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Chapter 7
Themes
Key
LitCharts assigns a color and icon to each theme in The Great Influenza, which you can use to track the themes throughout the work.
Leadership and Crisis
Truth, Free Press, and Propaganda
Science vs. Nature
Education, Research, and Institutions
Summary
Analysis
The body’s immune system is a complex system that needs to be able to determine “self” from “nonself” in order to keep out harmful invaders. When an immune system attacks foreign invaders with white blood (which defend the body by killing unknown antigens), it’s called an “immune response.”
Though pandemics are often viewed from a zoomed-out public health perspective, it is also important to understand what’s happening at the zoomed-in, microscopic level of an individual’s body. While Barry minimizes the use of scientific jargon, some terms like “antigen” and “pathogen” are so central to the story and to scientific history that they must be defined.
Themes
Before antibiotics, it used to be a race to the death between pathogens and the immune system. Once someone survives an infection, however, their immune system is better prepared against future infections, since specialized white blood cells (“memory T cells”) remember the shape of antigen attackers, allowing them to respond quicker. Similarly, vaccines also alert the body in advance about specific antigens.
Even when Barry first wrote the book, misinformation about vaccines was common, and the issue has arguably become even more widespread since the start of the COVID-19 pandemic. Because Barry writes elsewhere about how he believes in free press and the value of the truth, he likely believes that providing a clear explanation of how vaccines work (and how vaccines relate to typical immune system functions) is the best way to communicate with his audience.
Themes
Influenza, however, can sometimes evade the immune system. Unlike measles, which has a virus that mutates so slowly that most people can only get it once, influenza mutates so fast that sometimes it can evade the immune system because the body doesn’t recognize the new variant. This process of mutation is called “antigen drift,” and the greater the antigen drift, the less effective the immune system will be in responding. Antigen drift is what can create epidemics but does not cause great pandemics.
The previous description of the immune system raises a question: if the body “remembers” diseases, why do people seem to keep getting the same colds? While “reason” might suggest that people would stop getting colds after a certain age, in fact, a more scientific approach shows that there is actually a good reason why some viruses are able to evade the immune system’s memory.
Themes
When a more radical change occurs in the gene coding of a virus, this is called “antigen shift” (not “drift”). For example, when a virus that normally affects birds suddenly infects humans, this is an antigen shift. This shift led to major pandemics even before modern transportation connected people around the world instantly, with some historians concluding that the pandemics of the 15th and 16th centuries may have been influenza. Other mass epidemics, like the one in 1688, were undoubtedly influenza.
While the 1918 influenza pandemic was in many ways an unprecedented event, it also followed a pattern from history. Barry brings this up not only to provide context for 1918, but perhaps also as a way of suggesting that today’s public health officials shouldn’t get complacent, since there is ample historical evidence about how diseases can mutate and spread rapidly.
Themes
Get the entire The Great Influenza LitChart as a printable PDF.
More recently, influenzas like so-called “avian flu” and “swine flu” are antigen shifts that have threatened global pandemics but so far remained contained. Not all pandemics are lethal. Of the three major influenza outbreaks in the 20th century (in 1918, 1957, and 1968), the 1918 and 1957 outbreaks were deadly, but the 1968 one had a fairly low mortality.
While The Great Influenza is a historical book, the mentions of recent “swine flu” and “avian flu” make it clear that the issues covered in the book aren’t limited to the past, and that the lessons of the 1918 pandemic will be particularly important to public health officials who hope to combat inevitable mass outbreaks in the future.
Themes
