The Forgotten Flu: A Clue For Staying Well in the Next Pandemic

The Great War was over and then as many as 50 million people died of the Spanish flu.

This flu whipped around the world for 22 months before it fizzled out. It even struck on ships at sea.

From late Spring to Fall, 3 brothers, young husbands with a child or two each, died of this flu. They were the healthiest of their generation. They left their older alcoholic brother and 5 sisters. They died on their pleasant New Jersey farms, not among crowded conditions or poverty but in the height of their success as hard-working farmers. And not in winter chill but in the bright sunshine of perfect summer weather.

It has always been a mystery why these, of all the siblings, should have succumbed.

One idea that had some merit until recently was that this Spanish flu may have had a predecessor. The theory was that only the weakest caught the earlier round of this gentle virus, and thus became immune to the virulent wave to follow. Epidemiological studies don't give credence to this theory anymore.

So what might have accounted for their deaths?

It is true that half the deaths in the Spanish Flu were of the strongest, fittest members of society, typically between 20 and 40 years of age. Most flu epidemics kill the young and the elderly, and the height of the epidemic occurs in winter.

In the US the first sign of an outbreak was at Fort Riley, Kansas. Perhaps it was the weariness of soldiers returning home from war? But the young men from New Jersey had not been to war

It's important to note that the other members of their family did not get sick, and these brothers did not die in a cluster, but at two month intervals.

One idea about why the young and healthy died is tied in with what happens when a healthy person encounters a totally new organism. It's called a cytokine storm. In this case, the strong immune system in the healthy individual reacts so powerfully to the foreign organism that it causes severe, often fatal damage in the victim's body. So young, healthy individuals were thought perhaps to be more likely to be so strong as to undergo this fatal overreaction much more than weaker victims were.

In the flu of 1918, 20% of the population of the world became ill and a quarter of those died, some within a day of showing their first symptoms.

Still, why did 3 young men succumb to this flu, while their siblings didn't even catch it?

One answer may have to do with where

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