Could It Happen Again?

AS WE look back, the era may strike us as quaint, even appealing. In the Western world, for example, it was a time of horse-drawn carriages, top hats, and long, trailing skirts. But it was also a terrifying time when death was on the march worldwide. The cause?

It was not war, although war was then raging. No, we are speaking of another scourge, one that has been called the most destructive in all recorded human history​—the Spanish flu, or influenza, of 1918-19.

Victims died en masse, for there was no effective treatment or cure. Millions of healthy young people were suddenly cut down during their most productive time of life. Corpses piled up faster than they could be buried. In some places entire towns and villages were wiped out.

All this took place some 85 years ago. Do we know what caused that disease? Could a calamity like that occur again? If it did, could we protect ourselves?

There is another fascinating aspect of this subject. Did you know that the Bible long ago had something to say about the pestilences we have seen in our own era? (Luke 21:11; Revelation 6:8) Was the Spanish flu part of a fulfillment of Bible prophecy? The answers to this and other questions will be discussed in the following articles.

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Preparing to bury Spanish-flu victims, Philadelphia, U.S.A.

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Library of the College of Physicians of Philadelphia

The Worst Plague in History

IN October 1918, the world was still fighting World War I. Although the end of hostilities was near, news censorship remained. Therefore, it was left to the noncombatant country of Spain to report that civilians in many places were becoming ill and dying at an alarming rate. These circumstances gave rise to the name by which the disease would forever be known​—the Spanish flu.

The pandemic began in March 1918.a Many investigators trace its origin to the state of Kansas, U.S.A. From there it was apparently spread to France by newly arrived U.S. soldiers. After a sharp increase in influenza deaths, by July 1918 it seemed that the worst was over. Little did doctors know at that time that the pandemic was only gathering strength to become a more efficient killer.

When World War I ended on November 11, 1918, the world rejoiced. Ironically, at almost that same time, the pestilence broke out earth wide. It was a monster that now claimed international headlines. Few who lived through that time were untouched, and all were frightened. A respected authority on influenza noted: “Life expectancy in the United States dropped by over 10 years in 1918.” How did this pestilence differ from others?

A Unique Pestilence

A most alarming difference was the suddenness with which this flu struck. How sudden? In the recent book The Great Influenza, author John M. Barry quotes a written record of this experience: “In Rio de Janeiro, a man asked medical student Ciro Viera Da Cunha, who was waiting for a streetcar, for information in a perfectly normal voice, then fell down, dead; in Cape Town, South Africa, Charles Lewis boarded a streetcar for a three-mile trip home when the conductor collapsed, dead. In the next three miles six people aboard the streetcar died, including the driver.” All died of the flu.

Then, there was the fear​—fear of the unknown. Science had no answer as to the cause of the disease or exactly how it spread. Public health measures were imposed: ports were quarantined; movie theaters, churches, and other public meeting places were closed. In San Francisco, California, U.S.A., for example, officials ordered the whole population to wear gauze masks. Anyone caught in public without a mask faced a fine or jail. But nothing seemed to work. Such measures were simply a case of too little, too late.

There was also fear because the flu struck indiscriminately. For reasons still not clear, the 1919 pandemic did not primarily afflict the elderly; it struck healthy young people and killed them. The majority of those who died of the Spanish flu were between 20 and 40 years of age.

Moreover, it was truly a worldwide epidemic. It even reached tropical islands. Influenza was introduced into Western Samoa (now known as Samoa) by ship on November 7, 1918, and within two months about 20 percent of the population of 38,302 died. Every major country of the world was dramatically affected!

Also, there was the enormity of this scourge. For example, the disease hit early and especially hard in Philadelphia, Pennsylvania, U.S.A. By mid-October 1918, there was a serious shortage of coffins. “One manufacturer said he could dispose of 5,000 caskets in two hours, if he had them. At times the city morgue had as many as ten times as many bodies as coffins,” says historian Alfred W. Crosby.

In a relatively short time, the flu had killed more people than any other pandemic of its kind in human history. A common estimate of worldwide deaths was 21 million, but some experts now judge that figure to be low. Some epidemiologists today suggest that a more likely toll is 50 million deaths or perhaps as many as 100 million! Notes Barry, mentioned earlier: “Influenza killed more people in a year than the Black Death of the Middle Ages killed in a century; it killed more people in twenty-four weeks than AIDS has killed in twenty-four years.”

Incredibly, the Spanish flu killed more Americans in about a year than died in battle in both world wars combined. Author Gina Kolata explains: “If such a plague came today, killing a similar fraction of the U.S. population, 1.5 million Americans would die, which is more than the number felled in a single year by heart disease, cancers, strokes, chronic pulmonary disease, AIDS, and Alzheimer’s disease combined.”

To put matters succinctly, the Spanish flu was the most devastating pandemic in the history of mankind. What help came from science?

When Science Proved Helpless

By the beginning of World War I, medical science had seemingly made great strides in conquering disease. Even during the war, doctors took great pride in their success at reducing the effects of infectious diseases. At the time, The Ladies Home Journal declared that American homes no longer needed a room for laying out the dead for viewing. It suggested that such parlors henceforth be called living rooms. But then came the Spanish flu, and medical science proved almost totally helpless.

Crosby writes: “All the physicians of 1918 were participants in the greatest failure of medical science in the twentieth century or, if absolute numbers of dead are the measure, of all time.” Lest the blame be placed entirely on the medical profession, Barry makes this point: “Back then scientists fully comprehended the threat’s magnitude, knew how to cure many secondary bacterial pneumonias, and gave public-health advice that would have saved tens of thousands of American lives. Politicians ignored that advice.”

