The 1918 Influenza Pandemic

The 1918 Influenza Pandemic

 

Children wearing the masks that were required by the Public Health Service

Hygiene is one of the most underrated aspects of our modern society. Washing one’s hands in the bathroom, covering one’s mouth to cough, and staying home when a contagious illness is acquired is common courtesy in our culture, but nothing to applaud. With the advances in modern medicine and the development of an effective Public Health System, the people of this planet are healthier and more effective. In the early 1900s this was not the case. When the first wave of the 1918 Influenza Pandemic appeared in Kansas, it was ignored by the government and once medical researchers realized the dangerous outcomes that could occur, there was no form of communication fast enough to warn the nation and the world. Along with the a poor public health system and a lack of efficient systems of communication, the death toll from the Influenza Pandemic skyrocketed as it hit the Earth in the middle of World War I. While there were many reasons why the pandemic was so deadly and ultimately the United States dealt with the disease by attempting to reduce the massive death toll instead of actually finding a cure for the disease. 

In a span of 2 years, the influenza virus killed over 675,000 Americans, which is almost 6 times the number of Americans that died in the First World War. The number of people who died from the flu has been disputed over time, but rests somewhere between 30 and 50 million people. The Influenza Pandemic of 1918 was the first pandemic involving the H1N1 influenza virus, and was one of the deadliest worldwide episodes of disease in history. While the specific origins of the virus have been disputed, Professor Emeritus at the University of Texas at Austin, Alfred W. Crosby believes that the first observation of the flu took place in Haskell County, Kansas, in January of 1918 by Dr. Loring Miner. Many other researchers and historians have found this hypothesis to be the most accurate. On March 4th, 1918, company cook Albert Gitchell check into the infirmary at Fort Riley, Kansas and by noon on March 11th, over 100 soldiers were in the hospital. This outbreak was reported, but the Public Health Service took no precautionary measures and by March 1918, the disease had spread to Queens, New York. One of the largest causes of spreading of the disease was World War I.  In trench warfare, there is no place to be quarantined when one has a mild illness and when a soldier became severely ill, they were brought to crowded hospitals by train and spread the deadly virus even more rapidly. The war allowed the virus to spread through mass movements of men across countries and by ship, ultimately bringing the virus back to Boston in September 1918. The disease grew worse with time and 200,000 people died in October alone. In November 1918, the people of the Unites States celebrated Armistice Day by throwing parties and holding large gatherings, which only caused the disease to spread quicker.

The H1N1 virus that killed millions of people in 1918 and 1919

    When the disease first appeared, people mistook it for the common cold, but as the virus spread it mutated. During the second wave of the Influenza Pandemic, the virus was different than all previous and future flu viruses. It mainly affected adults from ages 20-40, instead of children and the elderly like all other influenzas. This mutation has been attributed to the circumstances that soldiers of World War I were in. This stronger, mutated flu virus had a worldwide mortality rate of 2.5%, compared to the 0.1% of viruses from previous influenza episodes. Although scientists understood that the virus had shifted and gotten stronger, there was controversy, and still is today, over which animal the virus started in and therefore, which type of flu virus killed so many people. The most concrete explanation of the outbreak is that the influenza virus was a mutation of the avian flu and that the virus jumped from birds to humans, and that pigs (swine) indirectly caught the virus from humans. In 1919, the American people demanded that the government fund research for both the causes and impact of the influenza pandemic. The Public Health Service conducted multiple small epidemiological studies across the nation, in order to study the effects of the flu in varying locations. Since the research was done after the pandemic, the data were varying and Public Health Service workers admitted that the results were most likely inaccurate, although modern scientists do agree on the finding that places with higher humidity had a deadlier case of the flu because the moisture and higher temperatures allowed the virus to grow. While no vaccine or cure was created during this pandemic, scientists studied influenza and finally understood the basic concepts of how the disease operated. They learned that the virus is spread through the air by coughing or sneezing and that if one is sick with the flu, then there are more at risk to get pneumonia, which is what made the virus so deadly.

Women wearing gauze masks

    . The Public Health Departments across the country began using their basic knowledge of the virus to try and protect the American people. Since they understood that the virus travelled through air, they attempted to prevent infected patients sharing the same air as the uninfected. Public gatherings were closely monitored, those infected were set to a strict quarantine, funerals were limited to 15 minutes, stores could not hold sales, and gauze masks were distributed to be worn in public. A fine would be collected from those who ignored influenza ordinances, but the actual enforcement of these practices varied from location to location, depending on the power of the local health departments and the severity of the virus in that specific place. Other organizations were created by the government to control the outbreak, such as the Committee of the American Public Health Association. The APHA was in charge of all public gatherings. They were the ones who decided that saloons, dance halls, and cinemas were to be closed during the pandemic. Churches were granted permission to remain open, but the APHA said that only the minimum number of services were to be held. One highly debated aspect of society that the APHA regulated to reduce the spread of disease was the closing of schools. While in other countries it was more  accepted, many Americans believed that the closing of schools in urban areas was less effective than in rural areas because there was no added exposure in a large city. While some flu preventative measures were extreme, American citizens, for the most part, followed the Public Health Service’s rules and regulations. A sense of nationalism throughout the country due to the World War cause the American people to place their trust in the government and accept the ways that they tried to deal with this pandemic.

