Not So Spanish
Nearly one hundred years ago this month, one of the deadliest moments of modern history began. It would last well into the spring of the next year, and even now we don't have enough information about it. At Fort Riley, Kansas, the first documented cases of the Spanish flu were recorded.
Countless soldiers there were being readied for deployment overseas. The United States had entered World War I the year before. Soldiers had already gone to Europe, and more were waiting to cross the Atlantic. On March 11, a cook was the first to come down with the flu. A few days later, he was followed by hundreds of soldiers into the camp hospital. That was the first recording of a virulent illness that quickly spread from one person to the other.
In May, thousands became infected in Spain, including the king, Alfonso XIII. This flu virus, however, affected mainly the young and the strong. The king was only 32 years old, yet he became very ill. At this time, however, no more died from the illness than those who got a secondary infection, such as pneumonia. We have to remember that there were no antibiotics until Dr. Alexander Fleming discovered penicillin in 1928, and even then, it was not used regularly until 1942.
But at this point, it was still no more than a more intense strain of flu than usual that just happened to affect people in the prime of their lives. In August, however, the worst happened, and the virus mutated. In Brest, France, the first soldiers fell ill and then died. As the colder weather approached in September and October, the second wave of the infection began to cause a rising death toll. In Spain, those who had been infected by the first wave had become immune. Therefore, there were less deaths in the provinces surrounding Madrid, where the first wave had been concentrated. Around 1.5% of the population of the entire country, died; about 260,000 people. In 1918 there were more deaths than live births, only to be repeated in 1936, with the beginning of the Spanish Civil War.
Precisely because Spain was neutral during World War I, there was no press censorship, and the news circulated widely. Thus the name "Spanish flu" was born. The real origin of this virus has never been known, though it is suspected to have been born in France, thanks to a mutation in an avian flu virus that made its way to pigs and humans. The ravages of war and troop movements gave it freedom to expand all over the world.
The death extended to every inhabited space on earth. Exceptions were those remote communities, usually islands, that established a strict quarantine. The winter of 1918 and spring of 1919 were seasons of illness and death. In the United States, there was an extreme shortage of doctors and nurses. Third and fourth year medical students were pressed into service. Even grave diggers were becoming scarce, and in some communities, bodies were dumped into mass graves. There was no real, effective treatment. The appearance of germ theories led investigators to understand the infection, but not how to treat it. After the Surgeon General and the Journal of the American Medical Association recommended patients be treated with up to 32 grams of aspirin a day, some of the deaths might have come about from aspirin poisoning.
Most of those who died, though, died from secondary infections for which there was no cure then. But the young and strong who died, mostly died from their bodies' reaction to the virus. Their deaths were the result of a cytokine storm. Cytokines are molecules that tell the immune cells in our body to go fight the invading pathogens. At the same time, it tells those cells to make more cytokines to tell more immune cells to go fight. Normally, the body keeps this reaction in check, and when sufficient immune cells are fighting the invader, the cytokines shut up. But, if the strong pathogen is new to human infection, the reaction can get out of control, resulting in the immune system overreacting in such a way, that it damages the tissues of the organs where the infection is occurring. Those who died of a cytokine storm in 1918, died from their airways being cut off because of the fluids created by the overreaction of the immune cells against the virus in their lungs. Therefore, those younger and stronger who died from the flu, died because their immune systems were young and strong. Older people whose immune system were weaker, would have less probability of a cytokine storm. (I had to look up this information, which is quite interesting. Any mistakes are due to a misinterpretation of what I read.)
It is estimated that around fifty million people died worldwide from the 1918 pandemic. But it is thought that the final figure was much higher. Many places did not keep official records of reasons for deaths, and many in remote places probably were never seen by a doctor or even known to have died. In numbers, more people died from the 1918 flu than from the Black Death. Life expectancy diminished by twelve years in the U.S. People would fall ill and die in days, sometimes even hours. There were stories of people on their way to work that suddenly fell ill, and died the next day. One story told of four women who were playing bridge one day. During the night, three of them died. People were told to wear gauze masks. Some towns demanded certificates of health to allow people to enter. Stores were forbidden to have sales, and funerals were limited to fifteen minutes, all in an attempt to limit contagion.
In one hundred years many things have changed. Scientific research has led us to understand how to combat illnesses, though we still have a long way to go. Could such a pandemic happen again? Possibly. Previous flu pandemics in 1957 and 1968 also killed many people, but much less that in 1918. The swine flu scare of 2009 was just that, a scare. But there are many strains of flu out there that are just waiting to mutate in a host that will transmit a new and improved strain to humans. It is speculated that the 1918 virus was an avian virus that somehow found a way to easily infect humans. Now we understand the world of viruses and bacteria, but we remain infectable humans, who are weaker than a tiny virus. It's humbling.
