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Spanish Flu: the deadliest epidemic in human history

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From 1918 to 1920, a strain of influenza known as Spanish flu caused a global pandemic, spreading rapidly and killing indiscriminately young, old, sick and otherwise-healthy people, and at least 10% of patients died. Estimates vary on the exact number of deaths caused by the disease, but it is thought to have infected a third of the world’s population and it caused a never seen number of dead: from 50 to 100 million people died in just over a year.

The greatest historical cause that led to such a number of deaths was certainly the First World War, which saw millions of soldiers on the front, infected with each other during a war that had become a war of position.
War and a particularly lethal flu virus caused the death of an never seen number of humans. Soldiers lived in cramped, dirty and damp conditions, and during the summer of 1918, as troops began to return home on leave, they brought with them the undetected virus that had made them ill.

But how did people die of Spanish?
Initial symptoms of the illness included a sore head and tiredness, followed by a dry, hacking cough, a loss of appetite, stomach problems, and then excessive sweating. Next, the illness could affect the respiratory organs and the symptoms were macabre: the lack of oxygen tinted the faces of the patients bluish, while bleeding filled their lungs with blood and caused a continuous vomiting and nosebleeds, with most victims dying suffocated by their own fluids. The flu also favored the contraction of pneumonia, which often resulted in the death of the patient due to an already heavily debilitated organism.

And why “Spanish”?
The term “Spanish” must not be misleading: the pandemic did not originate in Spain, nor was in Spain that struck most violently. Its name is a direct consequence of the First World War. Spain was in fact one of the few countries not involved in the conflict, and did not enforce strict censorship of its press, which could therefore freely publish early accounts of the illness. The Spanish newspapers were therefore the only ones to talk about the pandemic for a long time, unlike Germany, the United Kingdom, France, the United States, Italy and Austria. As a result, people falsely believed the illness was specific to Spain, and the name “Spanish flu” stuck. Among the many people affected was also the King of Spain, Alfonso XIII, who brought the flu to a degree of high popularity.
The first official cases of the 1918 Spanish flu pandemic were recorded at Camp Funston, a U.S. Army training camp in Kansas, where the flu emergency ward held patients.

A recent theory about the origins of the virus suggested that it first emerged in China: previously undiscovered records linked the flu to the transportation of the Chinese Labour Corps, across Canada in 1917 and 1918. The laborers were mostly farm workers from remote parts of rural China. They spent six days in sealed train containers as they were transported across the country before continuing to France. There, they were required to dig trenches, unload trains, lay tracks, build roads and repair damaged tanks and in all, over 90,000 workers were mobilized to the Western Front. Of 25,000 Chinese laborers in 1918, some 3,000 ended their Canadian journey in medical quarantine. At the time, because of racial stereotypes, their illness was blamed on “Chinese laziness” and Canadian doctors did not take the workers’ symptoms seriously. By the time the laborers arrived in northern France in early 1918, many were sick, and hundreds were soon dying.

If at the absolute value level the deaths were in greater numbers than any other epidemic in history, in two other pandemics it is indicated the worst mortality rate in history.
The 1340 black plague killed more than 10% of the world’s population, while eight centuries earlier another epidemic of the bacterium Yersinia pestis, the “Justinian Plague” in 541 and 542, killed between 25 and 33 million people, equivalent to between 13 and 17% of the world’s population of that time.
In particular, the plague of the fourteenth century, in the course of epidemics on several occasions, killed between 75 and 200 million people. Despite killing fewer people in a short time (the Spanish flu killed between 50 and 100 million people in just over a year), the consequences of the disease were certainly more serious than those of the flu of the beginning of the twentieth century.

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