What does a touch of the flu mean to you?

This epidemic is the greatest calamity of any kind except war that ever visited the American continent … It is a contagion spreading with inconceivable rapidity, and which has reached the most remote groups of people who seemingly had no communication with the outside world … It is the most difficult problem that medical science has ever confronted …

Those words weren’t written by a modern-day scientist confronted with some futuristic super bug; it was written over a hundred years ago and published in the North Missourian. The writer was talking about the Spanish Flu.

The Spanish Flu is still considered the most lethal event in human history.

The Spanish Flu marched across the world just as World War One was coming to an end in Europe. World War One lasted four years, 1914-1918, and claimed 16 million lives.

The Spanish Flu began in January of 1918 and lasted until December of 1920 and claimed 50 million lives.

The Spanish Flu caused more deaths than World War One and World War Two combined.

In America, some 675,000 people died of the Spanish Flu, and at least two-thirds of them would die during one short period — the fall of 1918.

In modern times, the flu is lethal to the most susceptible, the very young or the very old.

But half the people killed by the 1918 pandemic were young healthy adults, mostly 20-40 year-olds, including millions of soldiers who otherwise would have survived the war. Despite scientists’ efforts to reconstruct the 1918 pandemic, the reasons for this unexpected pattern aren’t exactly known. One recent theory is that the victims were killed when their bodies unleashed a type of “perfect storm.” It’s an overreaction by the immune system in which healthy tissue is killed along with the diseased.

Victims of the Spanish Flu suffered complications in the respiratory tract and drowned in their own blood.

The following is a story in the Gallatin North Missourian from Oct. 17, 1918. This type of tragic story would be repeated many times over.

Howard Tarwater, the 19-year-old son of Mr. and Mrs. Thomas Tarwater, is in a critical condition at his home south of Gallatin. He is suffering with pneumonia which resulted from Spanish influenza. He has been sick since Sunday and today his condition is very serious. At five o’clock this afternoon he was still alive, but there was little encouragement of his surviving through the night.

In 1918 people didn’t have social media. People found out who visited who by reading the “correspondent” news in the newspaper. Correspondents were located in Gallatin, Pattonsburg, Altamont, Blake, and Carlow.

The correspondents generally wrote about the pleasantries in life — who had a baby, who got married — but in 1918, their news took a dark and ominous tone. Again and again they wrote about how their friends and neighbors were dying and the “cause of death was pneumonia following influenza.”

These notes are from a single correspondent in one week’s issue in January, 1919, to give just a sample:

Miss Mary Frances Osborn has been sick during the past week.

The GHS basketball boys will play Breckenridge Friday night in the Hamilton hall here. The players on the Gallatin team will consist of Pettijohn, Graham, Place, VanDyke and White who will substitute for Ralph Day, who is sick.

Miss Dora Powell has been unable to be at her post in the Etter Store this week on account of sickness in the family of her brother, Wallace Powell. Mr. and Mrs. Powell and the baby have been suffering with the flu, and Miss Dora is assisting in caring for them.

What was worse and almost inconceivable, is that whole families succumbed to the Spanish Influenza. This story was from the October 24, 1918, issue of the North Missourian.

Only One Member of Family Survives Attack of ‘Flu ’… The entire family of Bert Goble, who lived about 12 miles north of Pattonsburg, except the baby, died of pneumonia, after an attack of influenza. The family was stricken the first of last week and little Clifford, the four-year-old son, passed away on Thursday afternoon and was followed at midnight Saturday by his brother, Herbert, nine years of age. The mother died Sunday night and the father Monday. One member of the family, a 14-month-old baby girl, survives them. The nurse in attendance was Opal Hilburn of Pattonsburg. She was also quite sick the first of the week, but is improving at this time.

Where did the Spanish Flu start … was it Kansas?

Today, historians continue to argue about where the Spanish Flu first surfaced.

The first recorded notice anywhere in the world of unusual influenza activity in 1918 came out of Haskell County, KS.

Several Haskell men who had been exposed to influenza went to Camp Funston, in central Kansas. On March 4 the first soldier known to have influenza was reported ill. The huge Army base was training men for combat in World War I, and within two weeks 1,100 soldiers were admitted to the hospital, with thousands more sick in barracks. Thirty-eight died.

