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Mark Honigsbaum, 'Living with Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918'

Palgrave Macmillan, 2008; ISBN 978-0230217744; £15.99

Between the summer of 1918 and the following spring about 230,000 people died in Britain from a deadly strain of influenza, popularly called Spanish Flu. The toll worldwide may have been as high as 100 million. This book describes the pandemic in Britain making use of unpublished testimonies of survivors and the memoirs of doctors, soldiers, and civil servants.

The title comes from a rhyme sung by children at the time: “I had a little bird / Its name was Enza / I opened the window / And in-flu-enza”. One theme of the book is that the 1918 pandemic was belittled, treated as a minor inconvenience, and ultimately largely forgotten by later generations. An explanation for this was, no doubt, the coincidence of the outbreaks with the ending of the war, eclipsing the pandemic. Faced with such huge numbers of deaths, amnesia may have been the psychological strategy that made most sense.

The book raises several possible links between the war and the pandemic. The huge British staging camp at Étaples in Northern France was a potential source of the outbreak. However, as with several other hypotheses presented, including the mutagenic impact of gas warfare, the ideas are left floating without the evidence needed to pin them down.

The final chapters bring us up to date with an account of subsequent flu pandemics and of current UK pandemic planning. In the author’s words the “government’s biggest fear is not so much the initial wave of morbidity as the knock-on effects on the British economy” (emphasis added). The key phrase is “business as usual”, which means, for instance, schools generally staying open to avoid parents being forced to stay at home and become “unproductive”, despite the fact that children are the greatest viral shedders. Reading this one gets a familiar sense of government preparing to act to preserve itself rather than the people.

I read this book at a great pace. The frequent use of first hand accounts gives it a welcome human dimension, and the handling of the history and science is at a level suitable for the general reader. I recommend it to anyone who doubts the seriousness of the pandemic flu threat and who has a critical interest in the actions taken by government in our name.

Topics: History