The Spanish Flu: The invisible killer of 1918

As World War One was winding down, worldwide carnage was triggered by the Spanish flu epidemic. There would be more casualties from the Spanish flu than from machine guns and shells combined.

By Hrothsige Frithowulf - History Editor
The Spanish Flu the invisible killer of 1918
In Kansas, in 1918, hundreds of patients were treated in this warehouse of the American army. © NYPL/Science Source

As World War I was nearing its end in the fall of 1918, a mysterious plague struck every segment of society. Worse than the threat posed by heavy artillery and fragmentation grenades, its effects exceeded those of the Big Bertha and mustard gas combined. People of all socioeconomic backgrounds, including the young and the elderly, rich and poor, and men and women, were dropping like flies as a result of this deadly epidemic. As World War I was winding down, worldwide carnage was triggered by the Spanish flu epidemic. There would be more casualties from the Spanish flu than from machine guns and shells combined.

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After four years of suffering, there was no letup; the epidemic killed as many as 100 million people around the globe in a single year, dwarfing the number of people murdered in World War I itself where the highest estimates put the number at 20 million.

The Spanish flu epidemic originated in Kansas, the United States

It had been shown beyond a reasonable doubt that the outbreak was initiated in the United States, namely at a base housing member of the American Expeditionary Force (AEF), whose troops were sent to France and Britain to aid the allied cause. In March of 1918, this Kansas military base saw its first instances of severe illness. The illness quickly spread throughout the Midwest and eventually reached the towns along the Atlantic Coast, from where soldiers were departing for Europe. The first symptoms of the sickness were not slow to reach the ports and cities of the Old Continent.

However, this did not cause health officials to take any action. According to the scientific writer Laura Spinney’s book Pale Rider: The Spanish Flu of 1918 and How it Changed the World, like the seasonal flu, this initial wave created inconveniences but no great fear. The second wave, which began in August in three ports (Boston, United States; Brest, France; and Freetown, Sierra Leone), would be different. This one spread quickly and, more importantly, killed quickly.

However, the governments of the afflicted nations didn’t seem to be freaking out. In the United States, the Spanish Flu was hardly mentioned in September because government authorities were suspicious and did not think an outbreak was imminent. Slightly hesitantly, the Health Department issued a warning to those who were coughing and sneezing on September 18. People weren’t wary, and celebratory processions like Philadelphia’s “Liberty loan” march continued as planned. More than 200,000 people showed up for the September 28 rally, which was organized to urge Americans to donate to the war effort.

In the days that followed, the number of reported flu cases skyrocketed, and the grim truth of a swift and catastrophic pandemic became clear. However, on October 1, 1918, the New York Times published advertising with chilling headlines like “Can You Afford Sudden Death? If Not, Protect Your Family and Business By Life Insurance.”

This evil, was slowly but surely devouring the United States, was increasingly impossible to conceal. The government was starting to take action. Schools, churches, theaters, and other public institutions were all shuttered in Philadelphia, the worst-hit city in the United States. A 24-hour hotline, “Filbert 100,” was established to disseminate initial details and prevent hospitals from being overwhelmed.

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The city swiftly became impotent since the infrastructure necessary to combat such a pandemic did not exist or had just been established. Most of the nurses had already evacuated to the European front, and the physicians were often powerless against the infection. Volunteers were needed to help the experts, yet there were more patients now than ever before.

There were 4,500 fatalities in Philadelphia by the third week of October, when the epidemic was at its peak. The scarcity of coffins was a major problem for funeral homes. Over the course of many days, the residences became morgues as bodies piling up were left inside. Some people at the cemetery and the mortuary used this to their advantage by charging exorbitant fees.

Philadelphia issued a request for volunteers to dig the graves and purchase coffins at a predetermined fee in order to address the sanitation situation. It also promised that, if required, public funds would be used to compensate the funeral directors. The fatality rate, though, did begin to drop by the end of October.

Dr. C.Y. White said that he had created a “vaccine” just as the outbreak seemed to be abating. As American historian Alfred W. Crosby said in his book America’s Forgotten Pandemic: The Influenza of 1918, if not effective, a placebo could still calm and reassure the population. The reopening of public spaces occurred on October 27. The body count had to be taken: in little over a month, approximately 12,000 people had perished in Philadelphia.

