Spanish flu

“ An epidemic of this fever on our southern seaboard, even if it be of short duration and attended by slight mortality, causes very great alarm—because the ravages of memorable visitations are recalled by the people—and paralyses commerce and industry throughout a wide area. The actual cost of such an epidemic may be 100,000,000 dols. The epidemic of last year entailed a loss of a third or a half of that sum. No relief can be expected so long as the island shall suffer under Spanish misrule. ”

“ By Oscar Jewell Harvey.
═══════ EARLY in September, 1918, the United States was invaded by a scourge of highly infectious and fatal disease, which spread with rapidity throughout the country. It was pandemic in its nature, and partook of many of the characteristics of influenza, grip and pneumonia. No one seemed to know much about the disease or its treatment, and medical science and public health agencies were alike unprepared to cope with it. ”

“ While in the Spanish Peninsula the French army is said to have lost 300,000 men in consequence of disease, and 100,000 men in consequence of the enemy’s arms. A particularly severe epidemic raged in Saragossa when that city was besieged by the French in the months of June, July, and August 1808, and again in the months of December-February, 1808 and 1809; of 100,000 inhabitants 54,000 succumbed to typhus fever, and of 30,000 soldiers 18,000 fell victims to the same disease, so that the city was forced to capitulate. ”

“ These people succumb quickly to disease. Their mode of living invites infection and spreads contagion. They suffer epidemics periodically, and these are like the plagues of Egypt. Measles is a scourge; they have known smallpox many times; the Spanish influenza decimated them. ”

“ Dysentery and typhus were doubtless the infections which had been bred, and became communicable to the fresh drafts of men. But in the Spanish ships, beating about on the high seas and unable to land their men or even to help each other, the sickness grew into true plague, so that the broken remnants of the Armada which reached Corunna were like so many floating pest-houses. ”

“ Among the most deadly menaces that beset human life upon this planet are those forms of disease classed under the head of so-called Endemic and Epidemic disease and including in its baleful limits Yellow fever, Cholera, Pellagra—otherwise known as Hook-worm, Plague and so-called Spanish Influenza. ”

“ A man in good condition should be able to withstand the wettings and exposures that lower the system, but in a winter campaign, pneumonia causes a large amount of sickness and is one of the serious enemies of the soldier.
"Above all others one disease has proved most [212] fatal in modern warfare—enteric, or typhoid fever. Over and over again it has killed thousands before they ever reached the fighting line. The United States troops had a terrible experience in the Spanish-American War. ”

“ When taken sick they received the best possible care and after their recovery they had the advantage of being 'immunes' who had nothing further to fear from the disease which has caused the death of thousands and tens of thousands of Spanish soldiers and immigrants who have come to Cuba under the orders of their Government or to seek their fortunes. ”

“ The death-rate of the city has always been high. In five years (not consecutive) between 1800 and 1819, with a population less than one-third of the present number of inhabitants, 26,576 people perished from yellow fever alone. In 1832 the cholera killed 10,000. The official reports of the Spanish garrison show that up to January 16, 1896, more than 82 per cent. of the total losses were due to yellow fever. In 1897 the total mortality by disease in the Spanish army in Cuba was 32,534.
“At present the death-rate in Havana is enormous. ”

“ If it was a matter of such deep and universal concern that in Spain 101,000 souls gave up their lives to this fell destroyer, should it not also be a matter of some interest to our own people that, within the borders of these United States, over 91,500 persons die each year of pulmonary consumption? [1] —that twelve out of every hundred deaths are caused by a disease which, though slow in its progress, is as sure in its results as cholera itself? ”

“ The total number of patients admitted to the Armory Emergency Hospital was 192, of which number 132 were males and 3660 were females. Ninety-four of the patients were pneumonia cases, and of these sixty-six died. Three died from influenza. Thirty-five patients died within twenty-four hours after their admission to the hospital. The largest number of patients admitted in one day was eighteen—on October 17. The largest number of patients in the hospital on any one day was 62; the largest number of deaths on any one day was seven, and the largest number discharged on any one day was fourteen. ”

“ Where churches and schools have been closed during the epidemic of influenza, great care should be practised at the time of removing restrictions. Many children have been kept completely out of danger during this dangerous period, and to open too soon and run the chance of bringing them into contact with persons who have recently recovered, and who may perhaps be carriers, may again bring fresh outbreaks of the disease, particularly among school children. ”

“ If they're not careful there could be a panic, with people evacuating the cities and spreading the disease. It takes time to organize police and military units for quarantine guards."
"How bad is it likely to be?" she asked.
"That's hard to say. The 1918 flu killed twenty million people and attacked about fifty times that number. Since then, ordinary flu epidemics have been reported with up to fifty percent of the people involved. ”

“ So it is, first, that every soldier up to the present moment landed in Mexico is free of all disease and immune to such diseases as smallpox and typhoid; and, second, that a complete and better body of data has been gathered by our surgeons on diseases in Mexico than has been gathered by the Mexican Government. Our men start uninfected with a fair promise of escaping infection when they tread Mexican soil. Thanks to our discoveries in Cuba some years ago regarding yellow fever, Vera Cruz was cleaned up. ”

“ A.D. 1728, influenza was epidemic in Spain: it was named by Pedro de Rotundis, ‘un catarro sufocativo.’ Yellow fever was very fatal to the inhabitants of Charleston, United States: it was termed ‘a bilious plague,’ from its severity. A similar disease carried off great numbers of the population of Carthagena and Portobello, in South America: the most fatal symptom was black vomit. This disease made great havoc among the crews of the vessels under Don Domingo Justiniani, and of the galleons under Lopez Pintado. Epidemic pestilence was rife in Poland, Austria, and Siberia. ”

