The Deadliest Pandemic in History

The Great Pandemic of 1918-1919 was the deadliest pandemic in the history of the world, killing more in one year than the Black Death of the Middle Ages in a century. It infected about one-third of the planet’s population. Original estimates during the 1920s put the death toll at 21.5 million. More recent estimates put the global mortality figure considerably higher—between 30 and 50 million, or even as high as 100,000 million. An estimated 675,000 were Americans. More Americans died from the Flu than perished in WWI.

The Spanish flu was 25 times more deadly than the ordinary flu. There are stories of men coming home sick from work and being dead by morning. Some collapsed where they stood. Many of the infected succumbed within 24 to 48 hours after becoming symptomatic.

But even more frightening was who got sick. Although most flus kill the very young and old, this strain killed healthy men and women in the age group of 20- to 40-years-old in alarming rates. Roughly half of those who died were in their twenties and thirties—the prime of the lives.

Death Was Swift and Horrific

Most infected people had a high fever of 100 – 104 F that lasted a few days. The onset was sudden—people felt dizzy, weak and in pain while at work or in the street. Once the disease became established, the mucous membranes became reddened with sneezing and sometimes hemorrhaged, causing bloody noses. Patients coughed. But the real danger came if the influenza infection progressed to bacterial pneumonia. This phase was often fatal. Victims’ lungs would develop thick, bloody fluid, and the lack of oxygen would turn their faces blue. They would bleed from their noses and ears, and a pinkish froth would spew from the mouth. After hours of anguish, victims would suffocate—drowning in their own lungs.

The lungs’ violent reaction was the body’s way of trying to throw out the virus. The immune system toxins designed to destroy invaders went into overdrive and literally scorched the lung tissue. Thus, those healthy 20 – to 40-year-olds—like soldiers in the camps—had the strongest auto-immune response and therefore the highest death rates aside from infants and the old and weak.

The Deadly Flu Spread Rapidly

Because it was wartime, soldiers crossed from camp to camp, and across oceans, spreading the disease across the world. In the summer of 1918, over 1.5 million Americans crossed the Atlantic in the war effort—some from Kansas. The Flu resurfaced in Europe in all of the armies—including the English, French and German. As it spread, the microbe mutated, becoming more deadly by the day.

Cities were hard hit. In New York, 851 people died in a single day. Over 11,000 died in Philadelphia in October of 1918. Death carts roamed the streets. The dead sometimes lay abandoned in gutters. Cities had to resort to mass graves. Crepe on the doors of house after house marked death inside.

People were terrified. Would this disease ever stop? Would it prove the end of mankind?

The Disease Came in Three Waves

This original version of the influenza occurred in the late spring and summer of 1918 as was relatively mild. As the virus mutated, it became more severe and more deadly. The deadliest was the second wave that erupted in the fall of 1918. The final wave hit during the spring of 1919. The last two waves had a much higher frequency of complicated, severe and fatal cases. The severity and speed of the disease was unprecedented. Never before had three extensive pandemic waves of influenza occurred in rapid succession in the same year.

Why it Was Called the “Spanish Flu”

It is important to remember that at the outbreak of the Flu WWI was still raging. The governments of countries actively involved in the Great War—France, Germany, Britain and the United States—did not want the press to print anything negative that might hurt morale. But Spain remained neutral during the war, and reported freely on the disease, especially after King Alphonso XIII himself fell seriously ill. The disease became known as “Spanish Influenza” most likely because only Spanish newspapers were truthfully reporting the spread of the disease.

Why Couldn’t They Stop It?

Towns and cities did what they could. Most governments imposed curfews, suggested masks be worn and banned any public gathering—including funerals. Churches, schools, theaters, pool halls and saloons were all closed. Some towns tried to close their borders altogether.

Yet, the virus continued to spread.

The reasons were many. Because of WWI, governments moved troops within their own bases and sent thousands of troops into battle in Europe despite warnings. Misinformation and lack of Information was rampant, such as the mistaken belief that wearing a mask could stop the virus from entering the lungs. People in close proximity, both in military camps and cities, made it easier for the disease to spread to new victims.

Various vaccines were developed and tried with no success. But the vaccines were based on a false premise. Researchers thought the bacteria collected from the lungs of the dead was the cause of the disease and worked to combat the pneumonia bacteria. What they couldn’t see was the influenza virus itself—microscopes in 1918 simply weren’t strong. That technology would take decades.

The Start of the Pandemic

Many medical and conspiracy theories circulated at the time. Some thought the Germans had planted the germ. The evangelist Billy Sunday blamed it on sin. Those in the medical field scrambled to identify what “it” was, at first misdiagnosing it as malaria or thinking it might be a new kind of infection or plague, as it was more deadly than any flu they had ever seen before.

John M. Barry suggests in his book, The Great Influenza, that The Flu began in America. The first reported cases were at Fort Riley, Kansas. An Army private and mess cook Private Albert Gitchell, reported to the camp hospital early on the morning of March 11, 1918. His complaints: fever, sore throat and headache. By noon, over 100 soldiers were ill. By week’s end that number jumped to 500.

Fort Riley stretched 20,000 acres. Winters were brutally cold, summers sweltering, and dust storms blinding. In addition to housing 26,000 men, Camp Funston also held thousands of horses and mules that produced nine tons of manure each month. The common method of disposing of it was to burn it. On Saturday, March 9, 1918, a black sky and driving wind warned of a coming dust storm; yet, the camp burned its daily manure. The dust and ash of the burning manure combined in a stinging, stinking yellow haze. Soldiers ordered to clean up the soot and ash worked with no protection. Two days later, soldiers began falling ill. The Fort was thought to be “Ground Zero”.

Yet, other evidence shows that the flu hit the United States, Europe and Asia at approximately the same time—in March of 1918. Viral sequence data suggest that the 1918 virus was novel to humans, and not a “reassortant virus” produced from old existing strains. Evidence points to swine and avianlike viruses jumping to humans—an H1N1 strain. Older individuals, those born before 1901, may have already been exposed to an earlier strain of The Flu, thus providing them with some immunity to the disease.

Whether Fort Riley was the lone source of the virus will likely never be definitely proven.

Sources

The Great Pandemic: The United Sates in 1918-1919; www.flu.gov

The Great Influenza; John M. Barry; Penguin Books; 2004, 2005, 2009

Influenza 1918: The Worst Epidemic in American History; The American Experience; produced by PBS; 1998

Pandemic Continuity Specialist; https://pandemicspecialist.com/2014/07/15/the-great-take-away-from-the-great-war-1918/

1918 Influenza: The Mother of all Pandemics; Jeffery K. Taubenberger and David M. Morens; wwwnc.cdc.gov

The Worst Flu Pandemic on Record; neiman.harvard.edu

The Medical and Scientific Conceptions of Influenza; virus.standford.edu/uda/fluscimed

Pathogenic Responses among Young Adults during the 1918 Influenza Pandemic; G. Dennis Chanks; Centers for Disease Control and Prevention; Volume 18, Number 2 – February 2012