The Great Influenza

Antigen drifts and shifts are types of mutations that viruses and other antigens undergo. In an antigen drift, the antigen changes just enough that antibodies struggle to attack it but still basically recognize it. In an antigen shift, the antigen’s gene coding changes, meaning the antibodies will no longer recognize the antigen, rendering them useless.

Blue was the surgeon general of the United States during the influenza pandemic. He was left off the National Research Council, as he was seen by other scientists as more of a politician. At first, Blue largely ignored the pandemic, but he eventually sent out posters and ads in newspapers offering advice on how to avoid getting influenza, though the ads were largely ineffective.

Camp Devens near Boston was the site of the first major outbreak of the influenza on a military base. The camp had proper medical equipment, but medical staff could not contain the virus as it overwhelmed the camp. Men from the camp also spread the virus to other camps and possibly to the city of Boston.

Cole was the first director of the Rockefeller University Hospital, the nation’s first research hospital. At Rockefeller, Cole and Oswald Avery developed an effective polio vaccine. During the pandemic, Cole served on a pneumonia board inside the National Research Council, where he worked on preventing pneumonia outbreaks in the army camps. He also investigated the early cases of influenza with others.

Royal Copeland was the anti-science head of the New York City Department of Public Health. Appointed by Tammany Hall because he was a loyal machine man, Copeland ignored the influenza pandemic for too long, allowing it to spread. Later, he erroneously assured people that William Park’s vaccine would be more effective than it was and that the virus would disappear.

Clemenceau was the prime minister of France during World War I. During the negotiations over the peace treaty, he was especially forceful that Germany cede land to France and pay reparations as punishment for the war. Woodrow Wilson opposed these measures but ultimately ceded them to Clemenceau after a bout of influenza.

Creel was the head of the Committee on Public Information, a government agency that censored news and popular entertainment as part of the war effort. The censorship helped the influenza pandemic spread, as citizens did not have accurate information about the dangers of the virus or how to prevent the spread of it.

Provost Marshall Crowder was the head of the draft board during the war. He refused to stop the draft even as the pandemic spread and issued an order requiring all men to work or be drafted, leading to crowded army camps and factories. He eventually canceled the draft in September 1918, which was one of the few things the army did in the interest of public health during the pandemic.

A cytokine is a white blood cell that attacks antigens in the body. However, cytokines release toxins that cause adverse physical effects in the patient, such as body aches and fever. The release of too many cytokines can kill a patient, as was likely the case for many of the influenza pandemic’s young victims.

Simon Flexner was the first director of the Rockefeller Institute for Medical Research. In that position he created a team of researchers rivaled only by that of Johns Hopkins University. Flexner was instrumental in reshaping American medical schools, writing an influential report in the early 20th century that encouraged medical schools to improve their standards. He served on the National Research Council during the pandemic and helped direct research efforts into the cause and treatment of influenza. Flexner also served as a mentor to Paul Lewis, with whom he had developed a vaccine for polio.

William Gorgas was the surgeon general of the army during World War I. Along with other members of the National Research Council, Gorgas aimed to prepare the military for a possible outbreak of infectious disease, although most were more worried about measles or pneumonia than influenza. Gorgas, who had history treating malaria patients in Panama, was well respected by military commanders. However, though he offered sound advice to the army about best practices for avoiding an outbreak of a disease, his advice was largely ignored. Going into the war, Gorgas’s main goal was to have the war be the first in American history in which more people died of battlefield wounds than disease. In the end, influenza won out, but just barely. Had Gorgas’s advice been taken earlier, perhaps he would have succeeded.

The first known cases of the influenza pandemic likely occurred in Haskell County, Kansas, in early 1918. A small outbreak occurred but disappeared quickly. However, infected men likely carried the virus with them to Camp Funston and spread the virus’s first wave to fellow soldiers at the camp. Though historians and scientists are pretty sure the first cases were in Haskell County, the influenza of 1918 is often erroneously called the Spanish flue, due to newspapers reporting cases of influenza in Spain but not other nations due to wartime censorship. It’s also possible the virus existed in other forms before it got to Haskell County, but Haskell County certainly provides the first historically documented cases of the influenza.

Johns Hopkins University in Baltimore was the first great science research center in the United States. The school eventually expanded to include a hospital and medical school, and the medical school became the model for all other medical schools in the country. Most of the scientists who fought the influenza pandemic either were educated at or worked at Hopkins.

Krusen, a medical doctor, was the head of the health department for Philadelphia during the pandemic. He ignored the virus’s spread, even allowing a Liberty Loan parade to take place with hundreds of thousands of people in the crowd. Because influenza spreads easily in crowds, the event was likely a super spreader of the virus. Eventually, Krusen let Philadelphia’s wealthy citizens take over public health duties, but by then the virus had killed thousands.

The brainchild of William Welch, the National Research Council was a committee of scientists, researchers, university presidents, and military officials created in the Wilson White House. The committee included Welch, Rupert Cole, Victor Vaughan, Simon Flexner, William Gorgas, and others, and it planned ways of preventing a disease outbreak in army camps, among other things. After the influenza pandemic, it divided up tasks for fighting the pandemic to various researchers across the country. Without the National Research Council’s direction, the research aspects of the pandemic would have been far more chaotic.

A pandemic is an outbreak of a disease that is large enough to cross borders or infect a significant part of the population in a large area. There have been several pandemics in world history, but the 1918 influenza pandemic was likely the most severe in terms of morbidity rates.

Park was the head of the diagnostic laboratory in New York’s Department of Health. There, he created one of the most impressive labs in the country, and one of the only labs that could mass produce vaccines. Williams was his frequent collaborator in the lab, and the two complemented each other in demeanor and skill set. During the pandemic, they worked on isolating Pfeiffer’s bacillus and attempting to create a vaccine for it. They later recognized that the bacillus was not the cause of influenza, however.

Discovered by the German Richard Pfeiffer, Pfeiffer’s bacillus (actually named Bacillus influenzae) was believed to be the antigen that caused influenza. During the pandemic, thus, researchers sought it in victims to confirm that they had indeed suffered from influenza. However, the bacillus turned out not to be the cause but rather an effect of influenza, which is actually caused by a virus.

The Rockefeller Institute in New York was the second great science research institution in the United States after Johns Hopkins. Its first president, Simon Flexner, recruited great researchers and created a world-class lab that made important discoveries on meningitis and polio, among other diseases. The Rockefeller Institute also founded the first research hospital, creating a model that is still followed today. During the pandemic, several of the men who fought or researched influenza were associated with or had been members of the Rockefeller Institute, including Paul Lewis and Oswald Avery.

Victor Vaughan was the dean of the University of Michigan Medical School. He was also an executive member of the National Research Council.