The Great Influenza (15 page)

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Camp Funston, the second-largest cantonment in the country, held on average fifty-six thousand green young troops. The camp was built at the confluence of the Smoky Hill and Republican Rivers, where they form the Kansas River. Like all the other training camps in the country, Funston had been thrown together in literally a few weeks in 1917. There the army prepared young men for war.

It was a typical camp, with typical tensions between army regulars and men who had until recently been civilians. When Major John Donnelly was stopped by military police for speeding, for example, he defended himself to the commanding general: 'I have, on a few occasions, corrected (enlisted) personnel along the road parallel to that camp for failure to salute; cases that I could not conscientiously overlook, there being no excuse whatever for their failure to do so. This, like my attempted correction of this guard, may not have been taken in the proper spirit, resulting in a feeling of insubordinate revenge and animosity towards me by members of this organization.'€

There were also the usual clashes of egos, especially since Camp Funston and Fort Riley had different commanding officers. These clashes ended when Major General C. G. Ballou, who commanded the cantonment, sent a missive to Washington. He had developed what he described as a 'training ground for specialists'€ at Smoky Hill Flat. In fact, Smoky Hill Flat was the best of three polo fields on the base. The commanding officer of Fort Riley, only a colonel, established the post dump beside it. The general requested and received authority 'to exercise command over the entire reservation of Fort Riley,'€ and the colonel was relieved of his command.

Funston was typical in another way. The winter of 1917-18 was one of record cold, and, as the army itself conceded, at Funston as elsewhere 'barracks and tents were overcrowded and inadequately heated, and it was impossible to supply the men with sufficient warm clothing.'€

So army regulations (written for health reasons) detailing how much space each man should have were violated, and men were stacked in bunks with insufficient clothing and bedding and inadequate heating. That forced them to huddle ever more closely together around stoves.

Men inducted into the army from Haskell County trained at Funston. There was a small but constant flow of traffic between the two places.

On March 4 a private at Funston, a cook, reported ill with influenza at sick call. Within three weeks more than eleven hundred soldiers were sick enough to be admitted to the hospital, and thousands more (the precise number was not recorded) needed treatment at infirmaries scattered around the base. Pneumonia developed in 237 men, roughly 20 percent of those hospitalized, but only thirty-eight men died. While that was a higher death toll than one would normally expect from influenza, it was not so high as to draw attention, much less than the death rate in Haskell, and only a tiny fraction of the death rate to come.

All influenza viruses mutate constantly. The timing of the Funston explosion strongly suggests that the influenza outbreak there came from Haskell; if Haskell was the source, whoever carried it to Funston brought a mild version of the virus, but it was a version capable of mutating back to lethality.

Meanwhile Funston fed a constant stream of men to other American bases and to Europe, men whose business was killing. They would be more proficient at it than they could imagine.

CHAPTER SEVEN

N
O ONE WILL EVER KNOW
with absolute certainty whether the 1918-19 influenza pandemic actually did originate in Haskell County, Kansas. There are other theories of origin. (For a fuller discussion of them see
Afterword
.) But Frank Macfarlane Burnet, a Nobel laureate who lived through the pandemic and spent most of his scientific career studying influenza, later concluded that the evidence was 'strongly suggestive' that the 1918 influenza pandemic began in the United States, and that its spread was 'intimately related to war conditions and especially the arrival of American troops in France.' Numerous other scientists agree with him. And the evidence does strongly suggest that Camp Funston experienced the first major outbreak of influenza in America; if so, the movement of men from an influenza-infested Haskell to Funston also strongly suggests Haskell as the site of origin.

Regardless of where it began, to understand what happened next one must first understand viruses and the concept of the mutant swarm.

Viruses are themselves an enigma that exist on the edges of life. They are not simply small bacteria. Bacteria consist of only one cell, but they are fully alive. Each has a metabolism, requires food, produces waste, and reproduces by division.

Viruses do not eat or burn oxygen for energy. They do not engage in any process that could be considered metabolic. They do not produce waste. They do not have sex. They make no side products, by accident or design. They do not even reproduce independently. They are less than a fully living organism but more than an inert collection of chemicals.

Several theories of their origin exist, and these theories are not mutually exclusive. Evidence exists to support all of them, and different viruses may have developed in different ways.

A minority view suggests that viruses originated independently as the most primitive molecules capable of replicating themselves. If this is so, more advanced life forms could have evolved from them.

More virologists think the opposite: that viruses began as more complex living cells and evolved (or, more accurately, devolved) into simpler organisms. This theory does seem to fit some organisms, such as the 'rickettsia' family of pathogens. Rickettsia used to be considered viruses but are now thought of as halfway between bacteria and viruses; researchers believe they once possessed but lost activities necessary for independent life. The leprosy bacillus also seems to have moved from complexity (doing many things) toward simplicity (doing fewer). A third theory argues that viruses were once
part
of a cell, an organelle, but broke away and began to evolve independently.

Whatever the origin, a virus has only one function: to replicate itself. But unlike other life forms (if a virus is considered a life form), a virus does not even do that itself. It invades cells that have energy and then, like some alien puppet master, it subverts them, takes them over, forces them to make thousands, and in some cases hundreds of thousands, of new viruses. The power to do this lies in their genes.

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In most life forms, genes are stretched out along the length of a filament-like molecule of DNA, deoxyribonucleic acid. But many viruses - including influenza, HIV, and the coronavirus that causes SARS (Severe Acute Respiratory Syndrome) - encode their genes in RNA, ribonucleic acid, an even simpler but less stable molecule.

Genes resemble software; just as a sequence of bits in a computer code tells the computer what to do (whether to run a word processing program, a computer game, or an Internet search, genes tell the cell what to do.

