Spanish Flu Centenary
September 2, 2018 10:00 AM   Subscribe

The 1918-19 pandemic was caused by an influenza A virus known as H1N1.

Whoah, the same as in 2009. I had it, or I think I did; the county told me they weren't interested in testing me unless I was sick enough to go to the hospital, but the CDC were saying that it was basically the only flu strain making people sick in early summer 2009. The terrible thing about it was it was most lethal to young, healthy adults. I was 42, and it was just like being really sick with the flu for 10 days, for me - no dangerously high fever or anything like that.
posted by thelonius at 10:11 AM on September 2, 2018 [5 favorites]

I highly recommend Gina Kolata’s book FLU for anyone else fascinated by this subject.
posted by armeowda at 11:04 AM on September 2, 2018 [9 favorites]

The Great Influenza by John M Barry is also an excellent book about this. Thanks for the post!
posted by john_snow at 11:08 AM on September 2, 2018 [9 favorites]

Pale Rider By Laura Spinney is also a very good book about this.
posted by Homo neanderthalensis at 11:11 AM on September 2, 2018 [2 favorites]

Essay about what we do and don't remember, and why the spanish flu should be remembered more than it is.
posted by Nancy Lebovitz at 11:13 AM on September 2, 2018

Also a helpful overview from Extra History.
posted by Scattercat at 12:03 PM on September 2, 2018

Essay about what we do and don't remember, and why the spanish flu should be remembered more than it is.

Link: How We Remember and What
posted by homunculus at 12:06 PM on September 2, 2018 [1 favorite]

My mother who was born in 1913 remembered her best friend's mother dying in the 1918 epidemic. My mother and her little friend were both 5. My mother told me about this, so I always had a personal memory of the horror of that epidemic.
posted by mermayd at 12:27 PM on September 2, 2018 [4 favorites]

American Experience did an episode on the flu of 1918. So good I bookmarked it.

Also second The Great Influenza. Truly riveting.

Thanks for the links. I will be reading them all.
posted by 6thsense at 12:57 PM on September 2, 2018 [2 favorites]

My Dad was 10 when he caught the Spanish flu in 1918. He was nearly dead when a local doctor, who was dedicating himself to child flu victims, visited and began treating him. My dad survived (duh), and years later after marrying my mother, discovered that the doctor who saved him had been my mother's uncle.
posted by Thella at 1:37 PM on September 2, 2018 [37 favorites]

"God in the time of sickness
God in the doctor too
In the time of the influenza
He truly was a God to you"
posted by the sobsister at 1:59 PM on September 2, 2018 [2 favorites]

And in greater detail,

"In the year of 19 and 18, God sent a mighty disease.
It killed many a-thousand, on land and on the seas.
Great disease was mighty and the people were sick everywhere.
It was an epidemic, it floated through the air.

The doctors they got troubled and they didn’t know what to do.
They gathered themselves together, they called it the Spanish flu.
Soldiers died on the battlefield, died in the counts too.
Captain said to the lieutenant, “I don’t know what to do.”

Well, God is warning the nation, He’s a-warnin them every way.
To turn away from evil and seek the Lord and pray.
Well, the nobles said to the people, “You better close your public schools.
Until the events of death has ending, you better close your churches too.”"
posted by the sobsister at 2:04 PM on September 2, 2018

Grandmother Ema died from this a month after mom was born back in 1918.
Liked to think maybe I inherited some flu antibodies to get me through the next pandemic.
posted by Mesaverdian at 2:40 PM on September 2, 2018

My maternal grandfather was apparently delirious in the hospital for some days with the Spanish flu but somehow managed to pull through. Between that and my mother having polio as a child, and my maternal grandmother having rheumatic fever, my parents made damn sure my sister and I got whatever vaccinations were available.
posted by gudrun at 3:03 PM on September 2, 2018 [9 favorites]

It's interesting that the Spanish flu and the pandemic flu of 2009 were both H1N1 flus, because the H1N1 flu of 2009 and one of its vaccines (Pandemrix) caused cases of narcolepsy across Europe and in China.

If the Spanish flu did the same, or perhaps even more, proportional to its virulence, and considering that many more people who had the flu probably had their ability to sleep damaged than developed frank narcolepsy, the rise of nightmarish fascist ideologies in the '30s becomes a little easier to understand.
posted by jamjam at 3:15 PM on September 2, 2018 [2 favorites]

If the Spanish flu did the same, or perhaps even more, proportional to its virulence, and considering that many more people who had the flu probably had their ability to sleep damaged than developed frank narcolepsy, the rise of nightmarish fascist ideologies in the '30s becomes a little easier to understand.

