The 1918 flu epidemic cannot be understood properly unless one goes back to at least some of the original medical articles about it. 

Copeland (1918. General survey of the influenza epidemic.  New York Medical Journal; October 26: 715-718) wrote “To begin with, it should be borne in mind that we have been living in abnormal times.  It is quite likely that when the history of this epidemic comes to be written, it will be found that it originated in the Orient, and that it was carried through the channels of military and commercial communications into Europe, and after spreading far and wide to every country of the latter continent, it was brought to these shores by vessels bringing traders, passengers, and troops who had left countries in which the epidemic was actively waging.  The urgent necessities of the war probably determined the federal authorities who guard our ports on entry, in the decision to admit ships bringing persons affected with influenza as well as those who were carriers”. 

For obvious reasons, I cannot quote Copeland’s every word, so I will quote selectively, but verbatim, or as close to verbatim as possible, his most relevant and material statements.

“We should bare in mind the fact that the large cities of this country were powerless to put into effect any official prohibition against the admission into this country of influenza cases and influenza carriers. 

We have been handicapped, unfortunately, by the enlistment in the military service of a large number of doctors and nurses of the health department t staff.

Methods of prevention have been handicapped by the unrealistic value of limiting the entry of persons infected with or suffering influenza.

The production of a vaccine which would effectively protect persons against influenza has not yet passed the experimental stage, and its use on a large scale has been decided by some as tending to produce a special susceptibility to the disease during the negative phase which it produces.  At all events, while those most competent to decide are not yet in accord with its value, it offers as yet only a measure of promise as an agent in the prevention of the spread of the disease.” 

Let’s pause here: the above quote shows how realistic then the New York (USA) health officials were about a documented fact that injections of any vaccines were followed by the negative phase of decreased bactericidal power of the blood accompanied by the increased susceptibility to the disease, as so well established by Wright (1901.  Lancet; 14 September: 715-723), the British army surgeon, who tested vaccines, such as typhoid, on himself and other surgeons or medical students, and demonstrated that such injections were followed by lowered bactericidal power of the blood lasting for days, weeks, months or even longer.  When the bactericidal power of the blood returned back to normal it was mostly on the same level as it was before the vaccine injection was given.  The same phenomenon was later observed and described by orthodox immunological research of Daum et al. (1989.  J Pediatrics; 114: 742-747) who demonstrated “The decline in serum antibody to the capsule of Haemophilus inflenzae type b in the immediate post immunization period” in babies.  Indeed, the unanticipated occurrence of invasive infections (with a number of deaths) in the babies that received the experimental acellular pertussis vaccines during the so called first trial of acellular pertussis vaccines in Sweden (1986-87) resulted in a withdrawal of the application for licensure of these vaccines by the Swedish health authorities (Anonymous 1989.  Lancet; 14 January: 114), the reason given was “The uncertainty about a possible association with deaths due to serious bacterial infections, which occurred among vaccinated children...”.

Compared with this valid research, statements by Offit (2002) that babies can handle 10,000 vaccines, is little short of unbelievably out of touch with reality.                                                               

Importantly, Harris (1918. New York Medical Journal; October 26: 718-721) wrote “… we had no intimation of the type of influenza which has since become epidemic, until August 11, 1918, when we were informed by the quarantine officers that a Norwegian steamer has arrived in this port, giving a rather interesting history.“  Then Harris proceeded to describe the symptoms suffered by some 200 passengers: abdominal pains, headache, general prostration, and fever; in addition they suffered from diarrhoea and vomiting,  Eleven patients were seriously ill, suffering pneumonia, and these were removed to a hospital on arrival.  There was a disagreement as to the cause of these symptoms, some expressing an opinion that it was purely a reaction to marked atmospheric changes due to a zigzag movement of the ship alternating between the “torrid zone” and regions in which icebergs were encountered.  Shortly thereafter, a French troopship and several freight steamers arrived, each bringing a few cases diagnosed as influenza and which were promptly removed to the hospitals of the health department (those were the times without private hospitals) and those who were in contact being kept under surveillance.       

