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Spanish Flu: historical event or precursor of H5N1 Bird Flu?

Updated on July 8, 2013


The 1918 Spanish Flu pandemic killed between 25 and 50 million people between 1918 and 1920. This was out of a total world population estimated at the time of approximately a billion.

It was an illness that, unusually, appeared to kill healthy young adults more often and more quickly than the usual victims of infectious disease, the young, disabled, immunosurpressed or elderly.

More than half the deaths caused by the Spanish Flu epidemic occurred in adults aged 20 to 40 years old H5N1

Two American Presidents, Franklyn Roosevelt and Woodrow Wilson, and a British Prime Minister, David Lloyd George, and the Emperor of Ethiopia, Haile Selassie, are all known to have been infected by the Spanish Flu and to have recovered from it.

There were some odd facts about the Spanish Flu epidemic. It came apparently out of nowhere, and even now no-one has any idea exactly where it arose, or how the strain mutated to infect humans.

Similarly, it vanished almost as suddenly in mid 1920. Spanish Flu has not been seen as an illness in humans since.

Books about the Spanish Flu

Pale Horse, Pale Rider (H B J MODERN CLASSIC)
Pale Horse, Pale Rider (H B J MODERN CLASSIC)

Pale Horse, Pale Rider, a mystical story of the narrow ledge between life and death, set at the time of the flu epidemic in 1918.

A tram in Seattle, 1918
A tram in Seattle, 1918

Brief history of the Spanish Flu

Spanish Flu is a bit of misnomer. It’s also known as the Great Influenza Pandemic, the 1918 Flu Epidemic, and La Grippe. There’s nothing to suggest it originated in Spain at all.

The name Spanish Flu seems to have arisen because the early stages of the illness received a lot more attention and media coverage in Spain than in the rest of the world because Spain had been neutral during the war, there were no other distracting major new stories, and no wartime censorship. The Spanish called it the French Flu.

The first outbreaks of Spanish Flu noted as being definitely this illness were in America, rather than anywhere else. In early March 1918, cases were observed in Fort Riley, a military base in Kansas, and Queens, a borough in New York.

The strain at that time seems not to have been quite as dangerous as one which later emerged. In August 1918, a more infectious and dangerous strain appears to have appeared simultaneously in France, Sierra Leone, and Boston, America.

Neither the exact world population at the time nor the exact number of people who died from the Spanish Flu is known. An estimated 2.5 to 5% of the world’s population may well have died of the illness, and over 20% of the world’s human beings caught the illness.

The Spanish Flu appears to have killed about 25 million people in the first six months after breaking into the human population, an interesting comparison with Aids, which killed 25 million people in its first 25 years after identification.

It struck some places much more viciously than others. The countries thought to have had the highest infection and death rates are in the Pacific, with Western Samoa having 90% of the population catching the virus, 25% of adults and 10% of children dying from the illness. The island territory of Nauru also suffered a death toll of 16% of the population.

Japan had a particularly low death rate, at about 0.5% of the population.

American Samoa and New Caledonia, in the Pacific, prevented any deaths whatsoever from Influenza by imposing quarantines and block aids which prevented infected people from arriving on the islands.

Far more people died from the Spanish Flu than died in all the theatres of war in the First World War put together.

For example, an estimated 650 to 700,000 American citizens died of the Spanish Flu, which is ten times as many as died in the First World War.

Half the American soldiers who died in the European war theatres died of the Flu rather than of fighting.

The flu

Influenza, or the Flu, is an infectious viral disease.

A lot of people say that they have suffered from Flu, when in fact they’ve had a bad or feverish cold.

Even a “normal” Flu infection is not much fun, and is usually the cause of a high temperature, muscle pains, aches in the bones, bad headaches, coughing, and a general feeling of illness.

Secondary bacterial infections are common after Flu, including chest infections, pneumonia, bronchitis, ear infections, tonsillitis and other associated respiratory infections.

The Flu viruses mutate regularly, and that is why developing a permanent vaccine against it is extremely difficult. Different strains of Influenza become dominant or dormant from year to year and the virus structure evolves rapidly.

Clearly types of Flu have been around for a long time, and were described by Greek physicians 2,500 years ago.

