If you thought your flu was bad ...

In 1918, the flu killed more than the world war -- and they were young

By Dave Gathman

STAFF WRITER

Eighty years have slipped by, but Grace Mooney Lofgren never will forget her mother's final hours.

"I think she had been sick for 10 days. Dr. Abbott said that if she could last through the night, she could have a chance.

"My dad -- he was named Ellsworth Mooney, but everyone called him E.A. Mooney -- my dad sat there by her bed all night and fanned her face with a magazine. I guess he thought that he could make it easier for her to keep breathing. But morning came and she died.

"I can remember sitting with my grandma at the funeral. My father was so upset, some people had to carry him away after the service."

Sarah "Sadie" Mooney, wife of Kenyon Dairy Farm worker E.A. Mooney, mother of three children ages 9 months to 14 years, died Dec. 5, 1918.

She was 32. The vicious disease that felled her was the flu.

At an Army camp in Kentucky about the same time a 22-year-old printer-turned-doughboy Joe Bennett was seeing soldiers catching the flu and dying all around him, too. "You could feel fine one day and be dead two days later," he recalled in a 1993 interview.

"They started piling up dead men like cordwood. They would tie one of your dog tags around your foot and another one around your wrist and just wrap you in a sheet."

The commander of the fort asked for volunteers to work in "the flu ward." Bennett said yes. It was the most dangerous thing he would do during his service in World War I. Outkilling the world war

The sickness that engulfed the Fox Valley between March 1918 and June 1919 was the deadliest epidemic to hit the world since the black plague of the 1300s.

The war raging at the same time in Europe killed twice as many soldiers (an average of 4,000 a day for four years) as all the wars of the previous century put together.

But some monster mutation of nature's ordinary flu virus -- so tiny the scientists of 1919 couldn't see it even with a microscope -- proved that mankind remained a rank amateur in the killing business. Worldwide, in just a year it killed at least twice as many people as the war. In America, it took 668,000 lives, more than combined totals of World War I, World War II, the Korean War, the Vietnam War and the Gulf War.

And like Lofgren's mother, most of those were previously healthy men and women in their 20s and 30s. This despite that almost all flu fatalities before and since have been frail elderly people or people already weakened by some chronic disease such as asthma or emphysema.

People of the day called it "the Spanish influenza." But it should have been "the American influenza." Experts think it first appeared in March 1918 on a U.S. cavalry base in Kansas.

A thousand soldiers got the chest congestion and fever and body aches of the flu. Then it began to spread across the Midwest.

The timing was odd. Flu outbreaks usually peak in January and February. But at first, the sickness acted pretty much like typical strains of the flu. By and large, the only deaths came among old people and people with lung problems.

Some later theorized the virus had come from the cavalrymen's horses. Just before the soldiers started falling sick, they had burned a big pile of manure. Wind had scattered its ash through the camp.

Biologists at the Armed Forces Institute of Pathology still are studying that 1918 virus. They now apply 21st century DNA analysis to bits of flesh from flu victims disinterred after being buried in frozen ground in Alaska for 80 years.

These scientists reported just last week that they think it is more likely the deadly bug was hiding out for years in hogs, not horses. A deadly mutation

After a few months, this late flu season epidemic subsided here but moved on to Africa and Europe. But something -- maybe a reaction with hogs' immune systems, maybe a freakishly unlucky combining of DNA from two different flu strains, maybe a pairing with a particularly vicious form of pneumonia bacteria -- suddenly made it different from any variety of influenza before or since.

Suddenly it seemed to prefer fall and spring to the winter. It was unusually lethal. And it preferred strong, young adults.

A 22-year-old soldier like Bennett now was more likely to catch it and die than a 70-year-old paralytic, though Bennett would avoid the disease and live on to become Elgin's second-to-last World War I veteran when he died of old age last year.

A 30-year-old Nebraska farmer was more likely to die than a 9-year-old school girl like Lofgren. She caught the flu soon after her mother but recovered in a few days. She lived on to have children of her own, one of whom later married Elgin Mayor George Van De Voorde.

The monster virus may have preferred young adults because it worked so fast. Biologist Alfred W. Crosby notes that younger, healthier people have more ability to fight infection by inflaming infected lung tissue with white blood cells. But if that extra inflammation response makes them better able to fight off a typical, slow-moving lung infection, it may simply make it impossible to breathe when an infection such as Spanish flu moves in very quickly and takes over the entire lung at once.

The first sign someone was getting the Spanish flu was a bad headache. Weakness, body aches and fever would follow. Most, like Grace, would recover after a week or so. But within two or three days, bacteria often would rip into the virus-torn lungs and the flu would turn into pneumonia. The victim's lungs would fill with fluid. His face would turn blue and he would drown in his own internal juices.

The demonized disease re-entered the United States at Boston aboard a Norwegian ocean liner in August, and the dying of America's young began.