Well, there was a seperate epidemic of "sleepy sickness" around the same time: The forgotten “sleepy sickness” epidemic transformed victims into living statues, speechless and motionless, and scientists still don’t understand it
Just after the end of World War I, a bizarre disease known as the sleepy sickness, or lethargic encephalitis, devastated millions of people across the world and left doctors puzzled for decades afterward. According to some sources, around 1 million of those affected by the disturbing illness died, while many others were transformed into living statues and spent the rest of their lives trapped inside their bodies and locked in institutions, speechless and motionless.
posted by homunculus at 3:30 PM on September 2, 2018 [10 favorites]

People that think they will be immune or survive the flu because they are healthy do not understand that the Spanish Flu killed some of the most healthy people in the population due to their "strong immune systems". Cytokine storms are worse in those with strong immune systems. The effects of those storms are what killed the healthy people. People that skip all opportunities to get a flu vaccine each year "because of their strong immune systems" are fooling themselves.
posted by RuvaBlue at 3:32 PM on September 2, 2018 [21 favorites]

There's also a great Backstory episode on it, Forgotten Flu: American & the 1918 Pandemic. (US history podcast, but they also share transcriptions.)

The segment on why it became a forgotten epidemic really got me when I listened to it.
posted by jenettsilver at 3:35 PM on September 2, 2018 [3 favorites]

Well, there was a seperate epidemic of "sleepy sickness" around the same time: The forgotten “sleepy sickness” epidemic transformed victims into living statues, speechless and motionless, and scientists still don’t understand it

The patients in Oliver Sacks' "Awakenings" suffered from this, iirc
posted by thelonius at 3:48 PM on September 2, 2018 [6 favorites]

There have been a number of attempts to connect the "sleepy sickness", also know as "Encephalitis Lethargica" or EL, to the Spanish flu, but as far as I know they have all failed, and some fairly recent work makes the case it was caused by a rare form of streptococcus which precipitated an autoimmune attack on the same part of the brain which is damaged in Parkinson's disease.
posted by jamjam at 3:49 PM on September 2, 2018 [3 favorites]

Blind Willie's singing aside, god's got nothing to do with it. But science, society and government most certainly do.

While flu vaccines are nowhere near as effective as regular vaccines due to the hypermutation of the virus+animal reservoirs, in the case of a massive outbreak, it would be vital to increase the vaccinated percentage of the population in order to slow transmission and the nucleation of more mutant outbreaks.

This would be sure to ignite a delightful response from the ignorant.


It's time to repost Blasdelbs amazing comment about biology and infectious disease.

When someone started whining about vaccination......


"We're talking about piercing the skin and injecting foreign substances into a person.

The ability to refuse that (for oneself, we can talk about minors later) is just about the first and most fundamental criterion for whether one is living in a free country."

If we intend to live in community with each other, there absolutely must be basic practical limits to how much our individual rights to autonomy interfere with public health. For example, while city dwellers have an otherwise absolute right to the privacy and sanctity of their homes absent a hell of a lot of due process and good reason, they do not have a right to keep firefighters from invading their homes, ripping them apart with axes, or drowning them with water or chemicals as part of efforts to prevent fires from spreading. The bare communal necessities of firefighting and epidemic control can absolutely require ways to set aside otherwise inviolate rights to personal integrity when there ends up being no other way. Currently, the public health need for the vaccination of free loaders is no where near this dire, but infectious disease doesn't care about your civil rights any more than fire does. The importance of civil liberties in the event of the more dire kinds of possible public health emergencies is an important conversation to have.

We really have no idea how bad it would get if some one let The Demon out of the freezer, but there were cataloged strongly contagious strains of flat-type smallpox that were vicious enough for the virulence rate to approach 100%. The Soviets also spent a considerable amount of effort to weaponize smallpox in a variety of different ways. Smallpox is already naturally explosively contagious, virus particles in the mouth spit out as its host talks, and a single particle of smallpox can be enough to get you sick. It especially loves children. After exposure then nothing happens for 8 to fifteen days, you feel fine, there isn't the barest hint of illness, but you can still be infectious. The virus then crashes into your system like a ton of bricks, there is a massive fever, vomiting, and general incapacitation as little red spots begin to appear. Those spots then expand into bumps, or pustules, and keep growing with pus until the pressure becomes so great that your skin splits open, through all of the sub-layers, and the pus leaks out and forms hard scabs, filled with more pus. Its like being flayed alive by a thousand tiny knives. Your entire body becomes completely encased in the delicate scabs that result, while they continue to grow and split in the most painful way imaginable. Your eyes squeeze shut from the scabs on your eyelids and while you become barely able to breathe, you remain conscious, fully alert and lucid to everything that is happening to you. If you survive, the scabs eventually fall off on their own, but if you don't there really isn't a consensus on how death happens if you don't. The best answer is probably a little of everything, between your fluids leaking out of your skin like a burn victim, your lungs slowly ceasing to function as they get clogged with pus and sores, and just the unimaginable horror, loneliness and pain of the whole ordeal.

