The Spanish Flu Pandemic Killed Far More People Than Died in World War One


Letter carrier in New York wearing mask for protection against influenza. New York City, October 16, 1918.

(photo and quote below courtesy of US National Archives)

Letter carriers, mass transit workers, and others who came in contact with the public, were especially vulnerable to disease. Wearing a face mask helped them avoid contagion.


Typist wearing mask, New York City, October 16, 1918

(Photo courtesy US National Archives)

There was great fear of the disease as you might imagine. Even people in the pink of health often died within hours of the onset of symptoms. People were refused entrance to buildings, not allowed on streetcars or into public spaces unless wearing masks.

Young Adults Had Mortality Rate 20 times higher

“Influenza and pneumonia death rates for those 15–34 years of age in 1918–1919, for example, were >20 times higher than in previous years (35). Overall, nearly half of the influenza-related deaths in the 1918 pandemic were in young adults 20–40 years of age, a phenomenon unique to that pandemic year.”

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On the date the Armistice which ended World War One —the 11th hour or the 11th day of the 11th month of 1918—- sixteen million human beings had died.

From Princeton’s history site:  The total number of casualties in World War I, both military and civilian, was about 37 million: 16 million deaths and 21 million wounded. The total number of deaths includes 9.7 million military personnel and about 6.8 million civilians. 

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Princeton Archives World War One Casualties

Life the Western world could not have gotten worse. But it did.  Very much worse. For beginning in the fall of 1918, just a few months before the Armistice which brought an end to the slaughter of World War One, people in Europe and the United States and Canada, began to die of a mysterious disease, marked by very high fever, which doctors could not identify, treat, or control.

We know this in history today as the Spanish influenza pandemic, this last word meaning it wasn’t confined to a smaller geographical area such as a region or country or even continent. That’s an epidemic. A pandemic is something that affects the entire globe.




Policemen in Seattle wearing masks made by the Red Cross, during the influenza epidemic. December 1918.
(photo courtesy of US National Archives)

The Spanish Influenza Pandemic killed at a minimum over fifty million people, the largest number of people killed by any pandemic known. It is the worst medical catastrophe in recorded human history. Incredibly, for all the lives it took, the pandemic didn’t even last very long. Less than twelve months give or take.

Scientists, doctors, and health officials could not identify this disease which was striking so fast and so viciously, eluding treatment and defying control. Some victims died within hours of their first symptoms. Others succumbed after a few days; their lungs filled with fluid and they suffocated to death….The plague did not discriminate. It was rampant in urban and rural areas, from the densely populated East coast to the remotest parts of Alaska. Young adults, usually unaffected by these types of infectious diseases, were among the hardest hit groups along with the elderly and young children.

The flu afflicted over 25 percent of the U.S. population. In one year, the average life expectancy in the United States dropped by 12 years.

If this last sentence doesn’t cause your jaw to drop then here it is again, all in caps: “IN ONE YEAR, THE AVERAGE LIFE EXPECTANCY IN THE UNITED STATES DROPPED BY 12 YEARS.”


Sources: US National Archives, US National Institutes of Health, US Center for Disease Control, America’s Forgotten Pandemic: the Influenza of 1918 by Alfred W. Crosby

[Images courtesy of  The National Archives.]

The Spanish Influenza – Did It Start in America?




Although the influenza epidemic killed millions worldwide, it has forever been known as the “Spanish Influenza” pandemic. There are several theories about this. Writing in America’s Forgotten Pandemic: the Influenza of 1918 (3 stars, slightly dated as it was originally published in the 1970s) by Alfred W. Crosby, the author speculates that in Spain, a neutral power during the war, strict military censorship of Spanish newspapers wasn’t being exercised, hence the news of the pandemic first appeared in Spain thus giving the epidemic its name.

This is confirmed by an abstract from a 2008 article published in the medical journal Clinical Infectious Diseases available online from the US National Library of Medicine, National Institutes of Health in which the authors state:

On 22 May 1918, the epidemic was a headline in Madrid’s ABC newspaper. The infectious disease most likely reached Spain from France, perhaps as the result of the heavy railroad traffic of Spanish and Portuguese migrant workers to and from France. Although a great deal of evidence indicates that the 1918 A(H1N1) influenza virus unlikely originated in and spread from Spain, the 1918-1919 influenza pandemic will always be known as the Spanish flu.

That is to say, it is unlikely that the influenza virus originated in or spread from Spain.

Historical photo of the 1918 Spanish influenza ward at Camp Funston, Kansas, showing the many patients ill with the flu.

Photo of Walter Reed Hospital, Washington, D.C., during the great Influenza Pandemic of 1918 – 1919, also known as the “Spanish Flu”. Patients are set up in rows of beds on an open gallery, separated by hung sheets. A nurse wears a cloth mask over her nose and mouth.

In America’s Forgotten Pandemic, the author says the disease we know as the Spanish Influenza, actually began in the United States in March of 1918.

Where did it come from? China, India, France – there were vague and ex post facto reports of flu or flu-like epidemics in those lands in the spring. But if we insist on contemporary documentary evidence from qualified physicians, then we must say that the new influenza appeared first in March (1918) and in the United States.

