In-flu-enza: A post in several parts

A multi-part post in which I alternately stand on my soapbox and step down to muse a bit.

There was a little bird

Her name was Enza.

They opened up the window,

and in-flew-Enza.

--American jump-roping song popular in 1918-1919

PART I: Flu on my mind.

I've been debating for months whether to add my voice to the cacophonous bluster about flu that fills our media these days. I'm writing about it here because the whole pandemic influenza thing is not a new worry for me. I've been wary of it for many years, probably because it hits all my sorespots of worry and illness and control. I'll get more into that in the third part of this post series. For now, hang on for a bit while I hop up onto my lecture/soapbox and explain a few of my thoughts on it.

If you know me, you might well know that I have been, at times in my life, a fantastic worrier. But I'm also pretty damn willful, and I've been willing myself to let go of that worrying tendency. Over the past five years, I'd say it's actually starting to work.

Sometime in my anxiety-ridden twenties, I discovered completely by accident that I loved reading about history. And it brought an added benefit: visiting and studying the past was soothing, comforting. I am nostalgic at heart, and a sucker for a story--it's amazing it took me until my twenties to cultivate an interest in history. As I read more, I found myself not only drawn into the stories, but also calmed by the greater fact of history: the fact that life goes on.

Of course, looking to the past presents other problems. History is unconcerned with neat endings or safe outcomes. The past is, in its essence, a place peopled with figures who, right or wrong, with dignity or with disgrace, lived--and died. To embrace history is to make the admission that we, too, recede into the past; our lives will become simply remnants of stories, bits of ephemera that fade away.

Did I say earlier that I had willed myself away from worrying? That history soothes? Because that last paragraph is nothing if not melancholy. But as I consider history, I find a strange comfort in the juxtaposition it presents. Thinking about the past offers that rare chance to hold in the mind, simultaneously, the ideas of both mortality and hope.

The events of the 1918 influenza pandemic distilled these feelings for me, when I stumbled onto it. As I learned more about it, I had the feeling of discovery, as though I had unearthed some weird secret of the recent past. Of course, it's getting its fair share of play right now, but for decades, it was a largely forgotten story.

My interest in what happened in 1918 fostered a curiosity about influenza in general. And what I hope to do with this next posts is to share some of my thoughts and attempt to make some sense out of pandemic flu since I started thinking about it years ago.

Pandemics are nothing new. And--this part is important--pandemic does not necessarily mean deadly. Pandemic just means a disease significantly "spread worldwide." Simply because a virus has a high infection doesn't always necessarily mean that it's deadly for many people.

But influenza is a tricky virus, and it *can* be deadly. It's that unknown element that makes it frightening.

The past 900 years of European history is peppered with accounts of entire countries or continents being besieged with deadly respiratory disease. We would certainly consider these pandemics today. Many of these aren't well documented, but the descriptions that do exist bear a striking resemblance to what we know as novel influenza. Of course, the most well-documented pandemic in history is the one of 1918, which killed upwards of 50 million people worldwide. As a comparison point, consider this: 675,000 Americans died as a result of the 1918 influenza, more than twice the number of Americans who died fighting during World War I.

When I first encountered them, these figures stunned me. I mean, come on. Flu. Everyone gets flu once in a while, right? A sore throat, a fever, a few days of rest---and it's gone. Flu is no big deal, right? I was incredulous that the flu actually killed so many otherwise young and healthy people. My initial, childish reaction to these accounts came from fear and ignorance: I scoffed at the limits of medicine at the time. What a long way we've come since then, I reassured myself. Nothing like that could happen today.

Still, my curiosity had been piqued, and I read anything I could about 1918. And then anything I could about influenza in general.

The picture that started to form in my mind was less ill-informed, and more frightening. The pandemic of 1918 was a perfect storm of circumstance, and it was not unlike what is happening now with the 2009 H1N1.

I want to be clear: I'm not implying that history is repeating itself. The H1N1 virus of 2009, while similar in makeup to the virus of 1918 , is not the same virus, and the scenario is obviously different. I do not believe that the strain of influenza (Novel H1N1/2009) circulating at this point in time will kill 6% of our population. I do not believe we are seeing the beginnings of story to rival The Stand, or the bible (how strange to see those in a sentence together). Still, some things happening now with the current strain of H1N1 give me pause. And my alarm bell, though admittedly prone to go off, has started ringing.

Part II: A Primer on Influenza

Part III: An Anti-definition of Influenza

And to skip to the reason on why I, in particular, am concerned:

Part IV: The Tricky Part for Me: Making Sense of Risk

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