The most frightening diseases humans have faced have come from many places.
The Black Plague, which reduced the population of Europe by one-third in the 14th century, is believed to have been transmitted to humans by fleas from Central Asia.
The SARS (Severe Acute Respiratory Syndrome) epidemic that killed 8,100 in 2002 was passed to humans by small mammals in the Guangdong Province of China.
Ebola, which was first traced to fruit bats and then other animals, has arisen several times in Africa since 1976.
Interestingly, the most deadly pandemic of modern times, the misnamed Spanish Flu of 1918, is now believed to have originated in a rural county in the American Midwest.
The Spanish Flu in Context
The world rejoiced in November 1918 when World War I ended. In its four years, more than 20 people, military and civilian, lost their lives. But an even worse killer was still on the loose.
During 16 weeks at the end of 1918, a vicious flu spread across oceans, among combatants and ordinary citizens, through cities and and countries worldwide. After four scant months, between 50 million and 100 million people -- no one can say for sure -- died and the virus went to ground and disappeared.
Where the Flu Began
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| Camp Funston Flu Patients, 1918, from the U.S. National Archives |
-- A British scientist suggested the origin was WWI British Army post in France where
doctors treated "purulent bronchitis" in 1916, but this theory was dismissed because
the disease had not rapidly or broadly as the flu had done.
-- Another flu outbreak in early 1918 in China was studied but seemed unlikely because
it stopped early and did not spread far.
-- Several other outbreaks of disease in early 1918 in France and India also were ruled out
for similar reasons.
All the signs pointed to origination in the United States where, Barry wrote, "One could see influenza jumping from Army camp to camp, then into cities, and traveling with the troops to Europe."
Gene sequencing of preserved tissue suggested that the outbreak was very rapid. Epidemiological studies and oral histories narrowed the focus to Haskell County, Kansas, a rural area with a population of 1,720 and an economy based on farming grains and raising poultry, cattle and hogs.
In early 1918, the local doctor observed many cases of influenza. Barry's article noted the following:
"Soon, dozens of his patients -- the strongest, the healthiest, the most robust people in
the county -- were being struck down as suddenly as if they had been shot. Then one
patient progressed to pneumonia. Then another. And they began to die . . . . The
epidemic got worse. Then, as abruptly as it came, it disappeared. Men and women
returned to work. Children returned to school. And the war regained its hold on people's thoughts."
The doctor's warning, sent to national public health officials, was the first alarm sounded anywhere in the world. By that point, the end of March, the flu had run its course in Haskell County but just begun its spread.
At the time, the U.S. Army was preparing recruits for service in Europe. Haskell County soldiers were trained at Camp Funston, home to more than 56,000 troops. Starting on March 4, soldiers at the camp started coming down with the flu; 1,100 were hospitalized and many others were treated at infirmaries.
The soldiers transferred from Camp Funston to other Army bases and then to France. According to Barry, "by the end of April twenty-four of the thirty-six main Army camps suffered an influenza outbreak. Thirty of the fifty largest cities in the country also had an April spike in excess mortality from influenza and pneumonia."
The flu proceeded from there. Its second wave, later that year, was far more deadly.
Barry's conclusion:
"The fact that the 1918 pandemic likely began in the United States matters because it tells investigators where to look for a new virus. They must look everywhere."
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