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BOOK REVIEW

A timely account of the 1918 flu pandemic

("The Great Influenza: The Epic Story of the Greatest Plague in History; By John M. Barry; Viking, 546 pp. illustrated, $29.95.)

The flu season started early last fall, with deaths being reported before many people even thought about getting their shots. By the time they did, there were warnings of a vaccine shortage. Now comes February, the peak month for what the Centers for Disease Control calls "influenza activity." Even in a non-epidemic season, the CDC estimates that 36,000 Americans will die from influenza.

All this, plus recent reports of avian flu spreading through Southeast Asian chicken flocks, reaching the United States, and beginning to infect humans, makes John M. Barry's "The Great Influenza," a sobering account of the 1918 flu epidemic, compelling and timely.

The 1918 pandemic took a staggering toll -- worldwide, 50 million to 100 million lives; in the United States, 675,000. More people died from mid-September to early December in 1918 than have died of AIDS in its 24-year scourge, Barry notes.

When the flu struck in 1918, it was killing, Barry writes, "in some new and awful way." As an internal Red Cross report put it, the flu spread "a fear and panic . . . akin to the terror of the Middle Ages regarding the Black Plague." Barry's descriptions of the disease's ravages are gruesome.

Barry's is the second major book dealing with the 1918 pandemic in the past five years. The earlier one -- which, curiously, Barry does not cite -- by New York Times science reporter Gina Kolata, focused on the still ongoing scientific research into its cause.

Barry, on the other hand, is a historian -- his book "Rising Tide," an account of the 1927 Mississippi flood, won the Francis Parkman Prize -- and the great strengths of his latest book lie in its accounts of the epidemic's origin, its devastating spread through US Army training camps, and its impact on civilian life.

While many flu viruses, this season's included, originate in Asia, Barry offers a persuasive argument that the 1918 epidemic began, mysteriously, in rural Haskell County, Kansas, early that year. "Evidence further suggests," Barry writes, "that this virus traveled east across the state to a huge army base."

At Camp Devens in Ayer, as an Army report put it, "the influenza . . . occurred as an explosion." On a single day in September, 1,543 men reported ill with influenza.

The situation was similar at other camps -- at Camp Custer in Michigan, 2,800 troops reported ill in one day; at Camp Grant in Illinois, more than 100 men died in a single day in October, and the camp's commander killed himself as the toll passed 500.

Initially, the Army refused to stop shipping troops from one camp to another or overseas on troop ships that became death ships. When the Army's provost marshal canceled the October draft order, Barry writes, "he did so only because he recognized that the disease was utterly overwhelming and creating total chaos in the cantonments."

Inevitably, the disease spread into the civilian population. As Barry writes, "The war had come home."

"It was a common practice in 1918," Barry writes, "for people to hang a [ribbon] of crepe on the door to mark a death in the house. There was crepe everywhere." In Philadelphia -- where 254 people died on Oct. 5 and 289 the next day -- a man said that on one street, it "looked like every other house had crepe over the door."

In Washington, a man remembered, "it kept people apart. . . . People were afraid to kiss one another, people were afraid to eat with one another, they were afraid to have anything that made contact because that's how you got the flu." A New Haven man, recalling "the same isolating fear," wrote that when someone fell sick, instead of family and friends "bringing food over. . . . nobody was coming in, nobody would bring food in, nobody came to visit."

Barry criticizes the press for its failure to report what was happening. He cites a number of instances when a newspaper reported the onset of influenza in another state or city, but did not report deaths in its own city. "As terrifying as the disease was," Barry writes, "the press made it worse. They terrified by making little of it, for what officials and the press said bore no relationship to what people saw and touched and smelled and endured."

It would seem improbable to see the 1918 pandemic, as Barry does, as "a case study" with lessons for the present. After all, we now have vaccines, which did not exist in 1918 -- even if they must await the appearance of a virus to be created. And medical reporting is now responsible and hard-hitting. Still, the CDC estimates that in a new epidemic with a virus as deadly as that of in 1918, the US death toll "will most likely fall between 89,000 and 300,000."

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