So now, about 85 years later, what has been learned about this terrible pandemic? What caused it? Could it come back? Could it be fought successfully if it did? Some of the answers may surprise you.

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The majority of those who died of the Spanish flu were between 20 and 40 years of age

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A school class of 1919, Canon City, Colorado, U.S.A.

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Courtesy, Colorado Historical Society, 10026787

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A police officer

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Photo by Topical Press Agency/Getty Images

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Baseball players wearing protective masks

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© Underwood & Underwood/CORBIS

Influenza​—What We Know Now

IT IS 1997. A scientist sits in the small Eskimo village of Brevig on the frozen tundra of the Seward Peninsula of Alaska. In front of him is the exhumed body of a young woman that he and four Eskimo helpers have dug out of the permafrost. She fell victim to the flu back in 1918 and has lain there, frozen, ever since.

What good can come from examining her now? The scientist hopes that the flu-causing agent is still in her lungs and that through the use of advanced genetic techniques, it can be isolated and identified. Why might that knowledge prove helpful? To answer, we need to understand a little more about how viruses work and what makes them so dangerous.

A Virus That Can Be Deadly

Today we know that influenza is caused by a virus and that it can be spread from person to person in respiratory secretions expelled by coughing, sneezing, and talking.a It is present worldwide even in the Tropics, where it can strike year-round. In the Northern Hemisphere, flu season runs from November to March; and in the Southern Hemisphere, from April to September.

Influenza type A, the most dangerous type of flu virus, is small in size compared with many viruses. It is usually spherical, with projections from its surface. When this virus infects a human cell, it reproduces so rapidly that often within about ten hours, a swarm of between 100,000 and a million new influenza virus “copies” explode from the cell.

The scary characteristic of this simple organism is its ability to change quickly. Because the virus reproduces so rapidly (far faster than the HIV virus), its many “copies” are not exact. Some are different enough to escape the immune system. That is why we face different flu viruses every year, which present a new set of antigens​—substances that test our immunity. If the antigen changes sufficiently, our immune system has little defense against it and there is risk of a pandemic.

Furthermore, flu viruses also infect animals, and therein lies a problem for humans. The pig, it is believed, can be a host for viruses that infect such birds as chickens and ducks. But it can also be the host for other viruses that infect humans.

Therefore, if a pig becomes infected by both types of viruses​—one sort that infects animals and another sort common to humans—​the genes of the two strains can get mixed together. The result can be a totally new strain of influenza, one to which humans have no immunity. Some feel that farming communities where poultry, swine, and people live in close proximity​—as is often the case in Asia, for example—​are likely sources of new flu strains.

Why Did It Become So Virulent?

The question is, What could have caused the flu virus of 1918-19 to turn into a pneumonia-causing killer of young people? Though none of the live virus is left from that time, scientists have long felt that if they could find a frozen specimen of it, they might be able to isolate intact RNA and discover what made this strain so lethal. Actually, to some extent they have succeeded.

Thanks to the frozen Alaskan specimen described at the outset of this article, a team of scientists has been able to identify and sequence most of the genes of the 1918-19 flu virus. However, scientists have still not figured out what caused that flu to be such a killer. Apparently, though, this strain was a relative of a flu virus that infects both pigs and birds.

Could It Come Back?

According to many experts, it is not a question of if such a vicious flu virus will return but of when and how it will return. In fact, some expect a significant new influenza outbreak every 11 years or so and a severe one approximately every 30 years. According to these predictions, mankind is overdue for another pandemic.

The medical journal Vaccine reported in 2003: “It has been 35 years since the last influenza pandemic, and the longest interval between pandemics recorded with certainty is 39 years.” The article continued: “The pandemic virus may emerge in China or a nearby country and could include surface antigens or virulence factors derived from animal influenza viruses.”

The Vaccine article predicted concerning the virus: “It will spread rapidly throughout the world. Several waves of infection will occur. Morbidity will be extensive in all age groups, and there will be widespread disruption of social and economic activity in all countries. Excess mortality will be evident in most if not all age groups. It is unlikely that health care systems in even the most economically developed countries will be able to adequately cope with the demand for health care services.”

Just how alarming is such a scenario? John M. Barry, author of the book The Great Influenza, provides this perspective: “A terrorist with a nuclear weapon is every national politician’s nightmare. A new influenza pandemic should be.”

What Treatments Are Available?

You may ask, ‘Aren’t there effective treatments now?’ The answer involves both good news and bad. Antibiotics can cut the mortality from secondary bacterial pneumonias, and certain medications can be effective against some flu strains. There are immunizations that can be helpful in combating a flu virus if the correct strains of it are identified and if the immunizations can be produced in time. Such is the good news. The bad?

The history of flu immunizations​—from the ill-fated swine flu episode of 1976 to the production shortage of 2004—​has been spotty. Even though medical science has realized momentous advancements since World War I, doctors still do not know of any cure for a powerful virus.

Hence, there is this disquieting question: Could there be a repeat of 1918-19? Note what is said in a paper from London’s National Institute for Medical Research: “In some ways, conditions prevail as they did in 1918: there is a huge volume of international travel due to the development of transport, there are a number of war-zones with their inherent problems of malnutrition and poor hygiene, the world population has grown to six and a half billion and a greater proportion of this population is living in urban situations many of which have decaying infrastructures in terms of waste disposal.”

Concludes a well-respected U.S. authority: “Put simply, each year brings us closer to the next pandemic.” Does all this mean, though, that the future is bleak, even hopeless? No!

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New flu strains can get their start in farming communities

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BAY ISMOYO/AFP/Getty Images

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Influenza type A virus

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Researchers have examined specimens of the 1918-19 virus

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© TOUHIG SION/CORBIS SYGMA