It was the spring of 1918 and the battlefields along the border between France and Belgium were full of corpses. These men had not knocked down projectiles or bullets. His attacker was an invisible scourge, an attacker who lived in the rivers of mud, blood and urine dripping from the trenches, an attacker floating in the air.
Kaiserschlacht was the name that was given to the last onslaught of Germany in the Great War. General Erich Ludendorff was a commander with sunken eyes, the twisted mustache of a nineteenth-century villain and an anti-Semitic inclination. He had sent the German troops to the western front with the hope that they could change the course of the war before the Americans arrived to reinforce the French and British forces. It was a sensible plan. But then the contagions started.
The effects of the flu were like spells cast by a cruel and imaginative fairy tale witch. Generally, people's hands and faces turned pale lavender, the result of a condition known as cyanosis. After a few days, the skin of some victims turned black, then their hair and teeth fell out. Others gave off a strange smell, like moldy straw. One doctor described seeing men asphyxiate themselves to death, "their lungs were so swollen with blood, foam and mucus that each breath was like the croak of a duck." American novelist Katherine Anne Porter survived, but not before her ebony hair became irrevocably white.
In the trenches the contagions were catastrophic, not only for the soldiers, but also for the armies. Towards the end of spring 900,000 German soldiers had been knocked out, destroying Ludendorff's plans (although after the war the general blamed the defeat of Germany on the disloyal Jews). However, the virus did not respect any line of battle, ideology or alliance: in a matter of weeks, up to three quarters of the French troops also fell ill and more than half of the British forces succumbed. He destroyed entire units, filling makeshift hospitals with feverish soldiers. "We had a high fever and were lying outdoors with only a sheet on the floor," recalled Donald Hodge, a surviving British soldier.
The flu spread rapidly and, according to the World Health Organization, "killed more people in less time than any other disease before or after". It was 25 times more lethal than most flu pandemics, which are already many times more deadly than seasonal flu. It went through the trenches like wildfire, which could have been extinguished had it not been for the ceasefire in November 1918 that sent millions of infected soldiers home, spreading the virus to the four corners of the world with military efficiency.
As the flu spread throughout the world, it left a tapestry of creepy scenes in its wake. In Rio de Janeiro, the gravediggers could not cope to bury all the dead: a man described seeing while walking a human foot "suddenly blooming" from the earth. In an Alaskan village the number of deaths could not be estimated because the dogs, hungry because their owners had succumbed to the disease, had made holes in the huts and devoured the corpses.
According to the disease and its extravagant symptoms spread, acquired a confusing list of nicknames. Each affected nation devised a label that blamed another group, a way to avoid being labeled as the source of the disease and at the same time, in many cases, a way to add notes of xenophobic cultural superiority. In Senegal it was known as the Brazilian flu; in Brazil, the German flu. In Germany it was known as "Blitzkatarrh," or lightning, while, for Spaniards, the epidemic became "the soldier of Naples." The English soldiers who fought in France used the term "Flanders grippe", while the Iranians blamed the British. The Japanese, curiously, blamed the fighters: the first victims of the country were sumo stars. The New York Times He described the virus in a June 1918 headline as a "strange epidemic" that swept through northern China.
In the end, geopolitics gave the virus the name that it stayed with. Although it did not arrive in Spain until May 1918, the country, which was neutral in the war, had no tactical reason to censor the news of deaths related to the flu. While the British, French and Germans pretended that their respective troops were immune, the Spanish media openly reported their victims of the flu. A scapegoat was exposed voluntarily. Thus, The global pandemic was due and strategically marked as a local concern: the Spanish flu.
When the disease vanished almost three years later, up to a hundred million people had died, a greater number of victims than the two world wars combined. The virus killed more people in 24 months than AIDS in 24 years; more people in a year than the Black Death in a century. Just as Laura Spinney, author of Pale Rider, a recent book on the pandemic, describes it, it caused the "greatest death toll" that humanity has seen in more than 500 years.
During the last century, historians, epidemiologists and virologists have been working to find when and where this disease originated. Three dominant theories are still the subject of discussion with a smoking gun.
The first and oldest theory goes back to the last century. The military doctors who treated the victims at the front believed that the Spanish flu came from China. "Everything came from the Far East," says Spinney. "It was believed that the Chinese had little hygiene." Over time, the theory was discarded as a racist stereotype: after all, how was a virus coming out of a relatively closed rural country? However, more recently historians have argued that, at least, it is feasible. The Chinese Labor Corps, often ignored, was a group of 95,000 Chinese agricultural workers who volunteered to leave their villages and support the British war effort. Many worked behind the lines for the Allies, building projectiles, repairing tanks … They traveled by ship through Canada or South Africa, going around the world: they were the perfect vehicle for the transmission of a respiratory virus.