There have been other serious outbreaks of Flu worldwide since the Spanish Flu, including the Asian Flu in 1958 which killed over a million people, and the Hong Kong Flu in the late 1960s which killed up to a million.

Flu can easily be transmitted from person to person, via either contamination of surfaces such as doorknobs or similar, or by aerosol when a person coughs or sneezes.

Treating influenza

People with Flu are advised to sleep as much as they can (superfluous advice, as most of them can’t get out of bed for a while anyway) drink lots of water, and take medicines such Aspirin, Ibuprofen or Paracetamol to reduce the symptoms.

Antibiotics are useless because Flu is a viral not a bacterial infection. On the other hand, antibiotics are useful for treating secondary bacterial infections.

There are two types of antiviral drugs which can be used in severe cases. They are not a cure, but might reduce symptoms and possibly complications from Flu. They work differently and with different effectiveness against different strains of Influenza.

An emergency flu hospital in tents, America, 1919.
An emergency flu hospital in tents, America, 1919.

Spanish Flu symptoms

The illness was unusual among Flu infections in being very sudden. People could be healthy one minute, and extremely ill suddenly while they were out at work, walking home, or at a social occasion.

More than most Flu illnesses, there were haemorrhagic features to the Spanish Flu. It was common for the membranes on the inside of the nose, throat and lungs to haemorrhage blood, and there was also a frequent noting of mental disturbances in the acute phase.

One of the reasons why young adults were thought to have died in such high numbers is that the virus seemed to trigger a particularly brutal immune response which caused a shortage of oxygen.

A blue-ish tinge to the skin was seen by many observers, indicating an acute lack of oxygen.

It was also the case that a very significant percentage of patients developed severe secondary infections, including both viral and bacterial pneumonia.

Suffering from Spanish Flu

" after case of leucopenia--a kind of leukaemia in reverse, where
the white corpuscles of the blood are strangely reduced in numbers... lost
her sight within six days... gangrene of the sexual organs... afflicted by
diarrhoea so intense he endured twenty movements a day.... On one factor, at
least, all doctors were agreed: only in Cholera did the collapse come so
suddenly that most victims could fix the precise moment when they fell...a
man staggering home at a run, handkerchief clapped to a bleeding nose--but
most often this killer-virus struck like a lightning-bolt."

THE PLAGUE OF THE SPANISH LADY: The Influenza Pandemic of 1918-1919
by Richard Collier

Future pandemic illnesses - fiction

Flu ward in an Army hospital in France, 1918
Flu ward in an Army hospital in France, 1918
A make-shift flu hospital in Oakland Municipal Auditorium, America
A make-shift flu hospital in Oakland Municipal Auditorium, America

Medicine - how the Spanish flu was treated

There was little that could be done to treat Influenza in 1918 once people had caught it.

The most common remedies were Aspirin, Cinnamon in hot milk, and oxygen in the case of people suffering cyanosis (shortage of oxygen in the system).

In many countries, therefore, the emphasis was on prevention rather than a cure. Large scale public health rules were put into effect in many countries.

For example, in Britain, almost all state schools were closed down, theatres, cinemas, and concert halls were all restricted in terms of the length of performance and the need for the halls to be ventilated between performances. In addition, people were encouraged to wear masks while out and about.

Many public health bodies in America undertook such measures as limiting the length of church services and funerals, and often banning all public entertainment altogether.

The varying of opening and closing hours of shops and places of work was encouraged, and in many parts of the United States, people could only board public transport if they were wearing a mask.

A lot of doctors also encouraged people who might have come into contact with Flu germs to disinfect their upper respiratory system by gargling and sniffing unpleasant mixtures such as warm water mixed with weak carbolic acid and quinine, or boric acid and sodium bicarbonate.

It was suggested that these liquids be sniffed, gargled, rinsed and spat out.

Non-fiction about future pandemics

Flu in animals

Humans aren’t the only species to get infected with Flu.

In fact, this is one of the problems, as not only can other animals get Flu, mutations can pass between species and birds and pigs,in particular, act as an animal reservoir.

Birds, dogs, horses, pigs, camels, ferrets, seals, mink, whales, and dolphins are all thought to suffer from various type of Flu. Not all of these can be caught by humans.

Although there is a nasty feline illness called "cat Flu", this is just a name - the illness is not in fact Flu at all, and it's a disease only cats suffer from, not humans

H5N1 Bird Flu

Most strains of Bird Flu are not a risk for humans. The H5N1 strain is different in that it can jump the species barrier and infect humans.

