The Fatal Strain

Journal of General Virology 75, no. 9 (Sept. 1994): 2183-88; and Ian H. Brown, “The Epidemiology and Evolution of Influenza Viruses in Pigs,” Veterinary Microbiology 74, nos. 1-2 (May 22, 2000): 29-46.

101 “Are the doctor and the media”: “PM Derides Doctor over Pig Comments,” Nation (Thailand), Jan. 28, 2004.

Chapter Four: Into the Volcano

This chapter draws on interviews with current and former infectious-disease specialists, investigators, and other officials at WHO and CDC in the United States, Geneva, and Asia, with Vietnamese, Thai, and Hong Kong disease specialists, and on documents from WHO and CDC and personal notes kept by participants in the events described.

104 When SARS broke out: The results of the outbreak investigation in Vietnam are discussed in Hoang Thu Vu et al., “Clinical Description of a Completed Outbreak of SARS in Vietnam, February-May 2003,” Emerging Infectious Diseases 10, no. 2 (Feb. 2004): 334-38; and Mary G. Reynolds et al., “Factors Associated with Nosocomial SARS-CoV Transmission Among Healthcare Workers in Vietnam, 2003,” BMC Public Health 6 (2006): 207.

109 The flu outbreak that began that fall: For more discussion, see Niranjan Bhat et al., “Influenza-Associated Deaths Among Children in the United States, 2003-2004,” NEJM 353, no. 24 (Dec. 15, 2005): 2559-67; and Laura Jean Podewils et al., “A National Survey of Severe Influenza- Associated Complications Among Children and Adults, 2003-2004,” Clinical Infectious Diseases 40 (June 1, 2005):1693-96.

109 flooded with the infirm: See, for example, Rob Stein, “Shortage of Flu Shots Prompts Rationing,” Washington Post, Dec. 9, 2003; Rob Stein, “24 States Hit Hard by Flu Outbreak,” Washington Post, Dec. 12, 2003; and Anita Manning and Tom Kenworthy, “Flu and Fear Run Rampant,” USA Today, Dec. 10, 2003.

109 give up their beds: “Influenza: Last Bad Flu Season Killed Nearly 65,000; Will This Season Be Worse?” Drug Week, Jan. 2, 2004.

109 made its first recorded appearance: Alfred W. Crosby, America’s Forgotten Pandemic: The Influenza of 1918, 2nd ed. (New York: Cambridge University Press, 2003), 71.

109 sailors transferred days earlier: John M. Barry, The Great Influenza: The Epic Story of the Deadliest Plague in History (Viking Penguin: New York, 2004), 192.

110 Fourth Annual Liberty Loan parade: Philadelphia Inquirer, Sept. 29, 1918.

110 an old photograph: www.history.navy.mil/photos/images/h41 000/h41730.jpg.

110 every hospital bed: Barry, Great Influenza, 220.

110 “When they got there”: Selma Epp, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 28, 1997, quoted in Barry.

110-11 “historic records of the plague”: Ellen C. Potter, letter to Miss M. Carey Thomas, Oct. 3, 1918, M. Carey Thomas Papers, Special Collections Department, Bryn Mawr College.

111 254 deaths in a single day: Barry, Great Influenza, 221.

111 daily toll was 759: Ibid., 329.

111 “none to replace them in the wards”: Francis Edward Tourscher, Work of the Sisters During the Epidemic of Influenza, October, 1918 (Philadelphia: American Catholic Historical Society, 1919), p. 18, accessed through Villanova University Digital Library Browser, reprinted from the Records of the American Catholic Historical Society of Philadelphia 30s, nos. 1-3 (Mar.- Sept. 1919).

111 Almost half the doctors and nurses: Barry, Great Influenza, 226.

111 “had no attention for over 18 hours”: Tourscher, Work of the Sisters, 18.

111 “After gasping for several hours”: Ira Starr, “Influenza in 1918: Recollections of the Epidemic in 1918,” Annals of Internal Medicine 145, no. 2 (July 18, 2006).

111 at the poorhouse: Tourscher, Work of the Sisters, 50.

112 the residence of a wealthy family: Ibid., 62.

112 cars bearing medical insignia: Starr, “Influenza in 1918.”

112 so they could help fill prescriptions: Eileen A. Lynch, “The Flu of 1918: It Started with a Cough in the Summer of 1918,” Pennsylvania Gazette, Nov. 1998.

112 Nearly 500 police officers: Philadelphia Inquirer, Oct. 20, 1918.

112 About 1,800 telephone employees: Barry, Great Influenza, 328.

112 “no other than absolutely necessary calls”: Philadelphia Inquirer, Oct. 18, 1918.

112 one Fishtown home: Tourscher, Work of the Sisters, 74.

112 During the second week: Great Britain Ministry of Health, Report on the Pandemic of Influenza 1918-1919, Reports on Public Health and Medical Subjects no. 4 (London: His Majesty’s Stationery Office, 1920), 319-20, quoted in Crosby, America’s Forgotten Pandemic.

112 abandoned corpses were stacked: “Emergency Service of the Pennsylvania Council of National Defense in the Influenza Crisis,” 35, quoted in Crosby, America’s Forgotten Pandemic.

113 piling up on the porches: Harriet Ferrell, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 28, 1997, quoted in Barry, Great Influenza.

113 “The smell would just knock you”: Interview by Charles Handy for WHYY-FM program “The Influenza Pandemic of 1918: Philadelphia, 1918.”

113 “They were taking people out”: Ibid.

113 “They had so many died”: Ibid.

113 dispatched a steam shovel: “Emergency Service of the Pennsylvania Council of National Defense in the Influenza Crisis,” 35, quoted in Crosby, America’s Forgotten Pandemic; and the Philadelphia Inquirer, Oct. 12, 1918.

113 people were stealing them: Michael Donohue, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 28, 1997, quoted in Barry, Great Influenza.

113 under armed guard: Barry, Great Influenza, 327.

113 12,897 Philadelphians: Great Britain Ministry of Health, Report on the Pandemic , 319-320, quoted in Crosby, America’s Forgotten Pandemic.

113 “It was the fear and dread”: Tourscher, Work of the Sisters, 105.

114 tremendous financial pressure: One-third of hospitals were reported to be operating