A-Z of Weird Animals: Part I – Influenza and You (And the Spanish Flu, Too)

EDIT: You can now read Part II here. Part III is here.

I apologize for the absence of a post on Sunday. It’s the end of semester, so everything’s getting a bit hairy.

Part I: The Spanish Flu

I had a little bird

Its name was Enza,

I opened the window,

and in-flu-enza.

On March 4th, 1918, an unnamed soldier stationed at Camp Funston, a US army training camp in Kansas, woke up feeling sick. Achy and feverish, he reported to the sick tent where the doctor diagnosed him with influenza – the common flu. The soldier was quarantined in a tent reserved for victims of contagious diseases, and the camp went about its business, preparing to send soldiers to Europe to fight in the final throes of World War I. A week later, Private Albert Gitchell woke up with the same symptoms. His throat burned, and his body was wracked by alternating waves of fever and chills. The medic on duty recognized flu symptoms, and had him immediately quarantined, joining the unnamed soldier.

Camp Funston's emergency hospital. Doesn't look that fun to me.

Camp Funston’s emergency hospital. Doesn’t look that fun to me.

Unfortunately for the population of Camp Funston, and eventually for the world, Private Albert Gitchell had been a camp cook, and up until the previous night had played a role in serving food to 56,000 men who would soon be sent to fight, and die, in France. By the following week over one hundred men had come down with the flu. By the end of the month, it was over a thousand. 46 died. The outbreak, compared to what would come, was minor: Camp Funston recovered, and its soldiers were sent to other camps for further training.

In April, influenza infection rates spiked, first in military bases, and then in the cities around them. Army doctors reported disturbing findings: this new flu killed rapidly, in only 24 to 48 hours, causing massive hemorrhaging of the lungs. But as April turned to May new cases were reported less frequently, bringing a faint hope that the outbreak had run its course.

That hope was false: the virus was only getting started.

In May, 1918, the virus arrived in Spain – carried, mostly likely, by an American soldier on furlough from the fighting in France. By the end of May, eight million Spaniards had died and the king, Alfonso XIII, had only barely survived. Spain was a neutral country during the war, and as a consequence its press was free to speak about the flu. In America, during the minor spring outbreak, both government and press had conspired together to suppress discussion of the outbreak and the looming threat of pandemic. So what should’ve been the American Flu became the Spanish Flu, and people that should’ve been talking about it and preparing for another outbreak instead stayed quiet in the name of patriotism, hoping that they had already seen the worst.

Keep Calm And DON'T EAT WHEAT. Britain's propaganda posters are a bit catchier.

Keep Calm And DON’T EAT WHEAT. Britain’s propaganda posters are a bit catchier than this American example.

A bit silly, in hindsight, because as most epidemiologists knew, outbreaks come in waves.

Influenza is normally a winter disease – arriving annually in September or October, it disappears again in February or March. In late summer, 1918, Spanish flu returned to American shores with a vengeance. America’s borders are never as secure as rednecks might like them to be, and 1918 was no different: possible ports-of-entry abounded. On August 18th, the Norwegian liner Bergensfjord arrived in New York harbour with a hold full of 200 sick passengers; a few weeks before that, the Somali had docked in Canada, coming from India with 89 sick crew members. Port towns and military bases were under siege – harbours and navy yards up and down the East coast reported outbreaks. In Philadelphia, the City of Exeter arrived from Liverpool with 28 sick crew members. Philadelphia’s government responded rapidly and effectively: the ship was designated a plague-ship and quarantined offshore, anchored in the harbour. This spared the City of Brotherly Love the brunt of the flu, but not for long.

The City of Exeter, pride of Exeter, bane of Philadelphia.

The City of Exeter, pride of Exeter, bane of Philadelphia.

In September 1918, the growing bubble of infection burst, and America was awash in flu virus. First Boston, then Chicago and New York – America’s major cities were devastated by flu outbreaks. The streets were deserted, people huddled inside darkened rooms, peering fearfully out of windows, wondering if they would be infected next. Coughing or sneezing was tantamount to an 8th deadly sin. A newspaper from Ottawa reported:

“Streetcars rattled down Banks Street with windows open and plenty of room inside. Schools, vaudeville theatres, movie palaces are dark; pool halls and bowling alleys deserted.”

