Spanish Flu 1918: 19 Sickening Events During the Spanish Flu of 1918
19 Sickening Events During the Spanish Flu of 1918

19 Sickening Events During the Spanish Flu of 1918

Larry Holzwarth - May 23, 2019

19 Sickening Events During the Spanish Flu of 1918
The death certificate of Pennsylvania’s Frank Geyer lists his cause of death as “La grippe” a commonly used term for the flu in 1918. Pennsylvania Department of Health

11. The symptoms of Spanish Flu were exceptionally severe

During the first wave of Spanish Flu in Europe and in the United States and Canada, the symptoms were of a severe case of the flu, but as has been seen, not alarmingly so among the young, previously healthy adults. It was the second wave, which almost appeared to target a healthy immune system to overreact, which became deadly. Both waves presented an illness which was highly contagious, but the second wave was both highly contagious and highly dangerous. Within a few hours of exposure, a healthy young adult felt extreme fatigue of muscle and mind. Fever followed, often dangerously high, along with severe headache, muscle aches, stiffness in the neck, and a developing deep cough, often coughing so violently as to tear abdominal muscles or suffer injury to the rib cage.

The victims of the disease developed a bluish tint to the skin, across the entire body, sometimes to such a deep shade of blue that it was no longer possible to identify the original skin color. The color indicated a lack of oxygen. The cough soon produced blood, foaming from the mouth and through the nose and sometimes the ears. Some died within hours of first exhibiting symptoms, others lingered for several days before succumbing to secondary infections, others died from the ministrations of ill-informed physicians or medics. Others survived. The severity of the symptoms, the number of deaths, and the virulence of the flu’s contagion led to disruptions of society which went beyond the treatment of the sick.

19 Sickening Events During the Spanish Flu of 1918
Mare Island Naval Hospital and emergency tents set up to handle the influx of ful patients, winter, 1918. US Navy

12. Spanish Flu caused societal changes due to its virulence

As Spanish flu raged across the United States during its deadly second wave it inflicted problems on the social fabric of American towns and cities. The first was the impact on the medical community, which was already short-handed with so many doctors and nurses serving in the military as a result of the World War. Morgues were overwhelmed with the number of dead, and many were forced to leave bodies of the flu’s victims in hallways, stacked like piles of firewood. In some communities, isolation wards were established for the victims of the flu. Necessity led to the establishment of mass graves for many of the victims, due to the lack of enough grave diggers to prepare individual resting places.

Communities closed their theaters, parks, schools, and other areas where the public gathered. Some communities passed laws making it illegal to expectorate and in some cases even to sneeze or cough in public, though few policemen were willing to approach someone who did so. Folk remedies, such as carrying a potato in one’s pocket, or swabbing one’s neck with garlic or camphor, were believed by some to be effective against contracting the flu. The second wave of the Spanish Flu hit its peak before the Armistice which ended the fighting during the Great War, as it was then called, but the illness did not fully disappear, and following the end of the fighting and beginning with the return of the troops from the front, a third wave of Spanish Flu appeared worldwide.

19 Sickening Events During the Spanish Flu of 1918
By the time of the third wave of the pandemic precautions against the flu were taken seriously. Wikimedia

13. The third wave of Spanish Flu was less severe than the second wave

As troops began to return from the horrors of the First World War and the world breathed a collective sigh of relief in early 1919, Spanish Flu returned in a third wave across the globe. It was not as devastating as the second wave – which had been the most deadly of them all – but it was still more severe than the first appearance in Europe and the United States, as well as in the rest of the world. Those who had already had the flu and survived appeared to be immune to the third appearance, and it took on the indications of most forms of influenza, in that it was more dangerous for the elderly and children younger than the age of two or three. Healthy adults were more likely to survive than during the second wave.

The third wave lasted longer than its predecessors, appearing in late 1918 or early 1919, depending on the source, and lasting until late 1920, when it finally disappeared. As with the previous waves it was most virulent in areas of overcrowding, and it is likely that it was less deadly due to the previous experience of the earlier outbreaks. There was also the return of medical personnel from the war zones, which eased the shortage of professionals able to treat those stricken with the flu. By the time of the third wave, many treated the flu as a horror to be scoffed at, with children creating nursery rhymes about the illness to which they could skip rope; “I had a little bird, its name was Enza, I opened a window, and In-flu-enza”.

19 Sickening Events During the Spanish Flu of 1918
Seattle policemen taking precautions against contracting the Spanish Flu during the winter of 1918-19. National Archives

14. The Spanish Flu differed from most forms of influenza in several ways

As has been seen, during the deadliest period of the Spanish Flu pandemic, its second wave, it differed from most outbreaks of influenza in many ways. All forms of the flu are highly contagious, but the Spanish Flu was exceedingly so. It killed previously healthy young adults at a higher rate than it did elderly victims and young children, the latter two being much more susceptible during most flu outbreaks. Curiously, it also was at its height during the summer and early fall of 1918, while most flu outbreaks are at their peak during the months of late autumn and the depth of winter. It struck worldwide simultaneously when it was winter in the Southern Hemisphere, but summer in the Northern climes.

