Spanish Flu Pandemic

An influenza pandemic killed somewhere between 50 and 100 million people in 1918 and 1919, more than the war it travelled with. It was not Spanish. The name comes from wartime censorship: the belligerent countries suppressed reports of an epidemic weakening their armies, and neutral Spain did not, so the news came from Madrid and the disease was named for it. Where it began is disputed — Kansas, northern France and northern China all have advocates — and the movement of millions of soldiers in crowded ships, trains and camps is what made it global in months. The first wave in spring 1918 was mild. The second, from August, was not: an H1N1 strain that killed by provoking an immune response so violent that it destroyed the lungs, which is why its mortality curve was unlike any other flu, with the highest death rates among healthy adults between twenty and forty rather than the very young and the old. Some 500 million people, a third of humanity, were infected. India lost perhaps 18 million, Western Samoa a fifth of its population, and some remote communities in Alaska were wiped out entirely. Public health measures — masks, closed schools, banned gatherings — worked where they were applied early, and Philadelphia's decision to hold a war bond parade in September 1918 remains the standard illustration of what happens when they are not. There were no antivirals, no vaccine and no reliable understanding that the cause was a virus. The pandemic simply burned out by 1920. Its virus was reconstructed from a body preserved in the Alaskan permafrost and from preserved tissue samples, and sequenced in 2005, which is how the H1N1 identification was made. The pandemic was largely absent from public memory for eighty years until it stopped being.

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