What do you think?
Rate this book
Influenza: The Hundred Year Hunt to Cure the Deadliest Disease in History
On the 100th anniversary of the devastating pandemic of 1918, Jeremy Brown, a veteran ER doctor, explores the troubling, terrifying, and complex history of the flu virus, from the origins of the Great Flu that killed millions, to vexing questions such as: are we prepared for the next epidemic, should you get a flu shot, and how close are we to finding a cure. Influenza is an enlightening and unnerving look at a shapeshifting deadly virus.
391 pages, Library Binding
First published December 18, 2018
530 people are currently reading
3765 people want to read
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 30 of 275 reviews
February 10, 2020
Influenza is a quick, interesting read on the history of the flu, where we are today in our fight against it, and how prepared we are should an epidemic strike in the future. I always enjoy a medical science book, and this one's no different. I come away from this having learned so much about this common disease that has killed countless throughout history and continues to do so today. It feels like a particularly appropriate time to read this book as the world is currently dealing with the Coronavirus outbreak.
There are many fascinating tidbits in this book, including what made the 1918 pandemic so deadly, and the often inverse relationship between how widespread an outbreak is and how deadly it is. The most relevant piece of information I gleaned is that not getting enough sunlight and too low humidity could contribute to the flu's uptick in the winter months. It's a good reminder to keep active and spend time outdoors, even and in particular during the coldest and darkest days of the year.
There are many fascinating tidbits in this book, including what made the 1918 pandemic so deadly, and the often inverse relationship between how widespread an outbreak is and how deadly it is. The most relevant piece of information I gleaned is that not getting enough sunlight and too low humidity could contribute to the flu's uptick in the winter months. It's a good reminder to keep active and spend time outdoors, even and in particular during the coldest and darkest days of the year.
January 4, 2019
Simply perfect. Not only does he inform but he also is honest. Actually, he is the most honest medical doctor to express his knowledge and a condition in print that I have come across yet. And I read medical as a group- both public deemed and "in group" heavy textbook criteria testing. In this field especially, I've read dozens over the years since 1976.
This book is absolutely the best of those which core the topic of the disease that has killed more humans than any other. More than plague, more than all the bacterial past plagues. And more than all the wars and conflicts combined. Many more. And not only in 1918.
What makes it the best is that he tells you exactly what isn't known. Much! But also tells you in precise detail the theories. There have been dozens and dozens. From sun spot and weather related theories- all the way to Vitamin D absorption levels per month per year.
But beyond the treatments given in the past, the theories and tests, the secondary diseases of demise just post-flu, the location of greatest wave returns, the stats in dozens of charting dependables to age, exposures, other criteria (100's) at the times of largest peaks, etc. etc. etc. Beyond all of that- he does immense criteria and analysis to the anti-flu current RX's- especially within the Tamiflu groups. And also for the governmental deposits of "waiting for the next" and what that costs. Way, way, way more than any border wall or security feature to invasion, homicide, property demolitions, violence to helpless, etc. And most of it is just thrown away.
Also, he details all the USA presidential history (especially under Gerald Ford and the crisis of 1976) and also for the 2009 peak year and for the years until 2017/18.
Excellent book. And his writing is excellent. Clear. Using all the medical terms but put into context so the least savvy will understand. Most of it, they will. Plus he admits the huge dichotomies of advice. Like the governmental "We know this does not work, but do it anyway" that has been the core prime of most recent years.
This review may be longer than I'd hope. But it's important. Read this book. For cultural reasons too- as different places do deal with real flu quite differently. It's a disease of the non-tropical regions of the Earth. Yes, it changes. Yes, it has intersect with birds, mammals at times. No, it's not going to be cured by antibiotics, like a bacterium can be.
I'm a witness. I had the flu H1N1(swine intersect) in 1976. Very early first wave, against the peak, in summer. And I don't remember 3 whole days. I had the Last Rites and my kidneys stopped working. But I had two little kids and knew I couldn't go for any reason. But I remember very well not being able to open my eyes because they were so glued shut with dried mucus. And fighting to suck in air. My brother got me to a hospital and it saved my life.
So this book was enthralling to me. And I'll think of that poor Private and all the samples used below the permafrost in Alaska (can you imagine being only 8 people left out of nearly 90!!).
The beginning of what was done to save that young mother (exact same age as when I had it too)- that starts this book off! Read that, if nothing else. It's particularly deadly to those in the 25-34 age bracket.
All reads come together. This one coupled a read I just completed last summer about how poorly testing is done now. The exact same mouse groups in insufficient numbers was cited and examined here too. All the reasons posited here, just exactly as the other sciences that are heralding "consensus" and publishing for job promotion. Consensus and science are opposite quantities by their very core onus.
You CAN have a flu in a milder form. So many unanswered questions are asked. He asks they all.
Excellent, excellent book.
One last stat that has been PROVEN to conclude. If your team NFL in North America goes to the Superbowl- YOUR HOME CITY will then have an increase in 18% flu deaths that next month (February/ March of the same year). Not to the people who WENT to the Superbowl either, but to those elders to which they brought home the virus. It has played that way for the last 20 years.
SO- do I want the Bears to win Sunday in the playoffs or not now?
This book is absolutely the best of those which core the topic of the disease that has killed more humans than any other. More than plague, more than all the bacterial past plagues. And more than all the wars and conflicts combined. Many more. And not only in 1918.
What makes it the best is that he tells you exactly what isn't known. Much! But also tells you in precise detail the theories. There have been dozens and dozens. From sun spot and weather related theories- all the way to Vitamin D absorption levels per month per year.
But beyond the treatments given in the past, the theories and tests, the secondary diseases of demise just post-flu, the location of greatest wave returns, the stats in dozens of charting dependables to age, exposures, other criteria (100's) at the times of largest peaks, etc. etc. etc. Beyond all of that- he does immense criteria and analysis to the anti-flu current RX's- especially within the Tamiflu groups. And also for the governmental deposits of "waiting for the next" and what that costs. Way, way, way more than any border wall or security feature to invasion, homicide, property demolitions, violence to helpless, etc. And most of it is just thrown away.
Also, he details all the USA presidential history (especially under Gerald Ford and the crisis of 1976) and also for the 2009 peak year and for the years until 2017/18.
Excellent book. And his writing is excellent. Clear. Using all the medical terms but put into context so the least savvy will understand. Most of it, they will. Plus he admits the huge dichotomies of advice. Like the governmental "We know this does not work, but do it anyway" that has been the core prime of most recent years.
This review may be longer than I'd hope. But it's important. Read this book. For cultural reasons too- as different places do deal with real flu quite differently. It's a disease of the non-tropical regions of the Earth. Yes, it changes. Yes, it has intersect with birds, mammals at times. No, it's not going to be cured by antibiotics, like a bacterium can be.
I'm a witness. I had the flu H1N1(swine intersect) in 1976. Very early first wave, against the peak, in summer. And I don't remember 3 whole days. I had the Last Rites and my kidneys stopped working. But I had two little kids and knew I couldn't go for any reason. But I remember very well not being able to open my eyes because they were so glued shut with dried mucus. And fighting to suck in air. My brother got me to a hospital and it saved my life.
So this book was enthralling to me. And I'll think of that poor Private and all the samples used below the permafrost in Alaska (can you imagine being only 8 people left out of nearly 90!!).
The beginning of what was done to save that young mother (exact same age as when I had it too)- that starts this book off! Read that, if nothing else. It's particularly deadly to those in the 25-34 age bracket.
All reads come together. This one coupled a read I just completed last summer about how poorly testing is done now. The exact same mouse groups in insufficient numbers was cited and examined here too. All the reasons posited here, just exactly as the other sciences that are heralding "consensus" and publishing for job promotion. Consensus and science are opposite quantities by their very core onus.
You CAN have a flu in a milder form. So many unanswered questions are asked. He asks they all.
Excellent, excellent book.
One last stat that has been PROVEN to conclude. If your team NFL in North America goes to the Superbowl- YOUR HOME CITY will then have an increase in 18% flu deaths that next month (February/ March of the same year). Not to the people who WENT to the Superbowl either, but to those elders to which they brought home the virus. It has played that way for the last 20 years.
SO- do I want the Bears to win Sunday in the playoffs or not now?
