In 2009 people globally learned of the appearance of a new strain of influenza named H1N1A or “swine flu” in Mexico. By June the World Health Organization had declared the outbreak to be a pandemic, the U.S. and European governments were spending billions of dollars on vaccines and medications, and the tourism industry in Mexico was devastated. For most Americans, vaccine became available only after influenza had already peaked in their communities. Predictably there was an outburst of anger when the mortality rate proved to be low, as people felt that they had been misled by authorities, and frightened unnecessarily. Conspiracy theories regarding the WHO, pharmaceutical companies, and national governments abounded on Youtube and Twitter. While the mechanisms for communication were new, the problem faced by governments was not. Indeed, the U.S. had faced a similar situation in the 1970s. A historical perspective on influenza can provide some much needed context for policymakers and health authorities. George Dehner’s recent book, Global Flu and You: A History of Influenza, is a concise, well written organized overview of influenza’s history, which can help us to better understand contemporary health issues.
Given the plethora of works on influenza published over the last decade, one might ask if there was truly a need for another book on the topic. What is impressive about Dehner’s work is his mastery of an immense secondary literature to provide a sweeping overview of the topic. While the title is somewhat misleading -it is not truly about global flu and you- the work itself covers a wealth of topics related to influenza. One key issue that emerges in the text is that multinational firms have emerged to produce vaccine, which creates local-global tensions regarding health security. Dehner also discusses the need to integrate animal and human health, because the two cannot be considered in isolation. What is remarkable about influenza is the wide diversity of animals that infects, from whales out in the ocean, to penguins in remote polar rookeries. Animals as diverse as bats and ferrets catch the flu. But for most of humanity, pigs and ducks are the two key species infected. In order to explain why these questions matter, he covers issues from biology to globalization in a clear, thoughtful manner.
This is not a book based on primary sources, nor was its primary audience meant -I believe- to be academics. As such, there are some weaknesses to the work, if it were to be used in an upper division class. I would have liked to have seen more discussion regarding inequalities in the global health system. While he touches on Indonesia’s decision to stop sharing viral samples with the WHO in 1997 (p. 132), this and related topics could been treated in greater depth. He also spends so little time discussing Mexico in the context of the 2009 outbreak that a reader could be forgiven for thinking that the pandemic began in the United States. At the same time, what is most impressive about the book is how he is able to tackle such an immense topic with such brevity. A great deal of coverage of influenza -especially H5N1 or bird flu- is rather sensational. This work places these events into a historical and geographical context without feeding popular fears, which he clearly warns against (p. 144). In the end, this is the best concise introduction to the topic on the market, and a must-read for anyone seeking to understand global health today.
If you are interested in global health, you might also with to read my own book on the AIDS Pandemic in Latin America.
Shawn Smallman, Portland State University