The Plague of the Spanish Lady



The Spanish flu pandemic of 1918-19 has largely faded from the public memory.  It got its name from the Russians, who called it the Spanish Lady.  In Spain, folks preferred to call it the French flu.  Many thought it was a German bioweapon, despite the fact that the flu pounded the poor Germans so hard that they finally hurled Kaiser Wilhelm overboard, and eagerly signed an unconditional surrender, which brought an end to the insanity of World War One (1914-1918).

Richard Collier wrote a book about the pandemic, The Plague of the Spanish Lady.  He was a journalist, and he described how the events unfolded in many localities.  The virus appeared on the radar in March 1918, and was fading out by May of 1919.  Collier focused his attention on the 17 week period when the flu had reached its maximum scale and mortality, beginning in early September 1918.  The pandemic killed at least 20 million in just five months (others say 50 to 100 million).  World War One, on the other hand, took five long and bloody years to rub out a mere 10 million lives.

For folks disgusted with the creepiness of life in the twenty-first century, Collier’s book provides a refreshing diversion.  You will be so happy that you are not living in 1918!  The only lucky group during that pandemic were the untouchables of India.  The flu hit India the hardest, killing more than 12 million.  Rivers were clogged with corpses.  There were times when 700 people died every hour in Mumbai (Bombay).  Since there was a social obligation to stay away from untouchables, far fewer of them got sick.

It was common for the flu to hit like a hammer.  Folks might have some aches and pains for a few days, and then maybe a sore throat, and then maybe some large blisters on their face, back, or chest.  High fevers were common.  Folks coughed up blood, and many bled from their ears, nose, and/or eyes.  Lungs filled with blood, and people turned blue from lack of oxygen — it was hard to tell white folks from blacks.  Some called it the Purple Death.  People wondered if the end of the world had arrived.

In late September 1918, a tram was carrying passengers through Capetown, South Africa.  One passenger dropped dead, and was laid on the sidewalk for city workers.  As the tram continued, four more riders died and were put off.  Then the driver of the tram dropped dead.

In early October, an official of the Canadian Pacific Railroad, who was normally a good boy, violated the quarantine, filled a train with soldiers, intending to take them from Quebec City to Vancouver.  At numerous stops, he left behind carloads of sick soldiers, unleashing the epidemic in each city.  Arriving in Vancouver with the remaining survivors, he immediately jumped on an eastbound train, with plans to take another load of soldiers west.  He learned about the deadly consequences of his foolish mission, and he had no remorse.

The Spanish flu had unusual effects.  Flu bugs generally prey on kiddies or the elderly, but this one hit folks who had the strongest immune systems.  Half of its victims were aged 20 to 40.  My grandmother’s sister, Emma Amundson, died of the flu at 33, on November 19, 1918.  She was a nurse who lived in a tiny village in middle of nowhere North Dakota.  The railroad that ran through the village probably delivered a sample of the hellish disease from the outer world.

In 1918, there was no commercial air travel.  To take a trip around the world took a year, via steam ship.  The H1N1 flu virus zoomed around Earth in just two months.  It moved by train, boat, bus, and camel caravan.  In 2005, the virus was identified as being avian, birds carried it.  Six miles off the coast of Tasmania, there was an island.  In October, the husband and wife who ran the lighthouse had seen no visitors in three months.  Birds brought the couple a yucky surprise.  The flu also found isolated native settlements in Alaska, where starving sled dogs broke into cabins and ate the dead and dying.

In 2018, the hundredth anniversary of the Spanish flu, the BBC produced a fascinating report: The places that escaped the Spanish Flu.  One advantage was living in a location that was isolated from the rest of the world.  Another was super strict, zero-exception quarantines.  Some communities were kept healthy by armed vigilantes who allowed no one to enter or leave.  Of course, in 1918, folks in nonurban regions primarily dined on food conveniently produced close to home. 

