Your RDA of Irony

The Influenza Pandemic of 1918

In 1910 any physician in Vienna, London or New York would have boosted that epidemics were a thing of the past.  Perhaps plagues were still a danger in backward cultures where medicine was rare or little more than witchcraft.  But the industrialized societies of the 20th century had nothing to fear.  Modern medicine was working wonders.  It found the cures for rabies and diphtheria, and was making major advances in the treatment of tuberculosis, yellow fever and malaria.  Civilization had come too far to worry about plagues….That sense of confidence would not survive the decade, and neither did 100 million people.  The influenza pandemic of 1918 taught a costly and humbling lesson.


Influenza never had been considered a threatening disease.  Hippocrates described it, and nothing had changed in 2500 years.  The disease certainly was infectious, easily spread by coughing and sneezing, but was regarded as just a common illness of winter.  The coughing, fever, sore throat, muscle pains and fatigue added up to a week of misery.  At worst, influenza could lead to pneumonia and so was dangerous to infants and the elderly, but the overall mortality rate was one-in-a-thousand cases.  The “flu” seemed so inconsequential that the U.S. Public Health Service did not monitor any outbreaks of the disease.


So when and where did this lethal form of influenza originate?  A study sponsored by the American Medical Association traced the epidemic to Haskell County in western Kansas.  This was an agricultural community, population 1720, and we can surmise that some animal virus mutated and infected a human.  A sneeze or a cough did the rest.  In January, 1918 many of the county’s young adults came down with a severe case of the flu.  Young adults were usually the least susceptible to the disease; but this strain seemed to target them.  Worse, this influenza had a greater likelihood of leading to pneumonia.  Some people were dying.  By the end of February, the outbreak was over.  Influenza was only a disease of winter.


The United States had entered World War I the previous year.  Any soldiers from Haskell County would have reported to Camp Funston in eastern Kansas.  On March 4, the first soldier at the camp reported ill with influenza.  Within three weeks more than eleven hundred soldiers were hospitalized.  Their symptoms were so severe and atypical of influenza that the doctors initially misdiagnosed the disease, thinking it cholera, typhoid or meningitis.


Camp Funston had 56,000 soldiers.  In the normal course of military operations, thousands had been transferred to other camps and now they were spreading the disease.  On March 18, army camps in Georgia reported the first cases of influenza.  By the end of April, twenty-four of the thirty-six main army bases had epidemics.  The army estimated that 36 percent of the soldiers were infected.  Despite this, the army was preparing to send one million soldiers–healthy or not–to fight in Europe.


In March the Germans had begun an all-out offensive to break the British and French lines before American reinforcements arrived.  The Americans were desperately needed.  Even if a third of the Doughboys were sick, the healthy ones could help turn back the German tide.  Besides, conventional wisdom reassured, it was only the flu; within a week or two, the sick could be expected to recover.  In late April, U.S. troops arrived in France.  Our Doughboys proclaimed “Lafayette, We are here!”   So was influenza.  American troops were rushed to the front, and they stopped the Germans with more than courage.  The Germans, too, came down with the flu.  By June the disease had sapped the German offensive and the Kaiser’s last hope of victory. 


In May the flu had spread to Britain.  The Royal Navy curtailed its operations that month; 10,000 sailors were sick.  By June the disease was in Spain where it acquired its notorious name: the Spanish Flu.  While the disease certainly had not originated there, Spain was the first to publicize the epidemic.  The country was not involved in World War I, and so was free of the military censorship that suppressed news of influenza in France and Britain.  Eight million Spaniards–including the King–had the flu.  Business came to a standstill in Madrid; one third of the populace was ill while the rest stayed home to avoid the disease.  Yet, in one way Spain’s bad name was also its good luck.  Being stricken by the flu at this time, the Spaniards would be resistant to the disease in its more virulent phase that autumn.   

