Many different diseases affect people on Earth. But history knows only one disease that took 100 million lives in 1 year. It is the Spanish flu. The disease impact is incredible: it killed more people than the First World War. Why did this happen? Who managed to survive despite the epidemic?
More than 100 years ago, on March 11, 1918, one of the first officially confirmed cases of the “Spanish flu” was recorded in the United States. In three years, the pandemic swept the world and took between 40 million and 100 million lives, becoming the deadliest epidemic in human history. Despite the lack of uniquely effective antiviral drugs that can treat the flu, experts believe that repeating such a tragedy is unlikely.
Some historians claim that the flu was known to people in ancient times—it was allegedly recognized in one of the diseases described by the “Father of Medicine” Hippocrates (born about 460 BC). However, in the scientific literature, the first reliable mentions of this virus generally date back to 9-12th centuries of our era. Since the 16th century, descriptions of flu epidemics have become absolutely recognizable to modern scientists. In the 18th century, the virus, which was then believed to spread either with “fetid” air, or with insects, received two of its modern names: “flu” and “influenza” (acute infectious respiratory disease).
From the fourteenth to the eighteenth century, flu pandemics occurred quite frequently. The spread of the virus was facilitated by the growth of the world's population and the development of transport technologies. Along with people, the disease also traveled—from city to city and across the seas and oceans.
Until the second half of the nineteenth century, people had no idea how to actually fight the flu, and tried to do so using various rituals and general medical, sometimes completely useless, recommendations—for example, do not wear tight shoes.
THE SPANISH FLU HAD TWO SPECIFIC FEATURES:
- High infection rate
- Rapid development of complications that caused death
The general clinical picture and symptoms are as follows:
- stabbing headaches;
- body pain;
- sharp drop in blood pressure;
- high temperature reaching critical values;
- confusion of consciousness; cough with blood and sputum;
- nausea and vomiting as a result of severe intoxication provoked by the virus;
- autoimmune responses to the virus.
The “Spanish flu” which is not Spanish
Contrary to popular misconception, the Iberian Peninsula was not the birthplace of the “Spanish flu”. Although the subjects of king Alphonse XIII did get sick en masse with “Spanish fever”, the disease that appeared much earlier reached Madrid and Barcelona as late as May 1918. And it got its name from the fact that it was in neutral Spain where, unlike most other Western countries that participated in the First world war, military censors did not have much power in those days. Information about the new disease was quickly leaked to the media. Therefore, the inhabitants of Europe covered by the Spanish flu had the illusion that the disease came to them from the Iberian Peninsula.
The first officially confirmed case of influenza, which later will be called “Spanish”, was recorded in Kansas on March 11, 1918 (or on March 4 according to some resources). Private Albert Gitchell, who was serving at Fort Riley (Kansas), complained to regimental medics of a very severe cold, accompanied by chill and coughing. The infirmary doctors at first thought that the soldier just caught cold, but in just a few hours the number of soldiers who fell ill with the same symptoms reached a hundred people, and it became clear to the doctors that it was the beginning of an epidemic.
Obviously, the virus was introduced to North America from East Asia, where it began to spread since 1916, but was not described as a separate disease. According to the results of research by medical historian Anton Ercorek, an employee of the University of the Basque Country, outbreaks of an infection of unknown origin, resembling the symptoms of the “Spanish flu”, were recorded in Indochina among the soldiers of colonial troops mobilized by France (annamites) in 1916-1918. In medical reports, the disease appeared under the name of “Annamite Pneumonia”.
In 1917, a disease resembling the Spanish flu in its symptoms struck residents of Chinese villages located 500 kilometers along the Great Wall of China.
In North America, due to the abolition of slavery and the categorical reluctance of local Indians to work for “white masters”, there was a severe shortage of cheap labor since the 19th century. The problem was solved by mass importation of local workers from densely populated and poor countries of East Asia (in particular, from China). They were nicknamed “coolies”, ready to work for a pittance. The new type of flu apparently hit Kansas when the next batch of Asian workers arrived.
