Was the Swine Flu Epidemic Inevitable?

Hillary J. Johnson's "Killer Flu" was originally published in the pages of Rolling Stone on January 22, 1998.

Manhattan, March 1999 The streets are still. Theaters, office buildings and government agencies have been closed for weeks. A few pedestrians hurry by, wearing white face masks in the cool spring air. Many of those whose jobs involved extensive social contact, including bank tellers, store clerks, schoolteachers, waiters and police officers, are gone from their posts — home, dead, no one knows.

The city's private hospitals are full. Bellevue remains open, but patients and doctors alike are stacked on gurneys along corridors. Inside their homes, several hundred thousand people have died or are terribly sick. Money confers no immunity. Luxury dwellings inhabited by the multimillionaires of Park Avenue are notable now for the absence of uniformed doormen to meet the ambulances and hearses that arrive hourly.

Trust between neighbors and within families has disintegrated. People exhibiting either extreme prostration or fever-induced deliriousness are shunned. The tabloid press, running limited editions only, publishes stories of an impending race war. Paranoia about the source of the outbreak is pervasive. A good portion of those still alive suspect that a biological-warfare experiment has run amok.

Death, when it comes, is blessedly quick. A fever that can shoot to 104 or 105 degrees in a matter of hours, accompanied by lung pain, appears suddenly. The end comes two to five days later, heralded by the victim's blackening skin, a condition known as heliotrope cyanosis, in which the body's tissues are starved of oxygen. Extremities sometimes turn gangrenous. Blood and mucus issue from the mouth and nose. Fluid pools in the lungs. In plain English, the patient drowns, a victim of a new strain of influenza.