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Epidemic and war, an explosive cocktail against the allies

Europe, across the Atlantic, was also experiencing the pandemic’s effects. There was a full-scale outbreak of influenza as Allied forces moved throughout the globe. The combination of the pandemic and the conflict was a time bomb. Ships crossing the ocean offered a perfect breeding ground for the epidemic because of the close quarters in which it could flourish.

About 4,000 American troops perished in the Atlantic Ocean on their way to Europe in the last two months of the war, October and November 1918, according to estimates made by Alfred Crosby. On October 17, 78 people aboard a ship bound for the United States disembarked at Le Havre, and 74 of them were ill with fever.

The conditions in the trenches were ideal for the spread of illness. The filthy water, the grime, the parasites, and the corpses made for an ideal breeding environment for the virus, even though living conditions had improved somewhat by the end of 1918. The men were undernourished and undermanned on both the French and German sides. Their ranks were decimated by the illness.

Slowly but surely, the illness wove its web over the world, beginning in the United States and Europe and eventually reaching Africa and Asia. Especially considering the growing number of intercontinental contacts: Senegalese and Algerian riflemen aided the Allies in the trenches; Indochinese laborers kept the French armaments plants operating; the British recruited Indian troops; and so on.

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Sick seamen were often departing Europe on ships bound for Africa, South America, India, China, and Oceania. Therefore, 500 million individuals throughout the globe become sick every winter. Most victims were found in India, where 18.5 million people perished. Several remote communities in the Arctic were wiped off the map, while Western Samoa in the Pacific lost 20% of its population since no other countries enforced quarantine policies.

The details of this hecatomb were almost entirely unknown. Even though in October some officials issued instructions to the prefects regarding disinfection and the possible closure of public places, limitation of activities, and travel, this was not the time to demoralize the troops in Europe, which was in the midst of the final decisive months of World War I. So, on the 10th of October, the Caen commune in France banned gatherings and shut down its cinemas.

The secondary schools in Paris remained closed once again on the 25th. The extent of the harm inflicted by the illness became too obvious to conceal. Around the middle of October, the publications started taking a more alarmist stance. A single ill individual was capable, by speaking and coughing, of polluting hundreds. Despite the fact that the nation was at war, separate trains had been set up for the military and civilians, and the cars had been disinfected, so the transportation system continued to function normally.

The number of reported cases of the Spanish flu rose dramatically

Still, no action was taken despite the rapidly increasing number of influenza cases. Pneumonia, pleurisy, and pulmonary congestion were common complications of the illness. According to the doctors’ accounts, the patients were lying on the ground, seemingly unconscious, with cyanosed skin and glazed, worried eyes. There were currently no viable treatment options, such as antibiotics or efficient vaccinations. As a result of their popularity, quinine and castor oil swiftly ran out of stock.

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The Ministry of Supply in France’s capital city distributed 500 hectoliters of rum on prescription due to its purported medical qualities. Instructions to wash hands, use a mask or gauze pads soaked in disinfectant, rinse the lips and teeth, gargle, and inhale hot water with bleach were published in the media.

The world was full of miraculous cures in these uncertain times. Aspirin, caffeine citrate, benzoate of soda, barley tea, couch grass, cherry stems, cinnamon tincture, cinchona, and more were listed as ingredients in a potentially lethal cure. People were so desperate that they formed lines outside of businesses. “Miracle pills” and other treatments for the flu, respiratory issues, cholera, typhoid, and smallpox were selling like hotcakes.

In June 1919, the number of fatalities in the United States almost topped 400,000, and funeral homes throughout the nation were unable to handle the influx. Since Lyon did not have access to hearses or caskets, the bodies had to be moved in makeshift shrouds directly on the carts before being buried in the night. Parallel events occurred in Paris, where an average of 300 people per day lost their lives during the final week of October.

Spanish flu had no connection with Spain

Grim speculation abounded in this setting. To begin with, the misguided moniker “Spanish flu” was given to the illness. Despite popular belief, neutral Spain was not subject to censorship throughout the conflict. Since the country’s monarch, Alfonso XIII, was afflicted by the pandemic, it made readily available details about the disease’s scope. While the Allies maintained a low profile. They were wary of giving the adversary an advantage by exposing their deficiencies or of lowering morale among the soldiers by disclosing too many exact numbers.