July 6, 2019
"Flu is certainly not the “emperor of all maladies” as cancer was described by the oncologist Siddhartha Mukherjee, but it is the malady of all empires."
This short but informative book about influenza encompasses everything from its history and its impact to the role pharmaceutical companies and the government have played in the pursuit to find an effective vaccine or cure. I found this fascinating. Dr. Brown writes so that layman can understand but also doesn’t shy away from using medical vernacular when necessary.
I particularly found the portion on tamiflu interesting as I worked in a doctor’s office years ago and during flu season every patient would beg for this (and research shows that it has very little affect on the flu). Also, the impact the flu has on an economy (both positive and negative) surprised me as I never thought about that before, but it made sense.
I highly recommend this for science buffs, history lovers, and anyone interested in learning about something we've all experienced.
I received an advanced copy through Netgalley in return for an honest review.
This short but informative book about influenza encompasses everything from its history and its impact to the role pharmaceutical companies and the government have played in the pursuit to find an effective vaccine or cure. I found this fascinating. Dr. Brown writes so that layman can understand but also doesn’t shy away from using medical vernacular when necessary.
I particularly found the portion on tamiflu interesting as I worked in a doctor’s office years ago and during flu season every patient would beg for this (and research shows that it has very little affect on the flu). Also, the impact the flu has on an economy (both positive and negative) surprised me as I never thought about that before, but it made sense.
I highly recommend this for science buffs, history lovers, and anyone interested in learning about something we've all experienced.
I received an advanced copy through Netgalley in return for an honest review.
December 21, 2025
There are worse books about flu. As an American ER doctor from the UK, the author provides some perspective and asks some questions that don't occur to other writers, like "why do we insist on giving everyone flu shots when other countries don't do that?" He also goes into the fuzziness of some of the factoids we have all heard about flu, e.g. tracking how many people have flu. There are one or two good magazine articles in here.
Nerd addendum:
Unfortunately, the author expands way beyond his clear circle of expertise and there it seems like he got tired of asking questions and merely repeated received nonsense.
Just to give one example: the 1976 epidemic of Guillain-Barre syndrome accompanying the Swine Flu vaccination program. He quotes the CDC director who got fired over the scandal defending his actions, and the CDC website making it sound like maybe there's a link between the flu shot and GBS and maybe not. He does not reference the Institute of Medicine report on the matter or the primary research articles in big journals like JAMA that show strong evidence for a causal link between the 1976 vaccine and GBS. In this context, he goes on a long rant about not assuming causality for potential side effects that are going to happen anyway by coincidence like heart attacks in old people. Fair enough. But then he should have explained how the GBS evidence is not like that, but he didn't. And he should have applied that level of rigor to the arguments for flu vaccination, but he didn't. He cites the Japanese coincidence study, which even the CDC flu experts wrote critical letters to NEJM about at the time, as if it were reasonable evidence for the benefits of mass vaccination.
As far as a book covering similar ground, I would recommend:Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients , and for the 1976 Swine Flu: The Epidemic That Never Was: Policy-Making and the Swine Flu Scare
Nerd addendum:
Unfortunately, the author expands way beyond his clear circle of expertise and there it seems like he got tired of asking questions and merely repeated received nonsense.
Just to give one example: the 1976 epidemic of Guillain-Barre syndrome accompanying the Swine Flu vaccination program. He quotes the CDC director who got fired over the scandal defending his actions, and the CDC website making it sound like maybe there's a link between the flu shot and GBS and maybe not. He does not reference the Institute of Medicine report on the matter or the primary research articles in big journals like JAMA that show strong evidence for a causal link between the 1976 vaccine and GBS. In this context, he goes on a long rant about not assuming causality for potential side effects that are going to happen anyway by coincidence like heart attacks in old people. Fair enough. But then he should have explained how the GBS evidence is not like that, but he didn't. And he should have applied that level of rigor to the arguments for flu vaccination, but he didn't. He cites the Japanese coincidence study, which even the CDC flu experts wrote critical letters to NEJM about at the time, as if it were reasonable evidence for the benefits of mass vaccination.
As far as a book covering similar ground, I would recommend:Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients , and for the 1976 Swine Flu: The Epidemic That Never Was: Policy-Making and the Swine Flu Scare
October 15, 2019
Lekko napisana i poruszająca szeroki wachlarz tematów z zakresu medycyny, jej historii, chemii, polityki czy socjologii. Tym wartościowsza, że pisana przez lekarza.
January 12, 2020
After having read Very, Very, Very Dreadful: The Influenza Pandemic of 1918, I was hungry for more books about this piece of history, so I picked this one up. I should have known from the title that it would be more about the flu in general, rather than the 1918 outbreak. Brown mostly talks about treatments for the flu, the efforts to learn about particular strains, tracking and predicting flu outbreaks, and the funding and research that goes into finding a cure. It's all presented in an interesting way, so I don't regret reading it. But I'm less interested in infectious diseases as a topic and more interested in the history of the 1918 flu itself. This is not that book. For what it is, it’s well written. So I can’t penalize it for not being the book I wanted it to be.
Where do I go for a history-focused study on this? Perhaps I'll pick these up next:
Pale Rider: The Spanish Flu of 1918 and How it Changed the World
America's Forgotten Pandemic: The Influenza of 1918
The Great Influenza: The Story of the Deadliest Pandemic in History
Flu: The Story Of The Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It
Read this review of Brown's book: https://www.goodreads.com/review/show...
Where do I go for a history-focused study on this? Perhaps I'll pick these up next:
Pale Rider: The Spanish Flu of 1918 and How it Changed the World
America's Forgotten Pandemic: The Influenza of 1918
The Great Influenza: The Story of the Deadliest Pandemic in History
Flu: The Story Of The Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It
Read this review of Brown's book: https://www.goodreads.com/review/show...
November 7, 2019
Whether you're looking for a historical account of the 1918 Spanish flu pandemic or some information about the influenza virus or the current state of medical research you can probably find something better elsewhere. This book tries to cover those areas and largely fails to combine them in a worthwhile way.
Dr. Brown writes well when describing medical information such as the workings of the immune system (early chapters); he's much less successful as a historian (the account of the 1918 pandemic); and he's fully unsuccessful as a social critic (his account of predictive flu models was dull filler).
A third of the way into the book I found myself speed reading to get through the material and checking the kindle to see how many pages (locations actually) before the end of the chapter. That's just never a good sign. I may be wrong but some of the material in the book seemed contradictory. One example that stands out is Brown's claim that excessively high doses of aspirin may have caused so many deaths in 1918 whereas he later, I think, offered other reasons. (I know I'm being unhelpfully vague but I just don't have the energy to go back into the book to prove my point.)
Brown raises questions about the necessity of vaccinating healthy adults (he doesn't claim the flu vaccine is harmful, only that it can be a poor match for the virus in circulation and not cost effective) but doesn't settle the matter. I didn't find the discussion helpful or interesting and I will continue to get my annual vaccination.
Dr. Brown writes well when describing medical information such as the workings of the immune system (early chapters); he's much less successful as a historian (the account of the 1918 pandemic); and he's fully unsuccessful as a social critic (his account of predictive flu models was dull filler).
A third of the way into the book I found myself speed reading to get through the material and checking the kindle to see how many pages (locations actually) before the end of the chapter. That's just never a good sign. I may be wrong but some of the material in the book seemed contradictory. One example that stands out is Brown's claim that excessively high doses of aspirin may have caused so many deaths in 1918 whereas he later, I think, offered other reasons. (I know I'm being unhelpfully vague but I just don't have the energy to go back into the book to prove my point.)
Brown raises questions about the necessity of vaccinating healthy adults (he doesn't claim the flu vaccine is harmful, only that it can be a poor match for the virus in circulation and not cost effective) but doesn't settle the matter. I didn't find the discussion helpful or interesting and I will continue to get my annual vaccination.
July 3, 2020
W obliczu trwającej pandemii ta książka napisana w 2018 nabiera nowego wydźwięku. Jest to bardzo solidna, napisana przez lekarza, analiza tego, co wiemy o grypie (w uogólnieniu także o wirusach), jaki mamy arsenał do walki z nią, jak możemy przewidywać i przygotowywać się na kolejne ataki, a także jaki grypa ma aspekt ekonomiczny (czy polityczny). Czyli wszystko to, co teraz obserwujemy na żywo, choć wcale byśmy nie chcieli.