The Spanish Flu was also linked to lower educational achievement in children of the survivors in the years which followed the pandemic. Of all the statistical categories of people who were stricken with the flu during the pandemic, the highest mortality rate overall was with women who were pregnant at the time they contracted the flu. Of those who did survive, over a quarter miscarried. The death rate for pregnant women was as high as 71% in some areas, and possibly even higher, as most studies are based on those who were hospitalized. In many areas, particularly small towns and rural communities, pregnancy and childbirth were still the realm of midwives, and statistics of deaths attributed to the flu in such areas are unobtainable.

19 Sickening Events During the Spanish Flu of 1918
A victim of Spanish Flu is removed from a home in St. Louis during the height of the pandemic. Wikimedia

15. The flu attacked communities for a relatively short time.

Although the pandemic lasted from 1918-1920 around the world, including in the United States, it did not ravage individual communities for that entire period, including during the deadliest period of the pandemic, the second wave. In most areas, the flu struck with ferocious speed, remained virulent in the area for about a month or so, and moved on, leaving the survivors to deal with the damage that it had done. The months in which it was at its peak in the United States were the months when epidemics were still fairly common in the larger cities and towns, particularly along the East Coast, including cholera and typhoid fever, which led the flu to draw little media attention.

In the United States and especially in war ravaged Europe, the flu was often considered to be a consequence of the ongoing war when it struck. Even in neutral Spain, which inadvertently gave the flu its name, it was considered to be a by-product of the global disaster of the Great War. Its economic impact was limited due to the overall impact of the war. Although individual communities suffered temporary losses, especially in service industries, they were limited by the short duration of the illness within their own areas, while the long-term economic impact of the war continued, masking much of the losses caused by the pandemic. The health care industry, and the pharmaceutical companies which made and sold aspirin, profited from the Spanish Flu.

19 Sickening Events During the Spanish Flu of 1918
Edvard Munch’s “Self Portrait with the Spanish Flu”. Wikimedia

16. The Spanish Flu was contracted by many noted leaders of the day

The Spanish Flu was first reported worldwide when it struck Alfonso XIII, the King of Spain, in 1918. His illness, which was grave and reported around the world, gave the impression that the flu originated in Spain and thus bestowed the name Spanish Flu on the pandemic. He survived. He was far from the only notable to contract the illness. In the United States, President Woodrow Wilson contracted the disease, and some believe its ravages contributed to his suffering a stroke later. Walt Disney contracted the flu while in training to serve in the Ambulance Corps at an Army camp outside of Chicago. Artist Edvard Munch suffered through the flu, survived, and later painted Self-Portrait with the Spanish Flu.

Franklin Delano Roosevelt, at the time the Assistant Secretary of the Navy, contracted the flu while returning from France aboard USS Leviathan. The flu led to pneumonia, and Roosevelt was carried off the ship on a stretcher upon arrival in the United States (he was not yet confined to a wheelchair). Some who did not survive the flu were artist Gustav Klimt, Frederick Trump (grandfather of US President Donald Trump), Bill Yawkey (owner of the Detroit Tigers Baseball Club), and Edmond Rostand, whose most famed work was the play Cyrano de Bergerac. Some sources claim the Dodge Brothers, John and Horace, who founded the Dodge Automobile Company, died of Spanish Flu, though others state that Horace died of cirrhosis of the liver.

19 Sickening Events During the Spanish Flu of 1918
A compilation of the symptoms of the flu reported at various US Army camps during the pandemic. US Army

17. The Spanish Flu pandemic was truly global in its scope

Of the areas of the world which were populated at the time of the pandemic only one – an island in the delta of the Amazon River near Brazil known as Marajo – did not report an outbreak of the Spanish Flu. Even the remote South Atlantic island of St. Helena, where Napoleon had spent his last years of exile a century earlier, was stricken by the Spanish Flu, though no deaths were reported there. The French colony of New Caledonia, similarly to American Samoa, imposed a blockade of its shores and prevented any deaths to the flu. Other areas seemed to be particularly vulnerable despite efforts to prevent the spread of the flu. Casualties around the world were staggering.

