These days, people worry about swine flu, avian flu, flu-flu, AIDS and HIV. 90 years ago, there was a disease which put all these worries to shame. They called it The Spanish Flu. It made its mysterious and deadly premier on the world stage in 1918, lasted for four seasons until the curtain closed on it at the end of 1919. By the end of its lethal performance…tens of millions of people would be dead…in what was probably the most deadly pandemic of modern times, and almost certainly the most deadly pandemic in recorded history, surpassing even the Black Death of the 1340s.

What was Spanish Influenza?

“Spanish Influenza”, as it was called, was brought back to the USA and to other countries around the world, by troops returning from Europe after the end of WWI. The large numbers of men travelling great distances around the world helped spread the fledgling virus so that it could infect several thousand people. Despite the name, there’s no actual proof that the disease ever came from Spain itself. Modern scientists and doctors believe that ‘Spanish Flu’ was originally an animal virus, much like modern avian or swine flu and that it mutated to a form which was infectious and deadly to humans. Spanish Flu was incredibly contagious and thousands of people died. It’s believed that approximately 75 million people died of the Black Death, while anywhere from 20 to 40 to 50 to as many as 100 million (estimates vary wildly from source to source) died from Spanish Influenza.

The Symptoms

Spanish Flu was a horrific disease. It was less like influenza and more like a hardcore version of pneumonia which was, in the 1910s, completely untreatable and fatal. People catching the Spanish Flu, first came down with cold-like symptoms: Dizziness, fevers and shortness of breath. Doctors encouraged people to sleep and take it easy like any doctor today would encourage a patient, who has a cold. However, the symptoms soon got a lot worse. From ordinary cold-like symptoms came difficulty breathing, coughing, chronic shortness of breath and eventually, vomiting. The shortness of breath and the vomiting was a result of the pneumonia-like qualities of the Flu, which caused internal bleeding, and the buildup of fluid in the victim’s lungs. For a while, you could cough and vomit the stuff out…but eventually, your lungs filled with pus and blood and you literally drowned from all the fluids inside you. Any pus you vomited out was slimy, off-white and sometimes flecked with blood from the internal bleeding.

The First Signs

Spanish Influenza was discovered in mid 1918, while the First World War was still being fought. It’s likely that soldiers being shipped back to America on leave, or who were invalided home, brought the virus with them when they left France. The first outbreaks happened in an army base called Fort Riley, in Kansas. From there, it spread rapidly throughout the USA, aided by the movements of troops around the country in the final months of WWI. Spanish Flu was incredibly contagious, and it’s believed that upwards of 25 million people had died within just 25 weeks.

Handling the Pandemic

It was soon obvious that serious attention had to be given to this new ‘Spanish Flu’. But there were several problems. To begin with, when the flu was first noticed, the world was still fighting WWI. This meant that there was a serious lack of professional medical staff to handle the outbreak, as many doctors had gone over to France to care for wounded soldiers. Microbiology was only just being understood in the 1910s and science had not yet discovered viruses. While people understood bacteria and how they worked and how to avoid them, viruses remained unknown to medical science at this time. To combat the spread of disease, it became mandatory for all people to wear face-masks while out in public. This proved useless, as the virus could easily penetrate the masks which people put on. A popular public-health slogan was:

“Obey the laws,
And wear the gauze,
Protect yourself,
From septic paws”.

While people tried to obey the laws, these health-precautions did little to stop the spread of the disease. As many as 675,000 people died in the USA; 200,000 in the UK, 400,000 in France and, right on the other side of the world, as many as 10,000 people died of the ‘Flu in Australia. At its peak in the USA, funerals were shortened to fifteen minutes each, mass graves were being dug to bury the dead, and doctors and scientists struggled to find a cure. Some scientists tried to develop vaccines to protect still-healthy people from the ‘Flu, but this backfired when the vaccine proved to be as deadly as the ‘Flu itself!

