Scare echoes a fearful time

The calendar says 2009, but our fears say it is 1918.

The front page tells us about Mexico, and a new strain of influenza that has killed more than a dozen people there and spread to the United States and Europe and Asia.

But our dire imaginations take us back to another contagion in another century. Victims sometimes died within hours, blood coursing from noses and mouths; coffins piled high on city streets. Worldwide, multitudes succumbed — 40 million, 100 million, no one knows for sure.

Could it all be unfolding again?

It’s unlikely. The Spanish flu epidemic was, in the words of writer Lynette Iezzoni, “the most catastrophic season of death in human history.” The cause was a new virus with a special talent for slaughter; scientists literally did not know what they were dealing with.

Mass movements of men to fight in World War I helped spread the disease, while government officials — eager to keep wartime morale high, and panic low — downplayed the disaster.

We live in a very different time. No one knows whether the new swine flu will develop into a major killer, but viruses are better understood. U.S. health officials say the new strain’s genetic makeup doesn’t show specific traits that showed up in 1918. Communications are quicker and treatments like Tamiflu are available. And governments are taking the new swine flu very seriously, and have planned for the best, the worst and everything in between.

Even though our health-care system is much more sophisticated, it too could be overwhelmed by even a milder flu epidemic, authorities say. And while modern medicine can do miracles, it cannot conquer nature entirely.

“No matter how well we prepare,” says Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University, “there will be illness, there will be death.”

‘Just the flu’

It started at Fort Riley, Kan., on March 11, 1918, when Army Pvt. Albert Gitchell reported to the camp hospital with a fever, sore throat and headache.

“Just the flu. Nothing to worry about,” writes Iezzoni in her book, “Influenza 1918: The Worst Epidemic in American History.” “A minute later, however, another sick soldier showed up. Then another. By noon, the baffled hospital staff had 107 cases on their hands. By week’s end: 522. In the next month, well over a thousand.”

All together, 48 died in that outbreak. The flu spread to other army camps, to a Detroit auto plant, to New York City and Minneapolis and some other cities. The death totals were not especially alarming, but some authorities noted something puzzling: The victims were more often young, healthy adults, the people who are normally least likely to die of the flu.

For most health authorities of the time, the flu was an afterthought. Years later, when Brigitte Charaus was researching the 1918 epidemic in Milwaukee, she found that flu fatalities were not normally recorded.