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RUNNING HEAD: The Spanish Influenza

The Spanish Influenza

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The Spanish Influenza

Introduction

The First World War was fought between the year 1914 to 1918, and it involved a fight

between the central and the allied powers of Europe. The cause of the outbreak of the war was

political tension in the superpowers thus the war spread to other parts leading to massive loss of

lives. One of the outstanding events during the war was Spanish influenza which attacked people

towards the end of the war in 1918. The Spanish Influenza has been rated as the worst epidemic

in the world history leading to loss of between 20 and 50 million people. The disease is said to

have affected 25% of the United States Army, a population of 1,125,401 soldiers. The flu did

affect not only the soldiers but also the native citizens. Records show that 25.6 million people out

of 105 million in the United States were affected. The disease caused more harm than good

leaving behind a tragedy that will never be forgotten in the American soil.

Taking a look at the First World War, it is noted that the war started in the year 1914 in

Europe, and it involved a fight between the central powers and the Allied powers. The war

showed a massive loss of lives and destruction of property because the powers were equipped

with great arsenals. World War I can be described regarding fronts whereby war was fought on

the Western Front and the Eastern Front. Apart from the two Fronts where war was fought, the

other outstanding events during the First World War include the entry of America into the war,

the Russian revolution and the signing of treaties to end the war. The First World War had a lot

of effects that affected the economy of many nations and loss of many lives at large.

It is good to understand the countries that were involved in the war. The central powers

involved the following countries: Germany, Austria-Hungary, Bulgaria and Ottoman Empire.

The Allied powers, on the other hand, consisted of the following Nations: Great Britain, France,

The Spanish Influenza

Russia, Italy, Romania, Japan and the United States. The War on the Western Front was the first

one to break. Germany field marshal Alfred Von Schlieffen came up with the strategy. Germany

started the war, and they invaded France through Belgium. Belgium was a neutral Nation by then

but was caught in between the war and forced to accept their involvement in the war. France

fought back with great force, and they managed to defeat the Germans on the western side. The

result of the war is that both sides dug into trenches making it difficult to end the war. It took

three years for the war to end in the Western Front.

Taking a look at the cause of an outbreak of World War I, we find out that on June 28,

1914, a young Serbian prince killed Archduke Franz Ferdinand, an heir to the throne of Austria-

Hungary. Ferdinand was killed when he was on his way with his wife to inspect the imperial

armed forces in Bosnia. From history, we find out that Russia and Austria-Hungary were in one

pact and when Russia realized the assassination of the young prince, they waged war on the

Balkans. The assassination has been said to have erupted a series of events that brought to the

start of the war. Following those events, Austria-Hungary declared war on Serbia on July 28.

Germany was not left behind upon hearing the news, and therefore it declared war on Russia.

The United States joined the war later because of their neutrality policy which could not allow

them to join the war. It is during this time that the pandemic affected the people making the war

weak and leading to massive loss of lives.

The 1918 pandemic involved H1N1 influenza virus which lasted from January 1918 to

December 1920 killing millions of people. The disease spread to the remote Pacific islands and

the Arctic making the life expectancy in many countries drop. The life expectancy of the United

States dropped by 12 years during the outbreak because the disease killed the young generation.

Several factors can explain why the young generation was affected, but during this time, the

The Spanish Influenza

young soldiers moved from one place to another to fight thus spreading the disease. Research

from experts has shown that the massive death was as a result increased the spread of the disease.

Some researchers say that the disease spread was accelerated by trans-infection in animals.

Others have suggested that the strain of the virus caused a massive reaction to the immune

system of the body thus a rapid death. From the research, it was concluded that the strong

immune system of the young adults ravaged the body, while the young and the elderly survived

because of their weak immune system.

The location of the war increased the spread of the disease in many ways. To start with,

overcrowding in camps and homes accelerated the transmission of the disease. Influenza is

transmitted through inhalation. It is an airborne disease thus when an individual coughs or

droplets of the sneeze gets you; then the individual is affected. The camps that soldiers stayed

accelerated the transmission because of the population. Apart from the camps, protective gear

and mouth covering could have been a problem since the people were running away from the

war. Through overcrowding and constant movement, the disease spread faster thus killing many

people.

Spanish flu was first confirmed in Camp Funston, a military training ground for the

American soldiers. Research done by scientists’ traces the first victim of the disease, Albert

Gitchell. The overcrowded camp was a medium of the disease transmission as more than

100,000 soldiers were in transit every day. The overcrowded hospitals made the situation worse

by cross infection. The neighboring homes started being affected thus the disease spread was

enhanced. The close quarters and troops of soldiers hastened the pandemic and most probably

increased transmission of the virus. Some speculations have had it that the soldiers were

weakened by the war thus the disease killed them at a faster rate.

The Spanish Influenza

The most critical factor that hastened the spread of the disease was travel. The allied

powers and the central powers had formed modernized transportation means which moved

soldiers from one front to another. Through the movement, the spread of the disease was faster

having it in mind that many people did not know of the disease existence by then. A report done

by scientists indicate that the news of the outbreak was upheld so that to give the soldiers morale

of fighting. The disease was noted in the United States of America in January 1918. Efforts to

notify the public health sector did not yield good results because, by March 1918, the disease had

reached New York City. The disease was later noticed in France and Sierra Leone. The flu was

spread through Ireland, carried there by the soldiers who returned home from war. Spain did not

participate in the war, but the massive death of people in Spain led to the name, Spanish flu.

