Temporary hospital in the Municipal Auditorium in Oakland California

It is the time of year when reminders about getting a flu shot begin to appear in my inbox. At first I ignore them. In fact, if the only reminders came via email, I probably wouldn’t bother, even though a long history of chronic bronchitis puts me on the hot list. But My Own True Love is insistent.(1) Eventually, I pack up a book and head out to spend some quality reading time in the waiting room of the walk-in clinic at the local Walgreens.

Today it is easy to forget just how dangerous flu can be.(2) A hundred years ago, as the flu pandemic of 1918 raged around the world, no one had any doubt.

The first wave of the flu appeared in the March, when a number of cases were identified at Camp Fuston in Fort Riley, Kansas.

A second, more contagious, outbreak appeared in the fall. Victims died soon after developing symptoms of the illness, suffocating from the fluid in their lungs. Unlike other strains of the flu, which tend to attack the elderly and the fragile, the 1918 flu struck down healthy young people, including many soldiers serving in the Great War.

Without vaccines to prevent infection (3) or drugs to effectively battle the disease and related secondary bacterial infections, the disease swept through the populations of major cities and remote rural communities alike. The disease quickly became a global problem, thanks in large part to mass troop movements on an unprecedented scale carried the virus between populations.

Hospitals in some places were so overcrowded with flu patients that local governments commandeered schools, private homes and other buildings to convert into makeshift hospitals. Hospitals were often staffed by medical students, because many doctors were serving in the army.

The only way to avoid infection was to avoid people who carried the virus. Some communities imposed quarantines and shut down public places, like schools churches, and theaters.(Some of which were needed for hospitals anyway.) People were advised to wear masks in public and avoid shaking hands. Libraries stopped lending books. In some places, public spitting was banned.(4) In New York, Boy Scouts carried cards that read “You are in violation of the Sanitary Code” and handed them to people they saw spitting in the streets. (5)

A third wave of the flu occurred in the winter and spring of 1919. The epidemic came to an end by the summer of 1919.

The flu epidemic of 1918 was the deadliest in history. The virus infected an estimated 500 million people around the world—roughly one-third of the population—and killed between 20 and 50 million people. More people than died in World War I.

Okay, I’ve convinced myself. Time to go get that flu shot.

(1) Perhaps because he has seen me suffer through multiple bouts of serious bronchitis and pneumonia. It’s not pretty.
(2) According to the Center for Disease Control and Prevention, the annual flu related deaths in the U.S. since 2010 have ranged from 12,000 to 56,000. Still not nothing.
(3) The first licensed flu vaccine appeared in the United States in the 1940s.
(4) A very small silver lining in a very large dark cloud.
(5) Perhaps an Eagle Scout project?