The Spanish Flu Pandemic, also known as the Great Influenza Pandemic, the 1918 Flu Epidemic, and La Grippe, was an unusually severe and deadly strain of influenza, a viral infectious disease, that killed some 25 million to 50 million people worldwide in 1918 and 1919. It is thought to have been one of the most deadly pandemics so far in human history. Negatively stained flu virions. ... A virus is a small particle that infects cells in biological organisms. ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ... A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. ... 1918 was a common year starting on Tuesday of the Gregorian calendar (see link for calendar) or a common year starting on Wednesday of the Julian calendar. ... 1919 was a common year starting on Wednesday (see link for calendar). ... This article is about outbreaks of disease. ... HIStory: Past, Present and Future Book I was a double CD released by pop singer Michael Jackson. ...

The nations of the Allied side of World War I frequently called it the "Spanish Flu." This was mainly because the pandemic received greater press attention in Spain than in the rest of the world, because Spain was not involved in the war and there was no wartime censorship. In Spain it was called "The French Flu". Spain did have one of the worst early outbreaks of the disease, with some 8 million people infected in May 1918. It was also known as "only the flu" or "the grippe" by public health officials seeking to prevent panic. World War I was primarily a European conflict with many facets: immense human sacrifice, stalemate trench warfare, and the use of new, devastating weapons - tanks, aircraft, machineguns, and poison gas. ... Censorship is the use of governmental power to control speech and other forms of human expression. ... 1918 was a common year starting on Tuesday of the Gregorian calendar (see link for calendar) or a common year starting on Wednesday of the Julian calendar. ...

Geographic origin

Many infections with similar but milder symptoms were recorded in the spring of 1918, with sore throat, headaches, dizziness, and loss of appetite. It has been proposed that the earliest known cases were in Haskell County, Kansas, in January 1918. Several local men were inducted into the army at Fort Riley, Kansas, where on March 4, 1918, company cook Albert Gitchell reported to the infirmary with a temperature of 103 F (39.5 C). He was soon followed by Corporal Lee Drake and Sergeant Adolph Hurby. Within two days 522 men at the camp had reported sick. In the summer, infections became much more severe. In August 1918 the more deadly version broke out simultaneously in three disparate locations — Brest, Boston, Massachusetts, and Freetown. Many of the worst outbreaks of the "Flu" were among soldiers, both at the front lines and in camps far away which soon spread into civilian populations. Severe outbreaks often required hospitalization and even with the best of care often killed one third of those infected. The strain was unusual in commonly killing many young and healthy victims, as opposed to more common influenzas which caused the bulk of their mortality among newborns and the old and infirm. People without symptoms could be struck suddenly and be rendered too feeble to walk within hours; many would die the next day. Symptoms included a blue tint to the face and coughing up blood caused by severe obstruction of the lungs. 1918 was a common year starting on Tuesday of the Gregorian calendar (see link for calendar) or a common year starting on Wednesday of the Julian calendar. ... Anatomy In anatomy, the throat is the part of the neck anterior to the vertebral column. ... A headache (medically known as cephalalgia) is a condition of mild to severe pain in the head; sometimes upper back or neck pain may also be interpreted as a headache. ... The appetite is the desire to eat food, felt as hunger. ... Haskell County (standard abbreviation: HS) is a county located in the state of Kansas. ... Fort Riley is a United States Army installation in northeastern Kansas, near Manhattan and Junction City. ... March 4 is the 63rd day of the year in the Gregorian Calendar (64th in leap years). ... 1918 was a common year starting on Tuesday of the Gregorian calendar (see link for calendar) or a common year starting on Wednesday of the Julian calendar. ... Temperature is the physical property of a system which underlies the common notions of hot and cold; the material with the higher temperature is said to be hotter. ... Location within France Brest, at the tip of Brittany Brest (population of the city: 146,000 inhabitants as of 2004 estimates; population of the metropolitan area: 303,484 inhabitants as of 1999 census) is a city in the Bretagne région, north-west France, subprefecture of the Finistère d... City nickname: Beantown, The Hub (of the Universe), Athens of America Location Location in Massachusetts Government Counties Suffolk County Mayor Thomas Menino (Dem) Physical characteristics Area      Land      Water 89. ... For other cities of the same name, see Freetown (disambiguation). ... Virus outbreaks occur when a virus bypasses infection control measures and a relatively high number of infections are observed where no cases or sporadic cases occurred in the past. ...

