Clinical indications in common with the 1918 pandemic included rapid symptom progression to a "dusky" heliotrope cyanosis of the face. Outbreaks of influenza-like illness were documented in 1916–17 at British military hospitals in Étaples, France, and just across the English Channel at Aldershot, England. This lack of scientific answers lead the Sierra Leone Weekly News ( Freetown) to suggest a biblical framing in July 1918, using an interrogative from Exodus 16 in ancient Hebrew: "One thing is for certain-the doctors are at present flabbergasted and we suggest that rather than calling the disease influenza they should for the present until they have it in hand, say Man hu-'What is it?'" Descriptive names The etymology of alternative names historicises the scourge and its effects on people who would only learn years later that invisible viruses caused influenza. This pandemic was known by many different names-some old, some new-depending on place, time, and context. 9.1.1 Influenza pandemic among Canadian soldiersįront page of El Sol ( Madrid), May 28, 1918: "The three-day fever.The ongoing pandemic of COVID-19, which began in December 2019 and is caused by SARS-CoV-2, is the deadliest respiratory virus pandemic since the Spanish flu. The 1977 Russian flu was also caused by H1N1 virus, but it mostly affected younger populations. The 1918 Spanish flu was the first of three flu pandemics caused by H1N1 influenza A virus the most recent one was the 2009 swine flu pandemic. Malnourishment, overcrowded medical camps and hospitals, and poor hygiene, exacerbated by the war, promoted bacterial superinfection, killing most of the victims after a typically prolonged death bed. The virus was particularly deadly because it triggered a cytokine storm, ravaging the stronger immune system of young adults, although the viral infection was apparently no more aggressive than previous influenza strains. Scientists offer several explanations for the high mortality, including a six-year climate anomaly affecting migration of disease vectors with increased likelihood of spread through bodies of water. Most influenza outbreaks disproportionately kill the young and old, with a higher survival rate in-between, but this pandemic had unusually high mortality for young adults. Limited historical epidemiological data make the pandemic's geographic origin indeterminate, with competing hypotheses on the initial spread. These stories created a false impression of Spain as the epicenter, so press outside Spain adopted the name "Spanish" flu. The pandemic broke out near the end of World War I, when wartime censors suppressed bad news in the belligerent countries to maintain morale, but newspapers freely reported the outbreak in neutral Spain. The name "Spanish flu" is a misnomer, rooted in historical othering of infectious disease origin, which is now avoided.
Estimates of deaths range from 17 million to 50 million, and possibly as high as 100 million, making it one of the deadliest pandemics in human history. Two years later, nearly a third of the global population, or an estimated 500 million people, had been infected in four successive waves. The earliest documented case was March 1918 in Kansas, United States, with further cases recorded in France, Germany and the United Kingdom in April.
Spanish flu, also known as the Great Influenza epidemic or the 1918 influenza pandemic, was an exceptionally deadly global influenza pandemic caused by the H1N1 influenza A virus. Public health recommendations from the 1918 Illustrated Current News, New Haven, CT
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