by ©2018 Sarah Becker

Pandemic Spanish Flu of 1918

Hospital reports of nursing shortages are nothing new.  Neither is flu season.  Influenza is a communicable, highly contagious, disease transmitted through droplet infection–or—by touching articles contaminated with infected nasaldischarge.  Contaminated hands, hand railings, enclosed air systems, populated school buses and military barracks are all breeding grounds.

In early 1918 “a mysterious malady” circulated through Spain “in the form and of the character of the grippe.”  It quickly spread to Switzerland, then to France, England and Norway.  World War I was ongoing and “in early August the disease, carried from Europe in ocean liners and troop transports,” arrived in the United States.  The Spanish flu was pandemic.

On October 5, 1918 Dr. W.L. Wood, of the United States Public Health Service, appealed “to women, regardless of color, to aid in nursing persons afflicted with Spanish influenza.”  The USPHS further ordered “that from now on all windows on the cars of the Washington-Virginia Railway Company must be kept open.”  Persons who refused were “subject to arrest and the imposition of a fine.”

Approximately 50 million of the world’s population died of the pandemic Spanish flu, perhaps three times the number of 1918 war deaths.  “Provisional totals of the United States, including the deaths of soldiers, sailors and marines, indicate about 500,000 deaths were due to the epidemic at the end of 1918, extending into the early part of 1919,” The Washington Post wrote.  The loss of life in 1919 was estimated at about 45,000.

“In connection with statistics collected from other countries, the figures for the [United States] emphasize the supreme importance of discovering, first, the cause of the influenza; second, a means of prevention or control of its spread; third, a means of cure,” The Washington Post stated in 1920.  The infectious agent: The bacillus influenza of Pfeiffer.  The preferred methods of control: the infected individual and the environment.  Vaccines were used with only partial success.

The flu virus has a short incubation period, usually 24 to 72 hours.  Since influenza attacks the respiratory tract, bacterial pneumonia can result.  In a pandemic the flu taxes the body’s immune system, sometimes excessively.  None is considered more serious, more medically intriguing than the pandemic Spanish flu of 1918.

“The Angel of Death has intruded into several Alexandria households during the past twenty-four hours,” the Alexandria Gazette reported in 1918.  “The victim in each case was a young man of the most representative class in our community.”  The Spanish flu first attacked soldiers, then mostly youth.

  “What is Spanish influenza?” The New York Times asked.  “Spanish influenza, if not the grippe itself, is accompanied by all the symptoms of the grippe, and differs from this disease only in that it is more severe and is more likely to lead to pneumonia…As with grippe, the disease is characterized by excessive sneezing, reddening and running of the eyes, running of the nose, chills followed by fever of 101-103 degrees, aching back and joints, loss of appetite, and a general feeling of debility.”

  “Spanish influenza is increasing in this city at an alarming rate,” the Alexandria Gazette reported on October 12, 1918.  “There are few houses in the city where there is not a case of the disease.  The death rate is increasing daily despite those who would have the public take a more optimistic view of the situation.”  In Alexandria, “expectorating on sidewalks” became punishable by law.

The pandemic Spanish flu slowed the First World War.  Spain disclaimed “the unwelcome guest” concluding that “this new evil, like other evils of the [world] war, must be traced to German origins.”  One theory postulated “that a new trench bacteria must have been born in the German lines, where the troops, poorly fed and clothed, were living in a reduced state of virility.”  Another assumed “that the disease was carried by the crews of the German submarine boats.”

It is “fairly certain that the Spanish influenza, if different from the familiar grippe, originated in the German camps,” The New York Times exclaimed.  “In this connection it may be noted that through all the wars of history diseases generated by unsanitary herding of men in the camps of belligerents have always produced epidemics.”

Meanwhile, in Alexandria, “another temporary hospital for the treatment of the Spanish flu was opened in the Westminister building of the Second Presbyterian church.  There also is a temporary hospital in Christ Church parish hall.”

In sum, 1918 public health officials recommended that citizens avoid crowds—street cars, theaters, indoor and outdoor gatherings—and hold private funerals.  If infected, then influenza patients were asked to:

• • Go to bed, take a purgative and send for the doctor;
• • Get fresh air, lower windows so as not to form a draught;
• • Sleep only two patients per room;
• • Spray nose, throat with tablespoon of bread soda in glass of warm water;
• • Take tablespoon of liquor in hot water;
• • Warm soup and liquor nourishments of all kinds, and
• • Take prescriptions only when given by an attending physician.

Today’s Tamiflu, an antiviral drug, contains no liquor.

Hand-washing is the best way to avoid the flu, to interrupt the disease cycle.  Live viruses can remain on hands for as long as two hours.  Women, not surprisingly, have the cleanest hands.

According to the American Society of Microbiology women are more inclined to indulge in 20-second hand-washing than men.  It is especially important to wash your hands before and after food preparation, before eating, after eliminating, or disposing of animal waste.  Germs are ever present and flu season is upon us.  The Center for Disease Control recommends getting a flu shot prior to October 31.

This year marks the 100^th anniversary of the pandemic Spanish flu.  The National Institute of Allergy and Infectious Diseases (NIAID) celebrated by unveiling its updated strategic plan, a plan which seeks “to find a vaccine that protects against multiple influenza strains, including those that might cause a pandemic.”  The influenza virus mutates readily, and as it stands new vaccines must be made yearly.  In an often frustrating attempt to match the strains projected to circulate in the upcoming season.

“Respiratory illnesses such as flu are what really keep infectious disease experts up at night,” NIAID Director Dr. Anthony Fauci told a National Press Audience on July 19, 2018.  “Each year seasonal influenza results in 140,000 to 710,000 hospitalizations and between 12,000 and 56,000 deaths in the United States.  The 2017-2018 U.S. influenza season was among the worst of the last decade.”

“We are in some ways the victims of our own success,” Fauci continued.  “It has created complacency, people thinking that the risk of the vaccine is more than the risk of the disease.  That is clearly not the case.”  Forty-two percent of flu cases are averted by vaccine; 2.9 thousand deaths are prevented.

President Donald Trump’s grandfather Frederick Trump died of the pandemic Spanish flu as did John Francis and Horace Elgin Dodge, founders of Dodge Brothers car company.  Others, like stricken President Woodrow Wilson survived.  Wilson allegedly collapsed on April 3, 1919, during the Versailles Peace Conference.    

Progress is change.  In 1997 pathologist Jeffery Taubenberger’s Walter Reed Army Medical Center research team “brought back to life the virus that caused the 1918 flu.”  They found fragments of the virus in a long-stored autopsy sample, taken from a soldier who died in 1918.  The group reconstructed the 1918 virus’ genome sequence as of 2005.

“We have to stick with it,” Fauci concluded.  “With a universal vaccine, we could take pandemics off the table…It is the challenge of reconceiving our relationship with a pathogen that is so close to us, we cannot see it clearly.”   

Sarah Becker started writing for The Economist while a graduate student in England. Similar publications followed. She joined the Crier in 1996 while serving on the Alexandria Convention and Visitors Association Board. Her interest in antiquities began as a World Bank hire, with Indonesia’s need to generate hard currency. Balinese history, i.e. tourism provided the means. The New York Times describes Becker’s book, Off Your Duffs & Up the Assets, as “a blueprint for thousands of nonprofit managers.” A former museum director, SLAM’s saving grace Sarah received Alexandria’s Salute to Women Award in 2007.