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354 pages, Kindle Edition
First published June 1, 2017
In 1918, as soon as the flu had become reportable and the fact of the pandemic had been acknowledged, a raft of social distancing measures were put in place - at least in countries that had the resources to do so. Schools, theatres, and places of worship were closed, the use of public transport systems was restricted and mass gatherings were banned. Quarantines were imposed at ports and railway stations, and patients were moved to hospitals, which set up isolation wards in order to separate them from non-infected patients. Public information campaigns advised people to use handkerchiefs when they sneezed and to wash their hands regularly; to avoid crowds, but to keep their windows open (because germs were known to breed in warm, humid conditions).
Durjarric thought that he had given himself flu via an injection of filtrate into his blood, while the pair in Tunis ruled out blood as a transmission route. Nicolle and Lebailly were right, in fact: influenza is not transmissible by the blood, so Dujarric cannot have caught it from the injection that Lacassagne gave him. He probably caught it via the usual route - the air - while bending over the four gravely ill soldiers whose blood he took in preparation for the experiment, developing symptoms after the usual incubation period of two or three days. As happens so often in science, in other words, Dujarric was right for the wrong reasons.
If the molecular clocks are right, humans contributed to their own misery both in 1918 and since [by domesticating wild animals]. There were two further flu pandemics in the twentieth century: the 1957 'Asian' flu, which claimed 2 million lives, and the 1968 Hong Kong flu, which killed perhaps twice that. They were caused by subtypes H2N2 and H3H2 respectively, but both inherited the lion's share of their internal genes from the 1918 flu, causing Taubenberger and his colleague, epidemiologist David Morens, to dub the Spanish flu 'the mother of all pandemics'. In the 1930s, the British and American teams who demonstrated that flu was caused by a virus surprised their peers by claiming that humans may have passed the Spanish flu virus to pigs, and not vice versa. Comparisons of human and pig flu sequences have since confirmed their suspicions, and in 2009 the H1N1 subtype that had been circulating in pigs since 1918 erupted again in humans, in modified form, triggering the first flu pandemic of the twenty-first century. It was dubbed 'swine flu', for obvious reasons, though in a longer timeframe it was humans who gave it to humans. Swine were mere intermediaries.
Wars and plagues are remembered differently. Collective memories for war seem to be born instantly, fully formed - though subject, of course, to endless embellishment and massage - and then to fade over time. Memories of cataclysmic pestilence build up more slowly, and once they have stabilised at some sort of equilibrium - determined, perhaps, by the scale of death involved - they are, in general, more resistant to erosion. The sixth-century Plague of Justinian is remembered better today than the eighth-century An Lushan Rebellion in China, although to the best of our knowledge, they killed comparable numbers.
We find ourselves at an interesting point on the remembering/forgetting arc with respect to the twentieth century. The two world wars are still raw, we refer back to them obsessively and are firmly convinced that we will never forget them - though past experience suggests that they will gradually lose their lustre in our minds, or be obscured by other wars. Meanwhile the Spanish flu intrudes more and more into our historical consciousness, but it can't shake the prefix 'forgotten'.
