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3.3 out of 5 stars12
3.3 out of 5 stars
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on 23 November 2005
This is a really impressive book that took seven years to write--not only covering the 1918-1919 influenza epidemic, but also how scientists tackle problems at the bench, as well as the personalities behind the rise of American medicine. As Mike Davis says in "The Monster at Our Door: The Global Threat of Avian Flu," Barry has written the best book on the influenza pandemic of 1918.
Although the book is more than 500 pages, it reads more like a novel than a study in medical history. Given the increasing likelihood of another influenza pandemic from the H5N1 strain of avian flu, it is helpful to see how the 1918 pandemic began in Kansas and spread thoughout the world. There is a careful explanation of how viruses develop and spread, but no previous knowledge is assumed.
Barry is especially good on the influence of World War I in stopping national governments from being open about how the flu was killing more people than the fighting. The only reason why we call the 1918 pandemic, "the Spanish flu" is because Spain was the only country that wasn't censoring the importance of the flu. Everywhere else it was "unpatriotic" to be honest. What emerges is the importance of public health authorities being honest or else a situation is created where the public does not trust the government--and rightly so.
As the Co-ordinator of Avian Flu Action ([...]) I found this book especially helpful in setting out the mistakes that were made in the last great flu pandemic, so that hopefully they will not be made again. As Barry points out: "Every expert on influenza agrees that the ability of the influenza virus to reassort genes means that another pandemic not only can happen. It almost certainly will happen"(p.449).
Reading this book will give you a good understanding of what a flu pandemic is, and how to react if another one hits us.
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on 18 October 2004
In 1918, the world was hit with the emergence of a new and deadly disease, one that struck down vast multitudes, and killed many - often killing young adults in the prime of life. But, this was not a wholly new disease; it was merely a variation on that perennial nuisance the flu! In a 24 week period, this disease killed more people than AIDS has killed in the last 24 years. This is the story of the last great and deadly pandemic to sweep the world, the Influenza of 1918.
This is a good thick book, one in which the author goes to great lengths to give the reader a good grasp on the issues and people involved - heck, the 1918 pandemic isn't even referenced until chapter six, and serious discussion of it doesn't begin until chapter fourteen! But, that said, the author does give the reader an excellent understanding into what happened in 1918 - what happened and why, what it meant to subsequent history (did American President Wilson contract that disease, and did it affect the Versailles peace process?), and what it means to us today.
Yes, if you are interested in the great influenza pandemic of 1918, then I would say that this is the book for you. It has all of the information you could want, and it presents it in an interesting, if not gripping, manner. I highly recommend this book!
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TOP 500 REVIEWERon 9 January 2008
This is an impressive piece of scholarship, but I have to admit skimming many of the pages as I found the book over-burdened with detail. The book would, I think, interest US readers more than others as the story is largely told from that country's perspective and all the main medical/scientific players worked in the USA. Many chapters are devoted to the biographies of these workers, preceded by the history of medicine from Aristotle culminating in the blossoming of medical training in the USA. I felt I had to plough through hundreds of pages of background material before the "Epic" started. There is a tremendous amount of information in the book, not just historical/biographical, but also very detailed descriptions of the evolution, replication and categorization of viruses; and how vaccines were finally produced.

If I appear critical of the book, that is not my intention, I'm just warning people who might want to know about the 1918 flu epidemic unburdened by so much background material.
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on 26 April 2011
Very disappointing. Lots of traumatic anecdotes about how people died. No insight into the epidemiological or public health consequences of the epidemic. Reading this book you could be forgiven for thinking that only America was affected and that only American scientists had anything to do with fighting and understanding the epidemic.
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on 5 October 2007
It killed more people in 6 months than the Black Death killed in a century. People who were young and strong were the most likely to die. In the US, 650,000 people died. The average life expectancy in the US went down by 10 years. Worldwide, perhaps 100 million people died. And yet, it was only the flu. Even today, 90 years after the epidemic, it kills 36,000 Americans in a typical year and we are hardly more prepared to face another epidemic.

John M. Barry has written a fascinating account of the influenza epidemic of 1918. But the book is a lot more than just a review of the flu. Barry starts out by examining the state of the American health system at the time of the epidemic and how it reached that state. He explores the revolutionary changes to medicine that occurred in the late 19th and early 20th century and the people who led those changes. He shows us why, even today, a cure for influenza is beyond our reach, explaining in layman's terms how the influenza virus changes to become deadly and changes again to lose that deadliness. He explains how an endemic virus can lead to an epidemic of unimagined proportions.

