Book: Pandemic 1918: The Story of the Deadliest Influenza in History
Basic Information : Synopsis : Expectations : Thoughts : Evaluation : Book Group : New Words : Book References : Good Quotes : Table of Contents : References
Basic Information:
Author: Catharine Arnold
Edition: ePub on Libby from the San Francisco Public Library
Publisher: Michael O'Mara
ISBN: B078WCDK3Q
Start Date: August 22, 2020
Read Date: September 5, 2020
368 pages
Genre: History, Science, OSHER
Language Warning: None
Rated Overall: 3½ out of 5
History: 4 out of 5
Synopsis:
he author traces the pandemic from its beginnings, maybe from a place in Kansas and how it spread across the nation. Then how it popped up in Europe and was intensified with America entering the war. Many stories of people catching it and the effects. This is mostly an English speaking group of events, but it did affect almost all nations.
At the end of the book, she talks about modern day attempts at isolating the virus and determining its structure.
- Recommendation: Dawn Diestelkamp
- When: June 2020
- Date Became Aware of Book: June 2020
- How come do I want to read this book: First, it is an OSHER book club read. Next Dawn highly recommended it, particularly because the subject matter fits with the times
- What do I think I will get out of it? How the 1918 pandemic ended and how attitudes were during that time.
Thoughts:
I will say from the get go, I do not like how Arnold tries to personalize the Spanish Flu and calls it the Spanish Lady. Then she gives it a will by saying she “attacked” a region, like it was a military operation. While it gives a feeling of being a relentless opponent, it does not help explain how it was human couriers who made this happen.
In various places Arnold talks about how masks were ineffective from stopping a person getting the Spanish Flu. She identifies that the masks were not comparable to today’s N95 masks so they would not stop a person from breathing in the flu virus. But I do not think I ever read if she said what the effectiveness of stopping a person from spreading the virus. That seems to be the key point in today’s COVID-19 crisis. A cloth mask has a limited effectiveness in stopping a person from getting COVID-19, but reduces the spread of COVID-19 by reducing the amount of particles circulated when a person breathes.
Introduction: An Ill Wind
Starts with the exhuming of Sir Mark Sykes in Yorkshire. He was a victim of the 1918 flu pandemic. Scientists wanted to understand how the H1N1 (H5N1??) killed him. Because he was buried in a lined lead coffin, it was thought his body’s soft-tissue might still be intact. He had died in 1919. His was one of several attempts to obtain samples of this flu.
The author notes: Today, despite regular health scares about bird flu, SAES, HIV, and Ebola, it is difficult to envisage a scenario in which something as common as influensa could cause widespread illness and death. Hard, but not impossible. Even though she wrote this two years before the 2020 COVID-19 virus, much of what she describes sounds like today’s pandemic. This is down to her description of influenza: a complex disease caused by an airborne virus which spreads between individuals in microscopic droplets, via coughing or sneezing. Maybe not coughing or sneezing, but just breathing. Just to be clear, COVID-19 is not the flu. But there are parallels to it.
The word influenza comes from the word influence. Some thought it was under the influence of the stars, some thought of it as a cold.
She traces several bouts of the flu through the centuries. In 1889-1891, 250,000 Americans were killed by the Russian flu.
World War I was a great influence on the spread of the flu. Troops were moved around the nation and around the world. As troops would rotate off of an area, some brought back the virus to other troops in back. Other troops returned home and spread it there. And still war time rally’s, particularly for war bonds, were super-spreader events.
She calls the Spanish Flu the Spanish Lady. I do not like that term. First, the flu was no lady. Next it seems like this is a bit sexist. Lastly, Spain was more of a victim than the start of the flu.
Several American notables were stricken by it, including Walt Disney, Lillian Gish, Groucho Marx, and John Steinbeck. The latter indicated that his outlook was forever changed by it.
War is a great time for conspiracy theories.
She notes that the symbol of this time is the mask. She goes on and says that they did not do much good. I am wondering if it was the type of mask? Or any mask?
Sort of eerily, she speculates and wonders if the Spanish Lady will return, maybe in a different form. Not in a different form, but in a similar style.
A Victim and a Survivor
Private Harry Underwood-one of the first victims of the Spanish flu. Speculation was that he was patient zero, the originator of the flu. But this is unlikely.
Traces through the early attempts to diagnose and understand the virus.
Interesting connection, HMAC Major Adolphe Abrahams, older brother of Harold Abrahams, was part of the group trying to identify the virus.