Owing to its early quarantine of the City of Exeter, Philadelphia was mostly spared through September. There was an outbreak of cases in the naval yard, home to the world’s largest shipyard, but the city had remained mostly unscathed. At least until September 28th, when Philadelphia decided to tempt fate. The press and governments joint refusal to print anything that might lower wartime morale meant that information about the nature of the influenza outbreak was scarce, and even medical journals were reporting that the flu was nothing to panic about – only a mild outbreak, nothing out of the ordinary.

This was plainly wrong to any doctor on the ground, but the bureaucratic machine successfully steamrolled their protests.

So there was no one with a loud enough voice able to say “maybe this is a bad idea” when, on September 28th, the city of Philadelphia put on the Liberty Loan Parade. Designed to sell war-bonds, it was the biggest parade in the city’s history.  Several hundred thousand people crowded together, standing for hours on a two mile stretch of sidewalk in the late September sunshine – coughing and shuffling and sneezing and spitting and laughing and shaking hands.

A parade is a superb idea during an epidemic.

A parade is a superb idea during an epidemic.

Two days later, several hundred people fell ill.

The city opened 12 emergency hospitals and closed its four medical schools, ushering their students from the classrooms to the hospital ward in a dangerous and stressful introduction to practical medicine. As in most epidemics, healthcare workers bore the force of the storm: half of Philadelphia’s nurses became patients, and 20% of them died.

The city closed churches, schools, and theatres – people became isolated and afraid in their own homes. Most stores closed of their own accord, and food and goods became difficult to find. Chaos descended. All the while, the municipal government continued to lie and say it wasn’t that bad (the “Ostrich Approach” to governing). In early October, the government-appointed head of public health told the newspapers that they had reached the worst point of the epidemic, and that mortality rates would decline. The next day, 430 people died.

Philadelphia's government. Credit: colourbox.com

Philadelphia’s government. Credit: colourbox.com

The next week, 5000 died.

And then it was over. The flu disappeared. By the end of October businesses had reopened, the survivors had returned to work, and arrests for being drunk-in-public were back to their normal pre-flu high (you know everything is going to be fine when the bars reopen). In its wake, influenza left 13,000 dead in Philadelphia, and 500,000 infected. In New York alone, 21,000 children were orphaned.

Around the world, 50 million people died (a conservative estimate) and 500 million were infected. That is 3% of the world’s population succumbing to the disease, and 27% infected, or, adjusted for 2012: 210 million dead, the population of the UK, France, Germany, and Spain combined, and 1.9 billion people infected – all of China, with room to spare.

The aftermath of the Spanish Influenza pandemic left whole populations on their knees, and cities, states, and countries struggling to know what to do with survivors, as they also coped with the end of WW1. In all of the confusion and upheaval, one thing got lost: just what the hell was the Spanish Flu? Where did it come from? Where did it go? And, could it come back?

Find out in Part 2, on Thursday.

Neil Griffin

60 responses to “A-Z of Weird Animals: Part I – Influenza and You (And the Spanish Flu, Too)

  1. I am Spanish and had no idea the Spanish flu originated in America! Very interesting post. Quite scary too…

  2. Thanks for the comment David! There are a few theories that it may have originated in France too, but right now the most likely source is a farm in southwest Kansas.

  3. As a physician, I have been fascinated by the “Spanish” flu. Have you read the book, “The Great Flu”?

    • Yeah, I read it a few years ago. Some of the information in it is a little out of date now, but it’s definitely the most comprehensive (and frightening) history of the pandemic.

      • I loaned it to someone a couple years ago and never got it back. Oh well, they say books are like cigarette lighters – they don’t really have owners.

  4. Wow. Truly frightening…and fascinating!

    Signed,
    The woman who is now on her way to get a flu shot ;)

  5. I heard that it was harbored in birds and mutated to pigs if that is true, perhaps we need to keep the mutated pigs away from birds and then no more Spanish Flu? I look forward to seeing Part II.

