For many of us, the flu is a seasonal nuisance that occurs every year as the days get shorter and the people inside huddle – annoying but not really threatening.
However, a century ago, the flu was more than just a minor inconvenience. This year, the deadly influenza pandemic of 1918, also known as the Spanish flu, marks one hundred billion people (then one third of the world's population), killing at least 50 million people.
This pandemic was so deadly that it claimed more lives than any of the fatal casualties of the First and Second World Wars, and life expectancy in the United States declined by about 12 years from 1917 to 1918.
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Where did the Spanish flu come from?
A century later we know much more about influenza pathology and prevention. But scientists are still trying to pinpoint where the 1918 influenza pandemic started and why mortality rates were so high.
Although she has been called Spanish flu, experts believe she did not start in Spain. This nickname was probably a side effect of the First World War, which also hit the globe at that time. Most of the major countries involved in the battle stifled reports of devastation in influenza, not wanting to appear as weakened targets for their enemies.
However, neutral Spain had no reason to hide the effects of the virus, giving the impression that its population suffered from the pandemic earlier and more intensively than the rest of the world.
In reality, the pandemic devastated almost all areas of the world – from Japan to Australia and South Africa – although some countries outperformed others. While China was affected, mortality was significantly lower than in the United States and the United Kingdom. An estimated 17 million people died in India, while in only 16 days 14 percent of the population died in the Fiji Islands.
Experts are not yet in agreement where the first outbreak occurred. Many studies point to an origin in the United States, but other scientists suspect China and some France. However, there is general agreement that the H1N1 virus that caused the pandemic was probably caused by a bird virus.
Spanish Flu in Utah
Like the rest of the world, Utah could not escape the 1918 flu. Worldwide, the pandemic occurred in spring, autumn and winter 1918 in three big waves. The third wave subsided in the summer of 1919. The first signs of an outbreak in Utah were reported in early October 1918.
According to historian Leonard Arrington, Utah's Minister of Health, TB Beatty acted swiftly on October 10 banning all public gatherings, including church meetings and theatrical performances, and closed the schools (which they did, most being closed until January 1919).
The virus ripped through Salt Lake City, probably due to its larger population and frequent visitors, Arrington said. In early November, more than 1,500 cases were documented and 117 people died.
Utah State Historical Society
Most other Utah communities also felt the effects of the pandemic. In Ogden, 2626 cases of influenza and 73 deaths were reported on 26 October. A headline from the October 30 October Desert Evening News states, "Every county reports influenza," although the article insisted that health officials remain optimistic as long as Utahns joins the board's health policies.
Prevention and Treatment
In addition to Beatty's ban on public gathering, the Utah State Board of Health issued an ad in the Deseret News calling for Utahns to avoid overcrowded public transport places and "shared towels". They also advised frequent hand washing, lots of rest, and staying home as soon as a disease occurred, no matter how slight it was.
Utahns was also instructed to wear gauze masks in public and among the sick. Houses with influenza victims had to show quarantine signs. Park City and Ogden tried to keep the disease out by requiring people who came to the cities to provide signed medical certificates to show that they were not infected.
In addition, the shops were not allowed to hold a sale, and funeral services were limited to half an hour (and later 15 minutes). The funeral of Joseph Fielding Smith, President of the Latter-day Saint, in November 1918 was reserved for only a few family members.
Utah State Historical Society
At that time, very little was known about the influenza virus has caused and how it spreads.
"There were no vaccines to protect against influenza virus infection, no antiviral drugs to treat flu, and no antibiotics to treat secondary bacterial infections such as pneumonia," according to Centers of Disease Control and Prevention.
Scientists and physicians also had little understanding of what made the virus of 1918 so virulent. It not only spread quickly, but also killed – most disturbingly – otherwise healthy young adults. Typically, young children and the elderly are the group most likely to die from the flu.
Utah State Historical Society
Today, scientists hypothesize that the inflammatory immune response that triggered Spanish flu in the lungs was probably more resilient to teens, leading to increased fluid retention and a higher likelihood of fatal pneumonia for this age group.
Because the virus has attacked the upper respiratory tract as well as deep in the lungs, coughing and congestion, in addition to severe side effects, were more common (and often fatal) symptoms. These included blue-stained faces due to lack of oxygen, along with hemorrhages and infections that literally drowned victims in their own fluids.
Without modern medicine, doctors prescribed fluids, hot compresses, to ease the constipation of the chest and alcohol (even in the dry state) Utah). With so many people infected, the hospitals quickly filled up and the staff went out. To keep pace with growing demand, improvised health clinics were set up in Utah's church buildings, with teachers closed as volunteer nurses.
A sobering toll
After many long months the number of people reported influenza cases gradually subsided. Although a massive truce day in Salt Lake City led to a predictable eruption on November 11, 1918, many public areas of the state began reopening in December. The epidemic declined significantly in the spring and summer of 1919, and by the spring of 1920 Spain's last flu left Utah.
The Utah State Historical Society
At least 91,799 Utahns were infected and 2,915 died after the pandemic took its course, although Arrington indicates that these numbers are likely to seriously underestimate the true breadth of the disease.
Sure, that caused the end of Spanish flu, although many speculate that the virus eventually mutated into a less deadly strain.
Can a deadly influenza pandemic recur? It is quite possible, scientists say. It could emerge a new influenza virus against which humans have no resistance. This is probably the case of 1918.
Fortunately, we are better prepared for a deadly virus than we were 100 years ago and could possibly develop a vaccine quickly enough to fend off a pandemic. But about the flu and the flu of 1918, there is still so much that we do not yet understand.
As Anne Schuchat, deputy director of the Centers for Disease Control and Prevention, told a seminar on the Spanish flu: "We have many more tools than before, but they are imperfect tools."