THE THIN WHITE LINE: the history of a future avian influenza pandemic

Chapter 3: Pandemic

Not the first time

    The Pandemic did not herald the end of the world or the break-up of civilization. The world, in fact, had suffered through influenza pandemics many times before in its history, with the most dramatic epidemic on record occurring less than 100 years ago.
    Hippocrates, the Greek physician who created the Hippocratic Oath, documented what may have been the earliest recorded influenza epidemic in 400 B.C. at Perinthus in northern Greece.
    In 212 B.C., the famed historian Livy described an infectious disease afflicting the Roman Army, which is believed to have been influenza. Ebn-al-Atir described a severe epidemic that devastated Central Asia and Persia in 855-56 A.D. In 1580 A.D., the first recorded pandemic swept through Asia and Europe, and then traveled to North America. In 1729-32, the Russian Flu spread throughout Russia and Europe. In 1789, a major influenza epidemic occurred in New England, New York and Nova Scotia. In the 1800s, three pandemics began in China and crossed the globe in 1830-31, 1836-37 and 1889-90.
    The twentieth century saw three major pandemics. In 1918-19, the Spanish Flu killed 40 to 100 million people around the world. In 1957-58, the Asian Flu (A/H2N2) killed covered the globe within six months and killed about two million people. In 1968-69, the Hong Kong Flu (A/H3N2) killed about a million.
    The world had suffered through pandemics before, and so had Canada.

    In 1918-19, the Spanish Flu burned its way through the world’s population of two billion in less than two years, killing more people than died in combat among the 19 nations involved in five years of fighting during World War I.
    More than 620,000 Canadians served in the war. More than 66,000 of them died and more than 170,000 were wounded in the battles of Ypres, the Somme, Vimy Ridge and other important engagements.
    It was a time for heroes. Canadian flying ace Billy Bishop shot down 72 German planes and once launched a single-handed attack on the German aerodrome at Arras, earning the Distinguished Flying Cross and the Victoria Cross. At Vimy Ridge, where the British and French had failed, the Canadians succeeded in storming fortified German positions on a hill and captured them. During the Battle of Ypres, poison gas, used for the first time in warfare, drove the French from their positions; the Canadians stood their ground against machine-gun fire, bombardment and poison gas, holding the line until reinforcements arrived. And a Canadian doctor, Lieutenant Colonel John McCrae, wrote his stirring poem, "In Flanders Fields," and began a tradition of remembrance that lasts to this day.
    At home, it was a time of change and unrest. A shortage of volunteers caused the conscription crisis of 1917. In December of that year, a Belgian ship collided with a French munitions ship and exploded, destroying most of nearby Halifax. The provinces began granting voting rights to women between 1916 and 1918. The following years saw violent labor struggles. There were too many soldiers coming home, too few jobs for them.
    Overall, more than 17 million people died during five years of fighting during World War I. As the war was ending, however, an even bigger threat loomed——the Spanish Flu, which followed in the wake of mass troop movements during the war, and ravaged the armies on both sides of the trenches. In fact, the Spanish Flu may have played a decisive role in ending the conflict; it is believed that the flu dramatically weakened the German Army and caused its last great western offensive to fail in 1918, bringing the war to a close.
    In the spring of 1918, Spain, a neutral power, did not have wartime censorship and so was the first to report the epidemic that subsequently became known as the Spanish Flu, the Indian Flu, the Naples Soldier and other names around the world. The flu, however, was thought to originate in Canton, China, although the first recorded cases occurred at a U.S. Army base in Kansas. At first, the flu seemed mild, although millions caught it, eight million in Spain alone, including King Alphonso XIII.
    As summer turned to fall, it turned deadly. The flu burned its way through every continent except Antarctica. Doctors were helpless against the scourge. Public authorities shut down public places such as churches and theaters. Some even passed laws against sneezing in public. People wore gauze masks in public. Wherever the flu struck, people displayed the best and worst of human nature——courage, charity, fear and prejudice.
    In October, the epidemic peaked in the U.S. and Canada. About a thousand Canadians were dying every day. Then the number of cases declined until the Spanish Flu disappeared the following July.
    Some 30,000 to 50,000 Canadians out of a population of 8.2 million died from the flu. Below the border, 22 million Americans got sick and more than 675,000 died out of a population of 103.2 million. As a result of the Spanish Flu, the average life expectancy of Americans dropped by 10-13 years.

The Spanish Flu influenza pandemic of 1918-19 claimed more lives worldwide than all combat-related deaths during the five years of World War I. In Canada, governments tried to halt the flu with business closings and other ordinances. Here, a street car conductor refuses to allow a passenger aboard because he is not wearing a mask. The Avian Flu virus turned out to be as virulent a pathogen as the Spanish Flu.(64)

    Globally, the Spanish Flu killed 40 to 100 million people, or up to five percent of the world’s population of two billion.
    About one billion caught it.
    Based on today’s population, this is the equivalent of more than three billion people catching it and 130 to 320 million people dying.
    History, as it turned out once again, has a way of repeating itself.