In late 1916, the Étaples camp in France was struck by a new disease with high mortality and flu-like symptoms, theorized by virologist John Oxford to be a precursor to the Spanish flu.

Étaples camp hit by new disease

The pandemic is conventionally marked as having begun on 4 March 1918 with the recording of the case of Albert Gitchell, an army cook at Camp Funston in Kansas, United States.

Beginning of the 1918 Influenza Pandemic

On Monday, March 11, 1918, the first wave of the deadly 1918 influenza pandemic began, impacting millions of lives worldwide. This event marked the initial domino falling in the devastating outbreak.

First Wave of the 1918 Influenza Pandemic

In March 11, 1918, young, healthy soldiers started getting sick in large numbers, leaving military physicians puzzled about the cause.

Outbreak of Influenza Among Soldiers

On March 11, 1918, the first recorded case of the Spanish flu was reported at Fort Riley in Kansas, United States. Overcrowding and unsanitary conditions in the camp created a perfect environment for the virus to spread rapidly.

First Recorded Case of Spanish Flu in the United States

In April 1918, the first mention of influenza appears in a public health report, detailing 18 severe cases and three deaths in Haskell, Kansas.

First Mention of Influenza in Haskell, Kansas

In late spring of 1918, early reports from Spain and Kansas described an unknown disease as 'three-day fever' or fiebre de los tres días.

First Reports of 'Three-Day Fever'

The disease, initially referred to as 'the unknown disease of a gripal character' in The Times of London, was later misnamed 'Spanish influenza' outside Spain.

Misnaming of 'Spanish Influenza'

On July 22, 1918, public health officials in Philadelphia issued a bulletin regarding the Spanish influenza outbreak, raising awareness about the disease in the city.

Public Health Bulletin on Spanish Influenza in Philadelphia

Starting from August 27, 1918, sailors stationed at Commonwealth Pier in Boston began reporting flu-like symptoms, indicating the spread of the Spanish influenza among naval personnel.

Sailors Sick with Influenza at Commonwealth Pier

300 sailors from Boston arrive at the Philadelphia Navy Yard.

300 Sailors from Boston Arrive at Philadelphia Navy Yard

Nineteen sailors are reported ill in Philadelphia, four days after the arrival of the sailors from Boston.

19 Sailors Reported Ill in Philadelphia

600 sailors and marines report ill to the Navy Hospital in Philadelphia, leading to a shortage of beds.

600 Sailors and Marines Report Ill to Navy Hospital in Philadelphia

On September 15, 1918, New York City saw its first fatality from the Spanish Flu, marking the impact of the pandemic on urban centers. The disease had started to affect various parts of the United States.

First fatality from Spanish Flu in New York City

Five doctors and 14 nurses in a civilian hospital in Philadelphia report falling ill with the flu.

Doctors and Nurses Fall Ill in Civilian Hospital in Philadelphia

Two sailors die of the flu in Philadelphia, with more deaths following in the coming days, including a civilian death at Philadelphia General Hospital.

First Deaths from Influenza in Philadelphia

On September 24, 1918, Edward Wagner, a Chicagoan who had recently moved to San Francisco, becomes ill with influenza. This event is significant as it highlights the spread of the deadly influenza outbreak to different parts of the United States.

Edward Wagner falls ill with influenza in San Francisco

Provost Marshal General of the US Army Enoch Crowder cancels the October draft call for 142,000 registrants due to reports of military camps being overrun with the flu.

US Army Cancels October Draft Call Due to Influenza Outbreak

Philadelphia's Liberty Bond Parade is held, despite objections from doctors and public health experts, leading to a further spread of the flu.

Philadelphia's Liberty Bond Parade Held Despite Influenza Outbreak

200,000 people gather for a 4th Liberty Loan Drive in Philadelphia. Shortly after the event, 635 new cases of influenza were reported, leading the city to acknowledge the existence of an epidemic and enforce closures of public spaces like churches, schools, and theaters.