H5N1 has spread from Asia to bird populations across the world.

Birds which have H5N1 can pass it to other birds through respiratory secretions, dung and urine, and saliva. Other birds can pick it up not only from direct contact with excretions but also from surfaces contaminated with viral material from such secretions.

One of the reasons why H5N1 has spread across the world despite strenuous efforts to prevent it is because migratory birds suffer from it as well as domestic birds.

American graph showing national death rates per 100,000 people by age group
American graph showing national death rates per 100,000 people by age group
Map showing the spread of H5N1. Lighter red shows places where birds have died from it, darker red shows human deaths.
Map showing the spread of H5N1. Lighter red shows places where birds have died from it, darker red shows human deaths.

Risks to humans from Bird Flu, H5N1

There is a real awareness at the moment that various types of Bird Flu could cause worldwide serious epidemics which could infect and kill a significant percentage of the world’s population.

One which particularly has scientists’ attention is known as Bird Flu, or H5N1.

For example, H5N1 Bird Flu spread to the human population in Hong Kong in 1997.

Of the 18 confirmed cases, a third died of the illness, despite modern medicine. In order to counter the perceived risk in Hong Kong, the authorities ordered the slaughter of every bird in the territory.

The Hong Kong infections of 1997 were, extremely fortunately, not able to transmit from one human host to another one in aerosol form.

The risk is that H5N1 might mutate and become transmissible in aerosol form from one person to another. In that case, there would be a serious worldwide pandemic.

The World Health Organisation suggests that a strain of H5N1 transmissible from person to person has the potential to cause up to 10 million people to die worldwide.

It’s still the case that it’s far better not to catch Flu than to be treated for it. The American Centre for Disease Control and Prevention advises a disposable type of mask in the case of potentially airborne infections such as Flu or Sars.

There have been a few isolated occurrences of human to human transmission of H5N1, particularly in 2006 and 2007.

In more recent cases of H5N1 in humans, there appears to be a mortality rate of about 50%, although it may very well be the case that milder infections aren’t reported to the authorities and therefore the mortality rate is lower.

There is a significant level of Cytokines, or oxygen shortage, and tissue destruction in infected people, similar to the Spanish Flu.

At the moment, there is no need to panic. H5N1 is clearly very bad for birds, and easily transmitted between different species of birds.

On occasion, the virus has mutated and infected people. However the virus has never mutated in a way which caused easy infection between humans. This is what would have to happen for a pandemic to occur.

It’s not wise to be complacent, because it is quite possible for such a mutation to occur.

The Spanish Flu epidemic of 1918 is therefore far from being purely a historical event. It is a warning of the possible consequences should H5N1, or another species of Flu in the future, mutate to cause a high-mortality pandemic.


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    • Schatzie Speaks profile image

      Schatzie Speaks 

      6 years ago

      wow, what a great idea for a hub and a very interesting read! before this i had no idea the spanish flu existed, i now feel much more informed, thank you!

    • conradofontanilla profile image


      6 years ago from Philippines

      A vaccine against the Spanish flu had been developed by Dr. Thomas Francis, Jr. and Dr. Jonas Salk in the 1940s. Doses were given to American soldiers deployed in the European theatre in WWII. This flu killed 44,000 American soldiers deployed in the same theatre in WW1 (Kluger. J. Splendid Solution, Dr. Jonas Salk and the Conquest of Polio. 2009). The vaccine consists of killed virus. Later on Dr. Salk and his team used the killed poliovirus to develop the Salk vaccine against polio.

      Recently, Dr. Arturo V. Estuita, a Filipino cardiologist and chelationist had reduced the population of hepatitis B virus from millions to a few thousands by means of infusion chelation therapy. It is known that the body cannot clear the virus after an infection with hepatitis B. It is unlike that with hepatitis A which the body can eliminate. Dr. Estuita's discovery is significant because it demonstrates that virus is vulnerable to chelation therapy. Dr. Estuita made this discovery with one patient. His protocol should be given support for a much larger trial with more patients under acceptable statistical design.

      Voted up and useful.