Unlike the time before the 18th and 19th centuries, we have no population of exposed survivors granting the herd some measure of immunity, and the vaccine was never designed to last the forty years it has been since anyone has been exposed to smallpox antigens in meaningful numbers. We are totally vulnerable in every respect except for our ability to mount a public health response, and even that is somewhat uncertain, front line responders are no longer routinely vaccinated and we haven't really had a meaningful test of what we can do in a long time. There are hopefully somewhere around 7 million doses worth of vaccine left in the four boxes in Lancaster Pennsylvania that hold the United States' supply, which could only hope to be enough to provide ring vaccination for a short period of time. For that to work, the CDC would need to be able to assemble everyone exposed to every known case of the outbreak and vaccinate them, whether they wanted to be vaccinated or not. Private property would need to be seized in order to house the sick and reduce pressure on hospitals, roadblocks assembled to prevent people in exposed areas from traveling, and those roadblocks would need to be real in a way none of us are prepared for.

The 1972 outbreak of smallpox in Yugoslavia is illustrative of just how important civil defense infrastructure and an ability to bypass civil liberties could be in containing the worst of what is out there. We also don't really have a very successful history with this kind of thing. If it ever happens to us, practitioners of woo would be all over the internet and Oprah with their own cures and theories with no one to stop them, armed libertarians would have no interest in their own good much less the public good, and Oath Keepers in the military would behave unpredictably. Would you panic? Find a gun? Comply with orders even if they didn't really make sense to you?

There are very real influenza scenarios that involve >50% global mortality, half of everyone you know and everyone you don't know dying in a single flu season. A tragedy that would dwarf all of the great wars of the twentieth century combined by an order of magnitude in a matter of months. Civil liberties would be among the least of our concerns, there are monsters lurking in our biology more terrible than the worst of tyrants.

(emphasis in above paragraph mine)
posted by lalochezia at 3:53 PM on September 2, 2018 [43 favorites]

It's time to repost Blasdelbs amazing comment about biology and infectious disease.

Oh good, I didn’t want to sleep again anyway
posted by schadenfrau at 4:14 PM on September 2, 2018 [11 favorites]

In library school I indexed a newspaper that served a rural area of few hundred square miles, encompassing many towns, from 1916-1921. The newspaper consisted of 2 pages of news, 1 page of ads and opinions, and 3-5 pages of small info bytes about the people in the areas. I'm talking about 1-5 sentences of...information, gossip, conjecture, kindnesses, airing of petty grievances, etc. Someone visited their cousin, the doctor was called to so-and-so's place late on Wednesday night, twelve young men shipped out to Army training camp, Mrs. Wresting's mother died in the Old County, so-and-so bought a new cow, Abraham J is taken sick, someone would like to announce that young ladies shouldn't ride bicycles in town, etc.

The notices around the time of the Spanish Flu were brutal. It slowly ramped up from being one or two notices about flu, to being a whole page (like, 1/3 of the whole gossip page is about people getting, recovering from, or dying from flu). The worst was that I had to read them all and index them (we indexed about 20 events, including doctor visits, illnesses, & deaths), so at the end, I could tell that there were families on families with the same progression: One week, there'd be a doctor visiting the Jones'. The next week, Sally Jones would be taken with the flu. The next week, all the Jones kids have the flu. The next week, Mom Jones has the flu. Five days later, Sally dies. Eight days later, all the Jones family is dead. I knew that a lot of people died, but this recounting of names was what made this real to me.
posted by holyrood at 4:48 PM on September 2, 2018 [24 favorites]

According to my father, the reason his father did not end up in Europe in WWI was that in basic training, the Spanish Flu ravaged his army camp. It was described as "every morning, they'd take another dead soldier out of the tent." Eventually they just broke up the camp and sent everyone home, including my grandfather, and never recalled them.
posted by tavella at 6:11 PM on September 2, 2018 [6 favorites]

Re: "strong immune systems". Since most of what we think of as colds and flus is not the virus, but the immune response to the virus, if you "never get sick" it may be that your immune system is actually weaker than the guy next door who always has a runny nose.
posted by benzenedream at 6:32 PM on September 2, 2018 [1 favorite]

I'm a little surprised this isn't an Indy Nidel channel.
posted by ChurchHatesTucker at 6:44 PM on September 2, 2018

What not many people realize is that there are a number of universal flu vaccines being developed, several of them are already at the human trial stage.

If these are successful, then you would have one shot for most flu variations. Ideally this would stop the ability of the flu to mutate and then reappear in a new form every year.