4th Liberty Loan Drive in Philadelphia

The Philadelphia Liberty Loans Parade held on September 28, 1918, resulted in a major outbreak of the Spanish Flu, leading to 12,000 deaths among attendees. The event highlighted the rapid spread of the disease in crowded gatherings.

Philadelphia Liberty Loans Parade outbreak

Every bed in Philadelphia's 31 hospitals are filled with the sick, leading to a dire situation with hundreds more sick at home.

Hospitals in Philadelphia Filled with Influenza Patients

On October 2, 1918, Boston recorded 202 deaths from the influenza outbreak. As a result, the city took preventive measures by canceling Liberty Bond parades, sporting events, closing churches, and implementing half-days at the stock market.

Boston registers 202 deaths from influenza

Dr. Krusen bans all public meetings and closes churches, schools, theaters, and public funerals in Philadelphia to contain the spread of influenza.

Dr. Krusen Bans Public Meetings in Philadelphia

The first temporary facility for the sick, Emergency Hospital #1, is opened in Philadelphia as the number of influenza cases rise.

First Temporary Facility for Influenza Patients Opened in Philadelphia

Philadelphia sets a grim record with 289 influenza-related deaths in a single day, marking the start of a devastating month for the city.

Record-breaking Influenza-related Deaths in Philadelphia

Dr. C.Y. White announces the development of an influenza vaccine in Philadelphia, sparking debates on its effectiveness in combating the flu outbreak.

Dr. C.Y. White Develops Influenza Vaccine in Philadelphia

In a single day, 869 New Yorkers and a significantly high number of Philadelphians die from influenza and pneumonia, highlighting the severity of the flu outbreak in both cities.

High Death Toll in New York and Philadelphia

In October 31, the crime rate in Chicago decreases by 43 percent, with authorities linking the decrease to the impact of the influenza outbreak on potential lawbreakers.

Drop in Crime Rate in Chicago

Sirens in San Francisco signal the end of the face mask mandate, indicating safety and legality to remove protective face masks after 2,122 deaths due to influenza.

San Francisco Lifts Face Mask Mandate

Within five days, influenza claims the lives of 72 out of 80 native Inupiat inhabitants in Brevig Mission, Alaska, leading to a mass burial of the victims by local survivors.

Influenza Outbreak in Brevig Mission, Alaska

The chief clerk of the Navajo Indian reservation reports that more than 2,000 Navajos in Apache County, New Mexico, have died due to influenza.

Influenza Outbreak Among Navajo Indians in Apache County

Boston reports a sudden surge of 454 new cases of influenza in a single day, indicating the rapid spread of the epidemic.

Boston Reports 454 New Cases of Influenza in a Single Day

By 23 January 1920, Japan had reported 780,000 cases of influenza with at least 20,000 deaths, reflecting a severity three times greater than the previous epidemic.

Influenza cases in Japan

In early February 1920, the United States experienced a swift fourth wave of the influenza pandemic. The U.S. Mortality Statistics noted that this epidemic resulted in one third as many deaths as the 1918–1919 experience.

Fourth Wave of Influenza Pandemic in the United States

Mexico experienced a fourth wave of influenza between February and March 1920.

Fourth Wave of Influenza in Mexico

Several Pacific island territories were hit hard by the Spanish flu, with New Zealand serving as a conduit for the virus. Tonga, Nauru, Fiji, and Western Samoa faced significant casualties, with Western Samoa experiencing the highest infection rate and death toll. Governor John Martin Poyer successfully prevented the flu from reaching American Samoa through a blockade.

Impact of Spanish Flu on Pacific Island Territories

In spring 1920, the Spanish flu finally reached Nenana, Alaska after managing to avoid the pandemic between 1918 and 1919. Within the first two weeks of May, the majority of the town's population became infected, resulting in an estimated 10% death rate, with most of the deceased being Alaska Natives.

