THE “SPANISH” FLU (1918-1920)

Causative organism: H1N1 influenza A virus

Spanish flu micrograph

What happens when you entrench soldiers for years in less than sanitary conditions, take no care of their constitutions, and feed them in a subpar manner? Let’s not forget the cold, the wet, the rats, and the fog that followed the explosions and gunpowder that characterised every battlefield during World War I, and voila!! you have the Spanish flu.

Any takers? Well, for the soldiers and much of Europe at the time, influenza was the ravaging menace that swept both sides of the fight. However, there was a disproportionate affectation of the Allied Forces, including the USA, the UK, and France.

For a disease generally regarded as a seasonal illness in many parts of the world, it is surprising that it wreaked such havoc on the world at the time. Some numbers estimate that it decimated more individuals than the actual battle, with some 17-50 million unfortunate souls compared to the estimated 16.5 million victims of warfare. This a chilling reminder that disease has no allies and crowns, no victors; neither is it a respecter of persons.

Spanish flu hospice
A typical field hospital during a Spanish flu outbreak.

Cramped quarters notwithstanding, many features of this illness made it a successful culler of the populace. One interesting fact was its predilection for young adults, as opposed to the usual extremes of age seen with other strains. And its uncanny ability to kickstart a feverish storm from the body’s immune defences. Seeing as young people had stronger constitutions, it followed that their reactions would be more fatal.

The Controversy of Names

An unresolved- perhaps forgotten- contention is the matter of naming the disease. Like many before, tradition called for a label of some nation or historical figure. But one name stuck longer than the rest and spread faster than it could be censored.

The Spanish flu was so named largely due to propaganda. Even though its effects ravaged many countries, widespread censorship had successfully stifled information about its reach. However, this censorship wasn’t practised in Spain, and the millions affected there were openly recorded. Soon, newspapers from London to Moscow, Serbia and the United States would come to assign the origin to Spain, hence the name. Russia’s naming it “The Spanish Lady” strikes a comical note.

Origins and Spread

A consensus of the flu’s origins claims Kansas, USA, as Ground Zero for this deadly virus. Dated first on the 4th of March 1918, it is said to have begun in an army cook. However, cases were already noted in other regions of the country as early as January of the same year. This makes a political assignation on the date rather than factual.

From its origins in America, travelling soldiers soon allowed spread from soldier camps to the rest of Europe. The trail was swift, hitting French ports by April 1918 and blazing through much of the Western Front. This First Wave finally subsided in July of that year. More than anything, the sickness rather than the kill count caused much disruption on the war front. The ring of death will come later on.

A strange climate anomaly is also claimed to have played a part in the pathogen’s virulence. Extremely cold and wet temperatures had persisted in Europe for some years before the pandemic, allowing for the virus’ transmission through water bodies and also depressing the immunity of exposed soldiers.

Death Toll

Like most problems, the second or third coming is when casualties start to hit the floor. From August 1918 and spanning till the middle of the next year, these waves culled adult populations across many cities. It was the first deviation from the normal sequelae of disease seen in other flu strains. Reports from the US were shocking. Over 290,000 people were put on ice in less than four months, and major cities ground to a halt.

In Europe, scores of thousands joined the dead, but the largest numbers by far came from India. It is estimated that 12.5 million people met their end there, courtesy of influenza.


Like the fever that usually accompanied it, it burned hot, fast, and alarmingly before it passed on. This symptomatology was largely accurate for the first wave of the disease. The second wave followed a more dangerous course, causing a phenomenon that coloured the face to a morbid purple. This presentation soon came to be known as ” The Purple Death”. A loss of taste, smell and visual disturbances were also common symptoms. A particularly striking presentation of the disease was spontaneous bleeding from the mouth, nose, throat and intestines. A vigorous overreaction of the host immune system also played a part in exacerbating disease conditions

Bacterial pneumonia due to superinfection by otherwise normal flora of the throat and mouth was a common cause of death. This occurred despite the many ways the virus could kill directly. It is an ironic way to meet the creator, killed by things once thought harmless.

The Aftermath

Modern scientists blame a wholesale shift in the genetic makeup of the virus strain for its effective spread and kill rate. Such an occurrence is common every 30-40 years.

Some sources also argue that the pandemic played a role in the Allies’ victory over Germany and Austria.

On the economic front, a major fiscal depression accompanied by large-scale inflation was more likely a result of the war than the disease.

Despite the high death rate and widespread impact on both sides of the war, the Spanish flu got relatively little coverage in the world news. In addition, little of its workings are stated in literature- fictional or otherwise. One theory for this weird fact is the coincidental occurrence of the illness with the war and three other minor epidemics across Asia and Europe. Due to the relatively little acclaim for its proficiency and rapid decline from historical and contemporary importance, the “Spanish” flu has been termed “The Forgotten Pandemic”.

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