April 28, 2020
In the middle of a crisis, it's difficult to find reasoned thought, careful reflection, scientific data. I'm happy I was able to find this book, published just two years ago, but far enough away from the current pandemic to feel ominously prescient.
It is comforting to be able to read a history of the flu in the world, to hear facts and data from past pandemics, to look at research, to see that politics and economics have always had a bearing on actions taken.
It is comforting to be able to read a history of the flu in the world, to hear facts and data from past pandemics, to look at research, to see that politics and economics have always had a bearing on actions taken.
July 16, 2025
Whenever one picks up a book about the 1918 pandemic — prepare to be disappointed. So much was unknown at the time and is still unknown.
This book is more about modern approaches to seasonal flu, the varying approaches to vaccination and so on. There are many pages about the anti-viral drug "Tamiflu" — which appears not to be very useful but is often prescribed and is massively stockpiled. (Dr. Brown does also discuss the "business" aspects of medicine).
This book was written for 2018, one-hundred years after the 1918 pandemic, and as you may recall — since then we had another little pandemic shooting around the world and disrupting daily lives. That intervening event adds another layer to this book, which warns we are unprepared, and outlines all the ways that lack of preparation can go wrong. Comparing these predictions to what just happened was particularly interesting for me; perhaps we will always react to a pandemic in a haphazard, confused, and contradictory manner.
Rounding up to 3 stars, because the predictive power here was strong.
This book is more about modern approaches to seasonal flu, the varying approaches to vaccination and so on. There are many pages about the anti-viral drug "Tamiflu" — which appears not to be very useful but is often prescribed and is massively stockpiled. (Dr. Brown does also discuss the "business" aspects of medicine).
This book was written for 2018, one-hundred years after the 1918 pandemic, and as you may recall — since then we had another little pandemic shooting around the world and disrupting daily lives. That intervening event adds another layer to this book, which warns we are unprepared, and outlines all the ways that lack of preparation can go wrong. Comparing these predictions to what just happened was particularly interesting for me; perhaps we will always react to a pandemic in a haphazard, confused, and contradictory manner.
Rounding up to 3 stars, because the predictive power here was strong.
April 5, 2020
Won this book from Goodreads giveaway program - thank you Goodreads!
I recently read Richard Preston's take on the ebola epidemic of 2014, and now to win this one - wow.
But how timely, both books. This one, with latest statistics from 2019, is almost prescient re. how the 'Spanish flu' of 1918 compares to what is happening today. The same old things: quarantines, stay home if you can, don't spit in public - okay we don't have to tell people that anymore, do we? - and the conflict between people, public health, and the politics involved, are all eerily similar. With the flu of 1918 bacteria were understood to cause disease; viruses were still unknown. But the fact that people were told - or ordered - to wear masks in public, and that getting together in large groups wasn't smart, that much is oh-so-sadly the same. (A parade in Philadelphia as the flu was warming up tragically showed what the results can be when large groups gather when the flu 'bug' festers.)
Takeaways: info on the nation's stockpile, with the author being oh-so-reassuring in that these exist when local or state supplies run out. Huh? (I write this on April 5, 2020). He even documents where the stockpiles are located and to some extent, what's in each. (Well this is news to me.) But along with a history of flu, and how we've dealt with it over the decades, the history of vaccination, and how if about 40% of us are vaccinated we can more or less protect the whole herd - illuminating.
And though Covid-19 and the Spanish Flu are really two diff. 'birds,' the fact is that both wear feathers, can infect us as easily as breathing air, and each must be taken so seriously...
(Did you hear that, folks - seriously!)
...are only few ways these two pandemics are/were so tragically alike.
Four stars.
I recently read Richard Preston's take on the ebola epidemic of 2014, and now to win this one - wow.
But how timely, both books. This one, with latest statistics from 2019, is almost prescient re. how the 'Spanish flu' of 1918 compares to what is happening today. The same old things: quarantines, stay home if you can, don't spit in public - okay we don't have to tell people that anymore, do we? - and the conflict between people, public health, and the politics involved, are all eerily similar. With the flu of 1918 bacteria were understood to cause disease; viruses were still unknown. But the fact that people were told - or ordered - to wear masks in public, and that getting together in large groups wasn't smart, that much is oh-so-sadly the same. (A parade in Philadelphia as the flu was warming up tragically showed what the results can be when large groups gather when the flu 'bug' festers.)
Takeaways: info on the nation's stockpile, with the author being oh-so-reassuring in that these exist when local or state supplies run out. Huh? (I write this on April 5, 2020). He even documents where the stockpiles are located and to some extent, what's in each. (Well this is news to me.) But along with a history of flu, and how we've dealt with it over the decades, the history of vaccination, and how if about 40% of us are vaccinated we can more or less protect the whole herd - illuminating.
And though Covid-19 and the Spanish Flu are really two diff. 'birds,' the fact is that both wear feathers, can infect us as easily as breathing air, and each must be taken so seriously...
(Did you hear that, folks - seriously!)
...are only few ways these two pandemics are/were so tragically alike.
Four stars.
February 1, 2020
Really interesting and slightly scary especially considering the current looming threat of a corona virus pandemic. I was fascinated to learn that the oft stated theory of flu coming in winter because people are inside, close together has been scientifically debunked and that at least some of the scientifically proven explanations involve Vitamin D deficiency and the ability of the flu virus to transmit better in cold, dry air.
Popsugar Reading Challenge 2020: A medical thriller
Popsugar Reading Challenge 2020: A medical thriller
March 14, 2021
I found this book very informative and interesting. As an ER doctor with experience in two countries, it enables Brown to compare various national responses. Not that it looks at the topic solely from a medical perspective. He covers a wide range of effects that the 1918 flu pandemic is still having on our lives: political, economic, and cultural.
Large sections of it cover the various theories that surround the flu both past and present. Brown does a good job of clear and fairly presenting them.
If you are looking for a book about the modern fight against the flu and its history, this would be a good book to start with.
Large sections of it cover the various theories that surround the flu both past and present. Brown does a good job of clear and fairly presenting them.
If you are looking for a book about the modern fight against the flu and its history, this would be a good book to start with.
May 11, 2020
---- Disclosure: I received this book for free from Goodreads. ----
Will complete the review later, but for now I'll say I can't recommend this. It's already out-of-date. Enough so that the epilogue needs to be re-written. Also, he is reckless when it comes to Vitamin D, & quite obviously behind the research. Additionally, some of the things he claims in 1 portion of the book are contradicted by what he claims in a later portion. I'm not referring to conflicting studies or sources here. I mean what he specifically claims can not be true in one section he later claims to be a definite issue. There are a few other things, but I will address it all later. Reviews like this that require a significant effort on my part b/c the author didn't do thorough work really get under my skin, so it's wise I don't go straight into them right after I've concluded the reading.
Given the current climate, I think it would be a really bad idea to go forward with publishing this book right now; irresponsible, even. With some (not insignificant) changes it could be a good product, & it's my opinion that the better option for every involved party would be to post-pone publication. I know better than to think that will happen, but my recommendation remains unchanged. ----- A more complete review will follow at a later date.
March 30, 2020
I fell asleep while listening to the last two chapters of this book, but I don't want to go back to see what I missed. I think, then, its a bit obvious how I felt about this book.
I feel like the author was stepping out of his area of expertise and, while I'm very sure that he researched everything he said, it still felt like a lot of what was said within the book was opinion based. He didn't go into depth on flu vaccines, for example, giving neither side the benefit of clear explanation and being a bit confusing as to what side he was on specifically. A lot of little things like that or the chapter-long tirade about Tamiflu just made the book feel jumbled and confusing.
Of course, there was also the biggest pet peeve I have towards medical history books in this book as well. It might not be a thing that grates on other people's nerves as much as mine. Still, I tend to devalue an author's opinion when they break out the classic "those remedies of the 19th century, like bloodletting, were so very barbaric" and "but why would they ever continue using a remedy that proved not to work????". The author was also perplexed as to why quinine would be used as a treatment for the 1918 flu pandemic. It's a small thing, but it shows how little regard they have towards the past. People of the 19th century kept using those remedies because they didn't have anything else. Acting as if the people of the 21rst century are so advanced is going to look arrogant to people in the future. It already looks arrogant, especially since the author continues to say that our modern flu remedies haven't advanced much past those of the 1918 flu pandemic.