One puzzling thing about the ‘Flu was that, instead of attacking the young or the elderly, it attacked people who were in the prime of life. Young men and women in their 20s, 30s and 40s succumbed to the virus more readily, while the people at the extremes of the age-scale remained largely untouched.

There were actually two waves of Spanish Flu, something that not many people realise. The first wave came in early/mid 1918 and died out around the end of the year. The second wave came a few months later in late 1918/early 1919, and lasted until the very end of 1919, when it began to disappear. This second wave was what caused the most deaths It was more virulent and infectious and caused more deaths than the first wave ever did.

Controlling the spread of the disease was difficult. Public officials largely ignored the advice of the medical profession, which encouraged quarantines and the dispersment of large crowds early on in the outbreak. The First World War had whipped up patriotic fervor in the USA and other countries and people gathered in large numbers for speeches, rallies, marches and functions in support of the war, which caused infections to rise. The end of the war in Europe in November of 1918 meant that people wanted to have parties celebrate the end of the conflic, and this only helped to spread the disease even more.

An emergency hospital set up in the military base of Camp Funston, Kansas.

When the War was over, the American government was able to concentrate its efforts on handling the Spanish Flu. But by then, it was too late. A full-blown pandemic had started and it was gaining speed rapidly. Hospitals, clinics and sick-wards were soon overwhelmed with the dead, sick and dying. Any and every large, public building was turned into an emergency ward to house the sick. Theaters, cinemas and schools were closed to the public and were instead transformed into makeshift hospitals where overworked medical staff tried their best to care for the infected.

The Oakland Municipal Auditorium in Oakland, California, transformed into a temporary hospital. The women are volunteer American Red Cross nurses. If you look closely, you’ll see the white, facial masks that the nurses, doctors and orderlies had to wear, to try and prevent infection.

Throughout the world, people took extraordinary precautions against the ‘Flu. They kept away from each other, they wore masks and they prayed for a miracle. What had once been bland indifference to a ‘cold’ was now turning into a panic against a deadly killer. If people had taken more notice of the ‘Flu when it was an insignificant threat in early 1918, it is unlikely it would have spread as quickly as it did. The refusal of people to believe, however, that another ‘mega-pandemic’ such as those which they had read of in their history-books, had actually returned to wreak havoc on mankind, allowed the virus to spread more rapidly, causing a great deal of pain and suffering later on.

In this photograph from Seattle in 1918, a streetcar conductor denies access to two men who aren’t wearing protective face-masks.

Public-health notices were put up in all major cities, warning against the outbreak of Influenza and for people to observe proper precautions and sanitary measures. Posters such as this one, could be found all over the USA and beyond:

If you can’t read it, it says:

“EPIDEMIC INFLUENZA (SPANISH)”.

This disease is highly communicable.
It may develop into Severe Pneumonia.

There is no medicine which will prevent it.

Keep away from public meetings, theatres and
other places where crowds are assembled.

When a member of the household becomes ill,
place him in a room by himself.

The room should be warm, but well-ventilated.

The attendant should put on a mask before
entering the rooms of those ill of the disease.

Issued by the Provincial Board of Health.

For two years, Spanish Flu affected everyones’ lives. They talked about it, they sang songs about it, they put up posters about it. It was all people worried about or thought about. Children playing jump-rope used to sing the song:

“I had a little bird,
It’s name was Enza,
I opened up the window,
And In Flu Enza”.

The Effect of Spanish Influenza

The effect that Spanish Influenza had on the world was both great and small, significant and insignificant. Today, almost nobody remembers that it ever happened at all, and yet it could lay claim to being the deadliest pandemic in the world, stealing the gold medal from the Black Death of the 14th century by a mile. It struck quietly, ravaged entire communities and then vanished just as quickly. By early 1920, cases of Spanish Influenza were few and far between, and over the following decades, its mark on world history was largely forgotten. It exists today, only as a fascinating, historical case-study for people learning about infectious disease, controlling pandemics and how history dealt with large outbreaks of lethal but invisible killers.