KATHRYN HUGHES

The Mail on Sunday - Event - - BOOKS -

In 1918, just as the world was be­gin­ning to feel hope­ful that the most dev­as­tat­ing war of all time might be com­ing to a close, an even big­ger dis­as­ter be­gan to un­fold. ‘Span­ish flu’ – which his­to­ri­ans now be­lieve ac­tu­ally orig­i­nated in ei­ther Kansas or China – raged across the globe, leav­ing up to 100 mil­lion dead in its wheez­ing, sneez­ing wake. Within a few months, far more men, women and chil­dren lost their lives as a re­sult of a virus than they did from en­emy ac­tion.

This might strike us as sad, es­pe­cially if we’ve grown up with fam­ily sto­ries of an­ces­tors who per­ished in the pan­demic, but still it feels like a sepia-tinted tragedy that has noth­ing to do with us. Re­ally, though, we should not be so com­pla­cent, warns Dr Jeremy Brown, a se­nior Bri­tish-born emer­gency medicine doc­tor work­ing in the US. In this au­thor­i­ta­tive yet highly read­able book, Brown ex­plains that flu, as we like to call it, is still a killer (30,000 peo­ple died of it in Amer­ica last year), and will in­evitably strike again soon. And it’s no good think­ing that mod­ern medicine will have the an­swers this time around ei­ther. An­tibi­otics are use­less in com­bat­ing a virus, and this year in the States, the flu jab turned out to be ef­fec­tive in only a third of cases.

That’s be­cause the flu virus is con­stantly mu­tat­ing, find­ing new ways to sur­vive. One of the most thrilling chap­ters in the book con­cerns Brown’s de­scrip­tion of the ac­tiv­i­ties of sci­en­tists in the Nineties who dug up vic­tims of the 1918 pan­demic whose bod­ies had been buried in the per­mafrost – mostly Na­tive Amer­i­cans liv­ing close to the Arc­tic Cir­cle. Sam­ples taken from their corpses were used to ge­net­i­cally de­code the virus. From here it be­came pos­si­ble to map the way that more re­cent vari­a­tions such as avian flu and swine flu have ar­rived in our midst, caus­ing the kind of panic fa­mil­iar to our great-grand­par­ents. Brown, though, is crit­i­cal of the phar­ma­ceu­ti­cal in­dus­try’s glee in rustling up ‘flu scares’ ev­ery decade or so. He is also quick to re­mind us that things were much worse 100 years ago, when more peo­ple died as a re­sult of their treat­ment than the ill­ness it­self. The well-to-do were ad­vised to drink cham­pagne af­ter a vom­it­ing episode, which left them more de­hy­drated. Oth­ers were given as­pirin at ten times the safe dose, lead­ing to or­gan fail­ure. Ene­mas and blood-let­ting were pop­u­lar treat­ments too – both served to weaken the pa­tient fur­ther. These days we have… noth­ing much, ac­tu­ally. And that, sug­gests Brown, is both a bless­ing and a curse. A bless­ing be­cause flu is best treated by stay­ing at home, rest­ing and drink­ing as much water as you can bear. A curse, be­cause doc­tors feel com­pelled to hand out an­tibi­otics (use­less) and anti-vi­rals (pretty use­less) to pa­tients who in­sist that there must be some­thing that can make them feel bet­ter. The re­sult isn’t sim­ply a huge waste of money but also the ter­ri­fy­ing prospect of other deadly, but treat­able, dis­eases be­com­ing re­sis­tant to what­ever the phar­ma­ceu­ti­cal in­dus­try has to of­fer. Part sci­ence, part his­tory, part pol­i­tics and part ex­pert ad­vice, In­fluenza is ex­actly the book you want to read when you’re tucked up in bed, feel­ing fever­ish. It is a brac­ing re­minder that, un­less you are very un­lucky, you will be feel­ing much bet­ter this time next week.

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