One hundred years ago, an invisible killer swept the planet.
First appearing in the spring as a relatively mild disease, the 1918 flu pandemic struck the bulk of its victims in the fall, flared again in 1919 and 1920 before fading as mysteriously as it arrived. By the time it ran its course, it infected 500 million people, roughly a third of the world’s population, and killed between 50 and 100 million people.
Among the dead in North Carolina were Carolina’s President Edward Kidder Graham, who died Oct. 26, 1918, at age 43, and his successor Marvin Hendrix Stacey, who succumbed to the disease Jan. 21, 1919, at age 41.
Are We Ready?
One hundred years later, scientists are still trying to understand what happened.
Questions remain about the flu’s origins, its unusual epidemiologic features (it was especially deadly for healthy young adults, for example) and the basis of its pathogenicity.
But one thing is certain. In 1918, authorities were caught by surprise and slow to react. Some of that is understandable. So little was known about the nature of infection, how it was caused and how it could be prevented. World War I was raging in Europe, and soldiers from the United States were being trained and deployed as quickly as possible, housed in barracks and ships never meant to hold so many people. If an outbreak of this scale happens again, public health experts around the world must be prepared.
To mark the 100th anniversary of the 1918 flu—and to assess the threat that an outbreak of this scale poses today—the Gillings School of Global Public Health and its partners hosted an interdisciplinary symposium April 4–6 titled “Going Viral: Impact and Implications of the 1918 Influenza Flu Pandemic.”
“The Gillings School, in collaboration with our co-sponsors, sought to create an interdisciplinary experience that examines the impact of the 1918 flu perspective from the lens of such varied disciplines as medicine, English, epidemiology, history, communications, veterinary medicine and other fields,” said Barbara K. Rimer, dean of the Gillings School.
Co-sponsors were Carolina’s Institute for Global and Infectious Disease as well as RTI International, UNC Libraries and the N.C. Museum of Natural History, which will host its own free presentation on April 7. The Smithsonian’s National Museum of Natural History also partnered on some aspects of the symposium and after-events.
The keynote speaker was New York Times journalist Gina Kolata, best-selling author of Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It.
Other speakers included Chancellor Carol L. Folt; former Centers for Disease Control and Prevention director Tom Friedan; Gillings School and School of Medicine professors David Weber, Myron Cohen and Ralph Baric, who are all internationally known virology and infectious disease experts; Zack Moore, state epidemiologist for North Carolina; and historian Howard Markel, director of the History of Medicine at the University of Michigan.
“For the Public Good”
The symposium also featured a day-and-a-half of panels and presentations with dozens of internationally recognized experts who explored the implications, past and present, of such a devastating infectious disease outbreak.
“Understanding what happened in 1918 and how to prevent it is clearly for the public good,” Rimer said. “Public health can be a great convener of people, crossing boundaries to forge conversations for the public good. That’s one of our goals.”
The 1918 flu, for instance, swept across a world that was already awash in turmoil and tens of millions of deaths as a result of World War I. Part of the reason the outbreak spread so far so fast was because of the increase in international travel and the crowded conditions that war-mobilized populations encountered.
There are reasons to believe that a similarly virulent epidemic today would be far worse because there are more people today who are more connected than ever before, Rimer said.
Elizabeth French, Gilling School’s assistant dean for strategic initiatives who helped put the symposium together, said the enormity of the 1918 flu led to the creation of modern health systems and to the rise of schools of public health like the Gillings School, which was established in 1940.
“This topic seized the imagination of so many of us planning the symposium,” French said. “In terms of public health history, it is a sentinel event.”
It also put a spotlight on the need for and value of teamwork across academic disciplines to solve the world’s greatest challenges, French added.
That need is deeply etched in The Blueprint for Next, the chancellor’s strategic framework for Carolina. One of the initiatives is The Great Convergence, a campus-wide call for collaboration across disciplines.
The symposium was developed with that idea in mind, French said.
“This was a core part of the vision for this symposium,” French said. “We are an eminent public health school. We should be leading the charge of thinking in the broadest terms about what are the big public health problems facing us now and who can be at the table to think about and develop solutions for these big problems.”
As part of the event, on April 4, Executive Vice Chancellor and Provost Bob Blouin hosted the free presentation “O Lost! The University of North Carolina at Chapel Hill, Thomas Wolfe and the Great Influenza Pandemic of 1918” at Wilson Library. Additional distinguished speakers at the symposium included health communicators, historians, biostatisticians, epidemiologists, virologists and others.
“’Going Viral’ reflects today’s imperative for interdisciplinary across disciplines, sectors, people and ideas,” Rimer said. “It is the actualization of Carolina’s low stone walls.”
Story by Gary Moss, University Gazette. Video by Aaron Moger, University Communications