Animal-human interfaces likely conduit for the disease. Particularly, the cavalry still used horses. But more likely ducks were in abundance. Their feces was in the ground which pigs nestled through.
"Knock Me Down" Fever
In Kansas, a strange sickness broke out in Feb 1918. It was influenza, but a more virulent strain than the local doctor had seen. It came on suddenly and then suddenly left Kansas. It was noted that a couple of men had come home from an Army camp unwittingly spread the virus.
It became that the worst place to spread the virus was in a densely packed Army camp. While inoculated against the common diseases, there was no vaccine for the Spanish flu, if they knew what it was.
The Killer Without a Name
Incidents of influenza flared up throughout the nation, particularly in military bases and camps.
Also San Quentin became a hot spot. This led to a prison doctor experimenting with a new prisoner from Los Angeles. From here he was able to gather data which was important in understanding the spread of the virus.
The Invisible Enemy
Both sides of the conflict during World War I were affected by th Spanish Flu. The British had been hit by influenza throughout the war. But what they were being hit with in March 1918 was different.
The Americans came in April 1918 to reinforce the British positions. While this was true, the Americans also brought a stronger strain of the Spanish Flu with them. More Americans died from the Spanish Flu than from armed combat.
The Army figured out that a certain amount of immunity built up if they kept units together than injecting new troops into a unit.
In May 1918, the Spanish Flu went over to the German side. This allowed the Allies to regroup.
When the Spanish king, King Alfonso came down with the flu, it was called the Spanish Flu. It was in Spain, which was neutral, did the medical diagnosis first surface that this was not the flu, but something else.
One Deadly Summer
Anywhere which people went to would soon have the Spanish Flu. A port in Scotland became an area where the military went through. Pretty soon it became a hot spot. It affected all classes.
In Manchester on July 18, 1918, all schools were closed. Why? Because children were dying at their desks. It was felt that the chief medical officer for Manchester saved thousands if not tens of thousands of lives by closing things down.
It was noted that live entertainment was the worst breeding grounds for the flu.
Note: Arnold says that Peter Pan was written by J.M. Barry. It is Barrie. Wonder what else slipped by her and her editor or what else is slightly mistaken. I wonder if she got herself confused with The Great Influenza (2004), by John M. Barry?
The Spanish Flu came into Britain and in four months left.
Know Thy Enemy
In Britain, was war or the sickness the priority? It needed to be the war.
This one statement says that things do not change much: There was little consensus on treatment apart from the traditional recourse to bed rest, opiate and folk remedies, while to make matters worse, significant individuals refused to take the threat of Spanish flu seriously. Not too much than today’s pandemic, except for the treatment. This was compounded by the public health people in Great Britain saying: I know of no public health measure which can resist the progress of pandemic influenza. So they did not issue any official health memorandum to those who governed.
That was the public facing. But behind the scenes, medical people were searching for how to deal with the Spanish flu. One of the people was a Cambridge trained physiologist. He was a cut above everybody else. What makes him notable to me was that he was set off by an endearing stutter when he became excited. I always enjoy having a person make good who are stutterers.
Some historians feel that due to censorship, the Spanish Flu among the troops was hidden, others felt that it was more of a pushing the blame to the Spanish. But it seems like the author is more on the side of the medical people were genuinely confused about what they were dealing with.
Today we are concerned about a second wave of the COVID-19 pandemic. It was a man named Major Greenwood compared the curves of the Spanish FLu with that of the Russian Flu. He realized that the Spanish Flu was not yet done in, but that a second more virulent wave was coming. I think that is the experience which today medical people are drawing on in predicting a second wave is possible.
The Fangs of Death
400,000 Germans died. The Kaiser also fell ill from it. This was not confined to those in Europe either. It went through Egypt and India as well as Greece and the Scandanvian countries. She talks about how it entered Indian through Bombay. Also Persia where the use of opium affected who died. During the next six months, 50,000,000 Africans died.
She then goes through death in the United States, particularly on military bases. Military doctor Victor Vaughn after witnesses how deadly and ineffective any remedy was said, At that moment, I decided never again to prate about the great achievements of medical science and to humbly admit our dense ignorance in this case. This is probably a good attitude to have in regards to all things. Once you think you have arrived, you will be shown not to.
A conspiracy theory was that the Germans had somehow released this flu on American soil. One theory was that the Bayer aspirin, which was German origin, had germs in the tablets. Some were in favor of calling this the German Flu.