The flu spread rapidly and, according to the World Health Organization, "killed more people in less time than any other disease before or after"
John Oxford, professor of virology at the Queen Mary School of Medicine in London, has a different theory: one that points out the patient zero was among the British troops stationed in France. In 1914, the British Army built a training camp in Etaples, France. It was a notorious place, "a huge and terrible camp," as the soldier poet Wilfred Owen put it, where men had a look "more terrible than terror, like dead rabbits." The camp had twenty-four hospitals to care for the injured and, among the staff, a team of pathologists.
In December 1916, an epidemic of flu arrived at the camp and killed about 40 percent of the infected who, before dying, turned lavender blue. Etaples was home to hundreds of thousands of birds: there are dozens of photographs showing men plucking chickens, ducks and geese. Could it have started in this field, the perfect incubator for a virus to become more virulent and, at the same time, to have contained it until it acquired the ability to transmit itself among humans?
The most likely source, however, was a farm in rural America. In March 1918, Albert Gitchell, the cook at the Camp Funston canteen, a US army base in Kansas (now Fort Riley), showed up at the camp infirmary complaining of sore throat, headache and fever. . At lunchtime, the infirmary was full of soldiers who showed the same symptoms. Within a month, many had reported that the camp medical officer had been forced to requisition a hangar to house all the sick.
John Barry identified in his 2004 book The Big Flu an outbreak of a respiratory illness in Haskell County, a few hundred miles east of Camp Funston, two months earlier. It was an aggressive outbreak, so exceptional that a doctor decided to report what was happening: it was the first record in the world of a flu outbreak so unusual that even a doctor warned public health officials of its appearance.
Haskell County was extremely poor and was mainly populated by farmers who lived very close to their birds and pigs. The most convincing theory about the origin of the Spanish flu is that a young man from Haskell County got the virus from some poultry (perhaps through a pig that served as an intermediary), was recruited by the expeditionary forces and took the heart disease of the American war machine.
Almost a century later, there are three certain things: that the first confirmed case of Spanish flu occurred, which did not originate in Spain, but probably in Kansas, and that the pandemic did not start in humans but in birds.
In addition to the logistical argument about how the Spanish flu was spread and spread, there is molecular evidence. Influenza viruses are incredibly mobile and constantly mutating: this is the reason why we currently have to update our vaccines every year. However, this also means that the virus's own history allows us to track its evolution. "Scientists know that inside the host the virus accumulates mutations at a constant rate," explains Spinney. "They can use that mutation rate to find out which viruses were closest to each other in the past and calculate the family tree and the origin of a given strain."
At the University of Arizona, Michael Worobey has led the work of creating a family tree for each influenza virus that has circulated among humans and other species over the past 100 years. Through this work, we know that the strain that caused the Spanish flu is very similar to the strain that circulates in birds in North America at that time. Like H5N1 and H7N9, the Spanish flu virus found a way to cling to humans.
Regardless of your point of origin, what remains striking about this century-old pandemic is how fast and how far you were able to travel in a world without massive air travel
Regardless of your point of origin, what remains striking about this century-old pandemic is how fast and how far you were able to travel in a world without massive air travel. After all, most of these deaths occurred in a period of 16 weeks, from mid-September to mid-December 1918.
Spinney believes that the virus could have adapted to take advantage of the circumstances of the war. "Most viruses moderate to keep their hosts alive long enough to spread through coughs and sneezes," he says. "But the peculiar circumstances of the Great War, with their hosts huddled in trenches, lungs weakened by mustard gas and dying amidst a multitude of bullets and mortar bombings, caused the best chance of survival of the disease was to become unusually virulent".
It is likely that between the spring and summer of 1918 the virus mutated through thousands of rounds of evolution between humans, becoming increasingly transmissible and deadly.
For today's epidemiologists, the Spanish flu continues to be a threat and warning. As a result of the disease, many countries renewed their systems and adapted them to ensure that it was never repeated.
Before 1918, government health departments depended on the money and power of other ministries. After the Spanish flu, many became separate entities so that they could better manage and within the time required a pandemic. The collection of health data began to be done systematically. Doctors are now required to report outbreaks of influenza. Epidemiology became a cornerstone in public health. Russia introduced a primitive universal health system in 1920 and other countries soon followed suit: an acknowledgment that, in a pandemic situation, one can not blame an individual for catching a disease, or treat it in isolation. Society must be treated as a whole.
This principle has not always been defended in subsequent pandemics: the AIDS crisis, for example, was marked by the moral culpability and ostracism of its first victims, most of whom were homosexual men and heroin addicts. President Reagan's first mention of the disease was in 1987, after the deaths of more than 25,000 people in the United States.
Unfortunately, developments in medicine, medical care and prevention have been counteracted by other advances that today make the virus more deadly. Our schools are incubators of diseases in young and healthy children. Our roads, which pass through humans and trucks loaded with animals, have become fast roads that carry viruses from one city to another. The democratization of air travel has allowed a virus to cross hemispheres at a speed that would have been unthinkable in 1918.
The question now is how could that virus slow down in a world that is spinning faster and faster.