The Spanish Flu Pandemic-1918

Without a cure in sight, and a spike in numbers of cases, it is tempting to compare the current Coronavirus pandemic to the worst global pandemic the world has witnessed in the last century “THE SPANISH FLU”.

The Spanish flu, also known as the 1918 flu pandemic, was an unusually deadly influenza pandemic caused by the H1N1 influenza, a virus. Lasting from February 1918 to April 1920, it infected 500 million people – about a third of the world’s population at the time – in four successive waves. The death toll is typically estimated to have been somewhere between 17 million and 50 million, and possibly as high as 100 million, making it one of the deadliest pandemic in human history. It was first identified in the United States in the spring of 1918 with 675,000 deaths recorded over the two-year period. Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic.

To maintain morale, World War 1 censors minimized these early reports. Newspapers were free to report the epidemic’s effects in neutral Spain, such as the grave illness of King Alfonso XIII, and these stories created a false impression of Spain as especially hard hit. This gave rise to the name “Spanish” flu. Historical and epidemiological data are inadequate to identify with certainty the pandemic’s geographic origin, with varying views as to its location.

Scientists offer several possible explanations for the high mortality rate of the 1918 influenza pandemic, including a severe 6-year climate anomaly that affected the migration of disease vectors and increased the likelihood of the spread of the disease through bodies of water. Some analyses have shown the virus to be particularly deadly because it triggers a cytokine storm, which ravages the strong immune system of young adults. In contrast, a 2007 analysis of medical journals from the period of the pandemic found that the viral infection was no more aggressive than previous influenza strains Instead, malnourishment, overcrowded medical camps and hospitals, and poor hygiene all exacerbated by the recent war, promoted bacterial superinfection. This superinfection killed most of the victims, typically after a somewhat prolonged death bed.


The pandemic is conventionally marked as having begun on 4 March 1918 with the recording of the case of Albert Gitchell, an army cook at Camp Funston in Kansas, United States, despite there likely having been cases before him. The disease had been observed in Haskell County in January 1918, prompting local doctor Loring Miner to warn the US public health service’s academic journal. Within days, 522 men at the camp had reported sick. By 11 March 1918, the virus had reached Queens, New York. Failure to take preventive measures in March/April was later criticized.

As the US had entered World War I, the disease quickly spread from Camp Funston, a major training ground for troops of the American Expeditionary Forces, to other US army camps and Europe, becoming an epidemic in the Midwest, East Coast, and French ports by April 1918, and reaching the Western front by the middle of the month. It then quickly spread to the rest of France, Great Britain, Italy, and Spain and in May reached Breslau and Odessa. After the signing of the Treaty of Brest-Litovsk(March 1918), Germany started releasing Russian prisoners of war, who then brought the disease to their country. It reached North Africa, India, and Japan in May, and soon after had likely gone around the world as there had been recorded cases in Southeast Asia in April. In June an outbreak was reported in China. After reaching Australia in July, the wave started to recede.

The first wave of the flu lasted from the first quarter of 1918 and was relatively mild. Mortality rates were not appreciably above normal; in the United States ~75,000 flu-related deaths were reported in the first six months of 1918, compared to ~63,000 deaths during the same time period in 1915. In Madrid, Spain, fewer than 1,000 people died from influenza between May and June 1918. There were no reported quarantines during the first quarter of 1918. However, the first wave caused a significant disruption in the military operations of World war I with three-quarters of French troops, half the British forces, and over 900,000 German soldiers sick.

The 1918 Spanish flu was the first of two pandemics caused by H1N1 influenza, a virus the second was the 2009 swine flu pandemic.

Also Read:


  1. Brundage JF, Shanks GD (December 2007). “What really happened during the 1918 influenza pandemic? The importance of bacterial secondary infections”The Journal of Infectious Diseases196 (11): 1717–18, author reply 1718–19. doi:10.1086/522355PMID 18008258.
  2. ^ Morens DM, Fauci AS (April 2007). “The 1918 influenza pandemic: insights for the 21st century”The Journal of Infectious Diseases195 (7): 1018–28. doi:10.1086/511989PMID 17330793.
  3. Dave Roos (3 March 2020). “Why the Second Wave of the 1918 Spanish Flu Was So Deadly” Retrieved 23 July 2020.