    • Yeah, birds are the reservoir for most influenza viruses. Many of them don’t seem to be able to spread directly to humans, or if they do (like bird flu), they don’t mutate the ability to pass from person-to-person.

      But when it jumps from birds to pigs first, the virus seems to mutate in pigs in a way that amplifies the virulence, and makes it more likely to spread from person-to-person. Keeping pigs and birds separate and in sanitary conditions, particularly on farms, minimizes the chances of transmission between species – but that’s a tall order, particularly in developing countries.

      • I look forward to seeing your next Part. Thanks for your comments. http://www.segmation.com

      • Well, physiologically pigs are very similar to humans, which is why we are able to use pig organs and tissues in humans such as pig heartvalves, etc. They have enough similarities with humans to be a good intermediate species by which a bird virus can gain enough genetic material from the pig to be able to infect humans effectively.

  6. I find it remarkable how rarely histories of WW I don’t mention the Spanish Influenza. I’m a film major, and one of my friends did a research project on the effects of the flu on movie theaters and the like. It’s almost as if life stopped for a while.

  7. Wow!! Pandemics are my favorite! (in a “that’s interesting really interesting!” way, not that I’m glad so many people died…)

  8. I can’t wait for Part 2.

  9. Wow, the Spanish flu seems very horrific!

  10. Fascinating! I look forward to Part 2. :-)

  11. Found this very interesting as I am currently suffering from flu like symptoms!

  12. Very interesting story. Thank you for educating me :)

  13. I am looking forward to Part 2; my great-grandmother died in this epidemic. And it’s history, which makes it all the better!

  14. I can’t believe how easily we’ve forgotten that flu used to be the number one cause of death. Get the flu shot people!!

  15. You had me at “On March 4th, 1918, an unnamed soldier stationed at Camp Funston…”. I’ll be back for part II!

  16. Fascinating subject. I read one of the flu books, I forget which one. You gave a great summary here. It’s amazing they had that parade. I’d love to read Part 2. Congrats on being Freshly Pressed!!

  17. Interesting- I want to know what happened!

  18. Whenever I’d get the flu as a kid, I used to have these ridiculously high fevers that made me hallucinate, it was terrifying! This is such a good post, I have such a huge interest in modern world history, and it always annoys me when its people talking about the history of politics which for some bizarre reason is all we ever tend to learn in school or talk about.. thanks for this post, I loved reading and look forward to part 2.

  19. thought provoking! And many naively think we are past the age of viral epidemics. The recent news that anti-biotics are not going to be as effective against bacterial infections is also disturbing.

  20. I wonder with all the new research on autism and the flu, (not excact numbers but they say 1-2% more likely to have autistic child if mother suffered high fever) if we saw an increase in autism after WW1. As many pregnant women suffered from prolonged high fevers . . . .

  21. My daughter just came down with what looks like the flu yesterday…how does today’s flu differ from the one that killed so many back then? Are we more resistant?

    • We occur resistance to some strains of the flu, particularly when we get it as kids, but not for all strains. Some types of flu, like the type to which the Spanish Flu belongs, mutate very quickly, which makes it virtually impossible for anyone to acquire long-lasting resistance. That’s why new flu shots are issued every year – the scientists who make them identify the most common mutations of the flu present in the world, and target a vaccine to protect against those strains.

      What made the Spanish Flu particularly deadly was the way it reacted with the body. It mostly attacked cells in the lungs, which triggered a hyperactive immune response from the body. Too many immune cells rushed to the lungs in an attempt to fight the flu, but ended up doing more harm then good, blocking airways and causing hemorrhaging. Its a rare effect in most types of influenza, but is also the primary cause of death in SARS and possibly in bird flu.

      Hope that’s not too depressing and/or frightening. I hope your daughter feels better soon!

      • Thank you for that quick response! Your blog is very interesting and I’m sure my daughter will also enjoy it when she gets better. She wants to be some sort of neuroscientist, which is way out of this cultural anthropologist’s realm!

  22. Love the opening opem! haha Wonderful. I pray I don’t get sick, there is nothing worse than being under the weather. Great post, thanks for sharing and congrats on being Freshly Pressed!

