The 1918 ‘Spanish Flu’ Pandemic
A
The 1918 flu pandemic, often referred to as the ‘Spanish influenza pandemic’, was one of the deadliest in recorded history, infecting 500 million people and causing the deaths of 50 to 100 million. Over 25 per cent of the global population became sick from the flu and between 3 to 5 per cent perished, making it one of the worst disasters humanity has ever faced. The flu was a truly global pandemic, infecting people in almost every region of the world, including on remote islands in the Pacific. It was particularly severe in Asia, and over 17 million people died in India alone. In America, over 25 per cent of the population was infected and between 500,000 to 675,000 died, whilst in Europe the pandemic was almost as deadly, killing 250,000 in the UK and over 400,000 in France. It was unusual in terms of flu pandemics since its victims were mainly healthy young adults, whereas most influenza outbreaks kill juvenile or elderly people, or those who are already sick. The pandemic was also unusual because of the speed at which it spread around the world, before subsiding at an equally rapid pace. Many experts have cited this as the reason the pandemic is largely forgotten today, despite occurring relatively recently. It deserves more attention, however, both for the lessons it could teach contemporary governments about coping with pandemics and because the exact causes of its ferocious impact are still unknown.
B
The flu pandemic of 1918 came at a particularly inauspicious time, as much of Europe was still embroiled in the latter stages of World War I. Indeed, there have been several theories that suggest that the flu epidemic started in the filthy conditions of the trenches on the Western Front. However, these theories do not account for the parts of the world that were not engaged in the war, but which still experienced high loss of life due to the flu. Nevertheless, it is evident that the ability of governments to respond to the pandemic was hampered by the fact that so many were preoccupied with this conflict, whilst the movement of troops around the world was probably a factor in the pandemic’s rapid spread. The war also led to the misleading way with which the flu was labelled. Wartime censorship meant the governments of Great Britain, France, Germany and the United States forbade newspapers from reporting on the pandemic for many months, purportedly as a means of maintaining their citizens’ morale. However, they were free to report on the pandemic’s impact on Spain since it was not involved in the war, which created the public perception that the flu was particularly grave there, and that it may have been Spanish in origin. This was compounded by the very public illness of the Spanish King Alfonso XIII, who contracted the flu but did not die from it.
C
The first confirmed case of the flu was actually in Fort Riley, a military base in the American state of Kansas, where troops were undergoing training for World War I. The first victim, Private Albert Gitchell, reported ill on the 4th of March and by the 11th there were over 100 soldiers infected; a few days later that figure was over 500. This first wave was, however, relatively mild, and more closely resembled typical flu outbreaks with symptoms such as chills, fever and tiredness. However, in August of 1918 another, more virulent strain appeared simultaneously in France, Sierra Leone and Boston in the United States. This strain was very different from the first one, and was incredibly deadly, with symptoms that included victim’s skin turning blue, fluid filling their lungs and suffocation. Many of those who contracted this strain died within hours or days. It spread quickly throughout the world, and was so deadly that the average American life expectancy had fallen by over ten years by the end of 1918. Communities across the globe were devastated, with the populations of whole towns killed in some countries. However, the pandemic ended as abruptly as it had begun, and by the end of 1918 cases had dropped sharply, which many attribute to either improved care or the virus mutating into a less deadly form.
D
The unique characteristics of the 1918 flu have baffled scientists since it first began. Firstly, it was far more severe than other flu strains, killing around 20 per cent of all those infected, whilst its tendency to infect healthier 20 and 30 year olds was a further mystery for experts. It also spread in the summer and autumn, whereas most influenza strains are common in the winter months. A further mystery is its origins and the reasons for its rapid spread, which scientists have argued over for a century. There are several competing hypotheses which explain the former, such as that the disease arose from a poultry virus at Fort Riley, and that troop movements helped it spread from there. More recent research suggests that the flu may have originated in pigs. Theories explaining how the virus spread so quickly are also plentiful. The most recent explanation has focused on 96,000 Chinese labourers who were brought to Europe in the latter stages of the war. They are thought to have brought with them a form of respiratory illness which could have been an earlier strain of the influenza. However, other researchers have discounted this claim, stating that the flu was far more likely to have originated in Europe. This debate will no doubt continue, as the ‘Spanish flu’ is a vital case study from which we can glean lessons about how to deal with a pandemic, and where exactly the next one might come from.