Mortality in the fast-progressing cases was primarily from pneumonia, by virus-induced consolidation. Slower progressing cases featured secondary bacterial pneumonias while some suspect neural involvement led to psychiatric disorders in a minority of cases. Some deaths resulted from malnourishment and even animal attacks in overwhelmed communities. Pneumonia is an inflammation of the lung. ...

Global mortality rate from the influenza was estimated at 2.5%–5% of the population, with some 20% of the world population suffering from the disease to some extent. The disease spread across the world killing twenty-five million in the course of six months; some estimates put the total of those killed worldwide at over twice that number, possibly as high as 100 million. An estimated 17 million died in India alone, with a mortality rate of about 5% of the population. In the Indian Army, almost 22% of troops who caught the disease died of it. About 28% of the population of the U.S. suffered from the disease, and some 500,000–675,000 died from it. Some 200,000 were killed in Britain and more than 400,000 in France. The death rate was especially high in indigenous peoples where some entire villages perished in Alaska and southern Africa. Fourteen percent of the population of the Fiji Islands died in a period of only two weeks while 22% of the population of Western Samoa died. By July of 1919, 257,363 deaths in Japan were attributed to influenza, giving an estimated Japanese mortality rate of 0.425%, much lower than nearly all other Asian countries for which data are available. Mortality rate (the word mortality comes from mortal, which originates from Latin mors, death) is the annual number of deaths (from a disease or at general) per 1000 people. ... Mortality rate (the word mortality comes from mortal, which originates from Latin mors, death) is the annual number of deaths (from a disease or at general) per 1000 people. ... ... 1919 was a common year starting on Wednesday (see link for calendar). ...

Social facts

While it usually only infected less than one-third of the population in most places and killed only a fraction of those infected, there were a number of towns in several countries where the entire population was wiped out. The only sizeable inhabited place with no documented outbreak of the flu in 1918–1919 was the island of Marajo at the mouth of the Amazon River in Brazil. Marajo is an inhabited island, located at the mouth of the Amazon River in Brazil. ... Length >6,400 km Elevation of the source 5,597 m Average discharge 219,000 m³/s Area watershed 6,915,000 km² Origin  Nevado Mismi Mouth  Atlantic Ocean Basin countries Brazil (62. ...

Many cities, states, and countries enforced restrictions on public gatherings and travel to try to stay the epidemic. In many places theaters, dance halls, churches and other public gathering places were shut down for over a year. Quarantines were enforced with little success. Some communities placed armed guards at the borders and turned back or quarantined any travellers. One U.S. town even outlawed shaking hands. Quarantine, a medical term (from Italian: quaranta giorni, forty days) is the act of keeping people or animaperiod of time before, for instance, allowing them to enter another country. ...

Even in areas where morbidity was low, those incapacitated by the illness were often so numerous as to bring much of everyday life to a stop. Some communities closed all stores or required customers to not enter the store but place their orders outside the store for filling. There were many reports of places with no healthy health care workers to tend the sick and no able bodied grave diggers to inter the dead. Mass graves were dug by steam shovel and bodies buried without coffins in many places.

The social effects were intense due to the speed of the epidemic. AIDS killed 25 million in its first 25 years, but the Spanish flu may have killed as many in only 25 weeks beginning in September 1918.

