Photo from the National Museum of Health & Medicine

When the United States entered World War I on April 6, 1917, the dire situation of British and French Allies made rapid US mobilization against the Central Powers (Germany, Austria-Hungary, and the Ottoman Empire) imperative. On May 18, 1917, the Selective Service Act was passed, through which 2.8 million would be drafted. That same month, construction began on 32 military camps throughout the United States. Because the commander of the American Expeditionary Force, Major General John J. “Black Jack” Pershing, insisted that Americans train and serve together rather than being used to plug holes in the British and French armies, recruits began crowding into the “raw, half born yellow pine camps [which resembled] nothing so much as western mining towns.”

At one of these, Camp Funston near Fort Riley, Kansas, on March 11, 1918, a cook named Albert Gitchell woke up with a fever and muscle aches. He reported sick to the infirmary, where he was joined by 100 other men by noon. Within a month, 1,000 soldiers at Camp Funston were sick, and nearly 50 had died.

These men may have been the first victims of the Spanish Flu. In terms of speed and deadliness it was the greatest medical catastrophe in the history of mankind, killing 50 million people worldwide in a matter of months. In the United States, out of a population of 103,208,000, the death toll was 675,000, a death rate of .5%. The odds that an American died of the Spanish Flu were 1 in 152.9.

Soldiers and sailors were particularly affected.

• Because the majority died of secondary infections of pneumonia or streptococcus, crowded conditions in military camps and troop transports meant greater contagion.
• The disease was unusually lethal in people ages 20 - 40. The average age of the American soldier was 25, a fact that probably explains why the death rate was 25% greater in the Army than in the civilian population.
• 25% of the Army and 40% of the Navy fell ill during the pandemic.
• The illness tended to strike new recruits hardest; 60% of those who got sick had been in the military less than 4 months. This is probably because so many American soldiers were from rural areas and less likely to have immunity than city dwellers.
• Hardest hit was Camp Sherman near Chillicothe, Ohio. From September 27 - October 13, a span of 16 days, 39.6% of the soldiers had the flu and 3.3% died.
• 49,992 soldiers died of pneumonia and influenza during the war, only 3,500 fewer than died in battle. 5,027 in the Navy died of those diseases, twice the number that died in combat.

Dr. Victor Vaughan reported to Camp Devens near Boston in September 1918. The camp was overcrowded with 45,000 men, and the hospital, built to accommodate 2,000, had 8,000 men. Vaughan later said the remembrance of that experience “will perish only when I die or lose my memory.” “Their faces soon wear a bluish cast; a distressing cough brings up the blood stained sputum,” he wrote of the young soldiers suffocating for lack of air as their lungs filled with fluid. “In the morning the dead bodies are stacked about the morgue like cord wood.”

The epidemic went through three waves, the first beginning in March, 1918, the second around August, and the third during the winter of 1919. It was the second wave that was a killer, and the ferocity of the mutation has led scientists to speculate that it took time for the virus to become perfectly adapted to humans, or that another virus may have joined the mix. Recently new attention has been given to a 1948 article by G. M. Richardson, who cited British experiments with mustard gas in 1940 which found that simple organisms like mold and bacteria reproduced more rapidly in the presence of mustard gas. Autopsies of victims did reveal that their lungs were a bloody mush that resembled those of the victims of poison gas. By 1917, the third year of the war, Germans, British, and French were using tear gas, chlorine, and mustard gas, making for a deadly soup that at least weakened the lungs even if it did not create a super flu.

The virus was dubbed Spanish Flu because Spain—which had stayed out of the war—freely reported on fatalities from influenza. In September, 1918, a wag at the Tulsa Daily World suggested that the War Department “equip the Yankee army with bombs filled with Spanish influenza germs and fire them over at the Germans.” In fact, the disease felled the Germans to the point that General Erich von Ludendorff blamed it for the failure of his offensive in July 1918.

In truth, the virus played no favorites in the war. By the first week in October, 45,000 American soldiers were sick in military camps and 340,000 were hospitalized in France. Alarmed, President Woodrow Wilson consulted the Army Chief of Staff about suspending the troop transports, which had become “floating coffins.” “Every soldier who has died” from influenza, General Peyton March insisted, “has just as surely played his part as his comrade who has died in France. The shipment of troops should not be stopped for any reason.” As March turned to leave the Commander in Chief, he was astonished to hear the little nursery rhyme the children were chanting that fall, a jingle that was prescient, now that we know the 1918 flu was of avian origin:

There was a little bird,

Its name was Enza.

I opened the window

And in-flu-enza.

The President himself became acquainted with the “little bird” during the Peace Conference at Versailles in April, 1919. Alfred W. Crosby, one of the most respected historians of the pandemic, has suggested in Epidemic and Peace: 1918 that because Wilson was too ill with the Spanish Flu to prevent Britain and France from punishing Germany with harsh reparations, a shamed and bankrupt Germany produced Adolf Hitler and yet another war.