That may be something others can look past, however, especially if you aren't as familiar with the history of medicine, hence why I gave this book two stars. There were some good things to this book, of course, or else I wouldn't have made it this far into it. It was interesting, for example, to see how the author did bring his expertise of being an ER doctor into the narrative. It was interesting to see the history of the flu and the way we treat it compared to the practical, on the spot treatment of it in the ER, and it helped to highlight the difficulties of tracking the flu and its spread. On top of that, amidst the 2020 COVID-19 pandemic, it's interesting to see an opinion of future flu pandemics before our current pandemic even happened and how obvious it was to many people that another pandemic would eventually occur.
All in all, I wouldn't recommend this book, since I feel like many others accomplishing what this book does well without all of the negative aspects. But I can't stop you from reading this, and I don't think this book is the worst out there.
I feel like the author was stepping out of his area of expertise and, while I'm very sure that he researched everything he said, it still felt like a lot of what was said within the book was opinion based. He didn't go into depth on flu vaccines, for example, giving neither side the benefit of clear explanation and being a bit confusing as to what side he was on specifically. A lot of little things like that or the chapter-long tirade about Tamiflu just made the book feel jumbled and confusing.
Of course, there was also the biggest pet peeve I have towards medical history books in this book as well. It might not be a thing that grates on other people's nerves as much as mine. Still, I tend to devalue an author's opinion when they break out the classic "those remedies of the 19th century, like bloodletting, were so very barbaric" and "but why would they ever continue using a remedy that proved not to work????". The author was also perplexed as to why quinine would be used as a treatment for the 1918 flu pandemic. It's a small thing, but it shows how little regard they have towards the past. People of the 19th century kept using those remedies because they didn't have anything else. Acting as if the people of the 21rst century are so advanced is going to look arrogant to people in the future. It already looks arrogant, especially since the author continues to say that our modern flu remedies haven't advanced much past those of the 1918 flu pandemic.
That may be something others can look past, however, especially if you aren't as familiar with the history of medicine, hence why I gave this book two stars. There were some good things to this book, of course, or else I wouldn't have made it this far into it. It was interesting, for example, to see how the author did bring his expertise of being an ER doctor into the narrative. It was interesting to see the history of the flu and the way we treat it compared to the practical, on the spot treatment of it in the ER, and it helped to highlight the difficulties of tracking the flu and its spread. On top of that, amidst the 2020 COVID-19 pandemic, it's interesting to see an opinion of future flu pandemics before our current pandemic even happened and how obvious it was to many people that another pandemic would eventually occur.
All in all, I wouldn't recommend this book, since I feel like many others accomplishing what this book does well without all of the negative aspects. But I can't stop you from reading this, and I don't think this book is the worst out there.
May 9, 2020
This is an excellent short examination of the flu epidemic of 1918 and an exploration of the current state of flu treatment and vaccination. The author is an emergency room physician, born in the United Kingdom and now living and practicing in the United States. I like the way he is able to compare the US vs the UK in dealing with annual flu outbreaks. The UK doesn't vaccinate everyone over 6 months of age like we try to in the US, and there seems to be little effect on outcome either way.
The author's writing style does an excellent job of imparting information without being textbook-dry, which I really appreciate. There are some things that have relevance to our current Covid-19 pandemic. For example, Philadelphia had a war bonds rally at the time the flu was just breaking out and because of the crowds at the event many people were infected and later died. Other cities which banned large public events had much less disease and fewer deaths. A lesson we would do well to pay attention to now.
The author's writing style does an excellent job of imparting information without being textbook-dry, which I really appreciate. There are some things that have relevance to our current Covid-19 pandemic. For example, Philadelphia had a war bonds rally at the time the flu was just breaking out and because of the crowds at the event many people were infected and later died. Other cities which banned large public events had much less disease and fewer deaths. A lesson we would do well to pay attention to now.
June 27, 2019
In Influenza: The Hundred Year Hunt to Cure the Deadliest Disease in History, Dr jeremy Brown looks at influenza from many different angles - history and why the 1918 flu was so deadly, the likelihood of another similar pandemic, market responses from the Pharmaceutical companies and their efficacy, government responses including warehousing stockpiles of anti-influenza medications, and the value of the flu vaccine and who, if anyone, should get it. The book is fairly short but it is interesting, well-written, well-documented, and in language that makes it accessible to people like myself with no medical background in the subject.
Thanks to Edelweiss+ and Atria Books for the opportunity to read this book in exchange for an honest review
Thanks to Edelweiss+ and Atria Books for the opportunity to read this book in exchange for an honest review
July 25, 2021
The dark history of influenza
It was a global pandemic at a scale never seen in hundreds of years. It was believed to have been originated in North China, which predated the general outbreaks in Europe and America by few months. And the disease “was found in the spray and mucus from the throat, nose, and mouth. It could be spread through droplet infection by sneezing and coughing, and by hand-to-mouth contact.”
Despite the striking similarities, this, of course, was not Covid-19, but the 1918 influenza pandemic. It was dubbed the worst influenza pandemic in recorded history, infected around 500 million people (about one third of the total population back then) where it is estimated that between 50 and 100 million people died.
So, what happened? According to the author, Dr. Jeremy Brown, the experts have settled on 4 explanations for why so many people died in that pandemic:
1. The virus had a protein on its surface that prevented the production of interferons, which normally functioned to signal our immune system that our body have been attacked. Then healthy lung cells that transfers oxygen into the bloodstream are hijacked by the penetrating virus which destroyed them and replaced them with dull fibrous ones that are incapable of transporting oxygen.
2. With the patients’ bodies weakened and their lungs damaged, they caught bacterial infections such as staphylococcus or streptococcus which were deadly in this era before antibiotics. This is what the experts believed to be the main cause of the majority of deaths in the 1918, not from the flu virus itself but from these secondary infections.
3. The flu virus triggered an overreactive immune response that turned the body against itself. Normally, a wound causes an inflammation (necessary to fight infections) and the inflammation is mediated by other kind of messenger protein called cytokines. And once the infection is healed, our cells stop producing cytokines and our immune system returns to its normal state. But in many of 1918 flu victims, the return to normal didn’t happen and instead their lungs suffer from “cytokines storm”, an overproduction of these messenger proteins, which in turn destroy healthy cells along with invading ones. When the cytokines storm strikes, the immune system spirals out of control.
4. The rapid spread of the virus is due to living arrangements at the time, where people were living in tenements or barracks due to war, working-class families shared beds, soldiers slept side by side.
Attacking the lungs? cytokines storm? We might as well change the label to Covid-19 and the symptoms wouldn’t be out of place.
So what did they do to cure it? The immediate prevention measures tick all the contemporary boxes: wearing mask, social distancing, while businesses, schools and theatres were shut down. The book then shows the gruesome “remedies” for the flu pandemic, the trial and errors that would make us think that we’re sure glad to live in a more modern time. Remedies such as bloodletting, enemas, a shot of mercury, enormous dose of quinine, etc that are not only worthless in curing flu but also dangerous (bloodletting was the same procedure that killed George Washington).
Moreover, we often take for granted all the progresses that have happened in history, since a procedure as trivial as consuming aspirin to cure our flu symptoms can have deadly side effects during the 1918 pandemic, as back then doctors still haven’t figure out the safe dosage of aspirin that we should consume, hence people weren’t only dying from the flu but a lot died due to aspirin overdozed.
But eventually, the pandemic was over after 2 years and 3 waves, and the world proceeded to have the Roaring Twenties. So what cured it? Here’s the harsh truth, the pandemic was over because people who got infected either died or developed immunity. It became endemic. In other words, it was simply due to herd immunity that was developed over 2 years and not from a super cure that emerged to save the day. A rather anti-climactic ending, don’t you think?
This is where the book, written in 2018, then switches into a more technical elaboration that focuses on the 100 years of evolution of medicine since that 1918 pandemic and the journey to once and for all attempt to cure the disease of influenza. Now it is almost impossible to summarise every discovery in this review, but the following are the most important and relevant ones.
So, a virus is a box of chemicals that does not have the structures of a basic cell. They have no mitochondria (so they cannot make energy), they have no ribosomes (so they cannot build proteins), they lack lysosomes (which get rid of waste and toxins), they cannot metabolise, they cannot replicate on their own. So in order to reproduce, they must invade living cells. Viruses infects bacteria and plants, birds, fish, reptiles, and mammals.
