Influenza Epidemic 1918-1919

Paul Andrews, who works with the medical artifact collection at HSL, is going to be writing a series of articles on the Influenza Epidemic of 1918-1919.

Please enjoy this first article in the series!

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I had a little bird, his name was Enza.

I opened up the window, and Influenza.

-Popular children’s song in 1918.

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Private Albert Gitchell, a cook at Ft. Riley in Kansas, reported to the infirmary on March 11th, 1918, complaining of cold like symptoms, a headache and a sore throat.  Soon several more soldiers had reported with the same symptoms, and the camp doctors decided it was a sever flu.  Within days, as many as 520 soldiers had reported as sick.  Within just a few weeks, 46 of those, most in the prime of life, were dead.  It is widely believed that these deaths were the first of the Influenza epidemic of 1918.

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Over the course of next months, I will present a historical account of the Influenza epidemic of 1918 and 1919.  I am not a medical professional, and will be looking at the epidemic from a historical view.  Starting with this brief introduction, I want to examine how the Influenza epidemic of 1918-19 affected the United States, and the rest of the world.  In future installments I’ll look at the worst months of the epidemic, and explore the world the epidemic left behind.

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The Influenza epidemic of 1918-19 was the most deadly two years that the United States has ever experienced because of an illness.  There were more deaths worldwide than all the wars of the 20th Century.  There are many factors why it happened, but two of the main reasons were the preoccupation with the First World War, and a misunderstanding of the disease itself.  When the epidemic finally passed, approximately 550,000 American had died, and the World death rate has been put at between 20 and 30 million.  In 1919, 550,000 American deaths represented 0.5% of the population.  There was not a single community in the United States that was not affected.  In many other places, the death rate was staggering.  In Samoa, 25% of the population died, in Alaska the death rate of Inuit peoples in Nome was over 50%, and many Native American villages in the still wild frontier of the Western United States had 100% death rates.   Perhaps the hardest hit country in the world was India, where approximately 12 million people died.

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It is widely believed that many of the deaths could have been avoided, but because of the First World War, and the state of medical science, Influenza, an airborne disease, was able to spread further than diseases had in the past.  The advancement of medical science of the early 20th Century did not understand viruses, and the cause of Influenza was never fully grasped.  The war effort, which overrode early public health concerns, packed troops ships with infected soldiers.  Large gatherings of citizens to see troops off to Europe, and for Bond rallies, allowed the flu to spread throughout the population.  In the trenches of Europe the flu mutated to become an even deadlier strain, and the returning soldiers, again packed into troop ships, brought the new strains back.  It was the strain of flu that hit Europe, especially Spain, which gave the 1918-19 epidemic its name, the Spanish Flu.  In addition to the mass movement of soldiers, and the large crowd gatherings, the United States was left with large shortages of qualified doctors and nurses because of the war.

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There are several things that are odd about the Influenza epidemic of 1918-19.  Two of them are in the way it presented itself, and one is in what it did to civilization.  Firstly, the 1918-19 epidemic was strange in its victims.  Different from epidemics in the past, which have high mortality rates amongst the old, young, and weak, the flu of 1918 affected those in the prime of life.  Approximately half the victims in the United States were between the ages of 20 and 40.  Secondly was the rapidity of the epidemic.  Although influenza hit different locations in three waves, the majority of deaths happened within months, and then the flu was gone.  In the U.S., the epidemic was worse in September through November 1918, and then it virtually disappeared.  Finally, there is the way society changed during the epidemic.  No one in the United States was unaffected during the 1918-19 epidemic.  As the epidemic began to spread, communities, instead of rallying around to help each other, began to isolate themselves.  Towns declared themselves quarantine zones, volunteers could not be found to help the sick, and cities were often seemingly deserted.  Victor Vaughn, the head of the Army’s communicable disease division in 1918, said ‘If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear.’  Society was on the verge of collapse.  In the end it didn’t collapse, and the epidemic retreated.  As with many tragedies, it was soon forgotten.

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The images used are from this article, Influenza in 1918: An Epidemic in Images by Julian A. Navarro, from Public Health Reports, Vol. 125, Supplement 3, 2010.