American Red Cross nurses learning how to help influenza victims

    Although the government and Public Health Service was working day and night to prevent people from getting the flu and treating people who were infected, other organizations were responding to the pandemic separately. One of the main organizations who made a significant impact on the fight against influenza was the American Red Cross. Once the war was over, thousands of wounded soldiers returned to America and this influx of patients pushed the hospital facilities and staff to their limits. This created a shortage of physicians, especially in the civilian sector as many had been lost for service with the military. Due to this shortage, only medical students were available to care for the people hospitalized by influenza. Volunteers were desperately needed during the 1918 pandemic. The U.S. Public Health Service sent the Red Cross an urgent request  for trained nurses in Boston Harbor on September 14th, 1918. By November 7th, 1918, the Red Cross had recruited 15,000 nurses. These brave women served military and civilian flu patients even though there were high risks of infection and death. 223 nurses died while providing treatment to influenza victims. As the virus spread, it became obvious that the American Red Cross and its volunteers would be important part in the outcome of the pandemic. Therefore, the Red Cross created a National Committee of Influenza to organize and utilize the vast amount of volunteer nurses that were working through the organization. On a local level, individual Red Cross chapters organized committees with local public health officers to discuss influenza in that specific area. The local committees surveyed the hospital workforce in the area and recruited nurses to join their cause. Along with local committees and the National Committee of Influenza, the Red Cross Motor Corps, established in 1917, to transport volunteers and infected patients. The Motor Corps consisted of almost all women, and most of them used their own cars. Also emergency hospitals were set up across the United States to give aid to infected people arriving from overseas and canteens were created to feed those who could not eat at home due to infection in the family. Not only did the Red Cross involve thousands of nurses and health care professionals with the cause, but provided an organized system for every type of aid, which save thousands of people’s lives across the United States.

A hospital filled with Influenza patients

    While in the middle of the pandemic it was obvious to the average citizen that there was a serious disease spreading, but the lack of rapid communication made it difficult for the general population to understand what was happening when the influenza virus first broke out. Without television, internet or radio, newspapers were the only source of information in the United States at the time and even newspapers were never 100% accurate. Amidst WWI, the United States, and like other countries, government attempted to hold off the pandemic by ignoring at first. In an attempt to keep a strong front against opposing forces, all news of influenza and deaths from the disease were held from official reports in every country, except the neutral country, Spain. This made it seem as though the disease was worse in Spain, thus coining the disease “The Spanish Flu”. This is just one example of how blind the people of America were. People learned about the millions of deaths that influenza caused through newspapers because the front pages were always filled with tragedy and drama. While this is exciting, the lack of actual evidence and scientific research about the disease left people confused, therefore turning to the Public Health Service for answers. The American Red Cross and other well known organizations were already well known because of efforts in previous tragedies across the world, but even though many people searched for aid from the government or the ARC, influenza killed many who were unaware of the severity of the disease.

    The Influenza Pandemic of 1918 and 1919 was one of the deadliest worldwide outbreaks of any disease throughout history. Records show that in 1 year, more people died from Influenza than in 4 years from the Bubonic Plague. While efforts based on scientific conclusions were made to keep the uninfected people of America healthy, the deadliness of the disease combined with general public's ignorance cause the death toll to break records. The ideas that came from this pandemic were innovative and progressive, but the execution was just not enough to save a good bit of the United States' population.

   

Works Cited

H., W. H. "Review: Report on the Pandemic of Influenza, 1918-19." Journal of the Royal Statistical Society 84.2 (1921): 280-83. JSTOR. Web. 20 Feb. 2015. <http://www.jstor.org/stable/10.2307/2340504?ref=no-x-route:d1d3a44088659e588af9e13a8edc39de>. This source is a medical journal that describes the Influenza pandemic that spread across the United States during the late 1910s. The report goes into detail about the amount of deaths from the disease and scientific side of why this tragedy occurred. I used this source to see what happened scientifically, from a first hand account. The information I gained was helpful in learning what exactly the people that experienced the pandemic were trying to fight.

Jones, Marian Moser. "The American Red Cross and Local Response to the 1918 Influenza Pandemic: A Four-City Case Study." The American Red Cross and Local Response to the 1918 Influenza Pandemic: A Four-City Case Study 125.Supplement 3: The 1918-1919 Influenza Pandemic in the United States (2010): 92-104. JSTOR. Web. 22 Feb. 2015. <http://www.jstor.org/stable/10.2307/41435303?ref=no-x-route:efd6f8995017aa7480d71f3038eca1f6>. This source is a study of the influenza disease's effects on four different cities in America in 1918. I used this source to further understand what the American Red Cross did to help the people of the United States. The source gave more in depth information on how organizations that were separate from the government responded to the pandemic.

"Red Cross Response To One Of Biggest Disease Outbreaks In History." Red Cross Respons To One Of Biggest Disease Outbreaks In History. American Red Cross, 13 Jan. 2014. Web. 23 Feb. 2015. This source describes the work that the Red Cross did to aid victims of the influenza epidemic. The source gave me more information on how the Red Cross helped people in the United States and the different organizations that the Red Cross supported and organized.

 Humphries, Mark Osborne, Paths of Infection: The First World War and the Origins of the 1918 Influenza Pandemic War in History Vol 21, Issue 1, Jan 2014. This source is a journal that tells the background information and the flu pandemic and its role in World War I. The journal also went into detail about the scientific side of the disease and how the conditions of the war caused the virus to become more deadly. I used this source to learn about the relationship of the war and the virus and why the virus was so deadly.

"Influenza pandemic (1918-1919)." The New Penguin Dictionary of Modern History 1789-1945. 2001. History Study Center. Web. 11 Feb. 2015. This source is a definition of the Influenza Pandemic of 1918 and a brief explanation of the affects that the disease had on the world. I used this source as a starting point for my research and I used it to gain basic understanding of what the Influenza Pandemic was.

Melzer, Richard. "Influenza 1918." The Journal of American History 85.3 (Dec 1998): 1179-1180. History Study Center. Web. 12 Feb. 2015. This journal talks about the pandemic and how people responded to it. I used this source to get information about how the government responded to the massive deaths and how people responded once they found out how deadly the disease actually was.