A WARNING FROM HISTORY: The Spanish flu did not originate in Spain — fact one. Fact two — it was the era before antibiotics and vaccines. The “Spanish flu” unleashed its deadly run from 1918. That was 10 years before penicillin, the first true antibiotic (discovered in 1928 by Prof. Alexander Fleming, a Bacteriology teacher at St. Mary's Hospital in London). Photo shows Red Cross litter carriers transporting a victim of Spanish Flu in Washington DC in 1918.
Image Credit: Library of Congress / CDC / https://bit.ly/2SV2en3
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VIRAL RAGE: Considered the biggest and deadliest pandemic in modern history, the Spanish flu has been dubbed as the "the worst catastrophe of the 20th century", infecting an enormous number of people who died very quickly. It killed more people in one year than the four-year "Black Death" Bubonic Plague from 1347 to 1351.
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HUMAN AFFLICTION: Influenza has afflicted humanity for ages. In 1733, Gagliarde used the term “influenza”, from the Italian word “influence” — which originally meant a “disaster from heaven”. The ancient Italians believed that there was a close relationship between disaster and astronomical phenomena. Numerous beliefs of a similar nature have been found in the Chinese literature. Hippocrates, known as the "Father of Medicine", recorded the first known influenza epidemic in 412 BC, and numerous outbreaks were reported during the Middle Ages. The most notable epidemic was the “Spanish influenza”, which occurred in 1918.
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HOW DID 'SPANISH FLU' GET ITS NAME? It's a misnomer, peddled by the media at that time — and had nothing to do with its origins. The 1918 flu pandemic was called the “Spanish Flu” because during World War I (when Spain remained neutral), the country was the first to report flu deaths in its newspapers. Commentators soon nicknamed it “Spanish flu”. The Spanish king fell victim to the flu. The US and European media soon began calling it the “Spanish flu”, too. In Spain, however, people nicknamed the new influenza strain Soldado de Napoles or “Soldier of Naples,” after a song in a popular Spanish operetta. The hit song was so catchy it was said to spread like the flu. Photo shows an influenza-prevention ad published in October 1918.
Image Credit: US National Library of Medicine
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500 MILLION PEOPLE INFECTED: The Spanish flu infected an estimated 500 million people worldwide — about one-third of the planet's population. It killed an estimated 50 million to 100 million victims, more than the total number of deaths from the terrors of World War I.
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ORIGINS OF SPANISH FLU: There are varying theories. In a 1999 report, researchers identified a major troop staging and hospital camp in Étaples, France, as being at the center of the Spanish flu. The research was published in 1999 by a British team, led by virologist John Oxford (Source: https://bit.ly/2HPGvql). Photo shows soldiers with the Spanish flu hospitalised inside the University of Kentucky gym in 1918.
Image Credit: University of Kentucky
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MILITARY CAMP IN FRANCE: In 2000, an article published in 'The Independent' (source: https://bit.ly/2T6aCiy), cites an investigation into the deadly 1918 flu, showing it "almost certainly" started in an army camp in France in the middle of the World War I.
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DEADLIER THAN FIRST WORLD WAR: The killer flu claimed more lives than World War I, which ended the same year (1918) the pandemic struck. In 2014, a National Geographic article cites research placing the flu's emergence in a forgotten episode of World War I: the shipment of Chinese laborers across Canada in sealed train cars.
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FROM BIRDS, THEN TO PIGS? In late 1917, military pathologists reported the onset of a new disease with high mortality that they later recognized as the flu. The overcrowded camp and hospital was an ideal site for the spreading of a respiratory virus. The hospital treated thousands of victims of chemical attacks, and other casualties of war. About 100,000 soldiers were in transit through the camp every day. It also was home to a live piggery, and poultry was regularly brought in for food supplies from surrounding villages. British virologist John Oxford and his team postulated in 1999 that a significant precursor virus, harbored in birds, mutated and then migrated to pigs kept near the front. (Source: https://bit.ly/2HPGvql)
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CROWDED HOSPITAL: Influenza victims crowd into an emergency hospital near Fort Riley, Kansas in this 1918 file photo. The 1918 Spanish flu pandemic killed at least 50 million people worldwide.