The Spanish Flu vanished within eighteen months, and the actual cause was not determined at the time. It appears to have been an H1 virus type. (The outbreaks of bird flu in Hong Kong in 1997 and other parts of Asia since then are an H5 type.) The influenza virus was not understood by medical science at the time, and most contemporary effort was spent in an unsuccessful quest to find a vaccine to the supposed bacterial cause of the disease, Bacillus influenza, which was in fact only one of several causes of secondary pneumonia associated with the epidemic. Two much milder influenza pandemics followed the Spanish Flu: the Asian Flu in 1957, and the Hong Kong Flu in 1968. A virus is a small particle that infects cells in biological organisms. ... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... The Asian Flu was a pandemic outbreak of influenza that originated in China in 1957 and spread worldwide (including to the United States of America) that same year. ... 1957 was a common year starting on Tuesday of the Gregorian calendar. ... The Hong Kong Flu was a pandemic outbreak of influenza that began in Hong Kong in 1968 and spread to the United States of America that year. ... 1968 was a leap year starting on Monday (the link is to a full 1968 calendar). ...

It has been suggested that the stresses of combat, possibly combined with the effects of chemical warfare, may have weakened soldiers' immune systems thereby increasing their vulnerability to the disease and accelerating its spread. Certainly the close quarters and mass movement of troops accelerated the process. The epidemic might be seen as the last and most tragic outcome of the war, having killed at least as many as the war itself. Dressing the wounded during a gas attack by Austin O. Spare, 1918. ...

Recent research

In September 2000, Noymer and Garenne published a study that poses an ætiological theory explaining the unusual W-shaped mortality age profile of the virus. This profile is characterized by a mode in the 25–34-year age group. Usually, influenza has a U-shaped profile, being most deadly to the young and the old. Additionally, after the pandemic the difference in life expectancy between men and women decreased (women had a historically longer life expectancy). Noymer and Garenne have causally linked these two anomalies with the predominantly-male mortality of tuberculosis. September is the ninth month of the year in the Gregorian Calendar and one of four Gregorian months with 30 days. ... This article is about the year 2000. ... Etiology (alternately aetiology, aitiology) is the study of causation. ... In statistics, the mode is the value that has the largest number of observations, namely the most frequent value or values. ... Instead, life expectancy figures can be thought of as a useful statistic to summarise the current health status of a population Although it is common usage to talk about life expectancy of any living being (e. ...

In October 2002, the Armed Forces Institute of Pathology teamed up with a microbiologist from the Mount Sinai School of Medicine in New York. Together, they started to reconstruct the Spanish Flu. In an experiment, published in October 2002, they were successful in creating a virus with two 1918 genes. This virus was much more deadly to mice than other constructs containing genes from contemporary influenza virus. The experiments were conducted under high biosafety conditions at a laboratory of the US Department of Agriculture in Athens, Georgia. October is the tenth month of the year in the Gregorian Calendar and one of seven Gregorian months with the length of 31 days. ... 2002(MMII) is a common year starting on Tuesday of the Gregorian calendar. ... Mount Sinai School of Medicine, located in New York City, provides superior medical education, outstanding research and innovative patient care. ... The U.S. Department of Agriculture, also called the Agriculture Department, or USDA, is a Cabinet department of the United States Federal Government. ... Downtown Athens, as seen through the University of Georgia arch Athens or Athens-Clarke County is a city located in Clarke County, Georgia, U.S., in the northeastern part of the state, just off of Georgia 316. ...

