The Worst Plague in History

IN October 1918, the world was still fighting World War I. Although the end of hostilities was near, news censorship remained. Therefore, it was left to the noncombatant country of Spain to report that civilians in many places were becoming ill and dying at an alarming rate. These circumstances gave rise to the name by which the disease would forever be known​—the Spanish flu.

The pandemic began in March 1918. * Many investigators trace its origin to the state of Kansas, U.S.A. From there it was apparently spread to France by newly arrived U.S. soldiers. After a sharp increase in influenza deaths, by July 1918 it seemed that the worst was over. Little did doctors know at that time that the pandemic was only gathering strength to become a more efficient killer.

When World War I ended on November 11, 1918, the world rejoiced. Ironically, at almost that same time, the pestilence broke out earth wide. It was a monster that now claimed international headlines. Few who lived through that time were untouched, and all were frightened. A respected authority on influenza noted: “Life expectancy in the United States dropped by over 10 years in 1918.” How did this pestilence differ from others?

 A Unique Pestilence

A most alarming difference was the suddenness with which this flu struck. How sudden? In the recent book The Great Influenza, author John M. Barry quotes a written record of this experience: “In Rio de Janeiro, a man asked medical student Ciro Viera Da Cunha, who was waiting for a streetcar, for information in a perfectly normal voice, then fell down, dead; in Cape Town, South Africa, Charles Lewis boarded a streetcar for a three-mile trip home when the conductor collapsed, dead. In the next three miles six people aboard the streetcar died, including the driver.” All died of the flu.

Then, there was the fear​—fear of the unknown. Science had no answer as to the cause of the disease or exactly how it spread. Public health measures were imposed: ports were quarantined; movie theaters, churches, and other public meeting places were closed. In San Francisco, California, U.S.A., for example, officials ordered the whole population to wear gauze masks. Anyone caught in public without a mask faced a fine or jail. But nothing seemed to work. Such measures were simply a case of too little, too late.

There was also fear because the flu struck indiscriminately. For reasons still not clear, the 1919 pandemic did not primarily afflict the elderly; it struck healthy young people and killed them. The majority of those who  died of the Spanish flu were between 20 and 40 years of age.

Moreover, it was truly a worldwide epidemic. It even reached tropical islands. Influenza was introduced into Western Samoa (now known as Samoa) by ship on November 7, 1918, and within two months about 20 percent of the population of 38,302 died. Every major country of the world was dramatically affected!

Also, there was the enormity of this scourge. For example, the disease hit early and especially hard in Philadelphia, Pennsylvania, U.S.A. By mid-October 1918, there was a serious shortage of coffins. “One manufacturer said he could dispose of 5,000 caskets in two hours, if he had them. At times the city morgue had as many as ten times as many bodies as coffins,” says historian Alfred W. Crosby.

In a relatively short time, the flu had killed more people than any other pandemic of its kind in human history. A common estimate of worldwide deaths was 21 million, but some experts now judge that figure to be low. Some epidemiologists today suggest that a more likely toll is 50 million deaths or perhaps as many as 100 million! Notes Barry, mentioned earlier: “Influenza killed more people in a year than the Black Death of the Middle Ages killed in a century; it killed more people in twenty-four weeks than AIDS has killed in twenty-four years.”

Incredibly, the Spanish flu killed more Americans in about a year than died in battle in both world wars combined. Author Gina Kolata explains: “If such a plague came today, killing a similar fraction of the U.S. population, 1.5 million Americans would die, which is more than the number felled in a single year by heart disease, cancers, strokes, chronic pulmonary disease, AIDS, and Alzheimer’s disease combined.”

To put matters succinctly, the Spanish flu was the most devastating pandemic in the history of mankind. What help came from science?

When Science Proved Helpless

By the beginning of World War I, medical science had seemingly made great strides in conquering disease. Even during the war, doctors took great pride in their success at reducing the effects of infectious diseases. At the time, The Ladies Home Journal declared that American homes no longer needed a room for laying out the dead for viewing. It suggested that such parlors henceforth be called living rooms. But then came the Spanish flu, and medical science proved almost totally helpless.

Crosby writes: “All the physicians of 1918 were participants in the greatest failure of medical science in the twentieth century or, if absolute numbers of dead are the measure, of all time.” Lest the blame be placed entirely on the medical profession, Barry makes this point: “Back then scientists fully comprehended the threat’s magnitude, knew how to cure many secondary bacterial pneumonias, and gave public-health advice that would have saved tens of thousands of American lives. Politicians ignored that advice.”

So now, about 85 years later, what has been learned about this terrible pandemic? What caused it? Could it come back? Could it be fought successfully if it did? Some of the answers may surprise you.

[Footnote]

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The majority of those who died of the Spanish flu were between 20 and 40 years of age

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A school class of 1919, Canon City, Colorado, U.S.A.

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Courtesy, Colorado Historical Society, 10026787

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A police officer

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Photo by Topical Press Agency/Getty Images

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Baseball players wearing protective masks

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© Underwood & Underwood/CORBIS