Today, the food story is very different.  Dinner ingredients are often shipped in from around the world via complex energy-guzzling distribution systems.  Another frightening difference is personal mobility.  Many do not hesitate to board a plane and fly to faraway places, unintentionally transporting pests and pathogens.  In 2018, airline passengers took a billion flights, domestic and international, to and from the U.S.  Even more people routinely jump into their motorized wheelchairs and drive other cities or regions.  Imagine how our super-mobility could turbocharge a highly virulent virus today.  Yikes!

In 1918, Australia got a gold star for displaying above average intelligence, which led to below average infection rates.  Eighty ships having infected people aboard were not allowed to dock.  Smart!  On land, 10,000 infected people were kept isolated from society.  Brilliant!

Unlike many traditional epidemics that were empowered by lousy sanitation and hygiene, the rich, famous, and powerful got no mercy from the Spanish Flu.  Mortality in plush neighborhoods was the same as in the slums.  The Purple Death was an equal opportunity killer.  In efforts to stop the spread, many cities closed schools, theaters, churches, saloons, race tracks, libraries, and all public meetings.  Phone booths were boarded up.  Caskets, in short supply, were rented.  Folks were urged to walk, and stay off the street cars.  In San Francisco, some courts were held outdoors in parks. 

Communities that downplayed the risk of disease, and attempted to continue business as usual, often paid dearly for their mistake.  In Kansas City, the Health Board tried to close saloons and theaters, but the mayor kept them open.  More than 1,800 died.  In Jamaica, the decision to not quarantine the sick led to 7,000 deaths. 

On September 21, the SS Niagara departed from Vancouver, Canada, heading for Auckland, New Zealand.  On October 9, when it landed in Fiji, 83 of those aboard had succumbed.  Passengers were allowed to go ashore.  Consequently, more than 8,000 died on Fiji’s 100 islands.  Then, on October 11, the captain of the Niagara sent a message to New Zealand, notifying them that sickness was spreading on his ship.  On October 12, the Niagara docked in Auckland — it was a floating hotbed of infection.  The ship should have been quarantined, but wasn’t.  Consequently, 6,680 New Zealanders died.  On October 30, Auckland authorities allowed the SS Talune, with infected passengers, to depart for Samoa.  “It was as if a death ray had struck the island” — 7,000 perished.

Another quirk of the flu was “apparent death,” in which the victim was cold, not breathing, and had no pulse.  It was a deep coma.  Quite a few were shaken out of comas inside their coffins.  Hundreds each week may have been buried alive.  In Cape Town, a notorious drunkard and wife beater, who had no friends whatsoever, screamed from his coffin on the way to the graveyard.  The drivers of the wagon ignored him.  “I reckon ain’t no one going to miss him.”

The grand finale of the Spanish flu was the glorious conclusion of “the war to end all wars” which occurred on November 11.  The world erupted with immense celebration.  Church bells pealed.  Big Ben rang in London, ending four years of silence.  All rules against public gatherings were disregarded, as the happy crowds hugged, kissed, and danced.  Victory “ushered in the greatest medical holocaust in history.”  In Cockermouth, England, which had entirely escaped the flu, one church service infected the whole town.  The state of Louisiana reported 350,000 cases in the week after the celebration.  Within a week, 19,000 died in Britain, and 17,000 doughboys died in France.

Collier’s book was published in 1974.  In 2006, Dr. Michael Greger published Bird Flu, which focused more on medical analysis, rather than lively journalism.  He estimated that the 1918 pandemic caused 100 million deaths.  Almost all of humankind was exposed to the virus, and half of them experienced some level of infection, from mild to fatal.  In the end, the flu ran out of victims.  Essentially, you were either immune or dead.

