American history [...] influenza pandemic that took place in 1918 across the United States (and the world). In 1918, shortly after the end of World War I, a virulent form of influenza began to spread around the world. The press called it the "Spanish Flu," but studies now indicate it did not originate in Spain. In fact, scientists do not really know where it originated, (some believe it was in the American Midwest), but they do know that it was the largest pandemic the world has ever seen, and it killed more, traveled faster, and covered more area than any other global pandemic.

Because accurate records were not kept around the world, it is not known how many people died globally, but modern estimates have reached 30 million, which is more than were killed in all of World War I.

Influenza has existed throughout history, but the pandemic of 1918 was exceptionally virulent and deadly. Two authors and experts note, "The Spanish influenza of 1918-19 had unique features for sufferers. In serious cases victims experienced severe headaches, body pains and fever; their faces turned blue/black, the marks of cyanosis, and they coughed blood and bled from the nose."

The flu spread from North America to Europe and around the world with great speed, and then began to reappear in areas that had been flu-free. It mutated several times, with remarkable speed, too. Across the country, the flu spread like wildfire, it spread across the entire continent in only two months. The authors continue, "Major cities suffered unevenly, for example Philadelphia had higher mortality rates than New York, much to the bewilderment of public health officials and later medical researchers. Some 675,000 Americans died in the pandemic."

Records show that indigenous peoples, like the Native Americans, were hit especially hard by the flu. In addition, one of the highest death rates was men between 20 and 40, who were traditionally stronger and better able to ward off diseases like the flu, and scientists really still do not know the reason for this statistic.

In a surprising twist, researchers took the actual 1918 virus from a victim that had been frozen in permafrost, and analyzed it in 1997. In 2005, researches sequenced all the genes of the virus and reconstructed it, trying to decide what made it so devastating. Their tests indicate that the victims' own immune systems helped spread the disease, because their immune systems attacked the flu so aggressively that it weakened their lungs, which ultimately led to their death.

Doctors and nurses who worked in the camps and hospitals where the victims were housed talked about how quickly it developed and affected the entire area. One Army doctor working at Camp Devens in Massachusetts said, "Camp Devens is near Boston, and has about 50,000 men, or did have before this epidemic broke loose. It also has the Base Hospital for the Div. Of the N. East. This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed."

Once the disease turned the skin black or blue and cyanosis began, the victim would not recover. The doctor continues that the number of victims per day was staggering. He says, "We have been averaging about 100 deaths per day, and still keeping it up. There is no doubt in my mind that there is a new mixed infection here, but what I don't know."

He also notes that the base usually employed a staff of 25 doctors, and they had brought in doctors from all over the country, (including himself), bringing the number to around 250. Of course, doctors and nurses were not immune, and they died in large numbers along with their patients. The doctor notes that special trains had to come to take the bodies away and that for several days they had no coffins, and bodies piled up. This particular doctor had to take care of a ward with 168 patients, with only five nurses, four orderlies, and a ward-master, and he says the doctors routinely worked 16-hour days, seven days a week.

The virus took thousands of lives, but it had other effects on the American population, as well. For example, it adversely affected the nation's life expectancy rate. Authors Phillips and Killingray note, "The influenza epidemic of 1918 left an unmistakable signature on the levels of e (0) for men and women, with both sexes losing about 12 years of period life expectancy, a dramatic shift."

(Phillips and Killingray 2003, 202). Studies indicate that ethnic victims also died at a greater rate than white victims, something historians do not really understand. In the city of New Haven Connecticut, the Italian population of the city succumbed much more frequently that their white counterparts. Another historian notes, "The case of New Haven during the First World War demonstrates that ethnic and class identities must be considered in analyzing the influenza pandemic, for they contributed to diverse individual and community understandings of the disease and its social implications."

The Public Health Department in New Haven attempted to control the disease through vaccination and treatment, and they even had to legislate that those infected get treatment. For example, they created new laws about sanitation and ventilation in public places, like theaters and streetcars, and they created new laws about public meetings. They also made it a requirement that doctors and hospitals report anyone who had the disease, but many were just too overworked to comply. Many schools and public businesses closed, and so did many businesses, simply attempting to control the spread of the disease. In the outbreak of 1918-1919, New Haven lost almost a thousand residents to the disease, and sixty percent of the deaths were in residents aged 20 through 40.

The epidemic taxed doctors and nurses, but it taxed their hospitals, too. Historian Irwin continues, "The recent epidemic,' Grace Hospital's superintendent wrote, 'taxed us almost beyond endurance, both physically and financially, and we hope we may in some way be able to secure the money to put things on a very firm basis'."

Most hospitals treated victims for free, and the only financial support they got was from donations, and the epidemic really added to their financial burden. They were also greatly understaffed, and they often had to rely on volunteers to help nurse the patients.

Finally, the flu affected the world's population and took millions of victims, but it affected families and communities, too. The expert authors note, "The dying and the dead placed heavy burdens on families and social institutions. Bodies remained unburied for days; in many towns and cities coffins were in short supply; many victims were buried in mass graves."

The doctor writing from Camp Devens also notes that entire barracks had to be turned into makeshift morgues, and often, there were not enough morticians to handle the demand.

It is interesting to note that researchers today do not know more about the virus, and the pandemic is often overlooking in history. Another author states, "Most of the genome for the 1918 pandemic virus has now been reconstructed, and we currently have in place a worldwide influenza surveillance network. Yet, as the author points out, we still do not know what made the 1918 virus so lethal."

In conclusion, the Spanish Flu epidemic of 1918-1919 devastated the entire world. It killed millions of people, and had a lasting effect on society. In the United States, it killed almost three-quarters of a million people, but it affected many aspects of society, from the healthcare community to social services. Many people no longer remember the pandemic, but reading about it today indicates just how aggressive it was, and how quickly it spread. We should remember that…