A Cruel Wind: Pandemic Flu in America, 1918–1920 (review)

This accessibly written monograph on the U.S. experience with pandemic influenza benefits from having as its coauthors a scientist and a historian. It will be of interest to a general audience and of perhaps slightly less interest to academic historians for reasons explored below. Organized chronologically, the book begins with a well-informed discussion of the “riddle of influenza” in which the authors discuss the history of disease from the Middle Ages, neatly summarize the evolution in scientific understanding of influenza viruses, and probe the cyclical nature of influenza epidemics and pandemics.

Both the spring 1918 and the spring 1919 “waves” of pandemic influenza are examined in detail; this is useful, considering the general focus in the literature on the more lethal fall wave from September to December 1918. The authors provide evidence that deaths from respiratory illness (influenza and pneumonia) were increasing in both civilian and military sectors in the United States perhaps as early as January 1918 and that an upward trend was certainly evident in March. At the same time, significant numbers of people suffered fairly minor cases of influenza without serious complications; it was a taste of what was to come.

Pettit and Bailie question the thesis that the 1918–20 influenza pandemic originated in the United States, which is probably the dominant interpretation among historians and epidemiologists at this juncture. Instead, they provide somewhat speculative evidence for the existence of pandemic influenza in the “Far East” and theorize that it could have been transmitted via laborers coming from China to North America and Europe. The authors, although critical of the poor conditions in military camps in the United States, place less of an emphasis on the role of military engagement in the nurturing and dispersal of influenza than does recent work by scholars including Carol Byerly for the United States (Fever of War, 2005) and Mark Humphries for Canada.¹

Pettit and Bailie trace the longer-term implications of influenza for those who survived the pandemic, and for social institutions both private and public. Although the evidence is anecdotal, the authors state that “conditions in poverty-stricken areas of the country were particularly bad” (p. 116) and make the reasonable argument that the pandemic caused financial hardship for many workers and firms. They point to the high number of children who lost one or both parents, the challenges this posed to working-class and poor families in particular, and offer some compelling examples of community mobilization in response to the need to provide economic and social security to influenza survivors and orphans. The authors refer to the “social wreckage” (p. 149) influenza left in its wake and draw on the eloquence of novelist Thomas Wolfe to describe the shock and bitterness provoked by the unexpected pandemic: “all felt the grim trickery of Death, which has come in by the cellar as they waited at the window” (p. 175). As a result of the pandemic, health came to be seen as a public, not a private, concern.

The main shortcoming of this text is its relative lack of dialogue with the historiography. Over the past ten to fifteen years, a significant amount of new research about the 1918–20 influenza pandemic has been published by historians, anthropologists, and demographers in addition to the scientific literature, but references to existing historical studies are scant. This is unfortunate, because despite the outpouring of new research, a very small number of full-length monographs have been produced about the 1918–20 influenza pandemic in the United States or elsewhere. The field could use a synthetic work that poses a new interpretation of the disease and its social significance; this is not that work. Nevertheless, it is an enjoyable read, and it provides some new insights and ample suggestions for future research possibilities.