While viruses do not target cells specifically to kill them, the mechanism where they hijack a cell and use it as a reproducing machine might injure, weaken, or destroy the cells as a collateral damage. In fact, if a virus is too lethal, it can destroy the host cells before they can even be used to create viral copies. This mechanism is the same for every virus, no matter how differ they are in the level of deadliness, from common flu to HIV to ebola.
According to Dr. Brown, in the discovery of the anatomy of viruses, “[w]e are especially interested in one particular family of viruses that has the clumsiest name: the orthomyxoviruses. Ortho means “straight,” in Greek, and myxa means “mucus.” The straight-mucus family of viruses includes influenza. Actually, there are three influenza viruses—they go by A, B, and C. Only the A and B strains cause significant disease in humans, and it is the A strain that is responsible for pandemic flu.”
Furthermore, if a mammalian strain and a bird strain of influenza hijack the same cell at the same time, their genes can mix to create an entirely new kind of virus that can turn deadly. This is exactly what happened in 1918 and in Hong Kong 1997, where birds contributed to parts of the influenza virus. While at first, the virus could only infect those who directly handled birds and could not be transmitted from one person to another, it would take only a small mutation for the virus to gain that ability, setting the stage for a new influenza pandemic.
And that is the key word, mutation.
But do not fret just yet, because our immune systems have evolved to prevent and contain the attacks from viruses, bacteria, and other foreign pathogens. The 1st line of defense consists of cells called phagocytes, which operates as a kind of traffic police that are always on patrol. Once they detect pathogens in our system they will envelop them and pull them inside the cell (where the pathogen will be obliterated). Dr. Brown explains, “Phagocytes do not target specific bacteria or viruses. Rather, they have been programmed in our genetic code to recognize pathogens in general. We are born with this innate immunity, and the phagocytes require no prior contact with a pathogen to search for, recognize, and destroy it.”
The 2nd line of our defense are the antigen-presenting cells, which target specific viruses or bacteria. While the 1st line is like a traffic police, this 2nd one is like detectives, they profile a suspect, they digest the pathogen and present some of its building blocks (such as a receptor or protein) to another type of immune cell called a helper T cell. These T cells then proliferate in huge numbers and use the pathogen profile to target the corresponding invader. Dr. Brown elaborates that “[e]ven years after a first encounter with a pathogen, T cells remember their old foe and spring into action. That’s why most of us get chicken pox only once. Our first encounter with the virus produces T cells that are forever on guard in the future.”
Indeed, the immune system does not care how the pathogen entered the body, as it will generate the same immune response regardless whether it came through the normal course of events or through a needle as a weakened form of vaccine. And after that the body is able to fight a similar invader more quickly and effectively the next time around, while if the antigen is new we may still produce antibodies against it but the process is slower and we become sicker for longer as our body adapts.
And that lies the core problem for influenza. The influenza virus throws a wrench into our immune system because it is a shape-shifter. It frequently changes the proteins on its surface, making it difficult for our existing antibodies to identify them. This is why we can catch the flu more than once, why the virus is almost impossible to eradicate, and this so-called “antigenic drift” is also why the flu vaccine needs to be updated every year (remember the key word, mutation).
In addition, there is a larger change that the virus can undergo, dubbed the “antigenic shift”, and this is how we get a flu pandemic. During antigenic shift viral proteins assume an entirely new structure and then the virus will become “novel.” (As in the case of novel coronavirus 2019). These novel viruses are most often arise when human and animal viruses share and swap their genes, and they emerge like entirely new criminals and not old one in disguise, which makes them more undetectable, more sneakier, more prolific, and potentially more deadly.
Antigenic shift generated the 1918 influenza virus and the swine flu outbreak of 2009, where the inflammation caused by the influenza virus can spillover to other problems, or the virus could attack the already existing disease(s) in our body, such as pneumonia, and make them worse by leading to a lung failure, kidney failure, and eventually multiple organ failures that culminated at the death of the patient.
And as Dr. Brown repeatedly mentioned in the book, it is not over yet. The battle against influenza has not been won, and another pandemic like 1918 was just around the corner because the virus itself never really go away and constantly mutating. Well, we now know what happen next in late 2019 and early 2020, with today in 2021 the “double mutation” delta variant is creating a new wave once again.
It was a global pandemic at a scale never seen in hundreds of years. It was believed to have been originated in North China, which predated the general outbreaks in Europe and America by few months. And the disease “was found in the spray and mucus from the throat, nose, and mouth. It could be spread through droplet infection by sneezing and coughing, and by hand-to-mouth contact.”
Despite the striking similarities, this, of course, was not Covid-19, but the 1918 influenza pandemic. It was dubbed the worst influenza pandemic in recorded history, infected around 500 million people (about one third of the total population back then) where it is estimated that between 50 and 100 million people died.
So, what happened? According to the author, Dr. Jeremy Brown, the experts have settled on 4 explanations for why so many people died in that pandemic:
1. The virus had a protein on its surface that prevented the production of interferons, which normally functioned to signal our immune system that our body have been attacked. Then healthy lung cells that transfers oxygen into the bloodstream are hijacked by the penetrating virus which destroyed them and replaced them with dull fibrous ones that are incapable of transporting oxygen.
2. With the patients’ bodies weakened and their lungs damaged, they caught bacterial infections such as staphylococcus or streptococcus which were deadly in this era before antibiotics. This is what the experts believed to be the main cause of the majority of deaths in the 1918, not from the flu virus itself but from these secondary infections.
3. The flu virus triggered an overreactive immune response that turned the body against itself. Normally, a wound causes an inflammation (necessary to fight infections) and the inflammation is mediated by other kind of messenger protein called cytokines. And once the infection is healed, our cells stop producing cytokines and our immune system returns to its normal state. But in many of 1918 flu victims, the return to normal didn’t happen and instead their lungs suffer from “cytokines storm”, an overproduction of these messenger proteins, which in turn destroy healthy cells along with invading ones. When the cytokines storm strikes, the immune system spirals out of control.
4. The rapid spread of the virus is due to living arrangements at the time, where people were living in tenements or barracks due to war, working-class families shared beds, soldiers slept side by side.
Attacking the lungs? cytokines storm? We might as well change the label to Covid-19 and the symptoms wouldn’t be out of place.
So what did they do to cure it? The immediate prevention measures tick all the contemporary boxes: wearing mask, social distancing, while businesses, schools and theatres were shut down. The book then shows the gruesome “remedies” for the flu pandemic, the trial and errors that would make us think that we’re sure glad to live in a more modern time. Remedies such as bloodletting, enemas, a shot of mercury, enormous dose of quinine, etc that are not only worthless in curing flu but also dangerous (bloodletting was the same procedure that killed George Washington).
Moreover, we often take for granted all the progresses that have happened in history, since a procedure as trivial as consuming aspirin to cure our flu symptoms can have deadly side effects during the 1918 pandemic, as back then doctors still haven’t figure out the safe dosage of aspirin that we should consume, hence people weren’t only dying from the flu but a lot died due to aspirin overdozed.
But eventually, the pandemic was over after 2 years and 3 waves, and the world proceeded to have the Roaring Twenties. So what cured it? Here’s the harsh truth, the pandemic was over because people who got infected either died or developed immunity. It became endemic. In other words, it was simply due to herd immunity that was developed over 2 years and not from a super cure that emerged to save the day. A rather anti-climactic ending, don’t you think?
This is where the book, written in 2018, then switches into a more technical elaboration that focuses on the 100 years of evolution of medicine since that 1918 pandemic and the journey to once and for all attempt to cure the disease of influenza. Now it is almost impossible to summarise every discovery in this review, but the following are the most important and relevant ones.
So, a virus is a box of chemicals that does not have the structures of a basic cell. They have no mitochondria (so they cannot make energy), they have no ribosomes (so they cannot build proteins), they lack lysosomes (which get rid of waste and toxins), they cannot metabolise, they cannot replicate on their own. So in order to reproduce, they must invade living cells. Viruses infects bacteria and plants, birds, fish, reptiles, and mammals.
