The 1918-1919 Influenza Epidemic

Its flu season in the Unites States, and this one is a bad one.  The worst that I remember for many years, maybe the worst ever during my lifetime.

For probably the last five years or so, or perhaps as long as a decade, people studying the topic of epidemics have been sort of looking toward the 1918 to 1919 Pandemic.  That pandemic is the very model of a horror, in terms of epidemics.  For one thing, it spread completely around the globe, which is what made it a pandemic. For another, it basically made it around the globe twice in some ways, and because the ability of the flu evolve very rapidly, it changed as it went.  Indeed, it got worse.

A killer virus is actually a bad strategy for a virus, survival wise.  Benign viruses, in terms of long term viabiltiy, are the best strategy, but for whatever reason, that doesn't define the flu.  Part of this may be because Influenza lives in a vareity of species.  When it breaks out in a new strain, which it does every year, usually that involves some sort of evolution in one of hte other speicies that hosts it.

The main culprits in this are swine and birds.  Hence, every few years, we get a "Swine Flu" or an "Avian Flu."  Often swine and birds are involved in an evolutionary jump, which is why the flu tends to come out of Asia every year.  Close proximity of swine, birds and people on Asian farms makes the jump through the various species easy for influenza.  It also can explain why one strain may prove to be so deadly in any one speicies.  A flu virus hanging around in a pig might not kill the pig, but it might be really deadly to people.

Nobody is definitively sure what got the 1918 Influenza Epidemic rolling,  but there's some fairly strong evidence that it made its first outbreak at Camp Funston, Kansas. There are some who maintain otherwise, but the evidence is quite strong.  Indeed, the evidence is so strong that it seems the very first victim of the disease there can be identified by name.  An individual soldier who reported to sick call on a day which, by the days end, a major health crisis was fully under way at Camp Funston.

 Sick bay, Camp Funston.  1918.

And the situation was ideal for that.  Camp Funston was an Army training base that spilled out, over the banks, of Ft. Riley Kansas.  Ft. Riley was an old, old Army post by the time the U.S. entered World War One in 1917, but the US hadn't attempted to muster an Army the size of the one it needed for the Great War since 1860.  There just wasn't enough room.  So camps, like Camp Funston, were formed.  Funston housed 26,000 men.

Camp Funston sat just off Ft Riley on the banks of the Republican River.  Mostly a tent city, thousands of men were camped there in primitive conditions.  The Army at that time, for cook's sections, kept livestock, mostly pigs.  The first victim of the flu was Private Albert Gitchell, a mess orderly whose duties included tending to pigs.  He reported to sick call on March 9, 1918, and never made it back out of the sick bay.   A second soldier, Corporal Lee W. Drake, reported right behind him. A steady stream came in after that, with there being over 100 men in sick beds by the end of the first day, a medical nightmare of unimaginable proportions.  The disease broke out to the civilian populatoin almost immediately.  US troops boarding troops ships carried it to Europe, where the years of war, harding living, and terrible conditions introduced it to the European population just as World War One was drawing to a close.

The disease, biazarrely, targeted the section of the population which is normally the least likely to be impacted by the flu, those in their early adult years.  The flu normally is a risk to the elderly, but the 1918 flu was oddly not.  It hit those in their teens and twenties particularly hard.  The reason has never really been understood, in spite of investigation, although it has lead to some slight cluse that the 1918 flu strain may have made its appearance as early as 1916 and then evolved into the lethal strain that isn't well understood even now.  Indeed, there's good evidence that the disease actually may have broken out in the Haskell County Kansas civilian population in January, 1918, in a frightening, but not fully lethal form.  A local Kansas doctor was so concerned that he did warn the U.S. Public Health Service of what he was observing.  British Army doctors noted a disease with much of the same symptoms as the 1918 Flu in 1916, in a British Army camp. What caused it to break out in the fully deadly and highly transmittable 1918 variant isn't really undestood, but what is remarkable is that in March 1918 it became massively communicable and very deadly.  In all likelihood the Haskell County disease was the same one that became the great killer, in a very similar but nto quite evolved form.  It probably was communicated to troops stationed at Camp Funston when they went home on leave, and Funston had the ideal conditions to get the disease really rolling, and perhaps really deadly.  Having hit Camp Funston on March 9, it was in New York by March 11, at which time over 500 troops at Camp Funston had reported ill.  By August 1918, it had become even more deadly and was ripping through France.  By November, it was in Spain, which was not fighting in the war.  Because Spain was as neutral, for the first time the press was able to fully report on it, leading to the misnoomer the Spanish Flu.  

Canadian victims of the flu being buried, 1918.

By 1919, the flue was in Japan, and had virtually circled the globe.  Japanese mortality peaked in July, 1919.  By the summer of 1919, it had hit the entire globe, killing up to 20% of those infected, and leaving many of the survivors permanently weakened or addled.  While the disease disappeared, the deaths did not, as young people who were weakened by it continued to die into the 1920s, including my Great Aunt Ulpha Patricia.

It's regarded as the greatest lethal disease incident of all time, spreading much quicker than the Black Plague and killing more people.  And it's not all that long ago, really.  The impact on the era in which it struck was huge, killing more people than World War One, and perhaps an offshoot of the war itself.  

Could this sort of event return?  It could, but it's unlikely.  Killer flus could indeed reemerge, but this one is freakish in its behavior and lethality.  Normally, less than 1% of those get the flu die from it, which is not to discount it.  The flu kills far more people annually, for example, than much more feared diseases like AIDS do.  But a 20% lethality rate is stunning and weird, and perhaps could only have evolved due to the conditions of the First World War.  Indeed, alternative theories to the Camp Funston origin all tend to have the close proximity of pigs, birds and soldiers as a common set of elements.  And all of this, of course came in an era when medications were few, and the ability to go home and rest either slight, or for many of the young afflicted, nonexistent.

A lesson it does teach us, however, is how life takes its own turns, sometimes huge ones, which we can little predict or little control.  Private Gitchell no doubt didn't join the Army expecting to feed pigs in Kansas.  And if he worried about dying in the war, he probably didn't think that death would come via a virus, which he thought was a "bad cold" when he checked into sick call.  Nobody, in 1918, could have foreseen a virus so virulent and communicable that it would be in New York City, and likely Quebec, within a week.  My great aunt, with a brother serving in France in the Canadian Army could not have foreseen that she'd be one of the victims of a disease that freakishly broke out in part due to wartime conditions.  Her brother, a physician, could have have seen that the family causality in the war would be his sister, back home in Quebec.  For millions life took a similar, and for many, short turn which few could have anticipated.