For the period of several months prior to September 12^th 1918, passenger steamers and freighters as well as troopships, were entering this and other US ports; the safeguards which have been established previously, had to be relaxed, apparently because of the great need of leaving undisturbed the channels of communication with the seat of war.  The departments of health were powerless to exercise their official powers to prevent entrance of infected persons. [It is perhaps of interest, that to this day a card the incoming passengers into the US have to fill-in, has one of the questions to answer whether he or she ever suffered any infectious disease?”  Even though the proper and desirable answer should be “Yes” (due to the desirability of being naturally immune to such diseases), I doubt that anybody would answer it in the affirmative.]   It was of interest that very few persons other than those between the ages of twenty-five and thirty five years, were attacked by the disease; markedly so until the first of October 1918, when earlier ages were included.  A total of 25,082 cases were reported to the Department of Health by private physicians and hospitals.   There were 2,149 cases in children under five years); 4,865 in children from five to fifteen years; 4,726 in persons from fifteen to twenty-five years; 4,833 from twenty-five to thirty-five years; 1,997 from thirty-five to forty; and 2,641 forty years and over.  According to Harris, apparently, the disease which had first been spread about through the avenue of commercial and mercantile intercourse, was carried into the homes and domestic or family contact becoming the chief source of transmission.   

The actual extent of the epidemic in New York was difficult to measure.  Neither was the actual mortality rate.  However, the estimate was about four percent, based on the mortality in foreign countries, in various army camps, and other communities.  The 2,550 deaths from influenza and pneumonia reported from September 18^th to October 1918 represented a mortality of two and a half per cent.  However, as may be predicted, there was a much higher concentration of morbidity and mortality in the poor, congested and crowded areas of the city.  

Another interesting observed fact was that robust and vigorous soldiers and sailors were seriously attacked and seemed to be able to offer little, if any, resistance to the infection.  It seemed that those who were very likely to have survived attacks of influenza of previous years enjoyed the highest level of immunity.

Young children appeared most resistant to influenza.  [This is understandable because they were not vaccinated as babies and would have enjoyed the overall robust immunity provided by the usual natural infectious diseases of childhood, such as measles.]

Another important observation by Harris was that public health education, in the sense in which the term is ordinarily employed, had very narrow limit of usefulness.   Harris referred in particular to the public education via pamphlets placed in public places to combat “the indecent and deadly habit of spitting in public places, and to educate persons, many of them quite intelligent, to use a handkerchief when coughing and sneezing”, despite heavy fines being imposed by judges on such offenders, brought before them by the police. 

“The public schools have been allowed to remain open, not as a result of laxity or because the commissioner and his official advisers have failed to appreciate the solemn responsibility which devolves upon them, but as a result of searching, painstaking, and thorough study of the merits and demerits of such a procedure, and also as a result of counsel obtained from some of the foremost public health experts in this country.  As the result of our deliberations and studies, we feel certain that the commissioner has taken, not only a courageous, but a sane and scientific view of the situation in keeping the schools open and utilizing many special provisions for safeguarding the health of the children which have been devised to meet the present situation.  From present indications, it seems likely that when the epidemic shall have passed, and when its results will have been carefully recorded, that it will be found that the city of New York has compared more than favorably with other cities, in the sanity and wisdom of its procedures, and the results achieved through such methods, especially when contrasted with the illogical and arbitrary methods employed in some communities where fear and panic have prevailed.”

Harris proved to be right.

The commissioner of health has closed only such moving picture theatres as were found to be violating the sanitary laws or harboring conditions conducive to disease, to ensure to avoid “the paralysis of industry and of social life which would have made conditions, in this, the greatest city in America, intolerable.“  

Harris concluded that “contact in the home was one of the most important, if not the most important, of all causes for the transmission of the disease throughout the community.  Possibly we will begin to realize when this epidemic is over, that in our reform of housing conditions, we must strive to insist upon a standard which will give the poorest family in our community an adequate number of rooms to make at least a small measure of isolation of the sick possible when a case of infectious disease occurs in a family.  In time we will come to pass, though this is perhaps a Utopian conception, that the law will compel the building of apartments and the maintenance of living conditions within them to be of such a standard that it will be held illegal to have families herded as they now are in various congested sections of the city, and it will come to be realized that no member of the community, however rich and sheltered will be safe from the visitations of an infectious disease with its terrible consequences, unless the poorest members of the community live in such fashion that infectious disease may not select their habitations and breeding place for contagion and pestilence which radiate to all other homes in the community...public health education in our elementary schools, night schools, high schools, and colleges will…promote  an understanding of personal and public hygiene and sanitation.”

