WWI Centennial: The 1918 Flu Emerges
Erik Sass covered the events of the war exactly 100 years after they happened. This is the 308th installment in the series. Read an overview of the war to date here.
May 22, 1918: The First Phase of the 1918 Flu Epidemic
Although doctors, epidemiologists, and medical historians still debate where the infamous 1918 flu pandemic originated, the most recent evidence seems to support the theory that it started in the United States—first emerging in rural Haskell County, Kansas before spreading to Camp Funston, now Fort Riley, a U.S. Army training camp in the northeastern part of the state that was home to more than 50,000 enlisted men.
Like other flu epidemics, the 1918 H1N1 virus, also known as swine flu, was a zoonosis—a disease that spreads from animals to humans. Researchers studying the natural history of the 1918 flu believe it may have first spread from wildfowl, domestic poultry, or livestock to farmers in Haskell County, many of whom lived in sod houses in proximity to their animals. After a local epidemic there in January and February 1918, the flu appears to have traveled with conscripted men to Camp Funston, about 300 miles to the east.
On March 4, 1918, Private Albert Gitchell, a cook at one of the Camp Funston kitchens, reported sick with a high fever, becoming the first documented case of this flu. The virus spread quickly over the next few weeks, surely facilitated by conditions including cold, drafty barracks, communal showers, latrines and canteens, and physically taxing training regimens. Additionally, in an age before widespread car and air travel, many new recruits had never traveled far from their homes in Kansas or elsewhere in the rural Midwest, meaning their immune systems were vulnerable to new diseases.
By the end of the month, the hospital at Camp Funston was overwhelmed with more than 1100 cases of the flu (below, the emergency ward at the camp). But the virus mutated over time and became stronger. Thus, this first phase of the pandemic, which spread around the world in spring and summer of 1918, was much milder than the second phase, which began in the fall of that year and killed far more people.
Wartime conditions provided ideal vectors for contagion, as hundreds of thousands of soldiers moved between army bases and then to port cities on America’s eastern and gulf coasts, where they awaited transport to Europe. In mid-March outbreaks were under way in Camp Forrest and Camp Greenleaf, both in Georgia; a month later the epidemic had spread to two dozen army bases and training camps, and also surfaced in the civilian populations of 30 of the country’s biggest cities.
The virus made its first appearance on European soil in April 1918 at Brest and Bordeaux, two of the main ports of disembarkation for American troops arriving in France. Once again conditions on the continent helped speed the spread of the virus, including shortages of food and fuel, which left millions of soldiers and civilians cold and malnourished. Men in the trenches were jammed together in squalid conditions, and soldiers on leave as well as those working in supply and transport units could spread the disease to civilians or carry it with them back to the trenches. Meanwhile, many doctors had been conscripted into military service, leaving civilians with few options for medical care.
Also commonly known as the three-day fever or the grippe, the virus got the misleading nickname Spanish flu because it was first reported in the Spanish press on May 22, 1918 (as a neutral country, Spain hadn’t imposed wartime censorship like the combatant nations). Madrid’s ABC newspaper announced the arrival of the epidemic in Spain, probably carried by migrant laborers returning from France, with a headline noting the virulence but otherwise not expressing much alarm. Shortly afterwards King Alfonso XIII briefly fell ill, and the Spanish newswire service Agencia Fabra reported to its partner Reuters, “A strange form of disease of epidemic character has appeared in Madrid. The epidemic is of a mild nature; no deaths having been reported.”
The mild form of the flu would continue spreading around the world through the later summer of 1918, when the far deadlier second phase took over beginning in September. It swept over both sides of the war with hardly a delay, skipping over No Man’s Land with captured prisoners as well as through people traveling to neutral countries. Dominik Richert, a German soldier from Alsace, recalled that in July 1918 the relatively mild version of the flu was largely dismissed by German military authorities, who had much bigger problems on their hands:
"Some soldiers had started to feel unwell for several days without anyone knowing what was wrong with them. Then we read in the newspapers about a new illness called the Spanish flu, because it had started in Spain. Now we knew. More and more soldiers were infected and shuffled around looking half-dead. Although they reported sick, hardly any of them went to hospital, as it had been declared that no more people should be classified as having minor illnesses or being lightly wounded—there were only the seriously wounded and the dead."
Later Richert fell ill himself, and experienced firsthand the brusque and unsympathetic medical treatment that tended to prevail on both sides during the war:
"I went to report sick immediately as the flu had now got worse and I had become quite hoarse. There were about a hundred men standing outside the house where the doctor examined people. NCOs were examined first. You could hardly call it an examination. You were asked what was wrong. When I had answered, the medical NCO gave me a peppermint tablet about the size of a penny and the doctor said: ‘Make some tea for yourself. Next please!’"