Like Fighting With a Ghost
It was that the Spanish Flu would be easily contained in the United States. The equivalent of the surgeon general today recommended bed rest, good food, quinine, and aspirin for those who came down with it.
Arnold recounts how various places dealt with it, along with stories of individuals. Even FDR was stricken with the Flu and had to be carried off of a ship (this was many years before he became president. He was part of the Naval administration.)
While high up medical pronouncements sounded promising, hospitals ran out of room.
Eye of the Storm
Philadelphia would be the epicenter in the United States for the Spanish Flu, similar to New York being for the COVID-19 pandemic. It was here that the Spanish Flu was isolated and named Pfeiffer’s bacillus. It was thought that a vaccine would be coming soon, so a huge Liberty Bond War Drive was staged where 200,000 people came. Within one day, the number of cases exploded. In about 20 days, 75,000 cases of the Spanish Flu were estimated. All schools, churches, and theaters were ordered closed. Also all public entertainment and saloons were closed. Within 3 weeks, 7,800 people died.
The poor was the heaviest hit. But all were affected. Absenteeism grief. The telephone company could only handle emergency calls.
Things got so bad, some cemeteries forced people to dig their own families graves. Security guards were hired to watch over caskets.
There was a lot of community spirit as charitable religious organizations would step in and try to help. But the usually friends and sometimes families were so terrified that they would not help.
A Winding Sheet and a Wooden Box
More destruction by the Spanish Flu. This time it moves into the MidWest. And of course, more stories. Medical facilities were removing patients at the rate they were coming in, usually to go to the morgue. One of the people who caught this was a guy named ‘Diz’, as in Walt Disney. He survived, obviously.
Even Alaska got caught up. The Inuit people were communal by nature. So when one caught it, it all but certain a whole village would be infected.
Canada was not spared either. Burial in Winter was all but impossible with frozen ground.
The Spanish Lady Goes to Washington
In Oct 1918, when 40 people were admitted to a DC hospital with the Spanish Flu, the health commissioner shut down DC, including schools, bars, theaters, and pool halls. Pretty soon all of Washington was closed-even the courts and Congress. This did not stop the toll from rising. But it did save lives, this shutting down the city.
"You Can't Do Anything for Flu"
Commercial ventures, even respectable ones, were not immune from the effects of the Spanish Flu. There was a way to make a buck by selling something which might cure or at least relieve the Spanish Flu. As the mortality rates soared, so too did the willingness to try something, anything, to save themselves and their loved ones from a horrible death.
One one knew what caused people to catch the flu, but it was pretty much assumed that you should avoid microbes and germs. So people went from the understandable-washing everything thoroughly and masking and avoid others to wear fragrant satchels around their neck along with potences made of certain herbs. Whiskey and voodoo were some of the other items tried. Probably one of the best things to do was to get into fresh air.
"Native Daughter Dies"
Arnold talks about San Francisco. The health officer thought that it would not reach the Bay Area because of its climate. But he was prepared to deal with it if it did. He did not impose restrictions. In a two week period starting on Sept28, 1918, there were events which drew over 235,000 people. By Oct 11th, the city had a full fledged epidemic going on. There was the special problem of Chinatown being suspicious of Western ways so they resisted any measures causing them to die in great numbers.
As a note: A more local to Fresno item, a Fresno State professor, Ethan Kytle, has put together a blog on how Fresno reacted to the Spanish Flu: Dispatches from Fresno, 1918-19: Following the ‘Spanish’ Flu Pandemic in Real Time
Health dept felt that masks would be of great benefit. Because the mask was very thin, they were not effective. These masks took a great deal of shape and fashion. They became a statement. Most people did wear masks. But some resisted saying it was unconstitutional.
Los Angeles fared better. But several movie stars including Lillian Gish caught the flu, some died.
The Fatal Voyage
The travail of the transport ship the USS Leviathan. Left New Jersey for Britain on Sept 29, 1918 with about 10,000 soldiers and 2,000 sailors. This was the biggest ship in the world and one of the fastest. The concern was more the German subs than the sickness, even though a number of men could not board the ship because on the way in, they fell sick. Immediately on being in the ocean, men fell sick, a large number of them.
Ship of Death
Death was recorded on the Leviathan. But then that record got overwhelmed. When they reached Britain, 969 patients were transferred to hospitals. There were no clear records of how many people died-but it would be around 76 soldiers and three sailors.