There was no mention in this article of the swine origin of the 1918 flu epidemic.  The swine flu phenomenon really started in 1976, with the infamous swine flu epidemic which never came.  Ingelfinger (1976.  New Engl J Med; 294 (19): 1060-1061) wrote (it seems to me, with tongue in cheek) “What does J.Q. (for Queasay) Healthsumer do when the President flanked by Albert Sabin, Jonas Salk, and a host of co-experts, proclaims, “Thou shalt be vaccinated against the flu”? J.Q.H’s response is predictable: he joins the legion of vaccinees -  i.e. if he can get the vaccine in time.  On March 25, 1976, when the newspapers announced this new “war” on a given disease, details of how the decision was made were meager, and some readers had strong misgivings.  Were, in fact, the viral experts summoned to Washington and told to support what a public-relations wizard had dreamed up as an election-year gimmick?  And had the scientists had any chance to discuss the host of problems that might make the “war” resemble our campaign in Cambodia?  As recently, as April 6 this year, the New York Times editorialized on the doubts that linger in the minds of many.  In the preceding editorial, however, Dr Louis Weinstein, a senior statesman in infectious disease and unencumbered by political pressure and presidential prestige, reassures us by supporting pan-vaccination – except for children and those sensitive to egg white.  The management of pregnant women poses a tough choice; in them, a reaction to vaccination may have more serious consequences, but in them, as well, the disease itself may be more serious. In addition, fears that the medical scientists merely served the President as window dressing appear unwarranted. Indeed, at an earlier meeting in January plans had been laid for the containment of any viral epidemics that might threaten.  Contrary to the impressions given by the rather skimpy news accounts at the time of the March 25 announcement, the decision was neither a response to an ultimatum nor a pro forma affair.  All the questions mentioned by Dr Weinstein, and others as well, were apparently well debated and not swept under the rug for political reasons…Firstly, whatever the competence and involvement of the scientists present when the decision to vaccinate for swine flu influenza was made, and whatever the prestige of the individuals or groups that have lined up behind the plan, decisions of this type unavoidably are made under circumstances in which the principles of Pascal’s Wager 2 predominate over those of objective decision analysis. ”      

The prediction of pandemic proved to be a colossal debacle but resulted in President Ford spending 135 million dollars purchasing some 40 million doses of swine flu vaccine.  Millions of people were injected and tens of thousands either died (while walking out of doctors surgeries) or became very ill with ascending paralysis (Guillain-Barre syndrome) or Legionnaire’s disease, named after the first major outbreak in members of an organisation named American legion and developed a deadly  pneumonia resisting all orthodox treatment.  Many got the flu from the vaccine.  Several billion dollars were paid in compensation.  President Ford apparently lost his re-election because of the swine flu debacle.   Swine flu showed no willingness to spread and/or cause a pandemic.  The flu vaccine did the job for it. 

Taubenberger et al. (1997.  Science; 275: 1793-1796) claimed that “RNA from a victim of the 1918 pandemic was isolated from a formalin-fixed, paraffin-embedded, lung tissue sample.  Nine fragments of viral RNA were sequenced from the coding regions of hemagglutinin, neuroaminidase, nucleoprotein, matrix protein1, and matrix protein 2.  The sequences are consistent with a novel H1N1 influenza A virus that belongs to the subgroup of strains that infect humans and swine, not the avian subgroup.”  This material came from “The Armed Forces Institute of Pathology in Washington, D.C.,” which “has autopsy material consisting of formalin-fixed paraffin-embedded tissue and hematoxylin- and eosin-stained sections from U.S. servicemen killed in the 1918 pandemic.” The researchers “randomly selected 28 cases for pathological review.  Of these, the majority died of acute lobar pneumonia, one of the most common sequelae of the pandemic.“ 

This article, unlike the swine flu virus, showed the ability to spread the above information like an epidemic, or wild fire, and was taken as evidence that 1918 flu epidemic was caused by the swine flu virus.  It was quoted extensively by St Louis Post-Dispatch.  The article claimed that “The 1918 influenza virus that killed more than 20 million people worldwide originated from American pigs and is unlike any other known flu bug, say researchers”.  The writer of the article warned that it could strike again.    His clairvoyant ability proved to be next to zero.     