During the summer of 1918 the flu virus mutated again and became far more deadly.  Traditional influenza would kill one-in-a-thousand; the Spanish Flu would kill one-in-forty.  People could be suddenly stricken.  Within hours they were too feeble to walk.  In addition to the usual afflictions of flu, the victims hemorrhaged and coughed up blood.  Many developed pneumonia and suffocated.

This flu strain infected India; an estimated 17 million people died.  The virulent form also returned to America.  On August 31 the first cases of Spanish Flu were reported in a Navy yard of Boston: 26 sailors were dead.  By September 11 the epidemic had reached Washington D.C.  The government should have declared a national health emergency but the war effort seemed more important.  In fact, the war encouraged crowds.  Thirteen million men were required to report to government offices to register for the Draft: long lines awaiting infection.  Hollywood stars were appearing at war bond rallies; who wouldn’t want to see Mary Pickford and Charlie Chaplin?  Soldiers paraded through the streets of  New York and Philadelphia; and hundreds of thousands went to cheer them on.  The contagion was effortless.

Millions of Americans became ill, at least one quarter of the population.  The epidemic could no longer be ignored, and government belatedly responded but had little to offer but advice:  avoid crowds and wear gauze face masks.  In fact, those masks were useless; the flu virus was so small that it easily passed through the porous gauze.  However, there was one service that government could provide: burying the dead.  Over 600,000 Americans died.  In many communities there were just too many bodies and too few healthy or brave undertakers.  The government would collect the corpses and dispose of them in mass graves.

There was no cure or treatment for the flu: only fortitude, hope and luck.  At the time medicine had only the vaguest knowledge of viruses.  The microbes were too small to be seen by a microscope.  In the face of this global epidemic, mankind was helpless.  During the four years of World War I, nine million men died.  In sixteen weeks in 1918, from September to December, fifty million died of the Spanish Flu.  An estimated quarter of humanity had become ill. 

That winter, a time when influenza usually occurs, the pandemic slowed and then ended.  Even now, we do not know why the Spanish Flu stopped.  Had the virus mutated again, this time into a less lethal strain?  That is a matter of conjecture best left to physicians, statisticians and theologians.

Today medicine has a strategy against influenza, using vaccines derived from killed viruses.  However, viruses mutate so the vaccines then have to be reformulated–and medicine always seems to be a step behind.  Another healthcare measure is to quarantine and kill flu-infected livestock.  The fear of Avian flu of Swine Flu is that the animal virus could mutate into a form deadly to humans.  Isn’t that what happened in 1918?  Modern medicine has learned its limitations against the virus.  The prospect of a pandemic, perhaps one as dangerous as the Spanish Flu, is not an abstract hypothesis.  In 2009 any physician would say that it is only a matter of time.


  1. Fran says:

    Thank you! Excellent!

  2. Alan Perlman says:


    Evidently the flu has not stilled your pen. Very informative and relevant. Viruses were here before us and will be here after we’ve gone. best,


  3. Megan Barnes says:

    Very timely and interesting! I had always assumed that the Spanish Flu started in Spain.

  4. Eugene Finerman says:

    The Spanish Flu was suspected of really being a German one. The American public already had war fever and was prepared to blame the Germans for anything. Having pioneered poisoned gas and submarine warfare, as well as subsidizing the Bolshevik Revolutions, the Germans certainly had not distinguished themselves for scruples. But they really did not have technology for creating viruses.

    However, Americans were so suspicious of the Hun that they actually shunned one of the few remedies of the time that alleviated some of the flu’s discomfort. Patriotic Americans boycotted aspirin. After all, Bayer was a German company.


  5. Tom Kelso says:

    An excellent but little-seen work on this is Horton Foote’s “1918”.

    As you might expect, it is a small, quiet little drama of a town in Texas ravaged by the epidemic, with the quintessential unspoken truths expected from the creator of The Trip to Bountiful and Tender Mercies. Definitely well worth the reading, or the viewing, if you are lucky enough to find the version shown on American Playhouse.

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