Barry also shows how the demands of World War I on troop movements, the propaganda campaigns to keep morale high, and the failure of leaders to listen to the doctors and researchers led to a killing field of historic size. His account tends to concentrate on Philadelphia because the city was hit extremely hard and much of the research going on was near that city but he does cover other areas around the world hit hard by the virus, although his coverage of the flu outside of the US is sketchy at best. He gives us writings from diaries and newspaper articles to show what was actually happening and how the media tried to downplay the epidemic. He gives us detailed accounts of the research (and the researchers) that was done to fight the epidemic, explains why this research was mostly unsuccessful, and does it all in a way that is easy to understand even if you don't have a medical degree.

Barry likes to use foreshadowing, hints of what is to come, to keep the reader's interest and it does work, even if it is a bit melodramatic. Even the chapter titles, "The Tinderbox", "It Begins", The Race", provide some melodrama to the story. The book mostly moves at a good pace and I found myself having trouble putting it down. Barry has written a book that everyone should read, whether you are familiar with the epidemic or not. It is a fascinating, terrifying, detailed, and extremely important book.
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on 26 July 2011
When writing a book about an event you of course want back story and a summary of events leading up to the main topic. However for a book about the 1918-19 Influenza pandemic to spend about 80 pages in the 19th century to me seems an unnecessary distraction. Ok so germ theory was still in its infancy in 1918 and America in one generation had gone from a medical backwater to being at the forefront of science just in time to witness one of the greatest pandemics in history but really is 5 chapters and a virtual blow-by-blow account of the founding of John Hopkins really warranted?

Like other reviews I agree that it is also a very American centric view of a disease that affected millions globally. It may have started in the US and a lot of the scientific work may have happened there but with Britain being the most powerful country in the world at that time and with all the globe's attention on war torn France and with Asia and it's crowded populations also ravaged by influenza it seems an odd choice to be so myopic in telling a global story.

Saying that the writing is fluid and the science and politics are well explained as is the building sense of a race against an unseen enemy but really this book needs either re-editing or a more honest (and by that I mean global) assessment of one of the forgotten tragedies of the 20th century.

If you liked this there's more historical debate and fun at @HistoryGems on Facebook and Twitter
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on 22 September 2011
The first quarter of the book provides wide-ranging context and background - too wide-ranging, going as far back as Roman medicine and spending a lot of time on the medical discoveries of the 19th century. The first death from Spanish flu occurs 90 pages in, and the outbreak doesn't spread until another 80 pages have passed. After that, we get a good overview of the pandemic, although this is a very American-based history. The author supports the theory that the flu outbreak began in Kansas, although does point out that there are alternative theories. Still, I'd have liked to have seen more of the global impact. We hear lots about how American cities, American politicians and American scientists responded. But what about their counterparts in the rest of the world? To sum up: an interesting read, but the introduction is too wide-ranging, the main section of book is not wide-ranging enough.
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on 19 June 2009
Heralded by some as the 'greatest work on the 1918 flu pandemic' this book is in reality a typicaly USA centric xenophobic offering that dedicates more pages to describing how US reasearch scientists 'became the best in the world' than describing the cause and effect of, what was a GLOBAL disaster. There are very limited references to the effect of the pandemic outside the USA & no reference to alternative theories of its origins (Etaples). In reading this book you would be forgiven to believing that the 1918 flu epidemic started in the USA, that US scientists have resolved just about every medical problem and that the rest of the world was affected as a by product of a US problem. This may sound harsh, but if you are looking for a well rounded impartial narrative on the cause and effects of the 1918 global flu pandemic this is not it.
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on 12 November 2014
This book is extremely disappointing. Most scientists/doctors who were not American have been either ignored or dissed, and apart from one brief chapter detailing how the influenza affected some of the rest of the world, it is as if only America suffered and only Americans who tried to tackle it.
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on 14 August 2015
Gripping and informative. A fascinating insight into how medical science evolved in the late 19th and early 20th century, told against a backdrop of rapid social change and war. I learnt a great deal from this book and thoroughly enjoyed reading it.
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