by Michael Rupp

Created on: February 07, 2009

CAUSES OF THE FLU PANDEMIC OF 1918

At least twenty million died in the 1918 Flu Pandemic, possibly more than 50 million. In the United States alone over 500.000 died. It was commonly called the Spanish flu. As many American soldiers in World War I died of flu as died in fighting the Germans. Europe and America were devastated. Even the Arctic and remote Pacific were affected. Few places escaped the Spanish flu.

What was the cause of this disaster? Much remains a mystery, but the story is beginning to unfold.

The influenza virus that caused the 1918 pandemic is, in a way, still with us. In the 1990's scientists working with tissue left from autopsies performed on victims of the 1918 flu were able to begin identifying the responsible virus. The 1918 pandemic was caused by Influenza type A, still the most common type of flu. Flu outbreaks are to this day caused by variations of Influenza type A viruses descended from the 1918 strain. Even the dreaded "bird flu" virus contains genes from the 1918 influenza strain.

Where did the pandemic of 1918 begin? We may never know. At that time, viral organisms had yet to be discovered. Some researchers thought flu was caused by bacteria, the existence of which were by then well known to science. There was no way to isolate or subtype flu virus in 1918. There was no requirement to report flu cases to government health agencies. Many of the tools we now have to track and trace flu outbreaks now didnt exist in 1918. With no tests available to identify flu virus, even the criteria for diagnosing which patients had flu were inexact.

What is known is that the pandemic didn't occur as one tsunami-like event. There were three separate, but closely spaced, waves of the 1918 flu, and they were far from identical. The first wave, the spring wave, hit the United States In March of 1918. The first wave was fairly typical of type A flu. It was highly infectious, but not particularly deadly. When the second and third waves hit over the next twelve months, the death rate would be twenty times as high.

The scope of death was only rivaled by the speed with which the Spanish flu killed. There are stories of groups of healthy friends playing cards at night, only to find several dead of flu the next morning. It is said that healthy young men left for work in the morning, and died of flu before the day ended. Some patients turned a blue color and suffocated while struggling to breath. Some died with frothy blood filled fluids filling their noses and

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