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(from "A Short History of Nearly Everything" by Bill Bryson, published in 2003:)

"Almost 80% of American casualties in the First World War came not from enemy fire, but from flu. In some units the mortality rate was as high as 80%.

A fifth of the victims suffered only mild symptoms, but the rest became gravely ill and often died. Some succumbed within hours, others held on for a few days.

In the United States, the first deaths were recorded among sailors in Boston in late August 1918, but the epidemic quickly spread to all parts of the country. Schools closed, public entertainments were shut down, people everywhere wore masks. It did little good. Between the autumn of 1918 and the spring of the following year, 548,452 people died of the flu in America. The toll in Britain was 220,000, with similar numbers dead in France and Germany. No one knows the global toll, as records in the Third World were often poor, but it was not less than 20 million and probably more like 50 million.

In an attempt to devise a vaccine, medical authorities conducted tests on volunteers at a military prison on Deer Island in Boston Harbor. The prisoners were promised pardons if they survived a battery of tests. First the subjects were injected with infected lung tissue taken from the dead and then sprayed in the eyes, nose and mouth with infectious aerosols. If they failed to succumb, they had their throats swabbed with discharges taken from the sick and dying. If all else failed, they were required to sit open-mouthed while a gravely ill victim was helped to cough into their faces.

Out of - somewhat amazingly - three hundred men who volunteered the doctors chose sixty-two for the tests. None contracted the flu - not one. The only person who did grow ill was the ward doctor, who swiftly died. The probable explanation for this is that the epidemic had passed through the prison a few weeks earlier and the volunteers, all of whom had survived that visitation, had a natural immunity.

Much about the 1918 flu is understood poorly or not at all. One mystery is how it erupted suddenly, all over, in places separated by oceans, mountain ranges and other earthly impediments. A virus can survive for no more than a few hours outside a host body, so how could it appear in Madrid, Bombay and Philadelphia all in the same week?

The probable answer is that it was incubated and spread by people who had only slight symptoms or none at all. Even in normal outbreaks, about 10% of people have the flu but are unaware of it because they experience no ill effects. And because they remain in circulation they tend to be the great spreaders of the disease.

That would account for the 1918 outbreak's widespread distribution but it still doesn't explain how it managed to lay low for several months before erupting so explosively at more or less the same time all over. Even more mysterious is that it was primarily devastating to people in the prime of life. Flu normally is hardest on infants and the elderly, but in the 1918 outbreak deaths were overwhelmingly among people in their twenties and thirties. Older people may have benefited from resistance gained from an earlier exposure to the same strain, but why the very young were similarly spared is unknown. The greatest mystery of all is why the 1918 flu was so ferociously deadly when most flus are not. We still have no idea."

Later in the book Mr. Bryson illustrates how this planet belongs to microbes and they just let us live here. The more we learn the more we understand how truly bizarre organic life truly is.