  23. Compelling account of the path of the Spanish Flu. I’ve always been fascinated with the way governments deal with epidemics and world wide disasters. It’s almost hilarious, if it wasn’t so tragic.

    • I think it was Horace Walpole who said “the world is a comedy to those who think, and a tragedy to those who feel”. It’s an accurate description of the way countries have historically handled pandemics and disasters, I think.

  24. Fascinating topic – not many people are familiar with the Great Flu Pandemic of 1918 – odd as its mortality rate was so high – I don’t have the exact statistics, but I believe it was more deadly than the avian and the swine flu that followed. Thanks for sharing!

  25. Thanks for your post. I’m looking forward to Part II.

    As an amatuer researcher of health topics, I learned eight years ago how to stop all my colds and allergic reactions to scents, just by stopping the triggers. My only illness since that time was some kind of flu after attending the State Fair of Texas. I don’t recall what year. I got no official diagnosis, but had the classic symptoms of fever, aching all over, wanting to sleep all day, etc. Afterward, I read in the paper that Swine flu had been confirmed in Dallas.

    The interesting thing was that I was able to avoid all congestion and cold-type symptoms. Even though the days of fever and over-sleeping left me feeling weak and exhausted, I remember thinking that at least I had reduced the chance of developing pneumonia.

    Do you think that congestion caused by the inflammatory response was the main cause of death?

    • As far as I know that is the best explanation for the high mortality from the Spanish Flu – an overactive immune response flooding the lungs with fluid.

      It would also explain why the flu affected the strong and healthy, those would be the individuals likely to have a stronger immune system to begin with, so when it went haywire, the reaction was larger in individuals who were healthier to begin with.

      • Now THAT’s scary. I very very rarely get sick, and have attributed that to having a very strong immune system. That this ‘gift’ may cause my undoing should such a pandemic reach my doorstep again is truly frightening.

      • I thought a compromised immune system was more likely to over-compensate with congestion, providing a haven for invading microbes. Do you know of sources for more information on this?

      • The response is called a cytokine storm. I’m going to discuss it a little bit on Sunday. The wikipedia article about it is not bad as a general introduction, but if you’d like more technical details I can find them for you.

  26. Dear Sir!
    My Grandfather was stationed in Camp Funston during World War I and I did a personal blog dedicated to his life entitled “My Grandfather – A Doughboy of WWI”. I also posted the very same picture of the emergency hospital of Camp Funston in my article with nearly the same caption. Unfortunately, I deleted the blog as it received very few visits. But my grandfather told us many a story of what took place at Camp Funston (now called Fort Riley in Junction City, Kansas). My grandfather grew up on a farm in the northwest part of Kansas and had lost two of his brothers and his Mother to the flu epidemic. Near where I currently live, there are three old and unused cemetaries that are ALL dedicated and filled with the graves of children who died during this epidemic – ages ranging from just a few months to just turned teenagers. I can relate very well to this article as it touches on a harsh past within my family.

  27. Wow! Quite an eye-opening read. Thanks for sharing — and congrats on being Freshly Pressed!

  28. Janet Rörschåch

    I have to say that this chapter in our history has always held some fascination for me. I read John Barry’s book The Great Influenza, back in the day. Of course, I followed that with Norman Cantor’s In The Wake of the Plague. Your piece was infinitely easier to read and far faster, but no less insightful. Well done. Isn’t it amazing how easy it could all happen again….and again.

    • Yeah it’s a little frightening. I think epidemiologists estimate that we’ll get about three pandemics per century.

    • If you’re interested in this sort of thing, I recommend William McNeills’ Plagues and Peoples. Far more readable (and accurate) than Cantor’s book.

      • Janet Rörschåch

        That was the one I was trying to remember. Thank you! That was the book that started it all. My teacher had the foresight to give it to us to read in Western Civ. I have to go pick it up again and reread. Thank you.

  29. I think I had a couple of grand-uncles die of Spanish Flu (something my mother mentioned in passing). This was before air travel was common too. Just makes you want to harass your senators to fund the CDC.

  30. very interesting to find out how the American government and the press collaborated on covering up the epidemic

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