Greger also presented uncomfortable information on how we’re getting even better at unintentionally encouraging flu viruses to mutate in new forms.  The H5N1 virus that hit Hong Kong in 1997 was far more deadly than the H1N1 variant of 1918.  Viruses keep themselves amused by constantly rearranging their proteins, so scientists who develop vaccines will never be out of work.  The H1N1 virus is still around, in multiple new variants.

In 2020, the COVID-19 pandemic rumbled onto the stage.  It’s caused by the SARS-CoV-2 coronavirus, not the influenza A H1N1 virus, but both types of virus are highly prone to “rapid viral evolution.”  Mutations limit the long term effectiveness of vaccines.  Many suspect that COVID-19 originated in the Huanan Seafood Wholesale Market in Wuhan China, where many species of live animals are concentrated in impressively unsanitary conditions, creating a delightful playground for viruses of every size, shape, and color.

Collier, Richard, The Plague of the Spanish Lady, Atheneum, New York, 1974.

Bird Flu

Dr. Michael Greger’s book, Bird Flu, is both fascinating and spooky.  Many people are aware of the Black Death, which hit in 1347.  Far fewer know anything about the Spanish Flu of 1918, which killed more people in one year than the bubonic plague killed in 100 years.  For some reason, our culture has suppressed the memory of this recent horror.

Back in 1918, millions of humans, mostly between the ages of 20 and 40, experienced muscle aches and pains for a few days.  Then their lungs filled with blood, they turned purple, bled from the ears, nose, and/or eyes, and died a few hours later.  It was hard to tell whites from Negroes.  Some called it the Purple Death. 

Within a year, up to 100 million died.  The virus ran out of targets.  You were either resistant or dead.  This was the H1N1 virus, and it infected half of humankind.  It was highly contagious, but only five percent of those infected died.  The only place that the pandemic missed was the island of American Samoa, a US Navy base, which cut all contact with the outside world for 18 months, into 1920. 

For millions of years, the influenza virus existed only in wild ducks, and it didn’t make them sick.  When humans domesticated ducks, the birds were raised in farmyards in close company with other domesticated animals.  These unnatural living conditions made it easier for pathogens to spread from species to species, and they did just that.  It was almost inevitable that humans would become vulnerable to them.

A number of epidemic diseases emerged in species that tend to herd or flock together, and some of these were domesticated by humans.  Goats and cattle gave us tuberculosis, which kills millions of people each year.  Measles and smallpox came from cows.  Typhoid is from chickens.  Whooping cough is from pigs.  There are too many to list here.  “Entire ancient civilizations fell prey to diseases birthed in the barnyard.”

Imagine what life would be like if we had never enslaved our animal relatives.  When Columbus arrived in the New World, the Native Americans had few domesticated herd animals.  They had no resistance to Old World diseases, and up to 95 percent of them died.  “Why didn’t Native American diseases wipe out the landing Europeans?  Because there essentially weren’t any epidemic diseases.”  We often blame disease on the filth and crowding of city living, but Mexico City was one of the biggest cities in the world in 1492.  Epidemic diseases were largely an unintended consequence of enslaving animals.

In 1997, the new H5N1 virus appeared in Hong Kong, and it was far more deadly than the H1N1 of 1918.  It killed an astonishing 50 percent of those it infected, but it was not highly contagious — yet.  Health experts had a panic attack, because flu viruses constantly mutate.  When/if the super-catastrophic mutant eventually appears, it will take six to eight months to create a vaccine.  By the time the vaccine is mass-produced, the pandemic will be over. 

The avian flu outbreak in Hong Kong was quashed by exterminating every chicken in the region.  But four years later, it moved from ducks to chickens once again.  It also spread into migratory waterfowl.  It kills humans and chickens, but it is harmless to the wild birds that move from continent to continent.  The cat is out of the bag.  Ducks crap in a pond, chickens drink the water and die, the dead chickens are fed to pigs, and the swine get the flu.  Pet cats, and tigers and leopards in zoos die when fed infected chicken.