While viruses do not target cells specifically to kill them, the mechanism where they hijack a cell and use it as a reproducing machine might injure, weaken, or destroy the cells as a collateral damage. In fact, if a virus is too lethal, it can destroy the host cells before they can even be used to create viral copies. This mechanism is the same for every virus, no matter how differ they are in the level of deadliness, from common flu to HIV to ebola.
According to Dr. Brown, in the discovery of the anatomy of viruses, “[w]e are especially interested in one particular family of viruses that has the clumsiest name: the orthomyxoviruses. Ortho means “straight,” in Greek, and myxa means “mucus.” The straight-mucus family of viruses includes influenza. Actually, there are three influenza viruses—they go by A, B, and C. Only the A and B strains cause significant disease in humans, and it is the A strain that is responsible for pandemic flu.”
Furthermore, if a mammalian strain and a bird strain of influenza hijack the same cell at the same time, their genes can mix to create an entirely new kind of virus that can turn deadly. This is exactly what happened in 1918 and in Hong Kong 1997, where birds contributed to parts of the influenza virus. While at first, the virus could only infect those who directly handled birds and could not be transmitted from one person to another, it would take only a small mutation for the virus to gain that ability, setting the stage for a new influenza pandemic.
And that is the key word, mutation.
But do not fret just yet, because our immune systems have evolved to prevent and contain the attacks from viruses, bacteria, and other foreign pathogens. The 1st line of defense consists of cells called phagocytes, which operates as a kind of traffic police that are always on patrol. Once they detect pathogens in our system they will envelop them and pull them inside the cell (where the pathogen will be obliterated). Dr. Brown explains, “Phagocytes do not target specific bacteria or viruses. Rather, they have been programmed in our genetic code to recognize pathogens in general. We are born with this innate immunity, and the phagocytes require no prior contact with a pathogen to search for, recognize, and destroy it.”
The 2nd line of our defense are the antigen-presenting cells, which target specific viruses or bacteria. While the 1st line is like a traffic police, this 2nd one is like detectives, they profile a suspect, they digest the pathogen and present some of its building blocks (such as a receptor or protein) to another type of immune cell called a helper T cell. These T cells then proliferate in huge numbers and use the pathogen profile to target the corresponding invader. Dr. Brown elaborates that “[e]ven years after a first encounter with a pathogen, T cells remember their old foe and spring into action. That’s why most of us get chicken pox only once. Our first encounter with the virus produces T cells that are forever on guard in the future.”
Indeed, the immune system does not care how the pathogen entered the body, as it will generate the same immune response regardless whether it came through the normal course of events or through a needle as a weakened form of vaccine. And after that the body is able to fight a similar invader more quickly and effectively the next time around, while if the antigen is new we may still produce antibodies against it but the process is slower and we become sicker for longer as our body adapts.
And that lies the core problem for influenza. The influenza virus throws a wrench into our immune system because it is a shape-shifter. It frequently changes the proteins on its surface, making it difficult for our existing antibodies to identify them. This is why we can catch the flu more than once, why the virus is almost impossible to eradicate, and this so-called “antigenic drift” is also why the flu vaccine needs to be updated every year (remember the key word, mutation).
In addition, there is a larger change that the virus can undergo, dubbed the “antigenic shift”, and this is how we get a flu pandemic. During antigenic shift viral proteins assume an entirely new structure and then the virus will become “novel.” (As in the case of novel coronavirus 2019). These novel viruses are most often arise when human and animal viruses share and swap their genes, and they emerge like entirely new criminals and not old one in disguise, which makes them more undetectable, more sneakier, more prolific, and potentially more deadly.
Antigenic shift generated the 1918 influenza virus and the swine flu outbreak of 2009, where the inflammation caused by the influenza virus can spillover to other problems, or the virus could attack the already existing disease(s) in our body, such as pneumonia, and make them worse by leading to a lung failure, kidney failure, and eventually multiple organ failures that culminated at the death of the patient.
And as Dr. Brown repeatedly mentioned in the book, it is not over yet. The battle against influenza has not been won, and another pandemic like 1918 was just around the corner because the virus itself never really go away and constantly mutating. Well, we now know what happen next in late 2019 and early 2020, with today in 2021 the “double mutation” delta variant is creating a new wave once again.
December 3, 2018
HOW do you review a book like this? I could absolutely do a term paper on this book and with a little more research and a few more notes [than what I already took], I could write a research paper on this book. But a review for Goodreads and NetGalley? THAT will be a little more difficult. So I am going to give it my best attempt [and I am sure this will be edited quite a bit while I am writing it] and I will hope for the best.
I will say to start, that this was one of the best books I have read in a long time, and one of the best-written nonfiction books I have read this year [Educated by Tara Westover is also one of the best-written books I have read as well]. This is not some dry, textbook-like tome. This book is full of facts and information yes, but there is also humor [which was unexpected] and optimism, which was also unexpected. The author doesn't shy away from unpopular opinions and speaks both what he sees as truth and believes to be truth, based on the exhaustive research he has done on this subject. I learned things I never knew [like what ECMO means - I have heard that in medical shows on TV all the time but had NO IDEA what it stood for {extracorporeal membrane oxygenation - basically, the heart/lung machine}], and confirmed things I had known [bloodletting IS bad!!] all along.
This book also gave me facts that blew my mind - in the 1918 Pandemic, it is estimated that between 50 - 100 million people died; 675,000 in the US alone [which is 10x as many as died in the Great War {that was just ending when the Pandemic broke out}]. And should an Pandemic of this level happen today, the estimate of death is close to 2 million people in the US alone. Those numbers are numbing and horrifying. To quote the book, "One hundred years after the pandemic of 1918, we have learned an enormous amount about influenza. We know its genetic code [And THAT is a great chapter in this book; how they are able to do this is absolutely fascinating], how it mutates, and how it makes us sick, and yet we still don't have effective ways to fight it. The antiviral medications we have are pretty useless, and the flu vaccine is a poor defense. In good year it is effective only half the time, and in 2018 the record was even worse; the vaccine was only effective in about one-third of those who received it [or about 20%]."
If you are a pessimist, you will believe that there will be another pandemic like the one of 1918. If you are an optimist, you believe that our defenses are well enough placed to ward off a pandemic, though there could still be some problems. And if you are a realist, like the author, you believe a little of both. With all the information given here, it will be quite some time before I am sure what I believe and where I lie on that spectrum.
There is BIG business and money in Influenza though and so the vaccines go on, even with the knowledge that they consistently do not work. There is HUGE money in the antivirals [the chapter on that will absolutely blow your mind], again with the knowledge that they consistently [and is proven] do not work. And we the public are bombarded with information that is has little truth to it but is touted as gospel and I think that is the biggest take from this book that scares me the most. Because ultimately, the very people we think that would help save us should a pandemic happen, have very little clue on how to actually DO that. They know how and where and why, but the treatment has and continues to baffle them. To quote the book again: "The impulse to do something, to react in the face of catastrophe, is a common theme in our fight against influenza." And that, is where the problem truly lies.
A VERY good read, one I recommend people to find and read themselves. We will never move forward without the masses themselves educating themselves about issues like this and making the best informed decision for themselves and not just what the government is telling them is truth and what to believe.
Thank you to NetGalley and Touchstone Publishing for providing this ARC in exchange for an honest review.
I will say to start, that this was one of the best books I have read in a long time, and one of the best-written nonfiction books I have read this year [Educated by Tara Westover is also one of the best-written books I have read as well]. This is not some dry, textbook-like tome. This book is full of facts and information yes, but there is also humor [which was unexpected] and optimism, which was also unexpected. The author doesn't shy away from unpopular opinions and speaks both what he sees as truth and believes to be truth, based on the exhaustive research he has done on this subject. I learned things I never knew [like what ECMO means - I have heard that in medical shows on TV all the time but had NO IDEA what it stood for {extracorporeal membrane oxygenation - basically, the heart/lung machine}], and confirmed things I had known [bloodletting IS bad!!] all along.
This book also gave me facts that blew my mind - in the 1918 Pandemic, it is estimated that between 50 - 100 million people died; 675,000 in the US alone [which is 10x as many as died in the Great War {that was just ending when the Pandemic broke out}]. And should an Pandemic of this level happen today, the estimate of death is close to 2 million people in the US alone. Those numbers are numbing and horrifying. To quote the book, "One hundred years after the pandemic of 1918, we have learned an enormous amount about influenza. We know its genetic code [And THAT is a great chapter in this book; how they are able to do this is absolutely fascinating], how it mutates, and how it makes us sick, and yet we still don't have effective ways to fight it. The antiviral medications we have are pretty useless, and the flu vaccine is a poor defense. In good year it is effective only half the time, and in 2018 the record was even worse; the vaccine was only effective in about one-third of those who received it [or about 20%]."
