The Great Influenza Pandemic of 1918-19

(This essay was originally published as “Remembering the Great Influenza Pandemic” by the Newport Daily News on December 17, 2018.)

One hundred years ago this month the world was celebrating the end of World War I; however, it was still contending with what the Centers for Disease Control (CDC) claim was “the most severe pandemic in recent history,” the 1918 influenza pandemic.
It was caused by an H1N1 virus with genes originating in birds. A total of about 500 million people worldwide were infected with the virus, one-third of the world’s population. At least 50 million people died, with some estimates as high as 100 million; indeed, far more deaths than the fallen in World War I.

The sickness was first identified in the United States in the spring 1918 among military personnel, and it eventually claimed 675,000 lives in the US. It was so severe that in the period 1917-1918, the life expectancy in the US declined about 12 years, to 36.6 for men and to 42.2 for women, according to the CDC. It struck most age groups; however, it was unique in that it hit the 20-40 year age group especially hard.

Treatment facility in large warehouse

There were three phases of the pandemic in the U.S. It first broke out in military camps and some cities in the spring 1918. Because of the desire to keep wartime morale high, officials suppressed information on the sickness. It is commonly known as the Spanish Flu Pandemic, not because it originated in Spain, but because Spain was neutral during WW I and had no reason to censor information on its impact.

The second wave, the most lethal, hit in September 1918. It began in Fort Devens, an Army post west of Boston, and also at a naval facility in Boston. About 100,000 Americans died in October alone. The third wave came in early 1919 and lasted through the spring. The pandemic finally subsided during the summer 1919.

At a symposium on the 1918 Influenza Pandemic in May, 2018, historian John M. Barry explained the progression of the disease. He repeated the words of a military doctor at the time: “…they very rapidly develop the most vicious type of pneumonia that has ever been seen. Two hours after admission, they have the mahogany spots over the cheekbones, and a few hours later, you see the cyanosis extending from the ears and spreading all over the face, until it is hard to distinguish the [black] men from the white. It’s only a matter of a few hours, then, until death comes.”

In a 1986 interview, Navy nurse Josie Mabel Brown, who survived the influenza, said, “The morgues were packed almost to the ceiling with bodies stacked one on top of another.”
The influenza pandemic inspired great fear. Barry quoted one person who lived through it, saying: “It kept people apart. You couldn’t play with your playmates, your classmates, your neighbors. The fear was so great, people were afraid to leave their homes. You had no school life, no church life, nothing. It destroyed all family and community life. People were afraid to kiss one another, afraid to eat with one another. Constantly afraid.”

It must be remembered that at this time there were no vaccines for protection against the infection, no antiviral drugs for treatment, and no antibiotics to treat secondary bacterial infections like pneumonia. Efforts to control the pandemic were limited to such things as the promotion of good personal hygiene, isolation and quarantine, and the closure of public places, such as schools and theaters. Some cities passed ordinances requiring face masks in public. New York City enacted an ordinance which fined or jailed people who did not cover their coughs.

The CDC maintains that for “more than 60 years, [the] CDC has worked to address the continuing threat of flu and prepare for the next pandemic.” There now exists a “global influenza surveillance system” which includes 114 World Health Organization member states. The Center’s Influenza Division is one of six global influenza centers which monitor and track flu activity worldwide.

Fred Zilian (; Twitter: @FredZilian) is an adjunct professor at Salve Regina University, an opinion contributor for The Hill, and a monthly columnist for The Newport Daily News

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