1918 flu Pandemic info

The Spanish influenza pandemic, which began in 1918, caught every nation by surprise. It infected an estimated 500 million people and killed 50 to 100 million of them in three waves. Governments around the world responded in ways that were reactive and almost ineffective before the pandemic ended in 1919 just as suddenly as it began one year earlier.

The Spanish influenza pandemic differed from previous influenza pandemics in its unprecedented virulence. Its unique characteristics included unusually high case fatality, especially among 20– to 40–year-olds.

Allies fighting in World War I designated this pandemic “Spanish” influenza because Spain’s uncensored press was the first to report freely on its widespread distribution. Elsewhere in Europe, governments feared that such newspaper reports would undermine public morale.

The First Wave of Spanish Influenza in the US

Epidemiological data indicate that pandemic began in the US in March 1918, at a crowded army camp in Fort Riley, Kansas. Subsequently, the transport of hundreds of thousands of infected troops in close physical contact between camps caused influenza to spread quickly even before troops assembled in East Coast ports en route to France. The troops brought the influenza to the trenches of the opposing armies and to other parts of Europe and beyond.

The overall response to the mild first wave of the influenza epidemic in the US was relatively subdued compared with the second and third more deadly waves.

The Second and Third Waves of Spanish Influenza in the US
The second wave struck lethally in September 1918 at a naval facility in Boston and at the Camp Devens military base in Massachusetts. At the nearby US Naval Radio School, located at Harvard University, however, few of the 5,000 trainees contracted Spanish influenza after the first cases were reported on September 6, 1918. Infected trainees were quarantined, and Harvard University took precautions to contain influenza and resume normal operations; nevertheless, six students died.

Nationwide, October 1918 was the most deadly month, when 195,000 Americans died. The supply of health care workers, morticians, and gravediggers dwindled, and mass graves were often dug to bury the dead. Among the survivors was Amelia Earhart.

The third wave of the pandemic, between late 1918 and March 1919, spread unevenly in the US and in parts of Europe, but with similar intensity as the second.

Reaction and Response



The influenza strain was unusual in that this pandemic killed many young adults and otherwise healthy victims – typical influenzas kill mostly infants (aged 0-2 years), the elderly, and the immunocompromised. Another oddity was that this influenza outbreak was widespread in summer and fall (in the Northern Hemisphere). Typically, influenza is worse in the winter months.

People without symptoms could be stricken suddenly and within hours be too weak to walk; many died the next day. Symptoms included a blue tint to the face and coughing up blood caused by severe obstruction of the lungs. In some cases, the virus caused an uncontrollable hemorrhaging that filled the lungs, and patients drowned in their body fluids (pneumonia). In others, the flu caused frequent loss of bowel control and the victim would die from losing critical intestinal lining and blood loss.[citation needed]

In fast-progressing cases, mortality was primarily from pneumonia, by virus-induced consolidation. Slower-progressing cases featured secondary bacterial pneumonias, and there may have been neural involvement that led to mental disorders in a minority of cases

An effort to recreate the 1918 flu strain (a subtype of avian strain H1N1) was a collaboration among the Armed Forces Institute of Pathology, Southeast Poultry Research Laboratory and Mount Sinai School of Medicine in New York; the effort resulted in the announcement (on October 5, 2005) that the group had successfully determined the virus's genetic sequence, using historic tissue samples recovered from a female flu victim buried in the Alaskan permafrost and samples preserved from American soldiers.[34]

On January 18, 2007, Kobasa et al. reported that monkeys (Macaca fascicularis) infected with the recreated strain exhibited classic symptoms of the 1918 pandemic and died from a cytokine storm[35] – an overreaction of the immune system. This may explain why the 1918 flu had its surprising effect on younger, healthier people, as a person with a stronger immune system would potentially have a stronger overreaction.[36]