It raced across country with trains full of drafted soldiers. It spread from coughers' mouths to breathers' noses at war bond rallies in crowded Grand Army of the Republic halls. As cold weather drove contagious people indoors, nationwide deaths zoomed from 800 in August to 12,000 in September to 195,000 in October. Capricious aim

The disease proved scarily unpredictable, hitting one town hard and another just down the road much less. Elgin lost 70 people. Joliet, roughly the same size, had 236 deaths. Aurora had 125.

A plaque at Gail Borden Public Library in Elgin lists 38 from the Elgin area who died serving their country in the war. But only 15 were killed by enemy fire. The other three-fifths succumbed to disease, undoubtedly most to Spanish flu.

The Army and Navy lost 53,000 to wounds, 43,000 to the flu. Not one "doughboy" riding an American ship was killed en route to France by a German submarine. But flu snuffed out 4,000 aboard crowded transports full of coughing men.

In Elgin, some people wore surgical masks all day, hoping to filter out germs. They didn't realize the virus was so microscopic that donning a cotton-mesh mask was like using a chain link fence to keep out fleas.

Lofgren's childhood friend, Myrtle Spiegler Gerberding, remembers other fourth graders coming to Elgin's Sheridan Elementary School with cloth bags stuffed with garlic or camphor hanging around their necks. Their moms hoped it would keep the flu away.

"Maybe it did help, because the smell kept other people too far away from you to spread their germs," Gerberding chuckles today.

As always, little girls found gallows humor.

Centuries ago, their British ancestors had made fun of bubonic plague with the nursery rhyme, "Ring around the rosey. Pocket full of poseys. A-choo, a-choo, we all fall down."

Twenty years before, their mothers had chanted a rhyme making fun of Lizzie Borden, who "took an ax and gave her mother 40 whacks."

In 1918, as girls such as Myrtle and Grace played jump rope, they would keep time with a new chant: "I met a bird. Her name was Enza. I opened a window, and in flew Enza." Could it happen again?

It's difficult to predict if such a deadly outbreak could reoccur, because scientists still don't know exactly what made that 1918 virus so deadly.

If it does, Lake in the Hills internist Dr. Luciano Orta notes that today's doctors now have three more weapons in their quiver.

If scientists can see a particular strain of the virus coming in time, they can create serums ("flu shots") that will keep a patient immune from catching that strain.

Once a person does become sick, antibiotics can help fight off many of the pneumonia bacteria that performed the coup de grace on 1919's victims.

Finally, scientists have developed two "antiviral" medicines named amantadine and rimantadine. These weaken some types of the influenza virus, including the types that are attacking the Fox Valley now. According to the U.S. Centers for Disease Control, someone taking these medications during an epidemic will avoid catching Type A influenza 70 to 90 percent of the time. Even if someone already has the flu, CDC officials say, taking amantadine or rimantadine will shorten the sickness's duration and decrease its severity.

But if the 1918 "bird named Enza" ever does fly back, it also will find one new modern invention working on its side. The 1918 epidemic apparently spread so quickly because so many soldiers and ships were moving around the globe to fight World War I.

Today, thousands of travelers routinely jump from one side of the world to the other in hours by jet. And they carry their viruses with them.

http://www.suburbanchicagonews.com/news1/strep/e01flu.htm

-- Martin Thompson (mthom1927@aol.com), July 06, 2001

Answers

The 1918 influenza was remarkable for the speed and severity with which it killed. Particularly remarkable was the mortality among persons in "the prime of life": apparently healthy persons in the 20- to 50-year age range that normally is not _severely_ impacted by 'flu (people in this age range certainly get sick, but they usually don't die, unlike the very young and especially the very old).

It is accepted that the 1918 virus was sufficiently "new"* that many people were not partially immune and hence less likely to get severe disease. [*Due to the well-described phenomenon of influenza virus "genetic shift," which is a more dramtic change from yearly "genetic drift". Very roughly every 11 years, it seems, genetic shift in the virus and the lack of adequate cross-immunity in many humans leads to larger-than-usual 'flu outbreaks. The 1957 and 1968 outbreaks are a good example.]

A leading hypothesis has always been that the 1918 virus was uniquely different -- i.e. more virulent, but recent evidence suggests it was not notably worse than other strains. There are many other hypotheses as to what made 1918 so bad, one of the more recent and interesting of which is that many people in the 20- to 50- year age range were co- infected with tuberculosis, and this combination made the demographic impact so unusual.

I wonder why this article is appearing now? Bit of human interest space in the paper to fill, I suspect, as I don't know of any recent news stories that would prompt this piece.

The standard reference to start with is by Crosby, _America's Forgotten Pandemic_.

More recently, NY Times reporter Gina Kolata wrote a book with a title something like _1918_ (I haven't read it yet).

-- Andre Weltman, M.D. (aweltman@state.pa.us), July 06, 2001.

Went back and checked the date for this and it was March 1999. Was scanning for something else and it popped up. Just a good reminder how bad influenza can be. Didn't find any Big 'flesh eating bacteria' stories either. I wasn't really expecting to find any.

-- Martin Thompson (mthom1927@aol.com), July 06, 2001.