“ A comet was seen this year. Vienna about this time suffered from epidemic pestilence, as also did Holland the year following; the disease continued until 1558. This disease commenced in the form of influenza in various parts of Europe, and in France, Italy, and Germany; Spain also suffered from its violence, which was greater in some countries than in others, viz. Florence and Tuscany. In France, malignant dysentery was the most predominant malady; agues in Holland, and petechial or spotted fever in Spain; the last-named disease was as fatal as the true plague. ”

“ If, under such conditions, an epidemic of fever had not broken out, it would have been so strange as to border on the miraculous. Nature alone would probably have brought it about, but when nature and man coöperated the result was certain. On July 8 the army surgeons reported three cases of yellow fever among the sick in the abandoned Spanish houses on shore. On the 10th the number of cases had increased to thirty, and included Dr. Lesser, chief surgeon of the Red Cross, and his wife, two Red Cross nurses, and Mrs. ”

“ Scarlet fever, influenza, yellow fever, relapsing fever, and malaria (if the war is waged in countries where this disease is endemic—especially in the Lower Danube region, in the Netherlands, Spain, and Italy) have also played an important rôle in many wars. But we give the name ‘war pestilences’ only to those infectious diseases which in the course of centuries have usually followed at the heels of belligerent armies, such as typhus fever, bubonic plague, cholera, typhoid fever, dysentery, and small-pox ”

“ Man! no, of course not to murder her. I only thought in any case of letting nature have its perfect work.... But could I have a blacker fate? Just imagine! I learn from a medical friend that Madrid is full of fevers and pneumonia, caused by the bad custom of riding on the Prado in September. Well now, after many entreaties, and 'making myself into syrup' to accomplish it, I succeeded in getting my wife out to drive with me several evenings. 'Come now,' I said to myself, 'if she does not get pneumonia, she may at least catch a bit of a fever, and as she is feeble.... ”

“ The proportion of men sent to hospitals on account of influenza has risen rapidly in all the German units in the last few days, and special hospitals are being established in the rear areas dealing solely with this disease. ”

“ Those who exposed themselves too soon frequently relapsed. Few died of the disease, except some old people. “In some parts of the country, when the disease was not taken care of in the beginning, as being attended with no alarming symptoms, it assumed the form of a slow fever, which sometimes proved mortal.”
The year after the localised influenza of Scotland there was an epidemic of the same kind in Peru and Bolivia, that year, 1759, being one in which no universal fever or catarrh is reported from any other country. ”

“ With the beginning of the modern period we come to more frequent pandemics, not of plague, but of minor or milder forms of pestilential infection. On the continent of Europe these were in part related to the state of war, which may be taken as beginning with the invasion of Italy by Charles VIII. of France in 1494. Typhus-fever, or war-fever with famine-fever, now begins to be a familiar form of sickness—in 1498, 1505, 1510, 1528, and so on. Other forms are putrid sore throat, dysentery, and varieties of fever included under influenza. ”

“ LONDON, June 26.—Influenza is now epidemic all along the German front, according to advices received from the Dutch frontier, and the prevalence of this ailment is said to be hampering the preparations for offensive operations. ”

“ For example, he told his mother that there wasn’t much flu around and that the medical facilities were excellent whereas one of the few things my father told me about the flu pandemic was the large number of men with the flu at the base in Corfu with little or no medical attention. He and others with the flu were, he said, left there to die in the opinion of some. ”

“ General Dougherty responded promptly to the call for his services, and he and the County Medical Inspector soon concluded, in view of the fact that the regular and permanent hospitals located in the 5th District were just about “crowded to their limits” with influenza and pneumonic patients, and that the new cases reported each day in the various communities were becoming more numerous, that it would be necessary to establish and equip several emergency hospitals. ”

“ In one community, where it was reported that thirteen deaths had occurred, correct figures show that the deaths numbered only three. Therefore, it was decided that the General Committee should be responsible for publicity given out only by the Chairman of the Coöperation Committee, to whom are sent all official reports from communities.
“It was also decided to recommend to the officials of all cities, boroughs and first-class townships in Luzerne County the placarding of homes in which influenza exists. ”

“ One attack of influenza does not seem to be protective against another; the disease in this respect resembling diphtheria, erysipelas, and cholera rather than smallpox, measles, or whooping cough. The duration of the epidemic in a locality is so short that it is difficult to distinguish between second attacks properly so-called, and relapses, which are frequent enough. A case is recorded in the ‘British Medical Journal’ of February 15, 1890, in which a patient who had suffered from influenza in France in December, 1889, had another attack in England in January, 1890. ”

“ The year following, epidemic catarrh prevailed chiefly amongst children in the principality of the Asturias. Palermo was nearly destroyed by an earthquake; 6000 persons perished. From this period unto 1727, malignant fevers prevailed all over Europe and America. Louis, king of Spain, died this year from small-pox, as did also the Duchess of Bedford. In the latter year, inoculation was practised on criminals.
A.D. 1726, a series of anomalous diseases was prevalent in Granada, and caused great mortality. Leprosy began to spread in the city of Lebrija, in Andalusia ”

“ The Devonshire diffusion was like the spreading circles in a still pool. The spread of influenza was like the flying ripples on a broad surface of water. The spread of plague, on the occasions when it was universal, was like the massive rollers of the depths, the onward march of cholera from the East having, in our own times, illustrated afresh the same momentum. ”

“ The recent epidemic of influenza has taught us several important lessons—First, we have been painfully reminded that we are completely ignorant of the causes of the pandemic waves of this terrible disease, which, at irregular intervals of years, traverse the world. We may surmise that the crowding and the mental and physical depression of war caused increased rapidity of spread and a greater fatality in the present outbreak; but influenza has spread and been only less fatal than in the present outbreak when there was no war, and we must admit our ignorance of the cause of this. ”