The Leviathan was just representative of the other transport ships.
"Like a Thief in the Night"
Miners in South Africa were affected. A mine cage operator suddenly was stricken by it. 20 miners were killed when the operator could not move. A troop ship came in. Some of the soldiers carried the virus causing the outbreak.
When the African workers were sent back, it was via train. Blacks were put into special cars. The conductors would refuse to go back there because of the sickness. Special hospital cars were attached to the train. All in all, the mine owners profits were affected by this. So they made things safer, not for the miners, but so that they would not lose productivity.
The Dying Fall
British Prime Minister Lloyd George caught influenza and was critically ill. He barely made it back to London from Manchester. Gandhi became ill with the Spanish Flu. He resigned himself to death. But survived when medical personnel insisted he at least take goat’s milk.
Arnold describes the strain on the medical staff.
Like today, there were those who believed they were dealing with something else. In their day, some medical people thought it was cholera.
Armistice Day
November 11, 1918 - Armistice Day. But soldiers were still dying - from the Spanish Flu. This was celebrated with huge gatherings. There was a general feeling that death and destruction was over. People could now live life. But as one doctor noted that, there can be no armistice between medicine and death.
Black November
As the Armistice came, New Zealand was still battling the Spanish Flu. Stories from this battle.
A major local paper said that: Those who are not doing so are not showing their independence - they are only showing their indifference for the lives of others. - for the women and the helpless little children who cannot help themselves. Some things do not change.
Aftermath
With the war ending, and I suspect the lack of troop movements, the Spanish Flu started lacking in numbers. President Woodrow Wilson became ill with the Spanish Flu on his way over to sign the Paris Peace Conference in February 1919.
The author gives the aftermath of several people’s stories who she has written about.
Arnold closes this chapter with quoting an editor who said: From that time on there was a sadness which had not existed before, a deep down sadness that never went away. We weren't safe. Nobody’s safe. Terrible things can happen.to anyone at any time. I wonder if this will be our outcome.
"Viral Archaeology"
So far in the book, Arnold has talked about how the Spanish Flu spread. But has not talked about how it began nor what exactly it was. She has shown us the confusing nature of this flu.
In this chapter she follows the modern investigators, exploring how the flu was tracked. The trick is to find a well-preserved body with soft tissue of a Spanish Flu victim. Three avenues. The first is to go to Alaska and see if some of the bodies are still well preserved as being frozen.
Dr. Jeffery Taubenberger took on the task of figuring out the Spanish Flu when a cancer project ran out of money. In 1996 a Dr Amy Kraft came across an autopsy of a soldier from Sept 1918. There was also a specimen of his lung. There was very little left and so they were cautious of destroying the matter. An additional specimen was obtained from a previous Alaska trip. The sequencing of the flu was done. This is the H5N1 virus.
Another question was how did it go from animal to human? One theory is that in humans this virus creates a cytokine storm-essentially the body of a healthy individual will go into hyper-mode to combat the virus, destroying whatever is in its path, including the healthy person. So the healthier the person is the more vigorous the counter-attack and the more likely the person will be killed.
Remember, this was written in 2018. Arnold says that Mercifully, the twentieth century has not seen another pandemic on the scale of 1918’s Spanish Flu. There has been other outbreaks, but nothing like this one. That is until 2020 when the COVID-19 pandemic came and shutdown most of the world. Of course, this is after the book was published.
The Hong Kong Connection
Is looking for an 80 year old flu strain an exercise in curiosity? Or does it have some real world use? In 1997 a three year old in Hong Kong was diagnosed with the H5N1 virus. A second boy died from this same strain. All through the fall more people, not just the young were admitted with this type of disease. A scientist connected this flu, a bird flu, to the Asain wet markets. In China, they like to have their poultry killed fresh. But there was cause for alarm. The wet markets were shut down and all the chickens on the island were killed. This seemed to take care of the situation, for now.
It was felt this was a dress rehearsal of the real thing.
Arnold says that two scientists thought that Hong Kong might be on the verge of a pandemic. Is that really the right word? If it is just Hong Kong, then it would be more of an epidemic. A pandemic involves a wider area, such as the whole world.
Arnold equates the potential for a pandemic with international terrorism.
Secrets of the Grave
Another mission to gather samples for sequencing. This time to miners who were frozen at death in Norway. This expedition did not yield suitable material. The same with another female in England.
