8 Things to Know About the Spanish Influenza Pandemic of 1918-1919

1. The global death toll for the Spanish flu is thought to be 50 million people, but it might have been as high as 100 million. In other words, between 3% and 5% of the world’s population died. In the United States, 675,000 people died. One third of the population became infected. The death rate in other influenza pandemics is usually around 0.1%.

2. During the Black Death Pandemic of the 1300s, plague (Yersinia pestis) killed 75 million to 200 million people, but the pandemic lasted longer than the Spanish flu, with the deaths spread out over more years. The death toll for the plague was also a greater percentage of the world population; it killed 30% to 60% of Europe’s population during the 1300s.

3. The Spanish flu was a more lethal form of flu virus, but it was not very different than other strains circulating at the time or since then. Almost all cases of influenza A except avian flu strains are caused by descendants of the Spanish Flu virus. Genomic sequencing conducted from autopsy samples and tissue samples from grave sites found that the Spanish flu was an H1N1 strain of flu. Some of the samples used for sequencing came from bodies buried in permafrost in Alaska

4. The Spanish Flu is misnamed. It didn’t start in Spain. Nations that were fighting in World War I kept a tight lid on the news of the epidemic, but neutral Spain did not censor the news, which made people think it started there and spread.

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5. In most influenza epidemics, the elderly, the infirmed and the very young make up the bulk of deaths. With the Spanish flu, many of those who died were healthy young adults. Some populations, notable Native American tribes, had very high death rates

6. The pandemic occurred in three waves in 1918 and 1919, possibly starting in Austria in 1917.The first pandemic wave of influenza in the United States was in spring 1918, in several military camps. Troop movements at the end of World War I helped spread the disease. The waves that occurred in the fall of 1918 and winter of 1919 were deadlier than the first wave

7. There had been influenza pandemics earlier, notably in 1889 and 1847. Later flu pandemics occurred in 1957 (Asian flu) and 1968 (Hong Kong flu).

8. The Spanish flu was so virulent that medical experts at the time were not sure if it was influenza. Some suspected the disease was a form of cholera or typhoid because of the high infection rate and severe symptoms.