Dr. Bob: Remembering the tragic 1918 Flu Pandemic

August 6, 2018

1918 flu epidemic: the Oakland Municipal Auditorium in use as a temporary hospital. The photograph depicts volunteer nurses from the American Red Cross tending influenza sufferers in the Oakland Auditorium, Oakland, California, during the influenza pandemic of 1918.

2018 marks the 100th anniversary of the deadliest flu pandemic in history.

An estimated 500 million people worldwide, about one-third of the world’s population, were sickened. Between 20 and 50 million victims died, including some 675,000 Americans. In fact, more Americans died as a result of the 1918 flu than have died in all wars combined over the last 100 years. Visit almost any older cemetery and note the high number of 1918 graves. It quickly provides convincing evidence of just how deadly this incident was.

You may have viewed the now famous picture of beds filled with flu-sickened soldiers at a hospital ward at Camp Funston. Unfortunately, most of the soldiers you see in the picture did not survive.

Where the flu was first observed and how it got started is debated to this day. Some accounts say Asia, but others claim it actually began here in the United States.

There is one thing all agree on, and that is everyone on Earth was exposed and the only thing that stopped it was those that got it and survived were immune and those who it killed were no longer capable of spreading it.

The Spanish flu (1918-1920), also known as the 1918 Flu Pandemic, was an unusually deadly form of the H1N1 influenza virus, making it the deadliest natural disaster in human history.

Some historians claim Fort Riley Army Depot in Kansas actually was responsible for the pandemic. It seems Army personnel were burning horse manure when strong winds blew the burning ash over the barracks. Reports indicate that within 24 hours, personnel began reporting in with respiratory symptoms.

The virus had crossed from animals, including poultry and horses, to humans. Because of WWI, an entire world away was in the balance. Thousands of new troops were needed. Many of these sick soldiers were crammed into troop ships, thus bringing the flu to Europe and the war itself. The flu would end up killing more soldiers on both sides of the conflict than the actual war.

At first, the flu was believed to be a new deadly weapon of the Germans, but it was quickly realized that just as many Germans were dying from the flu as the Allied forces.

Overcrowded military camps in the U.S. and at least one major troop staging area in Etaples, France, appear to be the so-called epicenter.

In 2014, historian Mark Humphries of the Medical University of Newfoundland in St. John put forth the idea that it was actually the mobilization of 96,000 Chinese laborers to work behind the British and French lines who were to blame. We may never know the unique cause of this pandemic.

In my epidemiology class, I show a video where President Wilson informs several WWI generals that in an effort to stop the spread of the flu, he will be cutting new troop shipments to the front. In a united plea they remind him that any solider who dies as a result of being exposed to the flu during transport is dying for his country just as much as the soldier in the trenches. In the end the president continued troop shipments, and the spreading of the virus.

In the United States, “flu season” typically runs from late fall to the spring, hospitalizing some 200,000 and killing as many as 36,000. The Spanish flu killed as many as 20 percent of its victims. Influenza typically kills less than one percent. In 1918, the flu season never ended.

The influenza virus is typically spread person-to-person when he or she coughs or sneezes. More than a million virus particles can be released into the air spreading to those that are nearby.

Overcrowding as well as poor sanitation spread the virus quickly. There could not have been a better way to spread the virus around the globe than the practice of crowding thousands of troops on a ship and letting them infect each other for up to a week.

Among the strange facts from the 1918 pandemic was that typically the flu kills the very young and very old — the weak. The mortality rate for “killer flu” was drastically higher among the young and seemingly strong. In fact, most were between 18 to 40 years of age. These were the strong farmhands and those considered in good health.

Next week, I will focus on why all the rules seemed to change with this particular influenza and why it has been both so important, but also horribly dangerous to literally raid cemeteries in the permafrost of Alaska to find bodies containing remnants of the original virus.

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