One model has that if another version of the Spanish Flu hits the United States between 188,000 and 337,000 people would die. Seems pretty close to where we are at right now.
Evaluation:
Reading this in 2020, this book seems mildly prophetic. She introduces us to the subject by saying: Today, despite regular health scares about bird flu, SARS, HIV, and Ebola, it is difficult to envisage a scenario in which something as common as influenza could cause widespread illness and death. And yet, two years from when the book was published, we are in the middle of a world-wide pandemic which seems like we will not escape for a while.
Arnold gives herself the narrative role while relaying a whole swath of stories centered around the Spanish Flu of 1918. This mixing is done well. At times the volume of the stories is overwhelming, but so was the pandemic. There are some let downs in the book. Some are minor flaws like using the word pandemic in the context of an epidemic, or the writer of Peter Pan being named Barry instead of Barrie. Those kinds of mistakes which I can pick out makes you wonder what else is not correct. Others are more aggravating such as the use of titling the flu as the Spanish Lady and then in places giving this “lady” what seems like a will.
Also the book ends without a good resolution to what was the Spanish Flu? Also I found myself wondering that the differences between the various nomenclature was-what is the difference between the H5N1 and H3N2 flus and why did it matter-a chart or explanation would be useful.
But this is a read which should be done during our current COVID-19 pandemic. A better understanding of what is being done today and why it is done. Also what reactions and mistakes happened. It is worth the read, and it is a read which can be done quickly with understanding.
Notes from my book group: (Osher group read it on Sept 4, 2020)
Why is the flu called “The Spanish Flu”? What effect does it have on how you look at it when you call it a country’s name? When the COVID-19 is called the “China Flu” or the “China Virus”, how does that affect your understanding of the pandemic?
Why does Arnold call the virus “The Spanish Lady?” There are places where Arnold gives this virus a “will”. Does this virus, or any other sickness, have intent?
What does Arnold think about mask wearing as protection from the Spanish Flu? What does she think of mask wearing as a means of stopping the spread of this virus?
Describe the state of science as talked about in this book. How was the challenge of figuring out what was happening in 1918 tackled? How have we advanced from there?
Describe how information about this flu was communicated to other scientists. Other policy makers. Do you think some sort of cohesive means of knowledge sharing would have saved lives? If so, how do you share the knowledge during war time? Which takes precedence: national security or stopping the spread of the virus?
World War I’s troop movements spread the virus. Once the military realized who the virus spread was occurring, how did they minimize. Why did this work? How does this affect our understanding of how viruses are transmitted?
What civilian measures were taken to combat the virus? How were they enforced? Were they effective? Was their resistance to these measures? How did uneven responses by public officials affect outbreaks of the Spanish Flu?
There was a second wave, and even a third wave of the virus. What made the second wave more deadly than the first? What was the general population's reaction to renewed restrictions?
How did religion play into this book? Where is God in the midst of a pandemic?
Talk about the similarities and differences between the 1918 and the 2020 pandemic. Why are the similarities similar? What made them different?
It seems like different locations, both cities, states and countries have different successes against the COVID-19 virus. Is there any one way to combat this virus?
The book concludes with scientists looking for information about the H5N1 flu strain. WHy is this important? Should we have emphasized this? How much resources should be spent go after things like this? How do you disperse this knowledge?
40 years from now when medical historians look back on 2020, what do you think they will say? Do you think that they will say our measures were effective?
Many of these questions are either from or adapted from LitLovers.
Why the title of Pandemic 1918?
Does this story work as a history?
Did the ending seem fitting? Satisfying?
Every story has a world view. Were you able to identify this story’s world view? What was it? How did it affect the story?
In what context was religion talked about in this book?
Why do you think the author wrote this book?
What would you ask the author if you had a chance?
What “takeaways” did you have from this book?
What central ideas does the author present?
Are they personal, sociological, global, political, economic, spiritual, medical, or scientific
What evidence does the author use to support the book's ideas?
Is the evidence convincing...definitive or...speculative?
Does the author depend on personal opinion, observation, and assessment? Or is the evidence factual—based on science, statistics, historical documents, or quotations from (credible) experts?
What implications for you, our nation or the world do these ideas have?
Are these idea’s controversial?
To whom and why?
Are there solutions which the author presents?
Do they seem workable? Practicable?
How would you implement them?
Describe the culture talked about in the book.
How is the culture described in this book different than where we live?
What economic or political situations are described?