Countless soldiers there were being readied for deployment overseas. The United States had entered World War I the year before. Soldiers had already gone to Europe, and more were waiting to cross the Atlantic. On March 11, a cook was the first to come down with the flu. A few days later, he was followed by hundreds of soldiers into the camp hospital. That was the first recording of a virulent illness that quickly spread from one person to the other.
In May, thousands became infected in Spain, including the king, Alfonso XIII. This flu virus, however, affected mainly the young and the strong. The king was only 32 years old, yet he became very ill. At this time, however, no more died from the illness than those who got a secondary infection, such as pneumonia. We have to remember that there were no antibiotics until Dr. Alexander Fleming discovered penicillin in 1928, and even then, it was not used regularly until 1942.
But at this point, it was still no more than a more intense strain of flu than usual that just happened to affect people in the prime of their lives. In August, however, the worst happened, and the virus mutated. In Brest, France, the first soldiers fell ill and then died. As the colder weather approached in September and October, the second wave of the infection began to cause a rising death toll. In Spain, those who had been infected by the first wave had become immune. Therefore, there were less deaths in the provinces surrounding Madrid, where the first wave had been concentrated. Around 1.5% of the population of the entire country, died; about 260,000 people. In 1918 there were more deaths than live births, only to be repeated in 1936, with the beginning of the Spanish Civil War.
Precisely because Spain was neutral during World War I, there was no press censorship, and the news circulated widely. Thus the name "Spanish flu" was born. The real origin of this virus has never been known, though it is suspected to have been born in France, thanks to a mutation in an avian flu virus that made its way to pigs and humans. The ravages of war and troop movements gave it freedom to expand all over the world.
The death extended to every inhabited space on earth. Exceptions were those remote communities, usually islands, that established a strict quarantine. The winter of 1918 and spring of 1919 were seasons of illness and death. In the United States, there was an extreme shortage of doctors and nurses. Third and fourth year medical students were pressed into service. Even grave diggers were becoming scarce, and in some communities, bodies were dumped into mass graves. There was no real, effective treatment. The appearance of germ theories led investigators to understand the infection, but not how to treat it. After the Surgeon General and the Journal of the American Medical Association recommended patients be treated with up to 32 grams of aspirin a day, some of the deaths might have come about from aspirin poisoning.
Most of those who died, though, died from secondary infections for which there was no cure then. But the young and strong who died, mostly died from their bodies' reaction to the virus. Their deaths were the result of a cytokine storm. Cytokines are molecules that tell the immune cells in our body to go fight the invading pathogens. At the same time, it tells those cells to make more cytokines to tell more immune cells to go fight. Normally, the body keeps this reaction in check, and when sufficient immune cells are fighting the invader, the cytokines shut up. But, if the strong pathogen is new to human infection, the reaction can get out of control, resulting in the immune system overreacting in such a way, that it damages the tissues of the organs where the infection is occurring. Those who died of a cytokine storm in 1918, died from their airways being cut off because of the fluids created by the overreaction of the immune cells against the virus in their lungs. Therefore, those younger and stronger who died from the flu, died because their immune systems were young and strong. Older people whose immune system were weaker, would have less probability of a cytokine storm. (I had to look up this information, which is quite interesting. Any mistakes are due to a misinterpretation of what I read.)
It is estimated that around fifty million people died worldwide from the 1918 pandemic. But it is thought that the final figure was much higher. Many places did not keep official records of reasons for deaths, and many in remote places probably were never seen by a doctor or even known to have died. In numbers, more people died from the 1918 flu than from the Black Death. Life expectancy diminished by twelve years in the U.S. People would fall ill and die in days, sometimes even hours. There were stories of people on their way to work that suddenly fell ill, and died the next day. One story told of four women who were playing bridge one day. During the night, three of them died. People were told to wear gauze masks. Some towns demanded certificates of health to allow people to enter. Stores were forbidden to have sales, and funerals were limited to fifteen minutes, all in an attempt to limit contagion.
In one hundred years many things have changed. Scientific research has led us to understand how to combat illnesses, though we still have a long way to go. Could such a pandemic happen again? Possibly. Previous flu pandemics in 1957 and 1968 also killed many people, but much less that in 1918. The swine flu scare of 2009 was just that, a scare. But there are many strains of flu out there that are just waiting to mutate in a host that will transmit a new and improved strain to humans. It is speculated that the 1918 virus was an avian virus that somehow found a way to easily infect humans. Now we understand the world of viruses and bacteria, but we remain infectable humans, who are weaker than a tiny virus. It's humbling.
My grandmother said there was a large barn chock full of coffins that disappeared in a few days to bury the dead.
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