THE SPANISH FLU (H1N1, 1918-19)
The World Health Organization (WHO) describes the Spanish Flu of 1918-19 (H1N1) as "the most deadly disease event in the history of humanity." The Spanish Flu infected an estimated 500 million people around the world and death toll estimates range from 25 to 50 million people. A lot has been written about this flu, but scientists are only beginning to understand its virulence...
In the early months of 1918, during the final year of World War I, soldiers around the European front were becoming ill. At first, British army doctors diagnosed the cause of the outbreaks as 'epidemic bronchitis', but this was far from the actual cause. Because of the war, news of the outbreaks was censored for security reasons. No one knew about the mysterious disease until several outbreaks occurred in Spain. Because Spain was a neutral country, news of the outbreaks spread around the world and it became known as the Spanish Flu. Note that the Spanish Flu did not actually originate in Spain; experts believe the Spanish flu originated on either an army base in Kansas, the trenches of France, or Southern China, but no one knows for sure.
The Spanish flu spread around the European front, infecting thousands of soldiers, and then it suddenly disappeared as quickly as it came. However, the Spanish Flu was far from gone. It came back in full force during the late summer of 1918, even more deadly than before. The sick displayed symptoms of fever, piercing headaches, and joint pain. Many people died within a mere 2 to 3 days, dying from gradual suffocation. When doctors opened the chests of the victims, they were startled to find that the lungs, usually light and elastic, were heavy and filled with bloody fluid.
The Spanish flu spread around Europe, infecting thousands of soldiers, and then it suddenly disappeared as quickly as it came. However, the Spanish Flu was far from gone. It came back in full force during the late summer of 1918, more deadly than before. The sick displayed symptoms of fever, piercing headaches, and joint pain. Many people died within a mere two to three days, dying from gradual suffocation. When doctors opened the chests of the victims, they were startled to find that the lungs, usually light and elastic, were heavy and filled with bloody fluid.
The Spanish flu spread around the world, infecting an estimated 500 million people. In Philadelphia alone, 12,000 people died of flu & pneumonia in October 1918. Everywhere around the world, schools, businesses, and churches were closed to help prevent the spread of infection. Some places like Australia and American Samoa imposed strict quarantines to protect the public from catching the flu. The flu died down after the winter of 1919 and the Spanish Flu pandemic faded away into the history books. Many historians and experts disagree on the exact death toll. Most experts believe about 25 to 50 million people worldwide died of infection; others put the death toll as high as 100 million. However, experts do agree that the working class and blue-collar workers suffered the greatest losses.
A CLOSER LOOK: Spanish Flu
When the Spanish Flu arrived on the shores of the United States in 1918, no one knew exactly how deadly the infamous flu would be. The flu went from city to city and from town to town, and everywhere it popped up, people were seldom prepared. And as the Spanish Flu spread, children around the country were playing jumprope to a new, grim rhyme...
"I had a little bird
And its name was Enza
I opened the window
And in-flew-Enza."
The mortality rate in the US varied around the country. Some cities came through unscathed, in others, mortality was high. Let's take a look at some of the mortality rates for selected cities.
| City | Estimated Population (July 1918) | Total Number of Deaths | ||
|---|---|---|---|---|
| Source: America's Forgotten Pandemic of 1918/Alfred W. Crosby | ||||
| Atlanta, GA | 201,752 | 212 | ||
| Boston, MA | 785,245 | 6,225 | ||
| Chicago, IL | 2,596,681 | 14,014 | ||
| Denver, CO | 268,439 | 1,652 | ||
| Los Angeles, CA | 568,495 | 3,184 | ||
| New York, NY | 3,215,879 | 33,387 | ||
| Philadelphia, PA | 1,761,371 | 15,785 | ||
| San Francisco, CA | 478,530 | 3,755 | ||
| Seattle, WA | 366,445 | 1,441 | ||
| Washington DC | 401,681 | 3,169 | ||
Decades after the Spanish Flu pandemic ended, scientists had made little progress in solving the mystery of the 1918-19 flu's virulence. Scientists knew that the H1N1 virus caused the Spanish flu, but they did not know why the virus was so deadly. In 1996, lung tissue samples were recovered from the body of a soldier who died of the flu in Fort Jackson, South Carolina. Scientists had managed to identify several of the virus's genes from the sample. It was not until retired pathologist Johan Hultin retrieved preserved lung tissue from a female body buried in permafrost in an Alaskan village. A team of scientists figured out the coding sequences of all eight viral RNA segments, and they proceeded to using reverse genetics to reconstruct the Spanish Flu virus. In their October 2005 report, the scientists studied the pathogenicity of the virus in mammal and chicken eggs, and examined its growth. The scientists concluded that the combination of those particular eight genes made it especially virulent; no single gene was responsible for its virulence. They also noted that no other human influenza virus compared to the pathogenicity of the 1918 virus when tested in mice. In addition, vaccines containing 1918 HA and NA genes, as well as FDA approved drugs oseltamivir and amantadine proved effective against the virus.