Image Credit: NATIONAL MUSEUM OF HEALTH
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TRYING TO FIND ANSWERS: A team of virologists led by John Oxford, Professor of virology at St Bartholomew's and the Royal London School of Medicine, exhumed frozen bodies of some of the known victims from permafrost burial grounds in Spitzbergen in Norway and Alaska to isolate the 1918 virus. Oxford and his colleagues believe the Etaples camp became the birthplace of an influenza strain in 2018, two years before it spread across the world with devastating effects.
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DID THE ‘SPANISH FLU’ ORIGINATE IN CHINA? In 2014, historian Mark Humphries of Canada's Memorial University of Newfoundland, however, told the National Geographic that newly unearthed records "confirm" that one of the side stories of the war — the mobilization of 96,000 Chinese labourers to work behind the British and French lines on World War I's Western Front — may have been the source of the pandemic. (Source: https://on.natgeo.com/2usdeyY)
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RECORD: Women in Japan wearing the gauze masks (left side). Mark Humphries (of Canada’s Memorial University) unearthed records that confirm the mobilization of 94,000 Chinese laborers to work behind the British and French lines in World War I. These Chinese laborers may have been the source of the pandemic. This information was reported in 2014 by a National Geographic video. It was also reported in the Journal of War History. He states that in 1917 these northern Chinese people were shipped to England and France. They were brought to Vancouver, Canada and by train to Halifax where they embarked to England and France to work behind the lines and replace those workers who were now soldiers. While in Canada their trip was kept secret, and they were guarded and prevented from leaving the train. Humphries discovered medical records indicating that more than 3,000 of the 25,000 Chinese Labor Corps workers who were transported across Canada en route to Europe starting in 1917, ended up in medical quarantine, many with flu-like symptoms. Some of the Chinese and some of the guards came down with flu like symptoms, much like that of the epidemic known as the “Spanish Flu.” After arriving in France many went to a Chinese hospital. Hundreds of Chinese died there with respiratory illness similar to the flu.
Image Credit: Kansas WWI Centennial Committee
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COMPLICATED WITH PNEUMONIA: The flu, frequently complicated with pneumonia, was little understood at that time. The epidemic occurred apparently simultaneously in places as far apart as South Africa, India and Indonesia.
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US CASES: The first official cases of the 1918 Spanish flu pandemic were recorded at the US Army's Camp Funston, Kansas. According to official records, the Spanish flu killed some 675,000 Americans. In some communities, many adults died and orphaned children had to fend for themselves.
Image Credit: Library of Congress
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CAUGHT UNPREPARED: Amidst the 1918 flu pandemic, America struggled to bury the dead. Historical records show that since cremation was an uncommon practice at the time, the sheer number of bodies overwhelmed the capacity of undertakers, gravediggers and casket makers to keep pace with the arduous task of burying the dead.
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PUBLIC GATHERINGS PROHIBITED: A prohibition on public gatherings that included funerals and wakes compounded the pain of many grief-stricken families who could not properly mourn the loss of their loved ones.
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DEATH COMES: “It is only a matter of a few hours, then until death comes… and it is simply a struggle for air until they suffocate. It is horrible,” US Army Doctor Roy Grist said about the effects of the so-called “Spanish flu”.
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CODENAME 'DISEASE XI': The 1918 flu pandemic, also referred to as the Spanish flu (Code name: “Disease XI” in the US and France) was the deadliest flu outbreak. A newspaper report on the Spanish flu in 1918. Left, a colorised image of the 1918 virus taken by a transmission electron microscope (TEM).
Image Credit: Wikipedia / C. Goldsmith - Public Health Image Library
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GLOBAL FLU: The deadly global flu outbreak of 1918, also known as the “Spanish flu”, killed anywhere from 50 million to 100 million people worldwide two years later, by about 1920. The flu, frequently complicated with pneumonia, was little understood at that time. By comparison, WHO estimates that HIV has killed 35 million people in total since its inception. The Spanish flu ranks as the deadliest epidemics in history.
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THREE CONTINENTS: The disease was truly a global pandemic, sprouting up on three continents within a week and disrupting social order on a global scale. Within months it had already killed more than any other disease in human history – and the pandemic stretched on for years.