I wonder about how this would affect a 1918 type flu. As the first link mentions, there was a more mild version of the flu that spread before the more deadly one struck. As RuvaBlue mentions, the later more deadly version of the flu was so strong that the body overreacted in its desperation in trying to fight it with a cytokine storm, so it was often the immune system's response itself that killed the patient and those with some pre-established immunity were worse off.

I would hope that a universal vaccine would stop the first wave of a future deadly flu in its spread before it has a chance to mutate to its more deadly form.
posted by eye of newt at 7:24 PM on September 2, 2018 [4 favorites]

Every day I walk the dog in an enormous cemetery just north of our house, and some days our path takes us by hundreds of inexpensive cast-concrete markers, lined up edge to edge outside the failing row of mature poplars that support the cable marking the sanctified ground of a subsidiary and independent Jewish burial ground, the official name of which I am uncertain. Each of these concrete markers records a name, a year of birth, and a year of death. Many times the first name is "INFANT". Nearly always the birth years are 1917, 1918, and 1919. Nearly always the death years are 1918 and 1919.
posted by mwhybark at 8:35 PM on September 2, 2018 [4 favorites]

Oh good, I didn’t want to sleep again anyway

Since you are up, might as well get that Kolata Flu book and read it all in one sitting in the Kindle
posted by mwhybark at 8:38 PM on September 2, 2018 [2 favorites]

If these are successful, then you would have one shot for most flu variations. Ideally this would stop the ability of the flu to mutate and then reappear in a new form every year.

Nah, one of the reasons Influenza A does so well is that it has a very large nonhuman host reservoir (ducks, chickens, pigs, whales, horses, seals and cats). Influenza A will be one of the last viruses eradicated.
posted by benzenedream at 10:01 PM on September 2, 2018 [1 favorite]

The book "Pale Rider" by Laura Spinney is about it and quite interesting. She points out that unusually it killed people in the prime of life, not just the young or old. Despite the name it also definitely didn't arise in Spain:
French military doctors referred to it cryptically as maladie onze, "disease eleven"... with a little nudging from their goverments, the French British and Americans started calling it the "Spanish flu"... In Senegal it was the Brazilian flu and in Brazil the German flu, while the Danes thought it "came from the south". The Poles called it the Bolshevik disease, the Persians blamed the British, and the Japanese blamed their wrestlers: after it first broke out at a sumo tournament, they dubbed it "sumo flu".
posted by TheophileEscargot at 10:04 PM on September 2, 2018 [6 favorites]

My family is from Junction City, Kansas, which is the army town for Fort Riley. I heard many stories about the influenza outbreak. The one that sticks to my mind concerns one branch of our family (Great Uncle??) that hadn't been heard from in a week or so. Someone went out to their farm to check on them and found the mother, dead in her bed, the father, dead on the floor of the dining room, and their toddler daughter, alive in the kitchen. Her father, knowing he was dying, had filled pots with water, made crackers and other foodstuffs available to tiny hands and barricaded her in the kitchen. I have often thought of that relative of mine in that kitchen for the 3 or 4 days it took to find her.
posted by jeporter99 at 4:41 AM on September 3, 2018 [28 favorites]

Apparently it was called "the Spanish flu" because Spain was, weirdly, neutral in WWI, so people could say anything about the country without risk of either being censored or dismissed as war propaganda.

It's mind-bending to imagine the impact of this pandemic attacking Europe after four years of horrendous, shocking, HG Wells-type warfare.
posted by doctornemo at 5:38 AM on September 3, 2018

It's amazing to read all of the personal stories about this.

My paternal grandparents died within days of each other of influenza in 1918, in Chicago. They were both in their twenties, and left four young children behind, my dad being the oldest at 7 years. The kids in the family were split up and sent to live with various other families, my dad with his maternal aunt. His youngest sibling was an infant at the time and put up for adoption.

Dad didn't share many stories of his childhood, except that he had to leave school after the seventh grade and go to work to help support his aunt's family.
posted by SteveInMaine at 8:24 AM on September 3, 2018 [6 favorites]

for my great uncle James Anton, who died age 8 in April 1919 of the flu, 50 years before I was born. Reputedly the strong one of the family, somewhere we have his last workbook which ends with an inscription in a shakier-than-before childish hand:
I am Jesus' little lamb
 & He doth call me home.
posted by scruss at 7:59 PM on September 5, 2018 [8 favorites]

My mom was born in the middle of the epidemic, September 14, 1918. She not only survived, she will be 100 years old next week, although she will not know it's her birthday (dementia). Her mom, dad, and both older brothers also survived, but only one lived as long as Mom. Grandma was 106 when she died.
posted by caryatid at 12:27 PM on September 7, 2018

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