Worried About a Pandemic? Consider the Spanish Influenza of 1918-1919

General La Grippe

Due to the ability of the flu virus to quickly mutate, the United States yearly experiences seasonal flu epidemics that are hard to protect against even with modern medicine.

Figure 1: At General Hospital Number 4, Fort Porter, N.Y, patients were given masks and placed in cubicles. The beds of the patients were reversed to prevent patients breathing on one another. (165-WW-269-B-4)

Health officials attempt to predict what those mutations will be and prepare vaccines to protect the public. These seasonal viruses are not as deadly as the 1918 virus because they are human viruses, ensuring that some percentage of the population will have or can build natural immunities. People who survive a flu epidemic build up natural immunities and others can become immune by receiving a vaccine. In 1997 Dr. Jeffrey Taubenburger and Dr. Johan Hultin excavated bodies of 1918 influenza victims buried in the permafrost of Alaska. Their research indicates that the 1918 virus was a bird-like flu virus that adapted to humans. Flu viruses that jump species are more virulent and often mutate faster.[1] A Boston physician at Camp Devin described how the disease progressed from "la grippe or influenza" to penumonia, to death in many soldiers.

Two hours after admission they have the mahogany spots over the cheek bones, and a few hours later you can begin to see the cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. 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. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up. . . For several days there were no coffins and the bodies piled up something fierce . . . It beats any sight they ever had in France after a battle.[2]

Today, the flu causes an average of 200,000 hospitalizations a year in the United States with an average of 36,000 dying from complications. Those with the highest risk are young children, two and under, the elderly, and people with pre-existing conditions.

image of hospital beds
Figure 2: An interior shot of the Influenza wards at the Red Cross House at Hospital #16 in New Haven, Connecticut. (165-WW-269165-WW-269)

During the 1918 epidemic, the B 40 victims were not the typical at risk groups, but rather young adults between the ages of 15-40. This is usually the group that has highest tolerance rate. It is still a mystery why young adults were so vulnerable, although one biologist, Dr. Michael Worobey, has a theory that it may just have been a matter of timing. In 1889 a similar virus had ravaged the United States infecting many who were now 40 or older and providing them with immunities that may have helped fight off the 1918 virus. Meanwhile, those under 25 had been exposed to what Worobey describes as a “prototype” virus which was the human version of the 1918 virus before it mutated with a bird version. When the Spanish Influenza hit in 1918, those under 25 had similar antibodies to protect them. Worobey explains that this would only have affected young children who were experiencing their first bout of flu. According to health officials, studies indicate that the first flu infection has the biggest impact on creating immune protections for the future. So those young adults who were not young children when the prototype was prevalent and who were not alive during the 1889 epidemic had no natural antibodies to protect themselves. In addition, many of those young adults were now serving in the military and living in cramped barracks or traveling on cramped transport ships when the epidemic attacked.[3]

Spanish Flu

image of spraying machine. Love Field, Texas.  Used as a preventative device on the soldiers. (165-WW-269-B-2)
Figure 3: Image of spraying machine. Love Field, Texas. Used as a preventative device on the soldiers. (165-WW-269-B-2)

Local papers and officials discussed in great depth where the flu came from. Some felt it was just a stronger strain of a disease that had always been prevalent in the U.S. Others described it as a strain of pneumonia from China. One newspaper suggested that the disease was brought by the Germans to the U.S. in a submarine. Others saw it as byproduct of war, perhaps caused by the use of poison gasses on the battlefield. We know now that the Spanish Influenza hit the United States in three separate waves and may have originated at Fort Riley, Kansas in March 1918. It spread among American soldiers as they gathered to be transported to Europe. American doughboys then brought the virus along with their kitbags to the trenches of both the Allies and Central powers. Soldiers returning from the front spread the disease throughout their home countries in Europe, causing especial devastation in Spain where 80% of the population contracted the disease which is why the disease was termed the “Spanish Influenza.”

“Although the present epidemic is called ‘Spanish influenza’ there is no reason to believe that it originated in Spain. Some writers who have studied the question believe that the epidemic came from the Orient and they call attention to the fact that the Germans mention the disease as occurring along the eastern front in the summer and fall of 1917.”[4]

The second wave hit the United States in September 1918 at the Naval Facility in Boston and at Devin military base in Massachusetts. From there it moved out into the general population killing 195,000 Americans in the month of October, 1918. The third wave was between December 1918 and March 1919 when the virus spread unevenly across the country. It’s obvious that the massive movement of military men during World War I did a great deal to spread the disease worldwide. In addition, cities crowded with war industry workers allowed the disease to spread rapidly from bases to the general public.[5] Before long, American citizens were no longer battling the disease on military bases and camps, but were contending with cases at work, in schools, on city streets and in their own neighborhoods.


All photographs are from the Still Picture Reference, Special Media Archives Services Division, National Archives at College Park and are part of the Photo Set: Spanish Flu Epidemic, 1918. Author has restored and enhanced images.

1. Armstrong, James F. "Philadelphia, Nurses, and the Spanish Influenza Pandemic of 1918." The Navy Department Library. March-April 2001. http://www.history.navy.mil/library/online/influenza%20phil%201918.htm (accessed September 24, 2014); Zimmer, Carl. "In 1918 Flu Pandemic, Timing was Killer." New York Times. April 30, 2014. http://nyti.ms/1rOIM5u (accessed September 24, 2014).; Laden, “We Heard the Bells,” 1-4.
2. "A Letter From Camp Devins, MA." American Experience: Influenza 1918. 2006. http://www.pbs.org/wgbh/americanexperience/features/primary-resources/influenza-letter/ (accessed November 2, 2014).
3. Zimmer, “Timing was a Killer,” 2-4 .
4. Coconino Sun, Spanish Influenza, 1..
5. Harvard University Library. Contagion: Historical Views of Disease and Epidemics. 2014. http://ocp.hul.harvard.edu/contagion/influenza.html (accessed September 24, 2014); Armstrong, Philadelphia, Nurses, and Spanish Influenza, Zimmer, “Timing was Killer,” 2-4; Morrisey, Carla R. "The Influenza Epidemic of 1918." The Navy Department Library. May-June 1986. http://www.history.navy.mil/library/online/influenza%20epid%201918.htm (accessed September 24, 2014).