The American flu, also known as the Kansas flu or the 1918 flu pandemic, was an unusually deadly influenza pandemic lasting from January 1918 until September 1919. Out of an estimated 300 million infected, it is thought to have killed anywhere between 20 and 60 million people. Unlike other influenza viruses, who kill especially small children and the elderly, about half of the victims of the 1918 pandemic were young people (between 20 and 40 years old).

Origin and first wave

The exact origin of the virus remains unknown, but several hypothesized locations have gained traction within the medical community: China, France, and the United States. However, in the former two cases serious inquiry has been frustrated by an absence of reliable information, stemming from China's frequent internal conflicts and lagging development, Weltkrieg-era censorship on both sides of the Western Front, and the destruction of still-sealed documents in the 1925 British Revolution. Due to the absence of these factors in the United States, far more information is available to speculate on the virus' source there.

The first reports of a particularly deadly strain of influenza were published by the Kansas doctor Loring Miner in early 1918. In several medical articles, Miner described the speed and relentlessness of an influenza wave in rural Haskell County. He also asked the federal health services for help, which was denied. Several weeks after the initial reports, cases were being reported throughout the US, concentrated in the major cities such as New York, San Francisco or Chicago.

There, at the University of Chicago, the bacteriologist Edwin O. Jordan in May and June first became aware of the national level of the dangers of the years’ influenza wave. Together with other medical experts, he tried to draw attention to the epidemic through publications in journals and newspapers, but these attempts did not have much success; the Weltkrieg still dominated the headlines. Calls for preparations against a further spread did not get a response from the federal administration, while attempts to build connections between local hospitals petered out together with the first wave.

Second wave

United States

The second wave started in August, almost simultaneously in the cities of Seattle, Boston and New Orleans. Within days, factories, worker’s living quarters and ships had become hotbeds, spreading the virus to almost all big cities within the US until September. This time, the American press quickly spread news of the exploding numbers of dead. While there were already initial outbreaks in Canada, Mexico and Europe, in this phase the pandemic became the American flu in the public consciousness.

Meanwhile, medical practitioners within the US started cooperating first on regional, then on a national level. While there was no shortage of equipment or medical practitioners, the lack of time meant it took several weeks until a somewhat adequate response could be organised. Ships with infected on board were quarantined, gauze masks became compulsory on public transport.

Global spread

Initially spread through general traffic, several passenger ships to Britain, France and Germany were later identified as major sources of infection for Europe. In October, the disease had reached the front lines in France; in November, the Spanish king Alfonso XIII fell ill but survived. The German sociologist Max Weber died in November 1919 due to complications resulting from his infection with the flu.

Mexico and several Latin American countries were infected directly from the US, while ships from Europe spread the disease to many colonies. In the end, the flu spread to every country in the world. China had relatively few reported deaths, likely in part due to inconsistent or nonexistent record-keeping, as did Japan due to severely restricted sea travel. Only a few isolated islands were not affected at all.

Legacy

In the United States, the delayed reaction of the Wilson administration to the crisis helped its defeat in the 1920 election. Edwin Jordan remains an active campaigner for improvements to the federal healthcare system.

In Europe, the destruction caused by the flu was overshadowed by that of the Weltkrieg and further covered up by wartime censorship. The lasting perception is therefore that the pandemic remained mostly confined to the United States, leading to its popular name.