What was the 1918 flu?
The flu infected a third of the world population in 1918, killing between 50 and 100 million humans, including 675,000 Americans and 4,114 Floridians.
The 1918-1919 flu pandemic was a global pandemic started by a type A H1N1 flu virus that killed millions of people near the end of World War I (1914-1918). Scientists believe the pandemic began at a US Army base in Haskell County, Kansas.
There were three wave of the flu. The first wave began in March 1918. The second wave began in September 1918. The third and final wave began in January 1919. The first and third waves were mild, but the second wave was catastrophic, killing millions within weeks. The pandemic is considered the greatest medical disaster in modern history, killing more people than both World Wars combined and more Americans than every U.S. war in the twentieth century combined.
A transmission electron microscopic (TEM) image of recreated 1918 flu virions. For more, click here. Courtesy: CDC, Cynthia Goldsmith, and Dr. Terrence Tumpey.
Why was the virus so lethal?
Scientists and historians often team up to learn more about the virus. They have found several reasons why it was so lethal.
Historians believe World War I-related global instability worsened the pandemic. At a scale and reach unprecedented in history, men and military equipment were shuttled worldwide in ships to go to war. If weeks at sea did not make a soldier or sailor sick, battlefield conditions certainly did. Horrifying trench conditions amplified the virus, killing more soldiers and refugees than combat itself.
Scientists researched the virus itself and found that it killed healthy adults between ages 20 and 40, unlike typical flu viruses which kill the very young and elderly because their immune systems are weaker. Scientists believe this was because young adults suffered “cytokine storms” due to their stronger immune systems. Cytokines are immune system-signaling proteins. The virus may have caused an overstimulation of cytokines after infecting the lungs with pneumonia, causing cells to block the victim’s airway and drowning them in their own fluids.
What is historiography and what does it say about flu mortality?
Historiography refers to the debates historians have about a topic and the consensus if an argument prevails. There is a growing historiography, or body of scholarship and scholarly debate, on the 1918 flu.
In 1976, environmental historian Alfred W. Crosby wrote Epidemic and Peace, 1918, the first authoritative book on the flu, which was republished in 1989 as America’s Forgotten Pandemic. In it, Crosby argued that the flu was a democratic killer, killing Americans of all social classes equally. The Floridian historian of medicine William Straight agreed, writing that whites died more than African Americans in Florida or that their mortality was commensurate.
This project argues otherwise. The flu disproportionately killed the marginalized and oppressed compared to the wealthy and insulated. We studied flu mortality rates, or the rate of death, in Florida counties using methods and sources previous historians did not access. We found that African Americans suffered higher mortality rates in seventy-six percent of Florida counties.
By reckoning with inequality and inequity as the conductor of disease and mortality, societies and organizations can better conduct disease surveillance and pandemic response around the globe by informing their practice with the political, social, and economic context of regions and peoples. For more about project results, visit the “Discussion” subheading on the Maps page.
Street car conductor in Seattle not allowing passengers aboard without a mask, 1918. Courtesy: National Archives.
American Red Cross workers, recorded as Mrs. Ralph Van Landingham, Mrs. Cameron Morrison, and Ms. Julia Baxter Scott bring food and sanitation equipment to an African-American family in Charlotte, North Carolina. The mother had just died of the flu. October 16, 1918. Courtesy: Library of Congress.
Why did African Americans suffer high mortality rates?
African Americans suffered higher mortality rates than whites in Florida because they were denied basic social services and their communities were underfunded and underdeveloped due to the marginalization and oppression of de jure segregation and racism. In a system of slow violence maintained by white supremacy, they were forced to live in poverty and isolation, far from hospitals. Many hospitals were forbidden to black people by law. Like poor whites, they had to rely on untrustworthy homemade treatments.
Because of these circumstances, persons of color died in higher proportions than whites and the flu lingered longer in their communities compared to others. We found that while whites suffered an average statewide mortality rate of 3.7 per 1,000 persons, African Americans suffered an average mortality rate of 5.2 per 1,000 persons.