If you are a pessimist, you will believe that there will be another pandemic like the one of 1918. If you are an optimist, you believe that our defenses are well enough placed to ward off a pandemic, though there could still be some problems. And if you are a realist, like the author, you believe a little of both. With all the information given here, it will be quite some time before I am sure what I believe and where I lie on that spectrum.
There is BIG business and money in Influenza though and so the vaccines go on, even with the knowledge that they consistently do not work. There is HUGE money in the antivirals [the chapter on that will absolutely blow your mind], again with the knowledge that they consistently [and is proven] do not work. And we the public are bombarded with information that is has little truth to it but is touted as gospel and I think that is the biggest take from this book that scares me the most. Because ultimately, the very people we think that would help save us should a pandemic happen, have very little clue on how to actually DO that. They know how and where and why, but the treatment has and continues to baffle them. To quote the book again: "The impulse to do something, to react in the face of catastrophe, is a common theme in our fight against influenza." And that, is where the problem truly lies.
A VERY good read, one I recommend people to find and read themselves. We will never move forward without the masses themselves educating themselves about issues like this and making the best informed decision for themselves and not just what the government is telling them is truth and what to believe.
Thank you to NetGalley and Touchstone Publishing for providing this ARC in exchange for an honest review.
August 2, 2020
Fascinating history on influenza! He does a great job of looking at the view from all aspects (medically, financially, how it affects the economy and impacts or reactions across the world). Especially interesting because of everything happening with COVID. He shares in the book that a major pandemic like the 1918 would happen soon and holy smokes it did. Loved the perspective and research he was able to give. Can’t wait to see what he writes about COVID!
November 27, 2018
Here's an idea: on the 100-year anniversary of the Spanish flu pandemic, a history of the flu written by an actual doctor. In this case, a medical doctor who actually has seen perhaps hundreds of cases of the flu himself provides an interestingly unique viewpoint. He's also a good writer.
Although the title and marketing of this book might lead you to believe it is about the 1918 pandemic, it really isn't.
It is about influenzas generally, and travels back and forth in time (without being at all confusing) from the author's present-day experience as an ER doctor to about 430 BC, when Thucydides made what is probably the oldest written record of an influenza-like outbreak. However, if you are going to write a history of influenzas generally, the 1918 pandemic is going to loom large in the narrative, and it does here.
Since I teach English, I think more about what words mean than the average clam, and this book made me realize that I have been, to my deep pedagogical shame, using the words epidemic and pandemic interchangeably. In my defense, I can only repeat information in this book, that is, The New York Times has publicly admitted that the definition depends largely on who is speaking. Furthermore, the author says, “[n]o one really agrees on exact meanings” (Kindle location 450).
The author continues:
I found the ending to be less than completely pleasing. In it, the author sets up two straw man arguments -- optimists and pessimists -- and then knocks them down before declaring himself to be a “realist”. It's hard to fault someone for being a realist, but I don't think he demonstrated that people who hold different views from his are somehow not “realists”.
After declaring himself a realist, the author says that the 1918 flu epidemic does not loom large enough in our collective memory, and suggests that a new memorial be built here in Washington DC in honor of those who died. It's hard to object to a memorial without appearing hard-hearted, but I think the city is already starting to experience monument overload. I don't see a monument having much of an effect other than perhaps making us feel good for a moment. Better history education would be a better solution, but better education is difficult and expensive. Still, accept no substitutes.
I received a free electronic advance review copy of this book via Netgalley and Simon & Schuster.
Although the title and marketing of this book might lead you to believe it is about the 1918 pandemic, it really isn't.
It is about influenzas generally, and travels back and forth in time (without being at all confusing) from the author's present-day experience as an ER doctor to about 430 BC, when Thucydides made what is probably the oldest written record of an influenza-like outbreak. However, if you are going to write a history of influenzas generally, the 1918 pandemic is going to loom large in the narrative, and it does here.
Since I teach English, I think more about what words mean than the average clam, and this book made me realize that I have been, to my deep pedagogical shame, using the words epidemic and pandemic interchangeably. In my defense, I can only repeat information in this book, that is, The New York Times has publicly admitted that the definition depends largely on who is speaking. Furthermore, the author says, “[n]o one really agrees on exact meanings” (Kindle location 450).
The author continues:
The most useful definition we have is that an epidemic is a severe local outbreak, while a pandemic is a global outbreak that makes people very sick, and spreads rapidly from a point of origin.New topic: toward the end of the book, there is quite a bit of interesting information about those villains at large pharmaceutical companies stirring up a sense of panic among the population in order to get bureaucrats and lawmakers to buy an expensive load of flu vaccine for emergency stockpiles.
I found the ending to be less than completely pleasing. In it, the author sets up two straw man arguments -- optimists and pessimists -- and then knocks them down before declaring himself to be a “realist”. It's hard to fault someone for being a realist, but I don't think he demonstrated that people who hold different views from his are somehow not “realists”.
After declaring himself a realist, the author says that the 1918 flu epidemic does not loom large enough in our collective memory, and suggests that a new memorial be built here in Washington DC in honor of those who died. It's hard to object to a memorial without appearing hard-hearted, but I think the city is already starting to experience monument overload. I don't see a monument having much of an effect other than perhaps making us feel good for a moment. Better history education would be a better solution, but better education is difficult and expensive. Still, accept no substitutes.
I received a free electronic advance review copy of this book via Netgalley and Simon & Schuster.
January 25, 2019
The 1918 epidemic has always held a fascination for me so I have read pretty much any book around on the subject. This one only touches on it lightly. It is written by a doctor and each chapter details a period of history and the effects that influenza epidemics had on the people, also the treatments etc. It got a bit dry towards the end with stats and whatnot. What was truly interesting was the politics and financial dealings around so call 'cures' for influenza. For example, he talks about antiviral medications such as Tamiflu which when it came out was heavily advertised as a wonder cure for the flu. So much so the US government stockpiled it. Further investigation by unbiased researchers in the following years shows that Tamiflu only lessen the flu by less than one day. But it is still prescribed and is extremely expensive. I guess someone is making money. Ironically this book arrived at my library just one week after I recovered from a month long bout of H1N1 influenza which is rife in my city at the moment. I had a flu shot but the virus got me. They are sneaky little things.
March 27, 2020
Great synopsis on Flu. Excellent mix of science and history. Very quick and easy to read/listen to. Perfect timing to read while under lockdown on COVID19. Full of interesting information about history of influenza, pandemics, vaccines, and even the ways we treat/treated flu.
April 6, 2020
Dr. Jeremy Brown, an ER doctor from the USA, explores the history of the Influenza virus. Its complications, the devastation that it caused in the past up to recent times claiming millions of lives and the race to create the ultimate cure to defeat the disease once and for all.
The purpose of this book is to provide insight into the Influenza virus and similar zoonotic diseases so we could be conscious of our unreadiness for another occurrence of epidemic or pandemic disease judging by the response that we have on past outbreaks.
I have included this on one of my next-read lists during this isolation considering its similarity on the current pathogen that stricken the world at the moment. I want to be enlightened with facts and not just mere guesswork prompted by emotional stress.
Such a terrifying crisis evokes various emotional reactions due to self-preservation instincts. This book reveals, indeed, that historically fatal and contagious disease causes panic and fear that leads to speculations and reliance on bizarre cures and treatments.
One of the conjectures made, as mentioned in this book, that the flu virus diminish during the summer season. Medical science could not possibly find the correlation except that one of their theory was that sunlight exposure grants us Vitamin D necessary for the enhancement of our immune response.
They also have a theory of close contact contagion during winter where the causal factor is that since it is often freezing, people tend to crowd together to beat the chilling season. Getting together in a confined space would be a perfect environment for contagion.
Theories materialized also in our own time of crisis which is now circulating online. They have this conjecture that the virus would die down when the summer season arrives. Experts have no scientific evidence to prove that based on the empirical facts provided by this book. It just does not work in that manner. The virus is just complex in nature and difficult to predict.