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EARLIEST RECORD: The earliest well-attested cases of Spanish flu were reported among army recruits in military camps in the USA in March 1918, and it was widespread throughout the world within a short period after World War I. Photo shows American Red Cross workers collecting victims of the 1918 flu in St. Louis. Photo Credit: St. Louis Post-Dispatch
Image Credit: St. Louis Post-Dispatch
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EVERYONE LIVED IN FEAR: During the height of the Spanish flu, which hit in three waves from 1918 to 1920, everyone lived in fear. But it was the 20-, 30-, 40-year-olds that were hardest hit. A lot of nurses and medical workers were also getting sick. Hospitals were overwhelmed. The global pandemic has led to sweeping changes in nursing and the health-care industry.
Image Credit: Library of Congress
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SAVED BY REMOTENESS: Other islands had similar success at keeping the pandemic at bay. The French territory of New Caledonia in the South Pacific did not experience an outbreak until July 1921, again escaping with just a mild form of the disease.
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TASMANIAN EXPERIENCE: The Australian island of Tasmania implemented strict quarantine measures for boats arriving on its shores — ot required all passengers and crew to be isolated for seven days. When the infection penetrated the island in August 1919, medical officers reported that it was a milder infection than that on the mainland. The death rate on Tasmania was one of the lowest recorded worldwide.
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TOMBSTONE: A single virus strain probably affected all Pacific islands. But its impact varied widely across the Pacific, with less than 0.1 per cent mortality in Tasmania up to 22 per cent in Western Samoa. (Source:https://bit.ly/2uo5Ww7)
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IT CAME BY SHIP: The second wave of the global influenza pandemic came to Western Samoa on board an island trader, the Talune, on 4 November 1918.
Image Credit: https://bit.ly/2HRx5KI
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AUSTRALIAN QUARANTINE: The Spanish flu did not strike in Australia until 1919. Quarantine camps like the one in Wallangarra, Queensland, were set up to treat and contain the illness.
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PROTECTION MEASURES: American Samoa implemented a five-day quarantine for all boats that kept influenza from its shores until 1920. When it finally did arrive, the virus appears to have lost much of its sting and there were no deaths attributed to influenza in a population of more than 8,000. The main island of Samoa to the northwest, however, lost around a fifth of its population to the pandemic.
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TERRIBLE TOLL: The outbreak spread across the globe — from North America to Europe, Asia, Africa, Brazil and the South Pacific. In places like Alaska, the Spanish flu exacted a terrible toll. In some communities, including some of the worst hit areas of Bristol Bay, up to 90% of the population died and the mortality rates were some of the highest in the world. More people per capita died from influenza in Alaska than almost anywhere else in the world.
Image Credit: Creative commons
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MORTALITY RATES: Research has indicated that, over time, as the virus burned its way through populations, it accumulated mutations that naturally reduced its capacity to cause disease. Another possibility could be that some populations may have acquired a degree of immunity against the pandemic strain from comparatively harmless seasonal flu strains that were circulating in the years running up to 1918.
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MASKED COPS: Policemen in Seattle city, wearing masks made by the Seattle Chapter of the Red Cross during the influenza epidemic, December 1918.
Image Credit: American National Archives, record number 165-WW-269B-25
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HOW DID THE SPANISH FLU END? The pandemic ended simply by running its course, without significant human intervention. Now, we know that it was the influenza virus that killed millions. More than 100 years later, the scientific community still does know for certain where or how it began – making it harder to plan for a repeat disaster.
Image Credit: National Geographic
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PATHS OF INFECTION: Map depicting the Spanish flu pandemic 1918, Patterson KD, Pyle GF, "The Geography and Mortality of the 1918 Influenza Pandemic." In a 2014 report, titled “Paths of Infection: The First World War and the Origins of the 1918 Influenza Pandemic,” (Source: https://bit.ly/2T7m39z) historian Mark Osborne Humphries claims he had found “archival evidence” that a respiratory illness that struck northern China in November 1917 was identified a year later by Chinese health officials as identical to the Spanish flu. He also found medical records indicating that more than 3,000 of the 25,000 Chinese Labor Corps workers who were transported across Canada en route to Europe starting in 1917 ended up in medical quarantine, many with flu-like symptoms.
Image Credit: Bulletin of the History of Medicine, 1991; 65(1): 4-21.
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MASSIVE LOCKDOWN: China has locked down dozens of cities, reportedly populated by up to 50 million inhabitants, after the Covid-19 outbreak to prevent its spread.
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