Thursday, February 1, 2018

100 Years Ago

The Global Pandemic of 1918
Ginger Dehlinger
Bend, Oregon

                               One hundred years have passed since that grim reaper variously called Spanish flu, Spanish Lady, French flu, or “La Grippe,” sickened one-third of the world’s inhabitants (roughly 500 million people). Death estimates vary, some being as high as 100 million people. Due to poor record-keeping in 1918/19, we don’t have an exact count. One fact, however, is certain—the Spanish flu caused more deaths than all military personnel killed by cannon, gunfire, bayonets, or poison gas during World War I.
                                 My paternal grandfather was one of the fatalities. He was living in Naturita, Colorado when he, his pregnant wife, and three young children came down with the deadly flu. His family survived. Two months after my grandfather died, his wife gave birth to my father. As a child, that unfortunate sequence of events always held a morbid fascination for me. Decades later I wrote a fictionalized account of the flu’s impact on my family in Never Done, a novel.
                                 While doing research for the book, I was shocked by what I learned, yet so riveted I had to force myself to stop reading about the disease and get back to writing about it. I was surprised to learn how easily the Spanish flu spread. Touching a flu patient, even being in the same room was enough to catch it, making the 1918 flu more virulent than Europe’s bubonic plague. Although the plague resulted in more deaths, they occurred over a span of two centuries versus one and a half years for Spanish flu.
                                  The fourteenth century plague was spread by rodents and their lice, whereas the 1918 flu was a virus. Early in the twentieth century, few scientists, let alone doctors knew a virus pathogen even existed. An estimated 25 percent of the US population was infected with the baffling illness, and as many as 650,000 Americans died from it. The mountainous regions of Colorado were particularly hard hit due to the Western Slope’s large concentration of miners, men whose lungs were already compromised by the dust and bad air they breathed underground.
          Crowded conditions in cities also increased the likelihood of catching the disease. At its height, the epidemic killed 759 Philadelphians in one day. President Wilson caught the flu while in Paris negotiating the Treaty of Versailles that ended World War I. It took him a long time to recover, leading me to wonder if the stroke he suffered four months after returning to the White House was related to the disease.
          Multiple theories exist as to where the twentieth century flu began—Spain, France, Austria, Vietnam. Current thinking is the virus originated in Haskell County, Kansas in January of 1918. Symptoms during that early outbreak were more like common flu, but the rate it spread caused a local doctor to report it to the U.S. Public Health Service. A few of the men exposed to the Haskell County flu carried it with them to a military training facility in central Kansas. From there the disease spread to other US bases, then to the civilian populations of nearby towns and cities, and eventually to Europe via troop ships.
          During the first seven or eight months of the epidemic, hundreds of thousands died in Europe and North America, but not nearly as many as would succumb later. The first wave was mild enough that French and British troops referred to it as “three-day fever.” However, US and European officials, worried flu headlines would disrupt the war effort, censored all news of the disease, resulting in rumor and panic. Speculation filled the phone lines, some people even claiming the epidemic was a secret weapon formulated by the Germans.
          Then the flu virus raised its ugly head in Spain. Thousands of Spaniards contracted the disease, but it wasn’t until King Alfonso XIII came down with it that Spanish newspapers started covering the flu in detail. Spain wasn’t a combatant in World War I, thus the Spanish press wasn’t censored. Their widespread reporting, the only news to be had about the flu, quickly gave the disease its Spanish label.
          By July of 1918 the epidemic appeared to be lessening. A month later, a more virulent strain of the virus appeared in Europe and Africa, returning in an explosion deadlier than the war itself. During the first wave most of the victims were the young, old, or infirm. In August, when the second wave began, the disease was more often fatal to healthy young adults.
          As the flu raced through the United States and Europe, daily routines were put on hold. Schools were closed, stores padlocked. People stayed home, fearful of talking to others, fearful of even breathing. Many who did venture out wore the poor quality surgical masks in use at the time. Made of porous fabric, the masks did little or nothing to protect the people who wore them.
          Flu symptoms began simply enough with a headache, runny nose, or sore throat. Following in quick succession were fever, nausea, aching joints, and cough. The person infected became so fatigued he or she could barely stand. Dark, reddish spots or an overall redness appeared on some faces, and within hours the virus attacked the patient’s lungs in a brutal pneumonia. In the worst cases, lungs filled with a bloody froth and the patient bled from their nose, ears, or eyes.
Some died less than a day after the first symptoms appeared. Other victims, like several in my family, suffered for weeks. So did noted author, Katherine Anne Porter. Miss Porter contracted the flu while living in Denver. After a prolonged ordeal, delirious much of the time, she recovered. She later fictionalized her near-death experience in the classic story, “Pale Horse, Pale Rider.”
          Several theories exist as to why the second wave of the flu killed so many adults in their prime. Thousands of victims were young soldiers, leading to the belief damp trenches, infected wounds, or overcrowded quarters were to blame. According to historian John M. Barry, a leading expert on the pandemic, the targeting of healthy adults may have been caused by an overreaction of their immune systems. In his book, The Great Influenza, Barry tells of a group of scientists who salvaged the 1918 virus from long-frozen bodies, and then injected it into lab animals. The animals experienced rapid respiratory failure and death when their immune systems tackled the disease with far greater intensity than they would an ordinary virus. Based on their findings, the researchers postulated that the strong immune systems of healthy adults attacked the virus, and then, in hyper attack mode, turned against the body of the host. Weaker immune systems fought the virus and eased off when it was under control.
          Worldwide, the death toll peaked during the fourth quarter of 1918. October, the same month my grandfather died, was particularly deadly in the United States. Philadelphia reported over 4,500 deaths during one week in October. Less than a month later, the number of fatalities had dropped dramatically. In 1919, sporadic flu-related obituaries continued to appear in American newspapers, but by summer the disease had run its course.
          Widespread speculation exists as to why the number of casualties suddenly dropped. Was it just a coincidence the epidemic ended about the same time as the war? Perhaps doctors learned better treatments. Maybe the virus mutated to a less lethal strain. Medical knowledge has expanded vastly since 1918, but we may never know why that particular strain of flu came and went so quickly.
          During the last 100 years, the medical community has fought polio, swine flu, bird flu, AIDS, Ebola and other highly infectious diseases. Panic erupts whenever the public hears a new virus is wreaking havoc somewhere. Then doctors find a treatment, and front-page headlines disappear. In 1918, especially during the month of October when flu deaths mounted and doctors hadn’t found a cure, many people believed it signaled the end of mankind. Since then, the world’s population has mushroomed; likewise the number of people traveling across borders. Medicine has also advanced, but if new viruses evolve, and they will, the chance of another global pandemic is even greater now than it was in the last century.

Barry, John M. “How the Horrific 1918 Flu Spread Across America.” Smithsonian Magazine, November 2017.
Barry, John M. The Great Influenza: The Epic Story of the Greatest Plague in History. Viking Penguin, 2004.

Dehlinger, Ginger. Never Done. The Wild Rose Press, April 21, 2017.

Gladwell, Malcolm. "The Dead Zone.” The New Yorker. September 29, 1997.

Caitlin Switzer. “When the Flu Came to Colorado…and the World.” The Montrose Mirror Online, April 17, 2013.

Knox, Richard. “Killer Flu Reconstructed,” PBS radio, All Things Considered, October 5, 2005.

Porter, Katherine. The Collected Stories of Katherine Anne Porter. Houghton, Mifflin, Harcourt Publishing Company. 1965.

“1918 Flu Pandemic-Facts & Summary,”, n.d., Web. December 18, 2017.

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