    • LAURENS WRIGHT profile image


      7 years ago

      It seems that the H5N1 VIRUS has been mutated in the lab to be airborne. From what I assume, this could affect 90 percent of the population and maybe kill 50 percent. This must be a really nasty virus! See the article:

    • surfgatinho profile image

      Chris Leather 

      7 years ago from Cornwall UK

      Excellent and in depth article. Voted up and linked to from my Swine Flu article ( which I just published 2 years after the fact.

    • Happyboomernurse profile image

      Gail Sobotkin 

      7 years ago from South Carolina

      Very interesting and well documented article. I have always been fascinated by the 1918 Spanish Flu epidemic as my mom told me that her father lost 2 siblings and a pregnant sibling during that epidemic.

    • profile image


      9 years ago from shortsvillie

      wow lots and lots of stuff i am so happy and i love your articlels

    • LondonGirl profile imageAUTHOR


      9 years ago from London

      Thanks for reading and commenting - glad you found it of interest!

    • BeautySpeaks profile image


      9 years ago from Prince Georges County, Maryland

      This was a great read....

    • Dolores Monet profile image

      Dolores Monet 

      9 years ago from East Coast, United States

      LondonGirl, what with the swine flu hubub, I've been reading up on the flu of 1918 and it seems that homeopathic remedies were successful in curing many more people than the standard medical treatments of the day. Interesting, huh?

    • amjadbhatti profile image


      9 years ago

      V best hub

    • packerpack profile image

      Om Prakash Singh 

      9 years ago from India, Calcutta

      Looks like you are in historical mood!! Your previous Hub on weird taxes was a good reading and I am sure you would have had to go back in time to get all those info. Now it is this. This too is great piece of information in the sense I had no idea that such thing had occurred in US. A disease killing more people then a war!!!! Good research and well written

    • kerryg profile image


      9 years ago from USA

      Very interesting and well researched! It's strange how little attention the Spanish Flu gets in history books. It's almost completely overshadowed by the war, even though it killed more people. I knew of it only from my mother's favorite book - Rascal, by Sterling North - until well into my teens.

      My family lives close to one of the many small rural cemetaries scattered around our county. It dates to the 1840's, when the area was first being settled by whites, and we go walking there sometimes. I remember it took an embarassingly long time for a family of history buffs like ours to realize why it had so many people - male and female, and most of them in their late teens and 20's - who died in 1918, far too many to be explained by farm accidents and childbirth alone.

    • LondonGirl profile imageAUTHOR


      9 years ago from London

      Hi Tatjana - some illnesses are dangerous though, herbs and modern medicine notwithstanding.

      Pam, I think you are right - awareness is useful, panic and fear isn't. Easier said than done, though!

    • profile image


      9 years ago

      Wow, you did a lot of research on this, this is excellent. It's welcome right now too, with all the press about the flu developing in Mexico. I had plain old regular flu once and was astonished at how severe it was. I had a 104 fever for four days and literally could not get out of bed to walk to the bathroom without severe muscle pain. (You are so right about the 'stay in bed' advice being unnecessary--as if you can do anything else!) On the fifth day, when the fever started to return, I did think I was going to die, I really did,  but it broke that evening. It was a good month before I felt strong again. And I was adult at the time--about 40, 41 years old.

      I do fear a flu pandemic more than anything. My worst fear is to see people I love die before me. I've already seen that, but to me, that is the scariest thing of all. But fear isn't helpful. Maybe it's time to start forcefeeding carrots and greens here and take away the potato chips. Thanks for this hub, LG.

    • Tatjana-Mihaela profile image


      9 years ago from Zadar, CROATIA

      It is said that H1N1 is affecting people in Mexico Cyty, San Antonio and San Diego. But - people died only in Mexico, plus we do not know anything about their other diseases before they were infected with H1N1.

      Whenever people get any type of flu, some of them die. Usually old people and that children who do not have strong immune system. But they do not die because of flu-virus, they die because of complications: like pneumonia etc. If the immune system is low, virus helps development of bacteries in the body. Bacteries cause various infections and infections can kill some people.

      Prevention and boosting immune system is the best possible protection for all of us.

    • Tatjana-Mihaela profile image


      9 years ago from Zadar, CROATIA

      Well, LG, I just got an e-mail from Natural News about new type of virus which is combination of bird-flu, swine flu and human flu, and is affecting people in Mexico, California, Texas (???), virus H1N1.

