On the Influenza Pandemic of 1918

Myra Young Armstead

March 23, 2020

The COVID-19 pandemic invites comparisons with a similar twentieth century worldwide plague.  Just over one hundred years ago, the influenza epidemic of 1918 was a global scourge killing approximately 50 million people in a one-year period.  Actually, the number of fatalities can only be estimated and range from 20 to 100 million because no one kept official records.  Still, these figures are staggering.  Most scholars agree that were three waves of the disease, (perhaps caused by different strains of the virus)—Spring 1918, Fall 1918, and Winter 1919—but some add a fourth that touched even previously untouched Scandinavia in 1920.[1] The first was relatively mild and limited in geographical reach, while the middle two were far more virulent and global in their deadly results.  The question of origins is still a puzzle for historians of science[2], but almost certainly conditions in World War I activated descendants of flu strains present throughout the world from earlier, less brutal influenza pandemics in 1847 and 1889, and the outbreak may have been linked to avian flu and/or swine flu, which were unknown to scientists in 1918.  The history of this pandemic allows us to reflect on public perceptions of disease, factors contributing to the spread of disease, and which populations are hardest hit by epidemics despite their undiscriminating expanse.

Contrary to what we are witnessing with the current COVID-19 pandemic, the first wave of the 1918 influenza epidemic seemed to begin in America’s heartland, concentrated especially in army camps, rather than in coastal cities and the press was relatively sluggish in picking up on the story.  In late March of 1918, for instance, using federal sources, the Grand Forks [ND] Herald noted a rise in pneumonia and influenza cases, but headlined that “epidemic sicknesses are declining.”[3] Similarly, the Oregonian announced in a most matter-of-fact way, “Mumps and influenza prevail in many National Army camps and some measles and meningitis are reported.”[4]  In retrospect, newspapers were relatively more concerned with an increase in cases of influenza in horses in early March.[5]

By early April, however, reports appeared of a “mysterious epidemic” affecting three hundred schoolchildren in Mexico, Missouri; thirty inmates and ten guards in the Wayne County, Michigan jail; Wayne County clerks and court attachés working in the county government building; and Ford factory workers in the Detroit area.[6]  Journalists revealed that a “nuplerious malady” “hits Duluth hard,” confining hundreds to their beds and crippling businesses.  Although the “flurry of influenza” at Camp Custer in Battle Creek was simplistically attributed to dust, remedied by sprinkling the roads with water, authorities soon realized that the disease was spreading at an usually rapid pace and that the airborne germs carrying it could not be so easily stopped.[7]  By the summer, however, new cases of the “three-day fever” dropped precipitously and the trouble seemed over in the United States.

Canada had scarcely been affected that spring.  As World War I progressed, though, poor, rural Chinese workers recruited by Britain as part of the Chinese Labour Corps  (non-combatants who served in France repairing damaged rails, digging trenches, unloading ships, and the like), traveled eastward across Canada to Halifax in crowded railcars on the Canadian Pacific Railway beginning in 1917.  Canadian doctors dismissed the fact that 3,000 of 25,000 of the CLC employees required medical quarantine from a respiratory illness in July of 1918, and instead blamed their sickness on “Chinese laziness.”  Such racial stereotyping meant that many of the sick went undiagnosed, unquarantined, and traveled onto Europe where they died and the disease, already present there, spread even more swiftly in the wartime incubator.[8]

Things were hardly over in North America, though.  In the Fall of 1918 and into the following winter, influenza returned with a ruthless vengeance—a byproduct of the movement of troops serving in World War I.   Identified first in late August in the Boston area among sailors and soldiers docked and stationed there, the contagion quickly reached civilians.  The new strain was far more vicious than the earlier one.  One doctor treating patients at Camp Devens outside of Boston explained how this particular flu, starting with familiar symptoms of chills, muscle aches, and headache, progressed to a deadlier form:  “[Victims] rapidly develop the most viscous form of Pneumonia that has ever been seen.  Two hours after admission, they have the Mahogany spots over the cheek bones and a few hours later you can begin to see the Cyanosis extending from the ears and spreading all over the face, until it is hard to distinguish the colored man from the white.  It is only a matter of a few hours until death comes and it is simply a struggle for air until they suffocate.  It is horrible.”[9]  On October 2 alone, the surgeon general report 14,000 new cases within 24 hours, with a concentration in army camps like Camp Meade, Maryland; Camp Pike, Arkansas; Camp Hancock, Georgia; and Camp Funston, Kansas.  By the time the pandemic ended, roughly 25 percent of Americans suffered from the epidemic.  Influenza claimed the lives of approximately 675,000 people in the United States and 50,000 in Canada—6.5 percent and 6.1 of the total populations of those countries.  Because soldiers lived in close quarters, they were highly vulnerable to the disease and contributed to the young age of those dying.[10]  In stark contrast, today, the elderly are the most susceptible to COVID-19.

Then, as now, medical advice warned about the extreme contagiousness of the disease and stressed social distancing.  People were warned to avoid shaking hands, to cover their mouths with masks, to remain indoors, to avoid touching library books, and not to spit in public.  Large assemblies were stopped in infected army camps, and schools and theaters closed.  Then as now, in the absence of a cure, scammers rushed to fill a desperate public’s need by advertising and selling bogus, unscientific remedies.