Computer code is a binary language: it has only two letters. The genetic code uses a language of four letters, each representing the chemicals adenine, guanine, cytosine, and thymine (in some cases uracil substitutes for thymine).

DNA and RNA are strings of these chemicals. In effect they are very long sequences of letters. Sometimes these letters do not form words or sentences that make any known sense: in fact, 97 percent of human DNA does not contain genes and is referred to as 'nonsense' or 'junk' DNA.

But when the letters spell out words and sentences that do make sense, then that sequence is by definition a gene.

When a gene in a cell is activated, it orders the cell to make particular proteins. Proteins can be used like bricks as building blocks of tissue. (The proteins that one eats generally do end up building tissue.) But proteins also play crucial roles in most chemical reactions within the body, as well as in carrying messages to start and stop different processes. Adrenaline, for example, is a hormone but also a protein; it accelerates the heart to create the fight-or-flight response.

When a virus successfully invades a cell, it inserts its own genes into the cell's genome, and the viral genes seize control from the cell's own genes. The cell's internal machinery then begins producing what the viral genes demand instead of what the cell needs for itself.

So the cell turns out hundreds of thousands of viral proteins, which bind together with copies of the viral genome to form new viruses. Then the new viruses escape. In this process the host cell almost always dies, usually when the new viral particles burst through the cell surface to invade other cells.

But if viruses perform only one task, they are not simple. Nor are they primitive. Highly evolved, elegant in their focus, more efficient at what they do than any fully living being, they have become nearly perfect infectious organisms. And the influenza virus is among the most perfect of these perfect organisms.

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Louis Sullivan, the first great modern architect, declared that form follows function.

To understand viruses, or for that matter to understand biology, one must think as Sullivan did, in a language not of words, which simply name things, but in a language of three dimensions, a language of shape and form.

For in biology, especially at the cellular and molecular levels, nearly all activity depends ultimately upon form, upon physical structure - upon what is called 'stereochemistry.'

The language is written in an alphabet of pyramids, cones, spikes, mushrooms, blocks, hydras, umbrellas, spheres, ribbons twisted into every imaginable Escher-like fold, and in fact every shape imaginable. Each form is defined in exquisite and absolutely precise detail, and each carries a message.

Basically everything in the body (whether it belongs there or not) either carries a form on its surface, a marking, a piece that identifies it as a unique entity, or its entire form and being comprises that message. (In this last case, it is pure information, pure message, and it embodies perfectly Marshall McLuhan's observation that 'the medium is the message.')

Reading the message, like reading braille, is an intimate act, an act of contact and sensitivity. Everything in the body communicates in this way, sending and receiving messages by contact.

This communication occurs in much the same way that a round peg fits into a round hole. When they fit together, when they match each other in size, the peg 'binds' to the hole. Although the various shapes in the body are usually more complex than a round peg, the concept is the same.

Within the body, cells, proteins, viruses, and everything else constantly bump against one another and make physical contact. When one protuberance fits the other not at all, each moves on. Nothing happens.

But when one complements the other, the act becomes increasingly intimate; if they fit together well enough, they 'bind.' Sometimes they fit as loosely as the round peg in the round hole, in which case they may separate; sometimes they fit more snugly, like a skeleton key in a simple lock on a closet door; sometimes they fit with exquisite precision, like a variegated key in a far more secure lock.

Then events unfold. Things change. The body reacts. The results of this binding can be as dramatic, or destructive, as any act of sex or love or hate or violence.

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There are three different types of influenza viruses: A, B, and C. Type C rarely causes disease in humans. Type B does cause disease, but not epidemics. Only influenza A viruses cause epidemics or pandemics, an epidemic being a local or national outbreak, a pandemic a worldwide one.

Influenza viruses did not originate in humans. Their natural home is in birds, and many more variants of influenza viruses exist in birds than in humans. But the disease is considerably different in birds and humans.

In birds, the virus infects the gastrointestinal tract. Bird droppings contain large amounts of virus, and infectious virus can contaminate cold lakes and other water supplies.

Massive exposure to an avian virus can infect man directly, but an avian virus cannot go from person to person. It cannot, that is, unless it first changes, unless it first adapts to humans.

This happens rarely, but it does happen. The virus may also go through an intermediary mammal, especially swine, and jump from swine to man. Whenever a new variant of the influenza virus does adapt to humans, it will threaten to spread rapidly across the world. It will threaten a pandemic.

Pandemics often come in waves, and the cumulative 'morbidity' rate (the number of people who get sick in all the waves combined) often exceeds 50 percent. One virologist considers influenza so infectious that he calls it 'a special instance' among infectious diseases, 'transmitted so effectively that it exhausts the supply of susceptible hosts.'

Influenza and other viruses (not bacteria) combine to cause approximately 90 percent of all respiratory infections, including sore throats.
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Coronaviruses (the cause of the common cold as well as SARS), parainfluenza viruses, and many other viruses all cause symptoms akin to influenza, and all are often confused with it. As a result, sometimes people designate mild respiratory infections as 'flu' and dismiss them.

But influenza is not simply a bad cold. It is a quite specific disease, with a distinct set of symptoms and epidemiological behavior. In humans the virus directly attacks only the respiratory system, and it becomes increasingly dangerous as it penetrates deeper into the lungs. Indirectly it affects many parts of the body, and even a mild infection can cause pain in muscles and joints, intense headache, and prostration. It may also lead to far more grave complications.

The overwhelming majority of influenza victims usually recover fully within ten days. Partly because of this, and partly because the disease is confused with the common cold, influenza is rarely viewed with concern.

Yet even when outbreaks are not deadly as a whole, influenza strikes so many people that even the mildest viruses almost always kill. Currently in the United States, even without an epidemic or pandemic, the Centers for Disease Control estimates that influenza kills on average 36,000 people a year.