Does the author examine economics and politics, family traditions, the arts, religious beliefs, language or food?
How did this book affect your view of the world?
Of how God is viewed?
What questions did you ask yourself after reading this book?
Talk about specific passages that struck you as significant—or interesting, profound, amusing, illuminating, disturbing, sad...?
What was memorable?
===
From the OSHER Book Club:
What parallels do you see between the 1918-1919 pandemic and the Coronavirus pandemic of 2019-2020?
How did the misguided decisions by the military, medical and political leaders impact the response to the Pandemic in 1918 and do we see that today during the pandemic?
The 1997 bird flu was stated to be a dress rehearsal. Has that made a difference in the response to the pandemic today?
Despite the horrific devastation, what were some of positive benefits that came about in the wake of the influenza in 1918 and 2020?
On page pg. 270 Taubenberger is said to have become intrigued by the sheer scale of the pandemic and the way it had faded so quickly from the “cultural memory”. There have been many articles about how our lives will change once we are back to “normal”. Will we change or will it fade from cultural memory and we go back to life as usual?
The Prime Minister of Britain had the influenza and there was a question of whether President Wilson had the influenza. Does the public have a right to know the health status of their leaders?
What were some of the sounds and smells associated with the Pandemic? How do the senses impact our memories good and bad?
Discuss the heroic day to day efforts of people. Also, the cruelty it can bring about in some people.
Discuss the perfect storm for disaster during the Pandemic of 1918 – the influenza and the war and the perfect storm for disaster – the virus, racial unrest and political election during the Pandemic of 2020.
New Words:
- Prophylaxis (1): action taken to prevent disease, especially by specified means or against a specified disease.
- Lagrippa ("Knock Me Down" Fever): Influenza, la grippe or epidemic catarrhal fever may be defined as a specific epidemic and contagious disease, caused by a specific bacillus. This disease spreads rapidly over wide districts of country, causing marked febrile symptoms, is often attended by serious complications and causes great and prolonged prostration of strength.
- Charnel (Ship of Death): associated with death
- Lakhs (The Dying Fall): a hundred thousand.
- Ghats (The Dying Fall): a flight of steps leading down to a river. Or a mountain pass
- Macaques ("Viral Archaeology"): constitute a genus of gregarious Old World monkeys of the subfamily Cercopithecinae.
- Recherche ("Viral Archaeology"): rare, exotic, or obscure.
- War of the Worlds by H.G. Wells
- Pale Horse, Pale Rider by Katherine Anne Porter
- Look Homeward, Angel by Thomas Wolfe
- Testament of Youth by Vera Brittain
- The Plague of the Spanish Lady by Richard Collier
- Peter Pan by J.M. Barrie
- Memories of a Cahtolic Girl by Mary McCarthy
- Night and Day by Virginia Woolf
- Black November: The 1918 Influenza Pandemic in New Zealand by Geoffrey W. Rice
- A Clockwork Orange by Anthony Burgess
- The Group by Mary McCarthy
- America’s Forgotten Pandemic by Alfred Crosby
Good Quotes:
- First Line: As the sun sank over a windswept Yorkshire churchyard in September 2008, a battered lead-lined coffin was reburied hours after being opened for the first time in eighty-nine years.
- Last Line: In 1918 there were more acts of heroism on the Home Front than on the Western Front.
- War is a great time for conspiracy theories. Introduction
- Introduction: An Ill Wind
- A Victim and a Survivor
- "Knock Me Down" Fever
- The Killer Without a Name
- The Invisible Enemy
- One Deadly Summer
- Know Thy Enemy
- The Fangs of Death
- Like Fighting With a Ghost
- Eye of the Storm
- A Winding Sheet and a Wooden Box
- The Spanish Lady Goes to Washington
- "You Can't Do Anything for Flu"
- "Native Daughter Dies"
- The Fatal Voyage
- Ship of Death
- "Like a Thief in the Night"
- The Dying Fall
- Armistice Day
- Black November
- Aftermath
- "Viral Archaeology"
- The Hong Kong Connection
- Secrets of the Grave
- Notes and References
- Bibliography
- Acknowledgements
- Picture Credits
- Index
References:
- Publisher's Web Site for Book
- Wikipedia-Author
- Amazon-Book
- Amazon-Author
- Barnes and Noble
- GoodReads-Book
- GoodReads-Author
- Literary Hub
- Gates Notes - Blog of Bill Gates
- American Writers Museum
- Publisher’s Weekly
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