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The Spanish flu in 1918 through 1920
1918 the year in which World War 1 ended is one of the most significant years in world history
But even as the final stages of that terrible conflict were being played out
second deadlier threat to humanity was underway an
influenza virus influenza type A subtype h1n1
to be precise
The Spanish flu as the virus is now known made its way around the world
Mindless of human politics borders and morality infecting soldiers and civilians rich and poor alike
It's spread was so wide reaching that the only continent it left untouched was Antarctica
By the time the virus had run its course approximately 500 million people roughly 1/3 of the world's population and fallen ill
conservative estimates place the death toll at 20 million people
but it's now widely accepted that the much more likely figure lies somewhere between
50 to 100 million if the higher end of this estimate is correct and the Spanish flu was
Responsible for more deaths than both World War and world war two combined
Over the course of three distinct waves the virus killed more people over a shorter period of time than even history's most famous
pandemic the Black Death
Symptoms included a severe headache a high fever a sore throat accompanied by a racking cough and body aches
So agonizing that some patients describe the pain as being similar to that caused by breaking bones
As the disease progressed brownish patches appeared on the cheeks and the final stages the extremities began to take on a bluish appearance
caused by lack of oxygen in the blood
This was called heliotrope cyanosis and lent to the virus. Sometimes being referred to as the blue death
Bleeding from the ears and nose was also common as was frothing from the mouth caused by fluid in the lungs
modern studies done on preserved lung tissue taken from victims of the pandemic
Suggest that in many cases death was not caused directly by the flu virus itself, but rather from a secondary bacterial pneumonia
unlike a normal seasonal flu
Which usually only kills the very young or old or those with an underlying health condition the Spanish flu disproportionately affected healthy young adults
Approximately 50% of those who've died were in their 20s and 30s
The reasons for this are still not entirely understood but there are a couple of theories that have been proposed
The first of these is that the virus sometimes triggered a cytokine storm an extreme overreaction of the immune system
Which resulted in the lungs filling up with bodily fluids and death occurring due to drowning
The healthier the immune system the more likely it is believed to be for this reaction to occur
The second suggestion is known as original antigenic sin
There is evidence to suggest that an individual's lifelong immune response to flu is determined by their earliest encounter with a flu virus
for many young adults in 1918
This would most likely have occurred during an earlier epidemic the Russian flu of 1889 to 1890
Which is believed to have been an h3 virus rather than an h1 virus like the Spanish flu
Despite the name the virus almost certainly didn't originate in Spain it became known as the Spanish flu due to Spain's
neutrality throughout World War one
countries participating in the conflict had reporting restrictions in place as they did not want stories that could affect morale or give an indication of
weakness to their enemies to become widespread
While in neutral Spain there was no such blackout in the country's reporters were free to write stories about the contagion
the fact that the Spanish king fell ill only helped to further the
association of the country with the virus in the minds of the rest of the world
As the way the first outbreak actually did occur. There are three main theories
It's widely accepted by scientists that all flu viruses originated in birds before mutating and making the jump to humans
Sometimes directly and sometimes via a third species such as pigs
For these crossover events to take place a few factors need to be in place
most importantly there needs to be close contact between animals and humans and
Secondly a large population of humans in which the virus can take hold and spread
8'f in northern france was home to a huge allied military hospital and it also lies on a migratory bird route
1916 the hospital suffered an outbreak of a disease with symptoms recorded by the doctors there that would prove to be
remarkably similar to those of the Spanish flu in
1917 china too suffered a disease outbreak at the time
This was attributed to pneumonic plague but later reassessments have suggested that this was perhaps a misdiagnosis of what was actually the Spanish flu
Thousands of Chinese workers were later transported to Europe via North America to provide support behind British and French lines on the Western Front
China seems to have suffered less than other countries during the main pandemic which has led to the suggestion that the
Population already had some degree of immunity to exposure from earlier outbreaks
Until further testing is carried out
It's impossible to determine if either of these events were really precursors to the pandemic or entirely unrelated incidents
Finally there is some evidence that the virus may have had its origins in the United States most likely in Haskel County, Kansas
This was a rural part of the country. That is also on a migratory
Route and much like China and France suffered from an unusual outbreak
Wherever the virus did come from the first undisputed recorded case occurred in the USA on the morning of the 11th of March
1918
US Army soldier private Albert Gitchell reported to the infirmary at Camp Funston in Kansas just 300 miles from Haskell with flu-like symptoms
The disease soon spread through the camp and then made its way to other military bases throughout the US
By April it had spread to Bordeaux and France most likely through American troop movements and within weeks
It was rife within both allied and German forces across the continent in June British soldiers began arriving at the hospital in a table
Suffering from what was then termed pyrexia of unknown origin medics working there noted the similarity of this condition to the previous
1916 outbreak
This first wave of the virus abated after just a few weeks
Any respite however proved to be brief by the middle of August the second wave was well underway
This was by far the most deadly stage of the outbreak is
Believed that the virus had mutated again and in the process had become much more dangerous
October saw the highest rate of mortality and in the United States, it still has the record for the deadliest month in history with nearly
200,000 Americans dying
In Philadelphia city officials against mounting medical advice a lot of parade to go ahead on the 28th of September
200,000 Philadelphians took to the streets to enjoy the spectacle and raise money for the war effort the
result proved to be disastrous
The large gathering was the perfect breeding ground for the virus and within 72 hours. All of the city's 31 hospitals were at full capacity
Schools churches and other public spaces were closed down in an attempt to slow the progress of the disease
But despite these measures within two weeks of the parade more than 4,500 people had died from the flu
Newspapers were soon full of adverts from both reputable brands and snake oil salesman peddling their wares to a public
desperate for any method of protection
People also turn to folk remedies such as onions and asafoetida
As useless as these treatments would have been actual medical advice was not always much better and time's included the use of strychnine
belladonna and kerosene a
Concerted effort was made to develop a vaccine
But this was greatly hindered by the fact that the flu was still believed to be bacterial rather than viral in nature
To make matters worse aspirin dosing and the effects of aspirin poisoning were not properly understood
Resulting in far higher doses of the drug being given to some patients than would be given today
We could never be entirely sure how much of a factor this was
But it's possible that the overuse of aspirin contributed to the mortality rate in some countries
Despite the best attempts of governments and the medical profession the spread of the contagion was relentless
hospitals ran out of beds morgues exceeded their maximum of capacities and entire countries ran out of coffins in which to bury the dead in
The u.s
The average life expectancy dropped by an average of 12 years and in the UK
1918 became the first year since records began with a death toll exceeded the birth rate
The average mortality rate for the virus was around 2.5%
but in some countries this was far higher in Fiji 14% of the population died in a little over two weeks and
Western Samoa as much as 25% of the population was wiped out
In terms of total numbers India seemed to have been the worst affected country
losing at least 17 million people over the course of the pandemic a
Third wave struck in early 1919 the most prominent casualty of this was the American President Woodrow
Wilson was taken ill while in Paris negotiating the Treaty of Versailles
His bout of illness and resulting confusion is considered by some historians to be at least a partial explanation
for the unfairness of the treaty which of course was a major factor in why World War Two came about
Several smaller outbreaks continued into the 1920s
But the Spanish flu had lost a lot of its strength and the mortality rate was significantly reduced
the science behind the sudden decline in the virus's viral 'ti is once again, not entirely clear but
Increased immunity within the human population and a likely further mutation of the virus were probable factors
-silence-