtondc.museum/collections/archives/agalleries/1918flu/1918flu.html>.
• Noymer, Andrew. "Review: Flu:... by Gina Kolata." UC Berkeley Press, 16 May 2001. Web. 26
Jan 2011. <http://www.demog.berkeley.edu/~andrew/kolata_review.pdf>.
• Palese, Peter. "Review: The Great Influenza: The Epic Story of the Deadliest Plague In
History." Journal of Clinical Investigation, 15 Jul 2004. Web. 26 Jan 2011.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC450178/>.
• Pettit, Dorothy A. and Janice Bailie. A Cruel Wind: Pandemic Flu in America, 1918-1920.
Murfreesboro, TN: Timberlane Books, 2008. Print.
• Phillips, Howard and David Killingray eds. The Spanish Influenza Pandemic of 1918-19: New
Perspectives. New York: Routledge, 2001. Print.
• Sealey, Anne. "Review: A Cruel Wind: Pandemic Flu in America." Ohio State University, 4 Jul
2009. Web. 26 Jan 2011. <http://ehistory.osu.edu/osu/reviews/reviewview.cfm?id=72>.
• Tomkins, Sandra. "Review: America's Forgotten Pandemic." Oxford Press, 26 Jan 2011. Web.
26 Jan 2011. <http://shm.oxfordjournals.org/content/4/1/150.full.pdf>.
• Tripodi, Jill. "The Lost Generation." Rowan University, 28 Apr 2000. Web. 26 Jan 2011.
<http://users.rowan.edu/~lindman/lost_generation.html>.
• United States. Dept. of Health and Human Services. The Pandemic: The United States in 1918-
1919. Aug 2009. Web. 24 Jan 2010. <http://1918.pandemicflu.gov/the_pandemic/04.htm>

10