Hence, one of the challenging factors by medical professionals in finding a vaccine on the Influenza virus was its ability to mutate so quickly. Frustration arises when a vaccine was already developed and it turned out to be a mismatch because it had already mutated itself. I pray that such a dreaded scenario will not befall in the search of COVID-19 vaccine.
The impacts of a pandemic have a uniform pattern since time immemorial. One of its devastating impacts is the serious economic consequence that comes with it. There is always a catch, and we cannot have the best of both worlds. It is rather grueling to find a solution that would both save the economy and protect the citizens at the same time. But there is always an option, however, to strike a balance as much as possible.
Mankind has reached heights in terms of medical advancement. We have reached the peak of modernity. Be that as it may, the ingenuity of these pathogens still outmatches us despite our cunnings. We just lack the awareness of its enormity not until at present and we have learned it, unfortunately, also at our own peril.
This book implies that the response system in times of an outbreak is outdated and the budget for advance research for pathogens is a pittance. Experts have warned us of an outbreak now and again but it fell on deaf ears. Another 1918 pandemic is just a matter of time, warned Dr. Brown, and it already landed on our shores and arrived on our doorsteps.
This book is so appropriate in this dark time. How can we utilize our time constructively in this lockdown except by gaining insights on the history of these pathogens? Being aware might perhaps influence future policies or it might bear our interest to urge our children to consider the calling of being an epidemiologist. This book is highly recommended at a times like this.
The purpose of this book is to provide insight into the Influenza virus and similar zoonotic diseases so we could be conscious of our unreadiness for another occurrence of epidemic or pandemic disease judging by the response that we have on past outbreaks.
I have included this on one of my next-read lists during this isolation considering its similarity on the current pathogen that stricken the world at the moment. I want to be enlightened with facts and not just mere guesswork prompted by emotional stress.
Such a terrifying crisis evokes various emotional reactions due to self-preservation instincts. This book reveals, indeed, that historically fatal and contagious disease causes panic and fear that leads to speculations and reliance on bizarre cures and treatments.
One of the conjectures made, as mentioned in this book, that the flu virus diminish during the summer season. Medical science could not possibly find the correlation except that one of their theory was that sunlight exposure grants us Vitamin D necessary for the enhancement of our immune response.
They also have a theory of close contact contagion during winter where the causal factor is that since it is often freezing, people tend to crowd together to beat the chilling season. Getting together in a confined space would be a perfect environment for contagion.
Theories materialized also in our own time of crisis which is now circulating online. They have this conjecture that the virus would die down when the summer season arrives. Experts have no scientific evidence to prove that based on the empirical facts provided by this book. It just does not work in that manner. The virus is just complex in nature and difficult to predict.
Hence, one of the challenging factors by medical professionals in finding a vaccine on the Influenza virus was its ability to mutate so quickly. Frustration arises when a vaccine was already developed and it turned out to be a mismatch because it had already mutated itself. I pray that such a dreaded scenario will not befall in the search of COVID-19 vaccine.
The impacts of a pandemic have a uniform pattern since time immemorial. One of its devastating impacts is the serious economic consequence that comes with it. There is always a catch, and we cannot have the best of both worlds. It is rather grueling to find a solution that would both save the economy and protect the citizens at the same time. But there is always an option, however, to strike a balance as much as possible.
Mankind has reached heights in terms of medical advancement. We have reached the peak of modernity. Be that as it may, the ingenuity of these pathogens still outmatches us despite our cunnings. We just lack the awareness of its enormity not until at present and we have learned it, unfortunately, also at our own peril.
This book implies that the response system in times of an outbreak is outdated and the budget for advance research for pathogens is a pittance. Experts have warned us of an outbreak now and again but it fell on deaf ears. Another 1918 pandemic is just a matter of time, warned Dr. Brown, and it already landed on our shores and arrived on our doorsteps.
This book is so appropriate in this dark time. How can we utilize our time constructively in this lockdown except by gaining insights on the history of these pathogens? Being aware might perhaps influence future policies or it might bear our interest to urge our children to consider the calling of being an epidemiologist. This book is highly recommended at a times like this.
December 31, 2020
This book was published in 2018 at the 100th anniversary of the 1918 flu pandemic (the Spanish flu). I have read it shortly after it was published and read it again this year in light of the current pandemic.
This book does not cover the history of the 1918 pandemic in detail but provides a light historical account of the 1918 pandemic as well as other subsequent flu outbreaks (1957, 1976, 2009). In addition to that, the book summarises the past 100 years of efforts to treat and prevent influenza, understand the science of the influenza virus, and where we currently stand. The book’s 10 chapters delve into past flu treatments; explanations for why the 1918 influenza was so deadly; resurrecting and genetic mapping of the 1918 virus; tracking and forecasting flu outbreaks; theories about the seasonality of the flu; anti-influenza drugs and vaccines and the debates over Tamiflu; funding for flu preparedness and research; and the economic impacts of the flu.
The book is short (under 200 pages of reading material), but it presents a very informative synopsis about the flu that blends history and science and strikes the right balance between content and depth to suit general readers. The author, a doctor trained in emergency medicine, clearly describes medical concepts for non-medical readers and adds relevant patient stories and insightful perspectives.
This is another timely and highly recommended read. In the prologue, the author writes: "Because of its mystery, and its ability to mutate and spread, the flu is one of mankind's most dangerous foes”. The WHO has warned a few days ago that the COVID-19 pandemic "is not necessarily the big one", and many scientists fear that the next big one will be a flu pandemic. This is an enlightening summary about what we know and where we are today in our flu-related knowledge and preparedness.
This book does not cover the history of the 1918 pandemic in detail but provides a light historical account of the 1918 pandemic as well as other subsequent flu outbreaks (1957, 1976, 2009). In addition to that, the book summarises the past 100 years of efforts to treat and prevent influenza, understand the science of the influenza virus, and where we currently stand. The book’s 10 chapters delve into past flu treatments; explanations for why the 1918 influenza was so deadly; resurrecting and genetic mapping of the 1918 virus; tracking and forecasting flu outbreaks; theories about the seasonality of the flu; anti-influenza drugs and vaccines and the debates over Tamiflu; funding for flu preparedness and research; and the economic impacts of the flu.
The book is short (under 200 pages of reading material), but it presents a very informative synopsis about the flu that blends history and science and strikes the right balance between content and depth to suit general readers. The author, a doctor trained in emergency medicine, clearly describes medical concepts for non-medical readers and adds relevant patient stories and insightful perspectives.
This is another timely and highly recommended read. In the prologue, the author writes: "Because of its mystery, and its ability to mutate and spread, the flu is one of mankind's most dangerous foes”. The WHO has warned a few days ago that the COVID-19 pandemic "is not necessarily the big one", and many scientists fear that the next big one will be a flu pandemic. This is an enlightening summary about what we know and where we are today in our flu-related knowledge and preparedness.
January 15, 2022
Very informational book about one of the deadliest plagues of the 1900's. I found this book to be really educational on how the Pandemic first started and how it quickly spread. It was a very terrifying book as well because the flu struck down the youngest and healthiest of people. It first attacked those in the military and then made it's way around the globe attacking everyone in sight. Doctor's and nurses were overworked and many lost their lives while trying to save others. I highly recommend this book!
May 6, 2021
Interesting and informative, Brown's book makes for a reader friendly history of influenza that was entertaining despite the current COVID pandemic. If I could reread the Stand this year, surely I could handle this, right? My wife was appalled that I would read such a text and refused to allow me to relay interesting facts. Favourite fact involved the Super Bowl and increased flu mortality rates in the participating teams' cities.
December 23, 2021
While this book may seem dated, as it was written several years before our current pandemic began. Jeremy Brown is an emergency room doctor and ponders the history of the flu, the Great Pandemic of 1918 and wonders if there is a chance another pandemic might happen in the future. Several years later it was upon us. He writes honestly and brings out so many unanswered questions about the flu. It is a very accessible book and still worth reading even while we are still in this on-going pandemic.
April 17, 2020
Great book on the pandemic of 1918 and the search for the cure for the flu. Lots of really good info and some not so good stuff on WHO. This book was published in 2018, the centennial of the pandemic. It covers research current to the time of publication and some really interesting info on the research. I wondered about reading this with the current pandemic going on, but it was great.
Displaying 1 - 30 of 275 reviews