THE WORLDWIDE INFLUENZA EPIDEMIC
(SPANISH FLU): APRIL 1918 – APRIL 1920
The worldwide epidemic of influenza (commonly known as “Spanish Flu”) broke out in April 1918, a few weeks after the pronouncement of Wilson’s Fourteen Points. It proved to be one of the most devastating pandemics in modern history, and certainly of the 20th century. Over the next two years there were four waves of the disease, the most serious being in the autumn of 1918 and the winter of 1920. It is estimated that 500 million people were attacked by this deadly virus – something like a fifth of the world’s population at that time – and that, worldwide, over 30 to 50 million lost their lives. Even the lower figure is far greater than the loses suffered by soldiers and civilians over the entire length of the First World War, put, generally, at around 20 million.
Acknowledgements
World Map: africacenter.org/spotlight Bug (detail): infectiousdiseaseadvisor.com Pandemic: Left: conncoll.edu Centre: History.com Right: variety.com Waves: futurity.org Flu (detail): britannica.com Age Groups: github.com Death: redbubble .com, by Dutch artist Louis Raemaekers.
WW1-
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At the beginning of the epidemic, losses in Spain were particularly heavy – allegedly put as high as eight million over one particular month (May 1918) – and this spawned the title “Spanish Flu”. In fact, however, it is now generally agreed that the first reported case occurred at Camp Funston, a military base in Kansas, early in March 1918. American troop were being sent to Europe in large numbers at this time (84,000 in March and 118,000 in the following month), and this movement of military forces was greatly increased later in the year with the ending of the war and the dispersal of troops across the entire world. And losses were not confined to the larger nations. The Fiji Islands, for example, lost 14% of its population in sixteen days, and Labrador and Alaska lost one third of their native populations during the pandemic.
Influenza is a viral infection which mainly affects the body’s air passages. This brings about a variety of effects such as fever, headaches, chills, joint and muscle pains, and a general feeling of weakness. At its worst – and such was the case in this particular epidemic – there is a real danger of a secondary infection which affects the lungs, namely pneumonia. At this time (the early 1900s), this was a major cause of death. There were no anti-
The Journal of the American Medical Association wrote at this time: “The year 1918 has gone: a year momentous as the termination of the most cruel war in the annals of the human race; a year which marked the end, at least for a time of man’s destruction of man; unfortunately, it was also a year in which was developed a most fatal infectious disease, causing the death of hundreds of thousands of human beings. For four and a half years medical science devoted itself to putting men on the firing line and keeping them there. Now it must turn with its whole might to combat the greatest enemy of all ….. an infectious disease.”
Incidentally, in addition to “Spanish Flu”, the “Great Influenza Epidemic” of 1918 attracted a number of other titles. The Poles called it the “Bolshevik Disease”; in Spain it became known as the “French Flu”; in Africa it was widely known as the “Whiteman’s Sickness”; in South Africa it was called the “Negro Disease”; and the Japanese blamed their outbreak on a group of sumo wrestles (the “Sumo Disease”) for bringing the infection back from a contest in Taiwan! Later, it became known as “The Forgotten Pandemic”, because it was overshadowed by the war at this time – then beginning to reach its climax – and news blackouts by the warring nations restricted the information available to the general public. ……
…… The severity of the pandemic led to a serious scarcity of doctors, nurses, morticians, gravediggers, and coffin makers. The majority of the dead were buried in shallow graves in open ground outside towns and villages.
The first wave of the disease occurred during the Spring of 1918 (see chart below). It was comparatively mild and came to be known as the “three day fever”, but in the autumn of that year there was a serious outbreak and the wearing of masks and social distancing began to be introduced in earnest. The final and worst wave came in the winter of 1920. The most damaging and unique feature of this epidemic was that it was not confined to the elderly, the weak, or young children, as one might expect. Indeed, as the second chart shows, it disproportionately targeted the healthiest members of society, those aged from 25 to 45. This could not be easily explained clinically, but, of course, the majority of men in this age group were serving in the forces and confined to the cramped, unhygienic conditions of life in the trenches. And on the home fronts this active age group suffered the most from a serious shortage of food and poor living conditions. It was not until 1921 that the death rate from influenza had returned to pre-