Spanish Flu Reaches Nenana, Alaska

On June 14, 1920, the individual passed away due to the Spanish flu.

Death from Spanish Flu

In 1921, a fourth wave of the influenza pandemic affected seven provinces in Chile between June and December, contributing to the ongoing global impact of the disease.

Fourth wave of influenza in Chile

Between November and December 1921, Helsinki experienced a major epidemic, marking the fifth wave of influenza since 1918 and showcasing the persistent nature of the disease.

Major epidemic in Helsinki

In January 1922, all-cause mortality in the Netherlands doubled due to a major reappearance of influenza, highlighting the continued impact of the pandemic in the Northern Hemisphere.

Significant influenza outbreak in the Netherlands

In early March 1922, California reported a high prevalence of influenza, surpassing levels seen since 1920, indicating the continued circulation of the virus in the United States.

Widespread flu in California

American Samoa effectively implemented quarantine measures, preventing any deaths from influenza until 1926. Despite a high infection rate, the island managed to keep the mortality rate low, showcasing the success of their containment efforts.

Successful Quarantine in American Samoa

Katherine Anne Porter's novella 'Pale Horse, Pale Rider' is a well-known fictional account of the Spanish flu pandemic. It provides a literary perspective on the impact of the disease.

Pale Horse, Pale Rider

In response to the 1957-1958 flu pandemic, the U.S. Public Health Service recommends flu vaccines for high-risk individuals in the U.S. to prevent flu complications.

U.S. Public Health Service Recommends Flu Vaccines

A new H3N2 flu strain causes a global pandemic resulting in about 100,000 deaths in the U.S. and 1 million deaths worldwide. Specific flu vaccines are developed for the pandemic strains.

H3N2 Flu Pandemic

Alfred Crosby's book, 'America's Forgotten Pandemic: The Influenza of 1918,' was first published in 1990. The book provides a chilling account of the world's deadliest flu pandemic from a U.S. perspective and sheds light on the epidemic's international impact.

Publication of 'America's Forgotten Pandemic: The Influenza of 1918' by Alfred Crosby

In 1991, Patterson and Pyle estimated the Chinese death toll to be between 5 and 9 million. However, their study was criticized for flawed methodology.

Chinese Death Toll Estimate by Patterson and Pyle

In 1993, virologist Claude Hannoun suggested that the precursor virus of the Spanish flu likely originated in China, mutated in the United States, and spread globally through Allied soldiers and sailors.

Claude Hannoun's hypothesis on precursor virus

Bird flu caused by the H5N1 flu strain infects humans, prompting the development of pandemic flu response plans globally.

H5N1 Avian Influenza Outbreak

In 1998, Iijima estimated the death toll in China to be between 1 and 1.28 million based on data from Chinese port cities, suggesting a lower mortality rate.

Iijima's Estimate of Chinese Death Toll

A book by Virginia Aronson published in March 2000, discussing the Influenza Pandemic of 1918-1919.

Influenza Pandemic of 1918-1919

A book by David Getz published in September 2000, focusing on the mysterious nature of the flu that occurred in 1918.

Purple Death: The Mysterious Flu of 1918

The Advisory Committee on Immunization Practices (ACIP) recommends annual flu vaccines for children aged 6 to 23 months.

ACIP Recommends Flu Vaccine for Children

The book 'Hunting the 1918 Flu: One Scientist's Search for a Killer Virus' by Kirsty E. Duncan explores the research and investigation into the 1918 flu pandemic, shedding light on the efforts to understand and combat the deadly virus.

Hunting the 1918 Flu: One Scientist's Search for a Killer Virus

The book 'America's Forgotten Pandemic: The Influenza of 1918' by Alfred W. Crosby delves into the history and impact of the 1918 influenza pandemic, highlighting its devastating effects on society and the lessons learned from it.