We were able to wipe out smallpox because it existed only in humans.  The flu virus now exists in a number of species, and the guts of highly mobile waterfowl provide a widely dispersed reservoir of H5N1.  It is now “virtually impossible to eradicate.”  All it takes to wipe out thousands of confined chickens is a virus brought in by a mouse that has stepped in duck poop.

In 1928, the average American only consumed a half pound of chicken per year, because it was expensive.  Today, it’s cheap, and we eat 90 pounds a year.  Nine billion chickens are slaughtered in the US each year (45 billion in the world).  If we deliberately set out to greatly encourage the possibility of a catastrophic influenza pandemic, we would raise of billions of chickens in high-density confinement, like we are now.

We would also slaughter and process the chickens the way we are now.  Super-efficient mechanized systems frequently puncture intestines, causing fecal contamination of the meat.  Then, the contamination is spread to uncontaminated carcasses in the soaking bath, where they absorb water (“fecal soup”) for an hour to make the meat heavier ($).  “At the end of the line, the birds are no cleaner than if they had been dipped in a toilet.”  Greger says, “As long as there is poultry, there will be pandemics.  It may be us or them.”  Our massive appetite for cheap chicken could trigger a pandemic that sweeps away a billion people. 

Some believe that raising chickens outdoors is safe, but there were no factory farms in 1918.  Any day the H5N1 virus could mutate into a highly-lethal form that excels at human-to-human transmission.  It could occur in someone’s backyard, but it is far more likely to happen in a poultry confinement facility.

Poultry corporations are concerned about disease because it’s a threat to profits.  Exterminating infected flocks is bad for business.  China and Thailand have a reputation for keeping disease outbreaks secret.  When H5N1 hit Turkey, and the government ordered the destruction all turkeys, the farmers opposed the authorities with pitchforks and axes.  The editor of a poultry industry journal clearly stated his priorities: “I'm not as worried about the U.S. human population dying from bird flu as I am that there will be no chicken to eat.”  Who could disagree?

Greger provides 19 pages of tips for surviving a flu pandemic.  Wear goggles, gloves, and a facemask (masks offer minimal protection).  Stay away from crowds.  Don’t breathe near coughers and sneezers.  Avoid contact with commonly touched surfaces like doorknobs, handrails, and so on.  Don’t shake hands.  Stay home.  If you don’t have antiviral drugs, the primary treatments are fluids, rest, prayer, and good luck.  Maintain a several week supply of water, non-perishable food, cash, and ammunition.  Do not trust officials and experts who proclaim that everything is OK.  Be prepared for civil unrest. 

Greger is not a wacko.  He is the Director of Public Health and Animal Agriculture at the Humane Society of the US, and an MD.  Virology magazine reviewed his book favorably.  His views are shared with world leaders in public health.  By 2005, the experts were very worried that a colossal flu pandemic was just weeks or months away.  The sky was falling, and humankind was essentially a helpless deer in the headlights.  Greger’s 2006 book was written with a mixture of urgency and paranoia.  For a long discussion on public health, it’s exciting and unforgettable.

As I write, it’s six years later, and the anticipated disaster has yet to arrive.  The H5N1 threat is not gone.  A catastrophic mutation may have happened five minutes ago.  Or it might happen in 30 years.  Or brilliant gene-splicers might succeed in creating 500-pound transgenic chickens that nothing can kill.

I just checked the website of the World Health Organization (WHO).  The first H1N1 pandemic in this century ran from April 2009 to January 2010, and spread to 19 nations.  About 70,000 were hospitalized, and 2,500 died.  On 7 June 2012, WHO issued a global alert on an H5N1 outbreak in Egypt, with 168 cases and 60 deaths.  On 6 July 2012 a global alert was issued on an H5N1 outbreak in Indonesia, with 190 cases and 158 deaths.

Greger, Michael, MD, Bird Flu — A Virus of Our Own Hatching, Lantern Books, New York, 2006.