Moreover, in early 1918, the authorities of the British Empire decided to recruit tens of thousands of Chinese “coolies” in their North American territories to work in the rear of the Entente forces in the European theater of the First World War. The first shipments of East Asian workers hired in Canada took place in February-March 1918. Some of the “coolies” complained of a disease similar in symptoms to the flu during transportation, but Canadian doctors discarded complaints of the Chinese as a simulation, “treated” them with castor oil and sent them back to railroad cars.
The flu, along with soldiers and Chinese workers from North America, began to spread en masse across Europe—France, Britain, and other warring nations. When about 40% of the population of Spain fell ill in May 1918, the fact could not be hidden—Spanish mass media were free. The whole world was talking about the new disease.
According to approximate estimates of historians, more than 500 million people—almost one third of the world's population—fell ill with the “Spanish fever”. The number of flu victims, according to the most conservative estimates, was more than 40 million people. In 2002, historians Niall Johnson and Jurgen Mueller stated in their research that the number of victims might range from 50 to 100 million people (from 3 to 6% of the world's population).
In absolute terms, the “Spanish flue” has become the deadliest disease in the history of mankind. In relative terms, it may have given way to the plague, which killed about 10% of the world's population (30-40 million people) in the 14th century.
The number of deaths, depending on the level of medical development, welfare, living conditions and quarantine measures, varied across the world from a fraction of a percent to a quarter of the total population. The “Spanish flu” killed 23% of the population of modern Samoa, 21% — in Zambia, 10% — in Zimbabwe, 7% — in India.
In Europe, the most affected areas were the Balkans, where about one in thirty died, as well as Italy, Spain and Portugal, where the death rate ranged from 1.4 to 2.3%.
Only remote areas of Brazil and the Pacific possessions of France and the United States, whose administration managed to impose strict quarantine measures (almost completely cutting off direct contact with the “mainland”), were not affected by the pandemic. For quite a long time, Australia did not allow sailors from countries affected by the disease to enter its territory, but then the quarantine had to be stopped due to the return of Australian troops to their homeland from the fronts of the First World War. As a result, about 12 thousand Australians died from the “Spanish fever”.
After the “Spanish” pandemic, several mass influenza epidemics took place during the 20th and 21st centuries: “Asian Flu”—in 1957-1958, “Hong Kong Flue”—in 1968-1969, “Swine Flu”—in 2009. However, their consequences cannot be compared to the impact of the Spanish flu.
The consequences of the Spanish flu pandemic were very severe for several reasons. Its symptoms were so unusual that the disease was initially diagnosed as cholera, typhoid fever and dengue fever. The “Spanish flu” caused, along with fever, wheezing and coughing, bleeding from the mucous membranes and blood spitting, swelling, pain in various parts of the body. In addition, many of those who caught “Spanish fever” suffered from cardiovascular and nervous system disorders.
At the same time, the new flu affected primarily young people with good immunity and spread surprisingly quickly. The virus activated such an intense immune response, that human organism could not cope with it and destroyed itself. The peak of morbidity and mortality in the world occurred in the fall of 1918, and not in the winter, as was expected by doctors.
In the Entente countries, conspiracy theories were popular that the Germans were deliberately spreading the disease that had turned into a deadly weapon. But doctors denied this version—the Germans and Austrians also suffered from the “Spanish flu”.
Today, scientists say that the Spanish flu was so unusual for a range of reasons.
War, hunger, fear, pain, cold… Lack of positive emotions made the human body vulnerable to the virus in those years. Why do many companies today prohibit frowning at work (flight attendants, waiters, etc.)? A smile triggers the immune system.
Usually, researchers of the pandemic pay little attention to another important syndrome of the Spanish flu—cardiovascular. Rapidly increasing damage to the cardiovascular system, sharp drop in blood pressure, loss of consciousness, hemorrhages developed in patients even earlier than complications in the lungs. These symptoms were attributed by contemporaries of the pandemic to the action of toxins from an unknown bacterial pathogen. But today it is clear that the genome of the flu virus does not contain the genes of toxins with a similar mechanism of action.