Every year, H1N1 flu viruses make people sick. Even the garden-variety flu can be deadly, but usually only for the very young or very old. In 1918, however, the flu mutated into something much more virulent.

This new, deadlier flu acted very strangely; it seemed to target the young and healthy, being particularly deadly to 20- to 35-year-olds. In three waves from March 1918 to the spring of 1919, this deadly flu pandemic spread quickly around the world, infecting one-third of the global population and killing at least 50 million people.﻿﻿

Vaccines had not been developed yet, so the only methods of fighting the pandemic were quarantine, good hygiene practices, disinfectants, and a limitation of public gatherings.

This flu went by many names, including the Spanish flu, grippe, the Spanish Lady, the three-day fever, purulent bronchitis, sandfly fever, and Blitz Katarrh.

First Reported Spanish Flu Cases

No one is quite sure where the Spanish flu first struck. Some researchers have pointed to origins in China, while others have traced it back to a small town in Kansas. The best recorded first case occurred in Fort Riley, a military outpost in the state where new recruits were trained before being sent to Europe to fight in World War I.

On March 11, 1918, Private Albert Gitchell, a company cook, came down with symptoms that at first appeared to be from a bad cold. Gitchell went to the infirmary and was isolated. Within an hour, several additional soldiers had come down with the same symptoms and were also isolated.

Despite the attempt to isolate those with symptoms, this extremely contagious flu quickly spread through Fort Riley. More than 100 soldiers became ill, and within just one week, the number of flu cases quintupled.﻿﻿

Flu Spreads and Gets a Name

Soon, reports of the same flu were noted in other military camps around the United States. Shortly thereafter, the flu infected soldiers on board transport ships. Unintentionally, American troops brought this new flu with them to Europe.

Beginning in mid-May, the flu started to strike French soldiers as well. It traveled across Europe, infecting people in nearly every country.

When the flu rampaged through Spain, the Spanish government publicly announced the epidemic. Spain was the first country struck by the flu that was not involved in World War I; thus, it was the first country not to censor their health reports. Since most people first heard about the flu from its attack on Spain, it was named the Spanish flu.

The Spanish flu then spread to Russia, India, China, and Africa. By the end of July 1918, after infecting people all around the world, this first wave of the Spanish flu appeared to be dying out.

The Second Wave Is More Deadly

In late August 1918, the second wave of the Spanish flu struck three port cities at nearly the same time. Boston, United States; Brest, France; and Freetown, Sierra Leone all felt the lethality of this new mutation immediately. While the first wave of the Spanish flu had been extremely contagious, the second wave was both contagious and exceedingly deadly.

Hospitals quickly became overwhelmed by the sheer numbers of patients. When hospitals filled up, tent hospitals were erected on lawns. Even worse, nurses and doctors were already in short supply because so many of them had gone to Europe to help with the war effort.

Desperately needing help, hospitals asked for volunteers. Knowing they were risking their own lives by helping these contagious patients, many people—especially women—signed up anyway to help as best they could.

Spanish Flu Symptoms

The victims of the 1918 Spanish flu suffered greatly. Within hours of feeling the first symptoms of extreme fatigue, fever, and headache, patients would start turning blue. Sometimes the blue tint became so pronounced that it was difficult to determine a person's original skin color.

Some patients would cough with such force that they tore their abdominal muscles. Foamy blood exited from their mouths and noses. A few bled from their ears. Some vomited. Others became incontinent.

The Spanish flu struck so suddenly and severely that many of its victims died within 24 hours of showing with their first symptom.﻿﻿

Taking Precautions

Not surprisingly, the severity of the Spanish flu was alarming—people around the world worried about contracting it. Some cities ordered everyone to wear masks. Spitting and coughing in public was prohibited. Schools and theaters were closed.

People also tried their own homemade prevention remedies, such as eating raw onions, keeping a potato in their pockets, or wearing a bag of camphor around their necks. None of these things stopped the onslaught of the Spanish flu's deadly second wave.

Piles of Dead Bodies

The number of bodies from the victims of the Spanish flu quickly outnumbered the available resources to deal with them. Morgues were forced to stack bodies like cordwood in the corridors.

There weren't enough coffins for all the bodies, nor were there enough people to dig individual graves. In many places, mass graves were dug to free the towns and cities of the masses of rotting corpses.

Spanish Flu Children's Rhyme

When the Spanish flu killed millions of people around the world, it transcended into the lives of everyone. While the adults walked around wearing masks, children skipped rope to this rhyme:

I had a little bird

Its name was Enza

I opened a window

And In-flu-enza.

Armistice Brings Third Wave

On November 11, 1918, an armistice brought an end to World War I. People around the world celebrated the end of this "total war" and felt jubilant that perhaps they were free from the deaths caused by both war and flu. However, as people rushed to the streets and gave kisses and hugs to returning soldiers, they also started a third wave of the Spanish flu.

The third wave of the Spanish flu was not as deadly as the second, but it was still deadlier than the first. It also went around the world, killing many of its victims, but it received much less attention. People were ready to start their lives over again after the war; they were no longer interested in hearing about or fearing a deadly flu.

Gone but Not Forgotten

The third wave of the Spanish flu lingered. Some say it ended in the spring of 1919, while others believe it continued to claim victims through 1920. Eventually, however, this deadly strain of the flu disappeared.

To this day, no one knows why the flu virus suddenly mutated into such a deadly form, nor do they know how to prevent it from happening again. Scientists continue to research and learn about the 1918 Spanish flu.