By far the most deadly outbreak of disease in human history was the flu pandemic that began in 1918, as World War I was reaching its conclusion. It was a true pandemic, spreading rapidly across the world. Although the outbreak lasted approximately two years, as many as two-thirds of the deaths occurred in a six-month period (roughly September 1918 to February 1919). By any measure, this was the most lethal single disease outbreak in human history. Because of the general chaos attending a world war, the task of reliably determining how many actually died has been difficult, though it was undoubtedly in the tens of millions.
Although experts do not fully agree on this point, the most likely origin of this outbreak was somewhere in the United States, having spread from bird populations to swine to humans. In February 1918, soon after its appearance, the flu was apparently brought to Camp Funston, a military base at Fort Riley, Kansas, by conscripted civilians. At the camp, the huge population of potential carriers and victims allowed the virus to spread rapidly. Within three weeks, more than 1,000 men were hospitalized, sick with the flu.
As World War I raged on, the virus spread easily via troop transport ships. When it hit Spain in May 1918, it was erroneously called Spanish flu, a name that is still used despite current knowledge that it did not originate there. Apparently, the lack of wartime censor- ship permitted more widespread reporting of the outbreak in Spain — a noncombatant in World War I — thus giving the impression that the flu was at its worst there.
In early September, the pandemic returned to the United States, again via troop transports, striking Camp Devens outside Boston. This second outbreak was not like the one of the previous spring, however, as the virus had mutated into a much deadlier form dur- ing the intervening months. The flu rolled across the United States, from east to west, leaving devastation in its wake. In a normal influenza outbreak, 10 percent or less of deaths occur among those age 16 to 40. In the 1918 pandemic, by contrast, as many as half of those who died were in their twenties and thirties. The flu was also dangerous for children, the elderly, and pregnant women. Nearly half of all deaths in the United States in 1918 are attributed to influenza.
The worst of the fatal cases were truly horrific. The onset of illness was sudden and often completely unexpected. The victim could expect not just the usual mild fever and aches associated with flu, but extreme fever and chills and excruciating pain. His or her lips and skin might turn blue or nearly black. Some would experience hemorrhaging from the nose or mouth, or even the ears or eyes, losing vast quantities of blood. For better or worse, such suffering was often relatively brief. It was not unusual for a seemingly healthy person to become ill and succumb within a day or two.
Although the flu spread worldwide, it was experienced differently in different countries. It was actually made up of several waves of the virus, which continued around the world well into 1919, with sporadic flare-ups in 1920. Regions that escaped earlier waves could be hit hard by later ones. Australia, for example, had avoided the earlier outbreak but felt the full force of the pandemic in early 1919.
Although experts have only rough estimates of the death toll from the pandemic, the figures that are availableindicate its terrible im- pact. In Paris, 10 percent of those who contracted the flu died; for those who also developed complications such as pneumonia, the mortality rate jumped to 50 percent. The United States had a death toll of approximately 675,000 (by contrast, about 118,000 Ameri- cans were killed in World War I, and about 418,000 were killed in World War II — a total of 536,000 deaths). In some regions, the figures were particularly ghastly.
Alaska and Samoa lost one-quarter of their population, and in the northern Canadian region of Labrador, one-third or more of the population died. In Iran, one nomadic tribe lost nearly one-third of its members to the disease.
Some estimates put the global death toll from the 1918 pandemic at 20 million, but others estimate the death toll in India alone at 21 million. Most who study the 1918 pandemic now agree that the total death toll was likely at least 50 million, perhaps as high as 100 million. Nothing else in human history — not plague, the Holocaust, atomic weapons, or any other form of warfare — has killed as many people in as short a time.
Turner, Julie. “Influenza.” Global Social Issues: An Encyclopedia. Ed. Christopher G. Bates and James Ciment. Armonk, NY: Sharpe Reference, 2013. 591-596. Gale Virtual Reference Library. Web.
Read a first hand account of an army doctor at Fort Devens »