America's Forgotten Pandemic: The Influenza of 1918

Efforts to recreate the Spanish flu strain involved genetic sequencing of the virus from historic tissue samples. This research provided insights into the characteristics of the deadly pandemic.

Recreation of Spanish Flu Strain

The novel 'The Last Town on Earth' focuses on a town's efforts to contain the spread of the Spanish flu. It explores themes of isolation and community response during a pandemic.

The Last Town on Earth

A 2006 Lancet study confirmed higher excess mortality rates in Germany and Austria during the Spanish flu pandemic compared to Britain and France, indicating the severity of the outbreak in Central Powers.

Study on Excess Mortality Rates

The FDA approves a flu vaccine for avian influenza A caused by the H5N1 flu strain.

FDA Approves Avian Influenza A Vaccine

Monkeys infected with the recreated Spanish flu strain exhibited symptoms similar to the 1918 pandemic. The research highlighted the role of cytokine storms in the severity of the disease.

Monkeys Infected with Spanish Flu Strain

In 2008, the body of British politician and diplomat Sir Mark Sykes was exhumed to study the RNA of the flu virus, specifically the H5N1 bird flu, by extracting samples of lung and brain tissue from his badly decomposed cadaver.

Exhumation of Sir Mark Sykes

In 2009, a new H1N1 flu strain causes a global pandemic resulting in about 61 million illnesses, 274,000 hospital stays, and 12,400 deaths. An H1N1 flu vaccine becomes available later in the year.

H1N1 Flu Pandemic

In June 2010, a team reported that the 2009 flu pandemic vaccine provided some cross-protection against the Spanish flu pandemic strain.

Cross-protection from 2009 Flu Pandemic Vaccine

In 2013, the AIR Worldwide Research and Modeling Group estimated the effects of a modern-day 'Spanish flu' pandemic, predicting significant life insurance losses and deaths in the United States.

AIR Worldwide Research on 1918 Pandemic

Historian Mark Humphries argued in 2014 that the mobilization of Chinese laborers to Europe might have been the source of the Spanish flu pandemic, based on archival evidence of a similar respiratory illness in China.

Chinese laborers as potential source

A report published in 2016 in the Journal of the Chinese Medical Association revealed that the 1918 virus was circulating in Europe before the pandemic, contradicting the belief that it was imported by Chinese and Southeast Asian soldiers and workers.

Study on 1918 Influenza Virus Transmission

A report published in 2016 found evidence that the 1918 virus had been circulating in European armies for months before the pandemic, suggesting an early origin.

Report on 1918 virus circulation

A 2020 study revealed that U.S. cities implementing early and extensive non-medical measures during the Spanish flu pandemic did not suffer additional adverse economic effects, challenging previous assumptions.

Impact of Non-Medical Measures on U.S. Cities

'The Pull of the Stars' is a novel by Emma Donoghue set during the Spanish flu pandemic in Dublin. It offers a fictional portrayal of the challenges faced during the outbreak.

The Pull of the Stars

The study investigates the transmission of swine influenza A viruses between species and the effectiveness of human seasonal vaccines in protecting against them using a ferret model.

Interspecies Transmission of Swine Influenza A Viruses and Human Seasonal Vaccine-Mediated Protection Investigated in Ferret Model

Research on the transmission of swine influenza A viruses between species and the effectiveness of human seasonal vaccines in protecting against them, conducted using a ferret model.

The study conducted in 2023 by van Diemen, Pauline M. et al. focused on investigating the interspecies transmission of Swine Influenza A viruses and the effectiveness of human seasonal vaccines in providing protection, using a Ferret model.

The Spanish Flu, or 1918-1920 flu pandemic, caused by H1N1 influenza A virus, infected 500 million people globally, with death toll estimates ranging from 17 to 100 million. It broke out during World War I, with high mortality among young adults.

Deadly global influenza pandemic in 1918-1920

Spanish Flu

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