The Flu

History Channel
The influenza or flu pandemic of 1918 to 1919, the deadliest in modern
history, infected an estimated 500 million people worldwide--about
one-third of the planets population at the time--and killed an
estimated 20 million to 50 million victims. More than 25 percent of the
U.S. population became sick, and some 675,000 Americans died during
the pandemic. The 1918 flu was first observed in Europe, the U.S. and
parts of Asia before swiftly spreading around the world. Surprisingly,
many flu victims were young, otherwise healthy adults. At the time,
there were no effective drugs or vaccines to treat this killer flu strain
or prevent its spread. In the U.S., citizens were ordered to wear masks,
and schools, theaters and other public places were shuttered.
Researchers later discovered what made the 1918 pandemic so
deadly: In many victims, the influenza virus had invaded their lungs
and caused pneumonia.

FluFacts

Influenza,orflu,isavirusthatattackstherespiratorysystem.Thefluvirusishighlycontagious:Whenan
infectedpersoncoughs,sneezesortalks,respiratorydropletsaregeneratedandtransmittedintotheair,and
canthencanbeinhaledbyanyonenearby.Additionally,apersonwhotouchessomethingwiththeviruson
itandthentoucheshisorhermouth,eyesornosecanbecomeinfected.
Fluoutbreakshappeneveryyearandvaryinseverity,dependinginpartonwhattypeofvirusisspreading.
(Fluviruses,whicharedividedintothreebroadcategories,canrapidlymutate.)IntheU.S.,"fluseason"
generallyrunsfromlatefallintospring.Inatypicalyear,morethan200,000Americansarehospitalized
forflurelatedcomplications,andoverthepastthreedecades,therehavebeensome3,000to49,000flu
relateddeathsintheU.S.annually,accordingtotheCentersforDiseaseControlandPrevention.Young
children,peopleoverage65,pregnantwomenandpeoplewithcertainmedicalconditions,suchasasthma,
diabetesorheartdisease,faceahigherriskofflurelatedcomplications,includingpneumonia,earand
sinusinfectionsandbronchitis.Aflupandemic,suchastheonein1918,occurswhenanespeciallyvirulent
newinfluenzastrainforwhichthereslittleornoimmunityappearsandspreadsquicklyfrompersonto
personaroundtheglobe.

TheFluStrikesFarandWide

Thefirstwaveofthe1918pandemicoccurredinthespringandwasgenerallymild.Thesick,who
experiencedsuchtypicalflusymptomsaschills,feverandfatigue,usuallyrecoveredafterseveraldays,and
thenumberofreporteddeathswaslow.However,asecond,highlycontagiouswaveofinfluenzaappeared
withavengeanceinthefallofthatsameyear.Victimsdiedwithinhoursordaysoftheirsymptoms
appearing,theirskinturningblueandtheirlungsfillingwithfluidthatcausedthemtosuffocate.Injustone
year,1918,theaveragelifeexpectancyinAmericaplummetedbyadozenyears.
Itsunknownexactlywheretheparticularstrainofinfluenzathatcausedthepandemiccamefrom;
however,the1918fluwasfirstobservedinEurope,AmericaandareasofAsiabeforespreadingtoalmost
everyotherpartoftheplanetwithinamatterofmonths.Despitethefactthatthe1918fluwasntisolatedto
oneplace,itbecameknownaroundtheworldastheSpanishflu,asSpainwasoneoftheearliestcountries
tobehithardbythedisease.EvenSpainsking,AlfonsoXIII(18861931),contractedtheflu.
Oneunusualaspectofthe1918fluwasthatitstruckdownmanypreviouslyhealthy,youngpeoplea
groupnormallyresistanttothistypeofinfectiousillnessincludinganumberofWorldWarI(191418)
servicemen.Infact,journalistGinaKolatahasreportedthatmoreU.S.soldiersdiedfromthe1918fluthan
werekilledinbattleduringthewar.FortypercentoftheU.S.Navywashitwiththeflu,while36percentof
theArmybecameill,notesKolatainherbookonthesubject.
Althoughthedeathtollattributedtothe1918fluisoftenestimatedat20millionto50millionvictims
worldwide,otherestimatesrunashighas100millionvictims.Theexactnumbersareimpossibletoknow
duetoalackofmedicalrecordkeepinginmanyplaces.Whatisknown,however,isthatfewlocations
wereimmunetothe1918fluinAmerica,victimsrangedfromresidentsofmajorcitiestothoseofremote
Alaskancommunities.EvenPresidentWoodrowWilson(18561924)reportedlycontractedthefluinearly
1919whilenegotiatingtheTreatyofVersailles,whichendedWorldWarI.

