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The 1918 Influenza Pandemic

  • Published
  • By Daniel Knickrehm
  • 43rd Airlift Wing, Historian
In the late spring of 1918, what would become the most virulent outbreak of influenza known to man began. The virus started at Fort Riley, Kan., when a Soldier reported symptoms of fever, sore throat and headache. By noon that day, the camp's hospital had 100 similar cases reported, and by the end of the week, there were 500 cases at the base. Although the first cases were little more than a "three-day fever," later that year the virus became deadly. It spread throughout the United States and into other parts of the world - the outbreak became a pandemic. 

The effect this influenza pandemic had, at least temporarily, on American society was profound. Welcome home rallies for Soldiers returning from WWI were cancelled. Other large gatherings were cancelled, including drives for war bonds and sporting events.
According to "On September 28, [1918] 200,000 [people] gather for a 4th Liberty Loan Drive in Philadelphia. Days after the parade, 635 new cases of influenza were reported. Within days, the city will be forced to admit that epidemic conditions exist. 

Churches, schools and theaters are closed, along with all other places of 'public amusement.'" Many Americans wore white masks over their mouths and noses to prevent transmission of the virus. In severe situations, in-home quarantines were enforced, sometimes on whole neighborhoods.
There were long-term effects of the 1918 influenza pandemic as well. As a direct result of this outbreak, scientists discovered Type A, the first influenza virus. Our current flu vaccines, including the one for H1N1, might not have been developed had the pandemic not forced the scientific community to focus on the influenza virus. 

The number of deaths from this pandemic was astounding. In October 1918, the death rate from the Spanish Influenza was 50 per 1,000 people, five percent of the U.S. population. By the end of the pandemic in 1920, an estimated 600,000 Americans died from the virus, and an estimated 20 to 50 million people died worldwide. Literally every family in the country was said to have known someone who died from what was eventually called the Spanish Influenza. 

To place the sheer number of deaths from the 1918 Spanish Influenza pandemic into context, consider these facts: 

- There were more deaths from the Spanish flu than any disease outbreak either before or since, including the "Black Plague" outbreaks in the Middle Ages.
- There were more deaths from the 1918 influenza outbreak than in any war in American history.
- The number of estimated deaths, using the lower estimate of 20 million, is roughly equal to twice the current population of the state of North Carolina. 

According to the Center for Disease Control, the 1918 pandemic virus was so virulent and deadly among healthy adults that it lowered the average life expectancy in the United States by more than 10 years. 

The death rate among adults between the ages of 15 and 34 may have also been a result of deaths in those still fighting WWI in Europe. The close quarters of otherwise young, healthy soldiers, weakened by months or years of fighting in trench warfare resulted in high mortality rates from the flu concentrated on the fighting fronts. The effect of the virus was also felt by the military on the home front. A letter from B. M. Holden at a depot in Philadelphia dated October 8, 1918, reports: "Epidemic Spanish Influenza hampering operations of depot. Eleven commissioned officers and 1,489 employees absent today. Of the latter, 1,177 work in factories. Situation not improving." 

The effects of the Spanish Influenza pandemic of 1918 were extreme. Even so, one can't help but make connections with the current outbreak of H1N1. One message to take away from the knowledge of the 1918 outbreak is that something as seemingly simple as the flu has the capacity to cripple our fine fighting forces. Today the medical community and military leadership urge people to get flu vaccinations (and other vaccinations as well), not just to prevent the aches and pains of the normal flu but to keep us from falling prey to outbreaks like the one that severely hampered the United States' ability to fight a war more than 90 years ago.