The 1918 Flu Pandemic

1918: A group of Americans in California with a message for their fellow countrymen
1918: A group of Americans in California with a message for their fellow countrymen

by Ray Setterfield


November 15, 1918 — Brevig Mission is a tiny ocean-side settlement in Alaska which, in 1918, had 80 adult inhabitants. During the five-day period starting November 15, 1918, 72 of them were killed by the influenza pandemic then raging across the world.

It is significant for two reasons. First, the number of deaths in the village shows the ferocity and extensive reach of this epidemic. Second, because the victims were buried (and preserved) in permafrost conditions scientists were able, years later, to study the virus in detail.

It is estimated that 40 million people died in the First World War between 1914 and 1918. In that final year of the war the great influenza pandemic took hold and was to cause possibly 50 million fatalities, some estimates claiming a global death toll as high as 100 million.

No pandemic before or since has resulted in deaths on such a scale. Tragically, many soldiers who survived the horrors of trench warfare then fell victim to the influenza scourge.

It is commonly referred to as “the Spanish flu” epidemic but Spain is highly unlikely to have been the source. Wartime censors in the UK, Germany, the United States and France, anxious not to lower morale, played down the numbers of victims. But there were no restrictions on reporting the figures for Spain, which had taken no part in the war. So the belief grew that seemingly badly hit Spain was the epicentre of the disease.

The 1918 pandemic came in three waves. During the first, in the early part of the year, deaths were relatively low. The second wave, which began in August, was much more serious, the virus having mutated to a considerably aggressive form and October was the deadliest month of the whole pandemic.

Those between the ages of 20 and 40 were the most vulnerable, the virus so savage that a victim might show no symptoms in the morning but be dead by nightfall.

The third wave in the spring of 1919 was more lethal than the first but less so than the second.

An unusual characteristic of the virus was the high death rate among healthy young adults. But after the lethal second wave peaked in late 1918 new cases of infection dropped abruptly and the virus eventually burnt itself out.

Many factors contributed to the virulence of the 1918 pandemic. The world was at war and large numbers of troops stayed in close contact. No diagnostic tests existed; in fact, doctors didn’t know flu viruses existed.

Even if they had known, vaccines did not exist, antibiotics had not been invented and no antiviral drugs were available. On top of that, there was no such thing as intensive care or mechanical ventilation.

Businesses, though, were not slow to offer so-called remedies. Products including Lifebuoy soap, Oxo, Aspirin, quinine, opium, turpentine, iodine, ammonia, cinnamon, cocoa, disinfectant and even cigarettes were all promoted as having properties that could either prevent the flu or ward it off.

As the years passed, scientists were keen to discover the virus’s secrets so that new vaccines and treatments for future pandemics could be developed.

In 1951, Johan Hultin, a 25-year-old Swedish microbiologist, went to Brevig Mission hoping to find traces of the virus frozen within the tissues of villagers buried there. He failed, but returned 46 years later in 1997 with other scientists and unearthed the remains of a woman, aged about 30, whom he named “Lucy”.

Traces from “Lucy’s” lungs allowed researchers to completely analyse the critical gene structures of the 1918 virus, revealing that it originated in birds and mutated to infect people.

Scientists called it “an H1N1 virus with genes of avian origin."

Three more pandemics would occur before Coronavirus would send the world spinning in 2020. They were: the 1957 H2N2 pandemic “Asian flu” causing 1.1 million deaths worldwide; the 1968 H3N2 pandemic “Hong Kong flu” with 1 million deaths; and the 2009 H1N1 pandemic "swine flu” with up to 575,000 deaths.

Putting it all in perspective, according to America’s Centers for Disease Control and Prevention, the “flu season” in the United States generally runs from late fall into spring. In a typical year, more than 200,000 Americans are hospitalised for flu-related complications, and over the past three decades there have been up to 49,000 flu-related deaths annually.

The question remains as to whether a devastating pandemic on the scale of 1918 could occur in modern times. Many experts think so.

Richard Gunderman, Professor of Medicine at Indiana University, wrote in the Smithsonian Magazine in 2020:

“For the foreseeable future, viral epidemics will remain a regular feature of human life.

“But today scientists know more about how to isolate and handle large numbers of ill and dying patients, and physicians can prescribe antibiotics, not available in 1918, to combat secondary bacterial infections. To such common-sense practices as social distancing and hand-washing, contemporary medicine can add the creation of vaccinations and anti-viral drugs.

“As a society, we can only hope that we have learned the great pandemic’s lessons sufficiently well to quell the current Covid-19 challenge.”

Published: March 21, 2020

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