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The plague’s newfound association with Spain ensured its place in history, even though locals in Spain referred to it as “the soldier of Naples” (after a popular operetta number). In Poland, it was the “Bolshevik evil.” Due to its penchant for spreading from one army to another, the “Flanders flu” was dubbed Germany’s national pandemic.

The French side naturally focused on the German opponent. The “Boches” were blamed for poisoning the canned foods and oranges during the midst of the fight. However, they too collapsed in mass behind the front line. General Erich Ludendorff wrote in 1920: “It was a serious occupation for me to hear every morning, from the mouths of the chiefs, the high figures of influenza cases and their complaints about the weakness of the troops if the English decided to attack.” Because the outbreak was, of course, hampering military operations.

The British army’s planned assault on La Becque, in Flanders, had to be called off at the end of June due to the first wave of the pandemic. Ludendorff, a German commander, said that the influenza pandemic was partly to blame for the disastrous failure of the German onslaught in July 1918, despite the fact that this perspective appeared very subjective.

The sickness, however, did not stay contained to the military, and it eventually spread to the general populace as well. Thus, the Austrian painter Egon Schiele joined the ranks of the illustrious and recently departed. He died on October 31, 1918, three days after his wife was six months pregnant. His last painting, The Family, painted in fever, depicts all three of them—her, him, and the son they will never have—haggard and with a lost look.

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The dramatist Edmond Rostand, the Brazilian president Rodrigues Alves, the pioneer of aviation Léon Morane, etc., were only a few of the well-known people that perished from the Spanish flu. Also lost to the pandemic was Guillaume Apollinaire. The poet, who was trepanned in the head while fighting in the trenches, lived through the ordeal but succumbed to influenza two days before the ceasefire.

The epidemic continued after the end of the First World War

However, the cessation of hostilities did not herald the end of the pandemic. The Spanish flu entered its third wave at the start of 1919 and remained deadly into the spring of that year. The masses and the subsequent hugs after the armistice provided ideal conditions for the spread of the disease. A peculiar atmosphere pervaded the Paris peace negotiations.

An adviser to U.S. President Woodrow Wilson said at Versailles, “There appear to be millions of gems spreading, and a number of diplomats have lost their voices.” Border disputes and the cost of repairs were still causing snags in discussions at the end of March and the beginning of April.

Woodrow Wilson was opposed to French President Georges Clemenceau’s desire for the takeover of the Rhineland and the Saar valley. At that point, the Spanish flu unexpectedly became a negotiation point. The American president’s voice changed and sounded hoarser on April 3. He was having a hard time getting air in and out, and he was coughing violently. His core temperature reached 39 degrees Celsius and up. Doctor Gary Grayson first thought he had been poisoned before finally concluding that he had the flu because of the severity of his symptoms.

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Wilson was unable to attend the negotiations for a few days due to being pinned to his bed. Upon his return, he approved of the peace accord that included the German occupation of the Rhineland and, most significantly, did not place any limits on the amount of reparations that the Germans would be required to pay. Historiographer Alfred W. Crosby attributes his downfall to the Spanish flu. His former bodyguard, Edmund W. Starling, provides the following testimony: “It left him very weak. He never regained his physical strength, and this weakness naturally impacted his state of mind.”

To qualify this notion, the actual difficulty was the stroke Wilson had in the autumn of 1919, which prevented him from convincing the U.S. Senate to approve the treaty or join the League of Nations. The United States therefore withdrew from its duty as arbitrator and permitted severe punitive reparations to be levied upon Germany, which would fume for the next two decades over the “Diktat” of Versailles.

However, this wasn’t the only knock-on effect. After the war, nations formed an international coalition to counter future pandemics. In order to combat illnesses all over the globe, the Hygiene Committee of the League of Nations was established as a result of the Treaty of Versailles. This committee eventually gave rise to the World Health Organization (WHO) in 1948. It took a big disaster for the United States to realize that it and other countries had common enemies.

Timeline of the Spanish flu

  • In September of 1918, the first cases of a mystery sickness were reported in the United States, at a military post in the vicinity of Boston.
  • In November 1918, as World War I was coming to a close, the “Spanish flu” virus swept over Europe. The sanitation systems could not keep up with the demand.
  • During the summer of 1919, after infecting half of the world’s population, scientists gave the illness the name H1N1. It reappeared less intensely until 1925.
  • In 1923, in response to the epidemic, the League of Nations established the Hygiene Organization, the precursor to the World Health Organization (WHO).