In Dutchess County, the Poughkeepsie Eagle News carried stories about a local pastor who contracted influenza while accompanying a contingent of local army volunteers by train to Camp Wheeler in Georgia and about local defiance of the order from Beacon’s Commissioner of Public Safety to close all that city’s saloons.  There were complaints of boredom about the closing of theaters, none about the closing of churches. The paper carried appeals to county residents to join the local Red Cross in a mask-producing effort for the army camps.  The newspaper also provided ostensibly expert overviews of the disease and treatments; as well as ads for questionable “Influenza Preventatives.” There were, of course, many items on individuals struck by the disease—those who died and those in recovery—but admirably, there were reassuring articles reminding citizens that despite its pervasiveness, the pandemic offered “No Occasion For Panic.” [11]

A few weeks before the 1918 pandemic gained wide notice in this country, the “Keep Well” column of the Wilkes-Barre Times Leader, a regular feature of that paper, offered a helpful, dispassionate, clinical description of influenza (known then also as “the grippe”):  “Influenza may be regarded as a mild disease, the complications constituting the real danger, especially among elderly people and those who are physically ‘rundown.’  Of the complications the most important and dangerous are the lobar and [broncho] pneumonia.  There can be no question but that there exists in all cities a certain number of carriers of the influenza germ.”  Offering further historical perspective, the writer explained, “Ancient records show that influenza epidemics were quite common.  This spread always followed the lines of human travel and commerce and covers widely separated countries with such rapidity as to have produced the superstition that its onset is due to a malign ‘influence;’ hence its name.  It is known now that there is no mysterious influence and that infection is due to [a] micro-organism.”[12]  We would do well in 2020 to absorb this now 100-year old observation by practicing not only social distancing, but also mental distancing from any prejudicial, uninformed thinking on the current public health crisis.

[1] Two good articles are Niall P.A.S. Johnson and Juergen Mueller, “Updating the Accounts:  Global Mortality of the 1918-1920 “Spanish” Influenza Pandemic,” Bulletin of the History of Medicine, Vol. 76, No. 1 (Spring 2002), 105-117 and K. David Patterson and Gerald F. Pyle," The Geography and Mortality of the 1918 Influenza Pandemic," Bulletin of the History of Medicine, Vol. 65, No. 1 (Spring 1991), pp. 4-21.  See also John M. Barry, The Great Influenza: The Epic Story of the Deadliest Plague in History (New York: Viking, 2004); Carol R. Byerly, Fever of War: The Influenza Epidemic in the U.S. Army During World War I (New York: New York University Press, 2005); Alfred W. Crosby, America’s Forgotten Pandemic: Influenza of 1918, 2nd edition (Cambridge:  Cambridge University Press, 2003); and Jeffery K. Taubenberger and David M. Morens, “1918 Influenza:  The Mother of all Pandemics,” Emerging Infectious Diseases, Vol. 12, No. 1 (January 2006), 15-22.  

[2] Frequently incorrectly referred to as the ‘Spanish’ flu. This is because Spain, as a neutral country during WWI, left its press uncensored in its reportage on the disease, therefore contributing to a relatively high frequency of newspaper stories on influenza in that country.

[3] Grand Forks Herald, March 29, 1918.

[4] The Oregonian, March 29, 1918.

[5] The Emporia Gazette, March 4, 1918; The [Ann Arbor] Daily Times, March 6, 1918.

[6] Kansas City Times, April 3, 1918; Detroit News, April 3, 1918.

[7] Duluth News Tribune, April 3, 1918; Daily Times News, April 2, 1918.

[8] Mark Humphries, The Last Plague:  Spanish Influenza and the Politics of Public Health in Canada (Toronto:  University of Toronto Press, 2013), 71-72.

[9] Letter from “Roy” to a friend in Detroit, September 1918, cited in Gina Kolata, Flu:  The Story of the Great Influenza Pandemic and the Search for the Virus that Caused It (New York:  Touchstone, 2001) , 13-14.

[10] Lexington Herald, October 2, 1918; Macon Daily Telegraph, October 2, 1918; Kansas City Star, October 2, 1918; Johnson and Mueller, “Updating the Accounts,” 106, 111.

[11] Poughkeepsie Eagle News, October 31, 1918; Poughkeepsie Eagle News, October 23, 1918; Poughkeepsie Eagle News, October 14, 1918; Poughkeepsie Eagle News, October 24, 1918; Poughkeepsie Eagle News, October 12, 1918.

[12] Wilkes-Barre Times Leader, March 1, 1918.

armstead

Myra Young Armstead joined Bard College in 1985 and currently serves as Vice President for Academic Inclusive Excellence and is the Lyford Paterson Edwards and Helen Gray Edwards Professor of Historical Studies. She is the 2019 recipient of the Dutchess County Historical Society’s Helen Wilkinson Reynolds Award for “necessary and accurate search for historical truth.”  Armstead authored,  Freedom's Gardener: James F. Brown, Horticulture, and the Hudson Valley in Antebellum America, 2012 and was editor and contributor to, “Mighty Change, Tall Within: Black Identity in the Hudson Valley.”