Now all roads lead to France and heavy is the tread
Of the living; but the dead returning lightly dance.
Edward Thomas, Roads

Monday, December 21, 2015

The Spanish Influenza in America: the Civilian Impact

Commder David Thompson, who contributed an article in 2013 on the impact of the Spanish influenza pandemic on the U.S. Military effort in the war, has sent us some interesting details on the civilian homefront suffering.

His earlier article on Roads to the Great War can be seen here.

The Spanish Flu in America: the Civilian Impact

The Killer of 1918: Virus H1N1

Estimated American deaths due to the Spanish influenza pandemic: 675,000

Compare to:
     WWI:  116,000
     WWII:  418,000
     Multiple Polio Outbreaks: 13,000
     HIV/AIDS: 658,000 (1981–2012)

Three waves of the flu hit America.  The last in the spring of 1919 left far fewer casualties.

Severe cases showed the following development: bodily aches, temperatures spiking at 104 degrees, rapidly developing pneumonia accompanied by cyanosis (a lack of oxygen in the blood turned one's skin bluish-black), and a high probability of death.

Improvised Hospital for Flu Patients, Oakland, CA, Auditorium

The average age of the flu victims was 33.

The Actuarial Society of America determined that the average loss of active life for every flu victim was 25 years.

The flu virus had an incubation period of 24 to 72 hours, meaning that a person who showed no symptoms could  pass on the virus.

The flu virus could survive airborne for up to 24 hours. The lower the humidity, the longer the virus lived.

Seattle, WA, Police in 1918

In most cities, the epidemic lasted six to eight weeks. Researchers believe the virus simply ran out of susceptible victims.

Thanks to David Thompson for sending us the December 2006 issue of American History magazine, which contained this information


  1. One in four humans worldwide were affected. Globally one hundred million people died because of direct or indirect causes. By early November 1918 clinicians were calculating the extinction of humanity within 36 months.

    And it could happen again, at any time. From the surviving viral fragments, no vaccine can be produced. And given the speed with which the virus worked, there may not be time to manufacture one if or when it comes back.

    1. 1918 was a time when no one felt safe in American society "on the home front." America was stressed almost to the breaking point toward the end of WW I.

      Especially hard hit by the 1918 influenza pandemic were cities, where death rates soared in urban areas like New York City (31,960 deaths), Philadelphia (15,556 deaths) and Chicago (13,176 deaths). There were over 25.8 million (out of 105 million population) infected by the flu (1 in 4) and 675,000 American civilians were killed by this flu pandemic.

      For U.S. civilians, the flu killed 5.8 times the total American military war deaths in WW I (116,000), killing more U.S civilians than all the American war dead from WW I, WW II, Korean and Vietnam wars combined. It killed more civilians than all the 618,000 military casualties of the Civil War.

      In the military, among 4.7 million Army & Navy servicemen, 25 % were infected in this battle with disease that killed 58,199 (51,154 due to influenza and its end stage pneumonia). It dwarfed even the largest American war casualties of the largest single battle campaign of the war, in the Meuse-Argonne campaign in the Fall of 1918, where 26,000 Americans were killed. This battle was waged concurrently with the 1918 flu, that killed 21,000 American solders "over there" in France and over 30,000 in U.S. training camps "over here."

      Dr. Carol Byerly, a medical historian for the U.S. Army Surgeon General, writes the best synopsis of the impact of the 1918 flu on our military in WW I (see: ).

      Dr. Peter Wever & Dr. Leo Bergen, military medical historians in the Netherlands also wrote recently an excellent article on "Death from the 1918 pandemic influenza during the First World War" (see: ).

      Surviving the 1918 flu was the most common experience of returning WW I veterans in 1918. Also, many WW I veterans returned home to their families to discover the devastation of the flu on the home front, with veterans visiting the graves of thousands of parents, spouses, and children felled by the flu in the Fall of 1918 while they were away serving their country "over there" and "over here."

      In a letter from "American History" magazine editors in its December 2006 issue, the editors write about the 1918 flu and the implications of this history repeating itself. They state,"government predictions in the event of a severe flu epidemic on a scale similar to 1918 estimate 90 million Americans becoming ill, nearly 10 million being hospitalized and 1.9 million dying."

      So, unlike a lot of history, this history of the 1918 flu may well repeat itself in our time, and according to the CDC we are not much better prepared to handle it than our 1918 relatives, especially due to the speed at which this flu travels, infects and kills, running its course long before vaccines can be created and manufactured to combat it. It indeed is a sobering story of one of the worst battles of WW I..."the battle with disease in 1918" and what could face us again today.

  2. My father and his twin brother were born on November 28, 1918. My grandmothers sister wanted to see the twins with her husband. My grandmother whose family had sold the farm in Belgium to come to the United States in 1910 refused to allow anyone to see her twins. Six months later my grandmothers sisters husband died. He was 27 years old and the father of three young children.