by Alison Bowler

Created on: April 01, 2009   Last Updated: April 19, 2009

The pandemic of Influenza known as the "Spanish flu" which infected the world in 1918 was devastating. It came on top of four years of war that had drawn in most of the worlds' population. Some sources state that the flu killed 20 to 40 million people, others put the total death toll as greater than 60 million people worldwide, while it infected over a billion persons. One statistic is known for sure more people died from the Influenza pandemic than died as a result of World War One.

Influenza is known as a killer disease but its' victims are usually elderly or suffering from some pre-existing disease such as diabetes, heart condition or chronic breathing problems. The 1918 "Spanish Flu" was different its victims, were often young adults who were otherwise healthy. The mortality rate of the 1918 Influenza strain is estimated at 2.5 % compared to a rate of less than 0.1% normally recorded for Influenza.

So what was this virus and where did it come from?

It seems likely that it was originally an avian flu strain which mutated slightly to allow it to infect humans. We do know that it was a H1N1 strain of Influenza A virus.

Despite its' name the Influenza virus responsible did not come from Spain, in fact the Spanish called it the "French Flu". It was given the name "Spanish Flu" because there was an early outbreak in that country. Studies on the epidemiology of the pandemic have shown that there was an outbreak of Influenza in the spring of 1918 in a military camp in Kansas, USA. This pre-dates the infection appearing in Europe so it is possible that military personnel traveling to the battlefields carried the infection from America to Europe. How the infection reached Kansas in the first place is unknown.

Why was the infection so widely spread?

Firstly the whole of the worlds' population was non-immune to this influenza strain. The previous pandemic known as the "Russian Flu" of 1889-90 was caused by a H2N2 strain while a smaller epidemic in 1902 was caused by a H3N2 strain. Infections with either of these two viruses would not have conferred immunity on a person to the new H1N1 strain.

Much of the world was involved in fighting in the Great War as World War One was then known. Many soldiers and support personnel were traveling to and from the battlefields of Europe. The close contact of traveling in crowded troop ships and troop trains was ideal for the transfer of infection. Life in the trenches and in military camps also brought many people into contact with the

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