In the United States alone up to 675,000 fatalities were attributed to Spanish Flu and the secondary infections it caused, more than died in the four years of the American Civil War a half-century earlier. Native American tribes suffered a disproportionate number of deaths, and in Alaska entire communities of Inuit natives were wiped out. Great Britain suffered 228,000 dead. Brazil lost its President, Francisco de Paula Rodrigues Alves, and over 300,000 of its citizens. Iran lost almost 22% of its total population during the pandemic. Even the tropical paradise of Tahiti was stricken, so severely that it was estimated to have lost up to a quarter of its population when the pandemic struck there, as with so many locations, brought to the isolated island by a visiting ship.

19 Sickening Events During the Spanish Flu of 1918
A contemporaneous chart depicts the spike in deaths of the second wave of the pandemic. Wikimedia

18 The legacy of the Spanish Flu pandemic

By the end of the year 1920, the Spanish Flu pandemic appeared to have finally faded away. Memory of the global disaster faded with it. During its height, media coverage was limited and what was present was for the most part localized, rather than covering the disease as it spread around the globe. With the end of the World War, once the flu had passed through one’s community, citizens wanted to get on with their normal lives. In the United States, the issue of Prohibition and the decade which became known as the Roaring Twenties moved to the fore. The flu which had ravaged the country became just another of the epidemics which were at the time a part of life. The world merely shrugged it off and moved forward.

Because of its coinciding with the Great War, as it was known at the time (it wouldn’t become known as World War I until the name World War II was coined), the overall impact on the public psyche in most countries was limited. With the majority of its fatalities among healthy young men, as with the war, it came to be considered a part of the war, a view especially prevalent in Europe. Its impact in Asia and the Pacific was relatively unknown to the great majority of people who were not in some manner connected to those regions. The same can be said about its impact in Africa. Not until the late 20th century, when public awareness of bird flu and other forms of influenza virus increased, was the Spanish Flu Pandemic brought to the public consciousness.

19 Sickening Events During the Spanish Flu of 1918
To this day the source of the Spanish Flu pandemic is debated by scholars and scientists. Wikimedia

19. Where did Spanish Flu come from?

The origins of Spanish Flu remain debated among medical professionals, scientists, epidemiologists, historians, and others. Some postulate that the virus originated in birds and hogs, was transmitted to humans, and then transferred around the world. A leading theory for years was that the epicenter for the virus was Fort Riley, Kansas, among the animals bred to feed American troops. Others postulate that the virus originated in birds as a type of avian flu and transferred directly to humans, with humans passing the virus on to swine. Still, others suggest that the virus originated in China, supporting the belief that it was passed to the troops in the trenches of Europe by Chinese laborers brought to the battlefront to build infrastructure.

In the 21st century efforts to understand how the virus developed, what caused it to mutate into the deadlier virus of the second wave, and how it spread, continue to produce often conflicting theories. The fact is though efforts to understand what the virus was continuing, a definitive answer remains elusive. The pandemic which killed so many people that it was compared to the Black Death of the Middle Ages – and may well have killed a greater percentage of the population of Europe than its predecessor – remains a mystery, even as its history becomes more widely known.

 

Where do we find this stuff? Here are our sources:

“Origins of the Spanish Influenza Pandemic (1918-1920) and its relation to the First World War”. Anton Erkoreka, Journal of Molecular and Genetic Medicine. November 30, 2009. Online

“How a killer flu spread from western Kansas to the world”. Beccy Tanner, Wichita (Kansas) Eagle. February 19, 2018

“1918 Pandemic Influenza: Three Waves”. Article, Centers for Disease Control and Prevention (CDC). Online

“The Plague of the Spanish Lady – The Influenza Pandemic of 1918 – 1919”. R. Collier. 1974

“Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It”. Gina Kolata. 2001

“A History of Influenza”. C. W. Potter, Journal of Applied Microbiology. October, 2001

“The Great Influenza: The Epic Story of the Greatest Plague in History”. John M. Barry. 2005

“America’s Forgotten Pandemic: The Influenza of 1918”. Alfred W. Crosby. 2003

“History of 1918 Flu Pandemic. Article, Centers for Disease Control and Prevention. Online

“The Great Pandemic”. Article, Historians.org. AHA Staff. May 4, 2009. Online

“Inside the Swift, Deadly History of the Spanish Flu Pandemic”. Toby Saul, National Geographic History Magazine. Online

“Out in the Cold and Back: New-Found Interest in the Great Flu”. Guy Beiner, Cultural and Social History, Volume 3. 2006

“A Cruel Wind: Pandemic Flu in America, 1918-1920”. D. Pettit & Janice Bailie. 2008

“How the Horrific 1918 Flu Spread Across America”. John M. Barry, Smithsonian Magazine. November, 2017

“Ten Famous People Who Survived the 1918 Flu”. David A. Lovett, Smithsonian.com. October 24, 2017

“The legacy of the Spanish Flu”. Suzanne Shablovsky, Science Magazine. September 22, 2017. Online

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