In the February 6, 2004, edition of Science magazine it was reported that two teams of researchers, one led by Sir John Skehel, director of the National Institute for Medical Research in London and another by Professor Ian Wilson of the Scripps Research Institute in San Diego had managed to synthesize the hemagglutinin protein responsible for the 1918 outbreak of Spanish Flu by piecing together DNA procured from a lung sample taken from the body of an Inuit woman buried in the Alaskan tundra and a number of preserved samples taken from American soldiers of the First World War. The two teams had analyzed the structure of the gene and discovered how subtle alterations to the shape of a protein molecule had allowed it to move from birds to humans with such devastating effects. February 6 is the 37th day of the year in the Gregorian Calendar. ... 2004(MMIV) is a leap year starting on Thursday of the Gregorian calendar. ... The website sciencemag. ... The National Institute For Medical Research, commonly abbreviated to NIMR, is a fairly large medical institute situated in rural Mill Hill, England. ... The clock tower of the Palace of Westminster, which contains Big Ben London is the capital city of the United Kingdom and of England. ... The Scripps Research Institute, in La Jolla, California is home to notable chemists such as K. Barry Sharpless and P. G. Schultz, as well as neurobiologist Gerald Edelman, and Nobel Laureate Kurt Wurtrich. ... San Diego County in the Southwest corner of California. ... Hemagglutinin (HA) is an antigenic glycoprotein found on the surface of the Influenza virus and is responsible for binding the virus to the cell that is being infected. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... Inuit woman Inuit (Inuktitut syllabics: ᐃᓄᐃᑦ, singular Inuk or Inuq / ᐃᓄᒃ) is a general term for a group of culturally similar indigenous peoples of the Arctic who descended from the Thule. ... State nickname: The Last Frontier, The Land of the Midnight Sun Other U.S. States Capital Juneau Largest city Anchorage Governor Frank Murkowski (R) Official languages English Area 1,067,653 mi² / 1,717,854 km² (1st)  - Land 1,481,347 km²  - Water 236,507 km² (13. ... In physical geography, tundra is an area where tree growth is hindered by low temperatures and short growing seasons. ...

A highly realistic but fictionalized cautionary tale of the reconstruction of the 1918 strain of influenza by a private biotechnology company in San Diego, and its application to 21st-century germ warfare, is captured in the science thriller Ninth Day of Creation, published June 2000. A cautionary tale is a traditional story told in folklore, to warn its hearer of a danger. ... Biotechnology is technology based on biology, especially when used in agriculture, food science, and medicine. ... San Diego County in the Southwest corner of California. ... Biological warfare, also known as germ warfare, is the use of any organism (bacteria, virus or other disease-causing organism) or toxin found in nature, as a weapon of war. ... Ninth Day of Creation, a first novel by Leonard Crane which blends high-octane political misadventure with cutting-edge genomic science, was published on June 26, 2000--the same day, coincidentally, of the announcement that the human genome had officially been sequenced. ...

Sources

• Terrence M. Tumpey, Adolfo García-Sastre, Andrea Mikulasova, Jeffery K. Taubenberger, David E. Swayne, Peter Palese, and Christopher F. Basler (2002) "Existing antivirals are effective against influenza viruses with genes from the 1918 pandemic virus". Proceedings of the National Academy of Sciences 99, 13849–13854.
• Alfred W. Crosby (1990). America's Forgotten Pandemic: The Influenza of 1918. Cambridge University Press. ISBN 0521386950.
• John M. Barry, (2004). The Great Influenza: The Epic Story of the Greatest Plague in History. Viking Penguin. ISBN 0670894737.
• Leonard Crane, (2000). Ninth Day of Creation. Connection Books. ISBN 0967571294.
• Andrew Noymer and Michel Garenne (2000). "The 1918 Influenza Epidemic's Effects on Sex Differentials in Mortality in the United States". Population and Development Review, 26(3):565–581.
• Geoffrey W. Rice and Edwina Palmer (1993). "Pandemic Influenza in Japan, 1918–19: Mortality Patterns and Official Responses". Journal of Japanese Studies, 19(2):389–420.

External links

• Influenza Pandemic on stanford.edu
• Article: The Deadliest Fall
• Influenza 1918 in the United States on pbs.org
• Secrets of the Dead: Killer Flu (PBS)
• Flu by Eileen A. Lynch. The devestating effect of the Spanish flu in the city of Philadelphia, PA, USA
• Dialog: An Interview with Dr. Jeffery Taubenberger on Reconstructing the Spanish Flu