Then, infected soldiers likely carried influenza from Funston to other Army camps in the States — 24 of 36 large camps had outbreaks — sickening tens of thousands, before carrying the disease overseas. Meanwhile, the disease spread into U.S. civilian communities.

Two area young men were soldiers at Funston and among those who died there. Here is a story from the Oct. 3, 1918, issue of the North Missourian:

Two Died at Funston … After two months and two days service, two Daviess County boys, Emmett Earl Downs, 24, and Elmer Oaks, 23, fell victims of pneumonia, which developed from Spanish influenza. These two young men lived in the Victoria community in the western side edge of the county and had been close friends for a number of years.

They left Gallatin July 23rd, with a contingent from this county and were sent to Camp Funston, Kansas.

Young Downs died at a hospital at Fort Riley, Kansas, last Wednesday, and in less than 48 hours his friend passed away. Their bodies were brought to Winston Friday.

On Sunday afternoon the funeral service of Emmett Downs was held from the Victoria church, conducted by Rev. Grant Creekmore. Being a soldier of the war the church was tastefully decorated with the national colors and a large American flag was draped around the casket. There was not standing room in the little church for the people who came to pay the last tribute to this splendid young man, and more people were compelled to remain on the outside of the building than there were on the inside.

A similar service was conducted by Rev. Price of Gilman, at the Baptist Church in Winston Tuesday afternoon for Elmer Oaks. A company of home guards were present and took part in the service.

Lessons from the past for the future

When a new flu virus spreads among people, causing illness worldwide, it is called pandemic flu. Because a pandemic flu virus is new, the human population has little or no immunity against it.

The 1918 flu pandemic is not just a lesson from the past; it’s a lesson about what can happen in the future.

Public health reports list the following four pandemics occurring after the Spanish Influenza (1918-1919):

The Asian influenza (1957–1958)

The Hong Kong influenza (1968–1969)

The swine-origin influenza (2009)

H5N1 avian influenza (2003-)

A pandemic is among the worst nightmares of the healthcare profession.

Oddly enough, we might even be more vulnerable to a flu pandemic today than a century ago …

Scientists still cannot predict what epidemic to expect next.

Influenza can mutate and there is no universal flu vaccine to protect against every strain of the flu.

Response would be faster, yes, but the strain of virus could also be more transmissible and more severe.

The Spanish Flu was a global catastrophe. What has science and medicine learned in the past 100 years? What can be done to prevent or manage the next pandemic?

A Public Health Report called “The Once and Future Pandemic” suggests two basic strategies: basic public health and basic science.

Basic public health:

The most obvious requirement is a rapid and expansive influenza surveillance and response network.

In Daviess County cases of flu are entered into the state’s communicable disease system, MOHSIS (Missouri Health Information Surveillance System), pronounced Moses.

Health care workers also keep tabs through the Sentinel Active Surveillance System. This system relies on reports from places most likely to see cases of the disease in question, like schools, nursing homes, daycares, etc.

The report suggests that such surveillance activity also needs to include domestic animals, and wild birds.

Basic science:

The development of new vaccines and antiviral drugs is needed, as well as basic scientific information about how avian and mammalian strains of viruses evolve and how they interface with humans.

We must develop further, effective intervention strategies to reduce transmission and disease. This means developing non-pharmaceutical intervention.

What you can do personally: Stay home when you are sick. Cover your coughs and sneezes. Wash your hands often.

What communities can do: Implement social distancing interventions in schools, workplaces, and at events.

What everyone can do to keep the environment germ-free: Clean frequently touched surfaces and objects like door knobs.

Non-pharmaceutical measures could potentially provide valuable time for pandemic-strain vaccine and antiviral medication production and distribution.

A century has passed since the nightmare outbreak of 1918, but the worries of the medical community haven’t changed much in 100 years, nor has the best advice….

In the January, 1919, North Missourian, the writer concluded…

The worst feature is that in its early stages the disease is so much like a common cold. Many doctors say that everyone who coughs and sneezes should be required to stay at home. This may finally seem necessary. Yet it would be a considerable blow to the industries and business of the country.

But the people must learn the danger of this treacherous disease. The man who has merely the incipient form is in serious peril himself, and he imperils all with whom he mingles.

May people having some of the characteristic symptoms, yet not feeling much sick, will force themselves to go to work. Whether they do this because they dislike to lose a day’s pay, or because thy fear the employer’s disapproval, they make a mistake.