Influenza

Described as being one of the most devastating pandemics of human history, the Influenza of 1918-20 or Spanish Flu as it is known, killed an estimated 50 million people in the course of six months (in total over 17 million had died in World War 1). Resulting from the emergence of a new strain of Influenza virus, Influenza Type A, subtype H1N1 (a subtype of avian or bird flu), no part of the population was protected or had immunity. Outbreaks occurred in nearly every inhabited part of the globe, with the virus first arriving in ports and then being carried from city to city along main transport routes.

 

The first of the three waves that occurred during the pandemic was considered to be much milder and had a significantly smaller death toll than its followers. Believed to have first broken out in the WW1 Camp Funston, Kansas, U.S. in early March 1918 it was then brought into Western Europe in April by American troops who were joining the fight alongside the Allies. By July it had spread to Poland. Over the Summer a more lethal type was recognised and identified as the second wave. Emerging in in August 1918, six days after the first case was recorded in Camp Devens, Massachusetts, U.S. the total number of cases had grown to 6674. Sufferers would contract pneumonia quickly and then died around two days later.  The third wave arrived during the following Winter and Spring and followed similar patterns to the second.

 

One factor that played a major part in the spread of the disease was World War 1. Crowded military bases, movement of troops and the delivery of supplies to the Western Front all provided environments that allowed the virus to have its biggest effect. Additionally, at the conclusion of the war when everyone returned home the disease was carried to many new parts of the world. Due to this it is believed 20-40% of the worlds population fell ill in just over 6 months.

 

Unlike normal influenza outbreaks where the very old and very young are the most vulnerable, during this pandemic it was people between 25-30 who were most susceptible, no matter their state of health. With a fatality rate of 2%, over half the recorded deaths occurred in people aged between 20-40 - a very unusual death pattern. It is also to be noted during this period male death rates exceeded female. As nothing like this had ever circulated before physicians had trouble identifying the cause and at the beginning misdiagnoses of the symptoms as cholera or typhoid wasn't unusual. Symptoms included: oxygen starved lungs, bleeding ears, petechia haemorrhages (red and purple dots on skin) and haemorrhages from mucas membranes in the nose, stomach and intestines, Edema (fluid beneath skin), pneumonia, and those occurring in the seasonal flu. Once identified work on a vaccine got underway but it wasn't until after the peak that this became available. In the meantime, streets and homes were disinfected, water fountains sterilised and public gatherings, spitting and hand shaking prohibited.

 

Influenza Type A subtype H1N1 is still in circulation today but the flu of 1918 will forever be remembered as the 'Great medical holocaust in history'.