This year marks the 100th anniversary of the great influenza pandemic of 1918. Some have called it the greatest pandemic in human history.
Between 50 and 100 million people are thought to have died, representing as much as 5 percent of the world’s population. Half a billion people or roughly one-third of the world’s population at the time were infected. India was the worst affected country with between 12-17 million deaths.
The National Memorial to Influenza victims in Waikumete cemetery, Auckland
In New Zealand about 9000 people died from the pandemic with 2700 deaths attributed to Influenza in the last two weeks of November 1918 alone. By way of comparison, around 18,000 New Zealanders died during the five years of World War One. Maori were particularly badly affected with whole communities decimated by the virus.
Ambulance at Wellington Town Hall during the pandemic, NZHistory
Especially remarkable was the 1918 flu’s predilection for taking the lives of otherwise healthy young adults, as opposed to children and the elderly, who usually suffer most. Over 60% of those who died were aged between 20 and 45 years of age.
With up to half of every nations population sick with the flu society virtually ground to a halt. So many were sick that government, public services and business closed, and all forms of public gathering were suspended.
Interesting facts about the pandemic:
The 1918 flu pandemic has been a regular subject of speculation over the last century. Historians and scientists have advanced numerous hypotheses regarding its origin, spread and consequences and there is still little consensus about all these aspects of the disaster. Here are some of the known facts:
- The pandemic did not originate in Spain
No one believes the so-called “Spanish flu” originated in Spain.
The pandemic likely acquired this nickname because of World War I, which was in full swing at the time. The major countries involved in the war were keen to avoid encouraging their enemies, so reports of the extent of the flu were suppressed in Germany, Austria, France, the United Kingdom and the U.S.
By contrast, neutral Spain had no need to keep the flu under wraps and reports of it were widely published. That created the false impression that Spain was the place of origin of the disease.
First mention of Spanish Flu in London newspaper
In fact, the geographic origin of the flu is debated to this day, though hypotheses have suggested East Asia, Europe and even Kansas. The most likely place of origin was in the massive military camps set up in Kansas, to train US servicemen for action in the First World War. The pandemic spread to Europe with those servicemen and thence to the rest of the world.
- The pandemic was not a ‘super-virus’
The 1918 flu spread rapidly, killing 25 million people in just three months from October to December of 1918. This led some to fear the end of mankind, and has long fueled the supposition that the strain of influenza was particularly lethal.
However, more recent studies suggests that the virus itself, though more lethal than other strains, was not fundamentally different from those that caused epidemics in other years.
Much of the high death rate can be attributed to overcrowding; in the trenches of the Western Front, military camps and urban environments, as well as poor nutrition, health care provision and sanitation, which all suffered during wartime.
Very few people died directly from the Influenza. Instead, it’s now thought that many of the deaths were due to the development of bacterial pneumonia in lungs weakened by influenza.
- There were three waves to the pandemic
The influenza pandemic of 1918 occurred in three waves; early in 1918, from October to December 1918 and early in 1919. The initial wave of deaths from influenza in the first half of 1918 was relatively low. The rate of death was similar to every other year as the flu is an annual visitor to most parts of the world.
It was in the second wave, from October through December of that year, that the highest death rates were observed. The peak month for deaths varied by country, in the United States 195 000 people died in the month of October alone. In New Zealand the peak was in mid to late November with a significant drop after the 23rd November 1918.
Map showing possible progression of the 1918 Influenza Pandemic
A third wave of influenza in the spring of 1919 was more lethal than the first but less virulent than the second. This third wave tended to impact places like Australia, Africa and the remote islands in the Pacific who had escaped the worst of the two preceding waves.
Scientists now believe that the marked increase in deaths in the second wave was caused by a genetic mutation of the parent virus cultured within and then transmitted by the millions of soldiers on both sides of the war in Europe. Having so many people in a confined space is a well-known vector for communicable disease.
- The majority of those who caught the influenza survived
The vast majority of those people who contracted the 1918 flu survived. National death rates among the infected generally did not exceed 20 percent.
However, death rates varied among different groups. Death rates were particularly high among indigenous communities in the U.S, Pacific, Australia and New Zealand. This is perhaps due to lower rates of exposure to past strains of influenza. In some cases entire indigenous communities were wiped out.
Of course, even a 20 percent death rate vastly exceeds a typical flu outbreak, which kills less than one percent of those infected.
- Medicines of the day had little impact on the disease
No specific anti-viral therapies were available during the 1918 flu. Various sprays, inhalations, potions and masks were used to stop transmission of the virus but they were ineffective. That’s still largely true today, where most medical care for the flu aims to support patients recovery, rather than cure them.
Even 100 years later there is still no guaranteed vaccine to protect you from the flu!
An influenza medicine depot in Christchurch for “poor” people. Taken by an unknown photographer 4 December 1918. Photo: Alexander Turnbull Library Ref: 1/1-008542-G.
One hypothesis suggests that many flu deaths could actually be attributed to aspirin poisoning. Medical authorities at the time recommended large doses of aspirin of up to 30 grams per day. Today, about four grams would be considered the maximum safe daily dose. Large doses of aspirin can lead to many of the pandemic’s symptoms including; fever, breathing difficulties, nausea, extreme headache and internal bleeding.
However, death rates seem to have been equally high in places in the world where aspirin was not so readily available, so the evidence is inconclusive.
6. The impact of the Influenza
Because the influenza affected younger people there were many more orphans and widowed parents than at any previous time. In New Zealand over 1300 families lost one, and 134 families lost both parents to the flu. This impacted on society for decades to come as the government, churches and individuals filled the gaps. Most families would have known someone who fell victim to the pandemic.
A positive outcome of the Influenza was better health care, disaster planning and urban renewal throughout the world. In New Zealand the Health Act of 1921 and various local ordinances directly resulted in changes to how the country looked at poverty. There were significant changes to housing and health care provision for societies most needy. This would never have happened without the 1918 Influenza.
Rice G., & Bryder, L. (2005) Black November: the 1918 Influenza Pandemic in New Zealand (2nd ed.). Christchurch, NZ.: Canterbury University Press. RC150.9.N5RIC 2005
The 1918 Influenza Pandemic on the NZHistory website
Jason Reeves compiles a list of all 1918 Influenza victims