Book Review: Flu by Gina Kolata - Rice University



Book Review: Flu by Gina Kolata

This book begins by describing the 1918 influenza epidemic that killed an estimated 20 to 100 million people worldwide during the fall and winter of 1918. This particular strain of the flu was known as the Spanish Flu since it was first seen in the spring of 1918 in Spain. It struck young healthy people around the world in a matter of months. The flu would begin with typical flu like symptoms that could then become pneumonia and killed 2.5 percent of people who contracted it. That is twenty-five percent more deadly than the average strain of influenza. Public health departments attempted to prevent further spreading by passing out gauze masks to people. It appeared all over the world and decimated some populations, including Eskimos and Western Samoans.

Since the 1918 flu killed millions, countries around the world have feared further epidemics and in 1976 fears of an outbreak of 1918 flu caused an unprecedented vaccination program. It was discovered in 1928 that the 1918 flu and swine flu were closely related strains of influenza (possibly the same) by Dr. Richard Shope. He found that swine flu occurring in pigs caused similar symptoms and the antibodies of swine flu were found in those who survived the 1918 flu. Then in 1976, four men were found to have swine flu at Fort Dix in New Jersey. One man died as a result and scientists began to worry that another outbreak of the 1918 flu could occur due to swine flu. Therefore, it was decided by President Gerald Ford, after consultation with many researchers, that a large-scale vaccination program would begin in the US, in an attempt to vaccinate 200 million Americans for swine flu. In the beginning, the public backed the program, but as dissenting doctors and scientists came forward, public support dropped. Insurance companies refused to insure the drug companies against lawsuits for swine flu. This forced the federal government to agree to accept liability. This was later regretted when the flu seemed to cause a rare neurological disease, Guillan-Barre Syndrome. The backlash was large and the program was stopped. In the end, more than 3000 people filed lawsuits against the federal government, complaining that the swine flu vaccine caused Guillan-Barre Syndrome and in some cases other diseases. The court cases were difficult because it is hard to ascertain if the vaccine had caused the disease or if it was just coincidental. The 1976 vaccination program is now a cautionary tale of whether or not large-scale vaccination is necessary.

This is much like when we studied the process of adopting vaccines and the problems associated with them. No trials were conducted for the swine flu vaccine and it was administered to a large portion of the population. The surveillance by the CDC found the possible causal effect of the swine flu vaccine, leading to the end of the program. As with the Rotavirus vaccine, the benefits of the vaccine did not outweigh the problems and thus, the vaccine was no longer administered. A vaccine for the 1918 flu has still not been developed, but if it were developed, the 1976 fiasco would make the US government more cautious before initiating widespread vaccinations again. The 1918 flu was devastating, if it were to hit today in the US, it would kill more people than heart disease, cancers, strokes, chronic pulmonary disease, AIDS and Alzheimer’s disease combined yet many today are unaware that this epidemic even occurred (Kolata 7).

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