A History of Flu Pandemics

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A History of Flu Pandemics

• By David W. Tschanz, MSPH, PhD
• Edited by Lamya Hamad

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What Happened in Previous Flu Pandemics?

• Pandemics are global disease outbreaks. An
  influenza pandemic occurs when a new influenza
  virus (seasonal or avian) for which people have
  little or no immunity and no vaccine emerges. In
  a pandemic, the disease becomes easily
  transmissible from person to person causing
  serious illness. It can easily sweep across the
  globe infecting millions. (www.pandemicflu.org)

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What Happened in Previous Flu Pandemics?

• There have been records of bird flu pandemics as
  early as 1889. Most of the previous pandemics
  have resulted in serious fatalities. The Spanish
  Flu, which occurred in 1918, was said to have
  caused approximately 40 million deaths due to the
  severity of the H5N1 strain that infected people.
  What happened during these pandemics?

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1889 Pandemic

• It was thought to have begun in central Asia in
  the summer of 1889, and then spread north into
  Russia, east to China, and west to Europe.
• It reached the United States in December 1889.
• Between February and May 1890, the flu had
  reached Africa, the Middle East, India, Southeast
  Asia, Australia, and New Zealand.

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1918 Spanish Flu Pandemic

• Third greatest killer in the history of mankind.
• Fastest killer in terms of number of deaths.
• At least 25 million died (in four months).
• Four percent of the population of India died (12
  million).
• 20 percent of all Micronesians died.
• 548,452 Americans died.
• 200,000 British and Welsh people died.

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First Wave

• From mid-March to early May people had a very
  mild three-day-long fever .
• Wrestlers fever in Japan
• Eight million cases in Spain (Spain, being
  neutral, did not cover-up cases, whereas European
  countries involved in WWI did not report cases).
• Flu was not reported in Latin America, Africa,
  Canada.

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Second Wave

• Started late August, continued through
  mid-November.
• Rapid movement throughout entire world.
• Cases in every part of world except Tristan da
  Cunha in the South Atlantic Ocean.
• Coast Guards reported that isolated Inuit
  villages had been wiped out.
• Remote lumberjack camps in Canada hit by flu.

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1918 Flu - Timeline

• Disease cases began to show in Europe.
• The HMS Mantua entered Freetown port with 200
  sick sailors. Ten days later, 500 out of 600 of
  Sierra Leones coal workers didnt show up at
  work.
• Aboard the HMS Africa, 550 out of 779 crew fell
  ill, 51 died in five days.

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1918 Flu in United States - Timeline

• September 11 US officials admitted Spanish flu
  may have reached the US.
• September 1213 One million men registered for
  army draft in city halls, post offices, and
  schools including 96,000 in Boston.
• September 13 Rupert Blue (surgeon general of the
  United States from 1912 to 1920) announced the
  beginning of an epidemic.
• September 14 Urgent call for nurses from the
  Public Health Service in Boston.

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1918 Flu in United States - Timeline

• September 20 9,313 cases reported by US Army
  since August.
• September 23 20,000 cases reported in US Army.
• September 27 Army postponed orders of induction
  of 142,000 men.

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Disease in the Troops

• Of the 44,000 men here, 11,000 are too sick to
  readily distinguish night from day. - Base
  Medical Officer, Camp Meade, Maryland
• The epidemic has not only quarantined nearly all
  camps, but has forced us to cancel or suspend all
  draft calls. Peyton March (Army Chief of
  Staff)
• Every soldier who dies from influenza has just
  as surely played his part as his comrade who has
  died in France. Woodrow Wilson (28th president
  of the United States)

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1918 Flu in United States - Timeline

• September 26 156 Boston residents died of bird
  flu.
• September 27 All US military camps were
  quarantined.
• September 28 Navy reported 31,000 cases and
  1,100 deaths army reported similar numbers.

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1918 Flu in United States - Timeline

• October 1 Boston reported 202 dead.
• October 6 Philadelphia reported 289 dead, single
  highest daily total in citys history to that
  point.

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1918 Flu in United States - Timeline

• October 7 Washington, DCs only healthy health
  commissioner ordered closing of all public
  places.
• October 13 Rupert Blue was given emergency funds
  to hire 1,035 doctors and 735 nurses.
• October 14 Senate and House of Representatives
  closed congressional visitor galleries.
• October 15 Supreme Court adjourned to prevent
  bringing people to this crowded and infected
  place.

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1918 Flu in United States - Timeline

• Morticians were unable to bury dead in Baltimore.
• In Pittsburgh, a street that was lined with
  stacked coffins built by the city was emptied in
  three days.
• San Francisco passed a law requiring a mask be
  worn at all times.

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1918 Flu in United States - Timeline

• Week of October 15 New York made public coughing
  and sneezing without a handkerchief illegal 500
  arrested first day.
• October 13 New York City recorded 3,077 new
  cases and 311 deaths.
• October 23 851 deaths in New York City record
  stood still until September 11, 2001.

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1918 Flu in United States - Timeline

• Obey the laws
• And wear the gauze
• Protect your jaws
• From septic paws

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Seattle
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Detroit
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Week of October 26, 1918

• 20,806 US civilians died in one week, the single
  highest one week mortality in US history ever
  recorded. It was amazing that only 78 percent of
  US population areas had reported to the Census
  Bureau.
• Final US civilian toll from influenza 548,452.

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Disease Pattern

• 18- to 45-year-olds most affected group
• 18- to 45-year-olds highest mortality, leaving
  thousands of children orphaned
• Children and older populations left relatively
  untouched

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• What Happened in Other Parts of the World?
• In Auckland, some children who had been
  playing in the street all day went to the nearby
  grocer and asked for food as they were hungry.
  They said their father and mother were in bed and
  would not get up or even speak to them. Both
  parents were found side by side in bed, dead." --
  Stethoscope and Saddlebags

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Japan - 1918
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Australia
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Brazil
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Legacy and Irony

• Virtually forgotten, as if it was being driven
  from collective memory of survivors.
• Few records in novels or in memoirs or history
  books.
• Loss was in potentialities, since those afflicted
  were young.

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Human Memory