FightingtheFlu

Whenthe1918fluhit,doctorsandscientistswereunsurewhatcauseditorhowtotreatit.Unliketoday,
therewerenoeffectivevaccinesorantivirals,drugsthattreattheflu.(Thefirstlicensedfluvaccine
appearedinAmericainthe1940s;bythefollowingdecade,vaccinemanufacturerscouldroutinelyproduce
vaccinesthatwouldhelpcontrolandpreventfuturepandemics,accordingtotheU.S.DepartmentofHealth
andHumanServices.)
ComplicatingmatterswasthefactthatWorldWarIhadleftpartsofAmericawithashortageofphysicians
andotherhealthworkers.AndoftheavailablemedicalpersonnelintheU.S.,manycamedownwiththeflu
themselves.Additionally,hospitalsinsomeareasweresooverloadedwithflupatientsthatschools,private
homesandotherbuildingshadtobeconvertedintomakeshifthospitals,someofwhichwerestaffedby
medicalstudents.
Officialsinsomecommunitiesimposedquarantines,orderedcitizenstowearmasksandshutdownpublic
places,includingschools,churchesandtheaters.Peoplewereadvisedtoavoidshakinghandsandtostay
indoors,librariesputahaltonlendingbooksandregulationswerepassedbanningspitting.Accordingtoan
April30,2009,reportinTheNewYorkTimes,duringthepandemic,BoyScoutsinNewYorkCity
approachedpeopletheydseenspittingonthestreetandgavethemcardsthatread:"Youareinviolationof
theSanitaryCode."

TheFluTakesHeavyTollonSociety

Theflutookaheavyhumantoll,wipingoutentirefamiliesandleavingcountlesswidowsandorphansin
itswake.Funeralparlorswereoverwhelmedandbodiespiledup.Somepeopleevenhadtodiggravesfor
theirownfamilymembers.
Thefluwasalsodetrimentaltotheeconomy.IntheU.S.,businesseswereforcedtoshutdownbecauseso
manyemployeesweresick.Basicservicessuchasmaildeliveryandgarbagecollectionwerehindereddue
toflustrickenworkers.Insomeplacestherewerentenoughfarmworkerstoharvestcrops.Evenstateand
localhealthdepartmentsclosedforbusiness,hamperingeffortstochroniclethespreadofthe1918fluand
providethepublicwithanswersaboutit.

FluPandemicComestoanEnd

Bythesummerof1919,theflupandemiccametoanend,asthosethatwereinfectedeitherdiedor
developedimmunity.Almost90yearslater,in2008,researchersannouncedtheyddiscoveredwhatmade
the1918flusodeadly:Agroupofthreegenesenabledthevirustoweakenavictimsbronchialtubesand
lungsandclearthewayforbacterialpneumonia.
Since1918,therehavebeenseveralotherinfluenzapandemics,althoughnoneasdeadly.Aflupandemic
from1957to1958killedaround2millionpeopleworldwide,includingsome70,000peopleintheU.S.,
andapandemicfrom1968to1969killedapproximately1millionpeople,includingsome34,000
Americans.Morethan12,000AmericansperishedduringtheH1N1(or"swineflu")pandemicthat
occurredfrom2009to2010.

1. What specific host does a flu virus attack?

2. Why do flu pandemics quickly spread?
3. What was unusual about the 1918 flu or Spanish Flu?
4. What was the range of the 1918 flu pandemic?
5. What were three problems associated with treating the 1918 flu?
6. Give 2 regulations that were aimed at preventing the Spanish
Flu from spreading?
7. Give two examples of how the flu impacted other areas of
society?
8. Why did the 1918 flu come to an end?