In late May 1918, Madrid's newspapers reported that a strange fever had swept the city — even King Alfonso XIII was bedridden. Spain, neutral in the Great War, had no wartime censor suppressing bad news, so its press covered the outbreak freely while the papers of Britain, France, Germany and the United States, forbidden from printing anything that might dent morale, stayed largely silent about the illness moving through their own armies. Readers abroad therefore first encountered the disease as a Spanish story, and the name stuck: Spanish flu. The Spanish, who knew perfectly well they hadn't started it, called it the "French flu" or the "Naples Soldier", after a catchy tune from a popular operetta. The naming is the pandemic's first lesson: the label records censorship, not geography.
Where it actually began remains unsettled. The most commonly cited first recorded case is at Camp Funston, a US Army camp at Fort Riley, Kansas, where cook Albert Gitchell reported sick on 4 March 1918; within weeks thousands of soldiers there were ill. Rival hypotheses point to the vast British base at Étaples in France or to earlier outbreaks in China. Whatever its origin, the H1N1 virus — descended from an avian influenza — rode the greatest troop movements in history, packed into ships, barracks and troop trains.
The scale still defies intuition. Something like 500 million people — roughly a third of humanity — were infected, and estimates of the dead start at around 50 million and range far higher, comfortably exceeding the battlefield deaths of the war itself. British India suffered perhaps the worst absolute toll, with deaths estimated in the low tens of millions. Most victims were killed not by the virus alone but by secondary bacterial pneumonia, in a world without antibiotics.
The W-shaped curve
Ordinary influenza kills at the extremes of life — infants and the elderly — producing a U-shaped mortality curve by age. The 1918 virus added a terrifying middle spike: healthy adults between about 20 and 40 died in extraordinary numbers, bending the U into a W. One leading explanation is the "cytokine storm" — a young, vigorous immune system overreacting catastrophically to the infection; another suggests older adults carried partial protection from exposure to an earlier pandemic in the 1890s. Whatever the mechanism, the disease inverted the natural order, emptying households of parents and soldiers in their prime.
It came in waves. The first, in spring 1918, was relatively mild. The second, from late August, was the killer — at Camp Devens near Boston, at Brest in France and at Freetown in Sierra Leone almost simultaneously — and produced scenes that became public-health parables. Philadelphia went ahead with a huge Liberty Loan parade on 28 September 1918, packing some 200,000 people onto the streets; within weeks the city's hospitals and morgues were overwhelmed and thousands were dead. St Louis, which cancelled gatherings and closed schools early, suffered a death rate far lower — the textbook demonstration of what a later century would call flattening the curve. A third wave rolled into 1919; Woodrow Wilson was struck down by influenza in Paris in April 1919, mid-negotiation, and some historians argue the illness weakened his hand at the peace conference.
The forgotten pandemic
Then it slipped from memory. The historian Alfred Crosby titled his study "America's Forgotten Pandemic", and the phrase fits most countries: no great memorials, little literature, a catastrophe folded silently into the war's shadow. Its famous victims hint at the scale — the Austrian painter Egon Schiele died three days after his pregnant wife Edith, and the French poet Guillaume Apollinaire died two days before the Armistice — yet the millions of ordinary dead left remarkably little public trace. It took the dead themselves to give up the ending. In 1951, and again decisively in 1997, the pathologist Johan Hultin travelled to Brevig Mission, Alaska — where the flu had killed most of the village in a week — and recovered lung tissue from a victim preserved in permafrost. From such samples, a team led by Jeffery Taubenberger reconstructed the complete genome of the 1918 virus, published in 2005: it was an H1N1 strain of avian origin, the ancestor of pandemic strains that returned in 1957, 1968 and 2009. The pandemic misnamed for Spain turned out never to have really left — its descendants still circulate every winter, carrying a century-old inheritance in their genes.
Quiz nuggets
- The pandemic is called "Spanish" only because neutral Spain's uncensored press reported it first; Spaniards called it the "French flu".
- The first commonly cited recorded case was cook Albert Gitchell at Camp Funston, Kansas, on 4 March 1918.
- Roughly a third of the world's population was infected, and at least 50 million people died — more than in the First World War's fighting.
- Mortality formed a W-shaped curve, with an unusual death spike among adults aged roughly 20 to 40.
- The virus's full genome was published in 2005, reconstructed partly from a victim buried in Alaskan permafrost at Brevig Mission.