He speculates that American troops being sent to Europe carried the disease with them.

Mounted on a wood stor­age crib at the Naval Air­craft Fac­tory, Philadel­phia, Penn­syl­va­nia, on 19 Octo­ber 1918. As the sign indi­cates, the Span­ish Influenza was then extremely active in Philadel­phia, with many vic­tims in the Philadel­phia Navy Yard and the Naval Air­craft Fac­tory. Note the sign’s empha­sis on the epidemic’s dam­age to the war effort.



[Images courtesy of Wikimedia and Experience Project.]

The Spanish Influenza – Did It Kill 6% of the Population of the Earth?






So why are physicians and medical researchers from all sorts of disciplines in many countries spending time and money on researching a pandemic that happened almost one hundred years ago? Because it is still with us in various, albeit less lethal strains, and because the Spanish flu had a vastly higher death rate than any other flu.

The following statistics are from a scientific paper, “1918 Influenza:The Mother of All Pandemics” published in Emerging Infectious Diseases Vol. 12, No. 1, January 2006.

The impact of this pandemic was not limited to 1918–1919. All influenza A pandemics since that time, and indeed almost all cases of influenza A worldwide (excepting human infections from avian viruses such as H5N1 and H7N7), have been caused by descendants of the 1918 virus, including “drifted” H1N1 viruses and reassorted H2N2 and H3N2 viruses. The latter are composed of key genes from the 1918 virus….An estimated one third of the world’s population (or ≈500 million persons) were infected and had clinically apparent illnesses during the 1918–1919 influenza pandemic.

Hit the pause button a moment and think about this. One Third of the entire population of the world contracted the Spanish flu? One third of the entire world? And it all happened in less than 18 months with the bulk of cases concentrated in a twelve month period. That is one hell of a flu. This is the scary part:

The disease was exceptionally severe. Case fatality rates were >2.5%, compared to

Chart showing mortality from the 1918 influenza pandemic in the US and Europe.

In an article published in the Bulletin of the History of Medicine (abstract available here) in 2002 the authors state the following:

An estimated 50 million people, about 3% of the world’s population (1.8 billion at the time), died of the disease. Some 500 million, or 28% (≈1/4) were infected.

Pause button again. Three percent of the humans on the globe at that time died from the Spanish influenza? Three percent? That’s astounding. Unfortunately, it may have been much worse. The same authors write:

The recorded statistics of influenza morbidity and mortality are likely to be a significant understatement. Limitations of these data can include non-registration, missing records, misdiagnosis, and nonmedical certification, and may also vary greatly between locations. Further research has seen the consistent upward revision of the estimated global mortality of the pandemic, which a 1920s calculation put in the vicinity of 21.5 million. A 1991 paper revised the mortality as being in the range 24.7-39.3 million. This paper suggests that it was of the order of 50 million.However, it must be acknowledged that even this vast figure may be substantially lower than the real toll, perhaps as much as 100 percent understated.

I broke out this last sentence. Using their figure for the population of the world (which they take from historical estimates made by the US Census Bureau), the math is simple. 50 million humans dead equals 3% of the population of the globe. 100 million dead of Spanish Influenza would mean SIX PERCENT of all the human beings on the face of the earth died in a very short period of time.

Children in the remote Alaskan village of Nushagak survived the 1918–1919 influenza pandemic. However, most of their parents and grandparents succumbed to the 1918 pandemic virus, probably because they had not been exposed to an earlier H1-like influenza virus as a result of their geographic isolation. The photograph was taken in the summer of 1919.

Let me make this suggestion, if your Congressperson is committed to making deep cuts in the Federal budget, please suggest to them that we not cut the funds being used to investigate the Spanish Influenza.

(Statistical note: the research teams who wrote these articles took their estimate of global population in 1918-1919 from two different sources which accounts for the difference since the first article says 1/3 of the global population was infected and the second article says 1/4 of the global population was infected.)

[Images courtesy of Wikimedia and Experience Project.]

Spanish Influenza Epidemic of 1919 Killed 675,000 in United States


Washington, D.C., circa 1919. “Walter Reed Hospital flu ward.” One of the very few images in Washington-area photo archives documenting the influenza contagion of 1918-1919, which killed over 500,000 Americans and tens of millions around the globe. Harris & Ewing glass negative.

Christopher Helin 1920s 6.5x8.5 glassneg eb 092014

The flushing of streets and sewers by sprinkler trucks was a widespread if not terribly effective public-health measure during the “Spanish influenza” epidemic of the late teens. LOC

San Francisco circa 1919. “Nash Two-Ton Tanker Truck.” This begins a new series of photos, scanned by Shorpy from large-format negatives taken by or for Christopher Helin, travel and automotive editor of the San Francisco Examiner from about 1915 to 1930.



The mortality rate among adults in the prime of life was so high that many parents of young children died.

November 24, 1925. Washington, D.C. “City orphans at Ambassador Theatre.” LOC source for number of deaths