      Majority of people who got it in USA have recovered, some of them died in Mexico (poor country, low immune system).

      WHO said that " the new virus is already resistant to amantadine and rimantadine (two popular anti-viral drugs), but appears to be sensitive to Tamiflu ".

      TAMIFLU is the medicine which pharmaceutic companies sell like ultimate cure against bird-flu, and earn a lot of money through this negative propaganda. It is negative, because they are scaring people. Panic is the worst human enemy, because is directly affecting our immune system.

      I would not be surprised that H1N1 is created in pharmaceutic labs and spread among the people.

      In the Middle Age, when pest was popular and very deadly disease, (much worse then flu) a lot of people survived by using natural protective herbs as lavender, garlic, thyme, origanum, combination. All this herbs protect immune system and have antibacterial and antiviral properties. The very interesting point is that this "secret" combination was used at first by criminals in France and Italy, who were able to stay healthy among the highly infected and dying people - while stealing the goods from them. But one day one group of them had been caught in one town in France, so they discovered this secret recipe to the judge - in order to survive. Thanks to this recipe, a lot of people was protected afterwards...

      Maurice Messegue,  one of the greates herbalist in past century, found the data about these happenings, I do not have his books with me here, so I cannot remember name of the city where criminals were caught.

      Interesting story, isn´t it? 

      Thumbs up, again.

    • LondonGirl profile imageAUTHOR


      9 years ago from London

      RVDaniels - did you think it was scary, or did I misunderstand....?

      oddnut, glad you found it of interest

    • LondonGirl profile imageAUTHOR


      9 years ago from London

      Hi Tania - nothing new is happening, and that's the problem. Every few decades, flu mutates across to humans in a particularly vicious form, and kills an awful lot of people.

      shamelabboush - normal flu epidemics are bad enough - they make a lot of people ill, and a few, mostly the elderly and very young, die from it.

    • LondonGirl profile imageAUTHOR


      9 years ago from London

      Hi bg - glad you found it interesting.

      Christa, in some circumstances, and with some strains, H5N1 can pass straight from birds to people. It is likely, though, that any serious mutation which allowed aerosol transmission between people would involve another species as well, perhaps pigs.

    • profile image


      9 years ago

      Nice hub, very interesting!

    • RVDaniels profile image


      9 years ago from Athens, GA

      Scary,scary, and did I say scary? The gov't. isn't ready either.

      Thanks for a great hub.

      Please aid me to help homeless children. Pass it on to someone who likes comics.

    • shamelabboush profile image


      9 years ago

      Amazing hub which discussed really a serious matter. I Heard the when the flu hit USA two years ago, it was like a plague bcz it spread quickly among people and cost the US governemt tens of millions.

    • Tatjana-Mihaela profile image


      9 years ago from Zadar, CROATIA

      Great Hub and great research.

      Few years ago I did my own research about Bird Flu. Majority of cases (if not all of them) when people got bird flu were among that ones who were directly working with poultry and eating diseased meat. If someone has very low immunity and eats meat of any ill animal - everything can happen. But actually there is no reason to panick about pandemia of bird flu among the people - this panic was directly created by pharmaceutic industry to sell the drugs against bird flu. Panic and fear of people is used to help pharm.industry to earn more money (a huge amount).

      Human immune system, if it is strong enough, can defend us of any possible virus, and virusis always mutate, so nothing new is actually happening.

      Fear of illness is the worst enemy of people, because fear and fobia directly block our immune system to do it`s job.

      Common sense is something else - to avoid meat which is produced for human consumption - it is not healthy at all. (Creutzfeld-Jacob disease, bird-flu, artifical hormones etc.etc)

      THumbs up and nice regards.

    • Christa Dovel profile image

      Christa Dovel 

      9 years ago from The Rocky Mountains, North America

      Is there an in-between animal, between people and birds, by which H5N1 is spread?  Or is that know? 

      I remember watching a documentary on one bird-flu, where scientists had been able to identify the virus responsible, and show it's mutation.  It had been spread from ducks to pigs, where it mutated into something humans could catch.  Then, once in humans, in mutated again, and was readily spread from one person to another.

    • bgpappa profile image


      9 years ago from Sacramento, California

      Another great hub. Well researched and well written.


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