Even the number of people allegedly killed by the 1918-1919 flu pandemic appears to be unsupported by the original information, it seems that it was really 20 million people infected, most of whom recovered and developed immunity.   This leads me to a very important article by Gill and Murphy (1985.  Naturally acquired immunity to influenza type A”, MJA; 142: 94-98), who conducted a well-designed research into the H1N1 subtype of influenza which reappeared in the Northern Hemisphere during 1977, after a 20-year absence.   They wrote, “…it behaved differently from the H3N2 subtype still in circulation... In Sydney, we studied the incidence of both subtypes of laboratory-proven influenza type A in 287 unvaccinated volunteers whose serum antibody titres were measured before and after each winter, to facilitate the detection of subclinical as well as clinical infection.  During a 1977 epidemic, the A/Victoria/3/75 strain of the H3N2 subtype attacked participants of all age groups, whereas during epidemics of n1979 and 1981, the A/USSR/90/77 and A/V Brazil/11/78 strains and H1N1 subtype attacked only subject born after 1950.  The older participants apparently possessed homologous protection acquired as a result of exposure to H1N1 more than 20 years earlier and not dependent upon strain-specific haemagglutination inhibition antibody”.   They also wrote that most influenza epidemics are caused by type A influenza viruses, few by type B.  From 1947 to 1957, epidemics throughout the world were caused by strains of the H1N1 subtype of influenza type A.  In 1957, as a result of major antigenic change, the H2N2, or Asian, subtype emerged and replaced the H1N1 subtype.  Strains of the H2N2 subtype then caused world epidemics until 1968, when further major antigenic change produced the H3N2, or Hong Kong, subtype subtype.  After each major antigenic change, the old subtype disappeared – not simultaneously in all parts of the world, but in one area after another as the new subtype spread.    Thus, a strain of subtype H2N2, strain A/Tokyo/3/67, was able to cause epidemics in Australia during August 1968 weeks after the new H3N2 strain (A/Hong Kong/1/68 had emerged, but before it had reached Eastern Australia…at a general practice in the Sydney suburb of Epping, patients who had been ill during the A/Tokyo/3/67 epidemic of 1968 resisted attack by A/Hong Kong/1/68 during the 1969 and 1970 epidemics; and from field and laboratory studies at Circencester (UK), Hope-Simpson reported similar findings…Natural cross-protection was again evident during the 1972 epidemic.  Patients who had suffered A/Hong Kong/1/68 influenza during 1969 or 1970 resisted attack by the A/England/42/72 strain in 1972.   Those who relied on the current subunit vaccine, still containing A/Hong Kong/1/68 strain, were relatively unprotected.   More detailed studies during the A/Port Chalmers/1/73 strain epidemic of 1974 and the A/Victoria/3/75 strain A/Hong Kong/1/68 or by A/England/42/72 had afforded substantial protection against the next two epidemic strains, despite antigenic drift.  Hoskins et al. from studies at Horsham (UK), reached similar conclusions.”

The above quoted research is important in showing that acquisition of natural immunity is very effective  in determining the protection and the dynamics of age distribution in natural flu epidemics. It also provided a unique opportunity to observe the contrasting behaviour of two different subtypes advancing in parallel in 287 unvaccinated people who remained in the study between 1977 and 1981.   The coexistence of the two different subtypes since 1977-78, a phenomenon never previously recorded, has been accompanied by an unusually low mortality rate from influenza infection, in both hemispheres.    The authors continued “Apparently, this is partly because H1N1 strains have spared the age groups most likely to die from influenza, and partly because the “aging” H3N2 subtype has immunized so many humans in most populations that the impact of its recent strains has been blunted.  Following the mild A/Victoria/3/75 epidemic of 1977 in New South Wales, A/Texas/1/78 caused negligible illness during 1980, A/Bangkok failed to generate an epidemic during 1982, 14 and A/Philippines/2/82 caused only a mild epidemic during 1983 (Figure 2).   The low mortality of the past seven winters has been without parallel since 1933, when virological studies first became possible.  Presumably, the longer the state of neutrality continues, the more severe will influenza epidemics be when it comes to an end.”

The benefit of having had influenza for individuals and the whole community shines brightly from the above research.

Moreover, just as the 1918 (and no doubt earlier) epidemic was affected by the war, poverty, poor nutrition and poor crowded housing of the majority of people, the modern epidemics under generally much improved nutritional and housing living conditions may be milder with most infections being subclinical and catastrophic pandemics not eventuating at all.           

I leave it here with a comment - why does humanity take such a long time to learn from its own history and good research, instead of eternally struggling with persisting ignorance and inability to see the most obvious, and repeatedly falling for the false panicky propaganda? When will it finally learn to separate the proverbial grain from the chuff right from the word go, or will there just be an endless repeat of the story of the emperor’s new clothes? [That would explain why particularly the politicians fall for the worst humbug the orthodox medical system can dish out?]