Spanish flu cannot be described without providing data of the pattern and the number of people

who died during the pandemic. The total population affected was approximately 50 million

people, representing 3% of the world’s population. Modern estimates say that about 100 million

people died during the outbreak. The disease is said to be compared with the Black Death, but it

was more fatal. The pandemic has been described as the greatest medical holocaust in history.

Research indicates that it killed more people in 24 weeks than HIV killed in 24 years, and even

more in a year than the Black Death killed in a century. In the United States, a total of half a

million people were affected, and 28% of the people died. In Iran, around 2 million people died

representing 21.7% of the total population. The other areas where massive deaths occurred

include Egypt, Somalia, Indonesia, India, Japan, and France.

Having talked much about the disease in the First World War, let us examine and

understand what the disease is, the pathogenesis and how it was managed in comparison to the

current management. Influenza is an infectious disease caused by influenza virus. The virus has

The Spanish Influenza

got three strains namely Type A, Type B and Type C. The virus is usually spread through the air

when individuals a cough or sneeze. The distance required for one to contact the disease is short

although the virus can stay on the air for some time. The disease can also be spread by touching

surfaces that have been contaminated and then touching the mouth, nose or the eyes. The people

who have been infected are contagious starting the day before symptoms first appear up to 10

days after the onset of the symptoms.

Upon infection by the virus, it causes lysis of the respiratory epithelial cells. The

consequence of this is edema and desquamation of the cells thus only the basal cells, and the

basal membrane of the respiratory epithelium are left. The exudative mechanism causes a

running nose from excessive mucus formation and also nasal congestion. Coughing observed is

due to irritation of the nasal mucosa. The immune response to the virus is mediated by cytokines

and interleukins. The two components are responsible for the systemic manifestation of the

disease to include fever and myalgia. Influenza is limited to the lungs except for rare

circumstances where muscles and the central nervous system are affected. Death mostly occurs

due to the desquamation of the epithelial cells and congestion leading to hypoxia of tissues in the

body.

The pathogenesis of the disease leads us to the signs and symptoms that are observed in

the affected individuals. Those that are most affected by the disease include the young children,

adults older than 65 years, pregnant women, those with the weakened immune system and finally

those having chronic illnesses like HIV/AIDS. The most common signs and symptoms for the

disease include Fever, aching muscles especially the back and legs, headache, dry cough, fatigue

and weakness, nasal congestion, chills and sweats and running nose. The complications of the

disease include pneumonia, bronchitis, Asthma, sinusitis and ear infections.

The Spanish Influenza

Influenza is not common because of immunizations that people get in hospitals.

However, there is a treatment regimen for those who by any chance are found to be having the

disease. Antiviral drugs are prescribed by the doctor to reduce the severity of the disease. An

example of the drugs used is Oseltamivir. It is an oral medication used in curing mild symptoms

of the disease. The other drug is Zanamavir which is used as an inhalant. Preventive measures

taken at home to prevent the outbreak and spread of the disease include hand washing,

containing cough and sneezes and avoidance of overcrowded areas.

The current management of Influenza is seen to be different from that of the world war

times because of the treatment regimen used. It is noted that during the outbreak, the only

management that was present was bed rest and basic nursing care. There was no use of

medications thus those who had a strong immunity survived the attack. There were no antibiotics

to cure pneumonia that followed the influenza attack. Preventive measures were also hard to

deploy because of the constant movement of the soldiers and the people at large. Lack of

medication could have been the cause of massive loss of lives.

A comparison between the outbreaks of the Spanish flu in 1918 can be made with a

possible outbreak of the disease in the year 2017. I strongly argue that if there was war today and

by bad lack, the disease breaks out, fewer lives could be lost. In 1918, there were no treatments

for the disease. Bed rest and nursing care was the remedy for the disease. In today’s world, a lot

of drugs for both symptomatic and actual management are present. With the invention of

antiviral drugs, the disease could be cured faster. The massive loss of lives in 1918 could be

attributed to lack of information by the people on prevention and management of the condition.

Technology in 2017 is vigorous, and the information could reach many people within a short

The Spanish Influenza

period. Also, the use of protective gear such as face masks will help reduce transmission of the

disease. Therefore fewer lives will be lost in 2017 speculated outbreak than in 1918.

The Spanish Flu resented the largest loss of life in the history of epidemics with a total

loss of between 50 to 100 million people in the world. The flu killed people for two years but

eventually it was overshadowed by the war. Among the affected people were soldiers who

moved from place to place thus spreading the disease to the people. However, with modern

treatment modernities, Influenza has been forgotten like it never happened.

The Spanish Influenza

References

Crosby, M. C. (2014). Asleep: The forgotten epidemic that remains one of medicine's greatest

mysteries. New York: Berkley Books.

Dicke, T. (January 01, 2015). Waiting for the flu; cognitive inertia and the Spanish influenza

pandemic 1918-19. Journal of the History of Medicine and Allied Sciences, 70, 2, 195-

217.

Marciniak, K. (2014). The flu pandemic of 1918.

Ritchey, D. (2015). The deadliest pandemic: 1918 Avian influenza virus.

Gilbert, M., & Folio Society (London, England). (2011). The First World War.

Pokorski, M. (2017). Influenza and respiratory care. Cham: Springer

Crosby, A. W. (2010). America's forgotten pandemic: The influenza of 1918. Cambridge:

Cambridge University Press.

Johnson, J. R. (January 01, 1992). Kansas in the "Grippe": The Spanish influenza epidemic of

1918. Kansas History, 15, 1.)

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