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  • Writer's pictureNotes From The Frontier

The Godzilla of Pandemics: The 1918 Flu

It was the most deadly pandemic in world history. Worse than the Bubonic Plague—The Black Death of the 1300s. Worse than the smallpox epidemic of the 1700s (that killed many Americans during the American Revolutionary War). Like both of those epidemics, the Flu Epidemic of 1918 coincided with major wars. In fact, it was believed that American soldiers first brought the scourge from America to Europe and from there it spread!

Today disease experts say that the disease was originally a bird flu in the United States that mutated to pigs, then spread to humans in Kansas first. The first major outbreak was at Fort Riley, Kansas, when as many as 500 soldiers were hospitalized. But, strangely, the affliction seemed meek and passed over quickly. Most of the recovered soldiers departed soon for the war in Europe. From there, it is believed the virus mutated into the most deadly strain in human history and spread rapidly.

Although the killer virus was called the “Spanish flu,” it was not Spanish any more than any other nationality. Pandemics do not recognize national boundaries. It was dubbed the Spanish flu because Spain was a neutral country in World War I and was the first nation to report the contagion. Although it was ripping through ranks of soldiers in the trenches and spared no one, no matter their country of origin, no country wanted to report it at home for fear it would hurt their war efforts. President Woodrow Wilson had rammed through the Sedition Act making it illegal to say or publish anything against the war effort. Any discussion of the flu was prohibited even though Wilson himself contracted the virus!

The flu proceeded to spread globally and by the end of the war—Armistice Day, November 11, 1918—when the world should have been celebrating, nations around the world were reeling from massive death counts on their homefronts. World War I claimed about 16 million lives. By the time the flu pandemic had run its course, it would kill 50-100 million worldwide. In fact, by the end of 1918, more soldiers had died of the flu than during the entire War.

In the United States alone about 680,000 died. (By today’s per capita standards that would be about 2.3 million Americans and between 240-450 million worldwide.) Because so many medical personnel had been sent overseas for the war effort, there was a drastic shortage of doctors and nurses, as well as hospitals and hospital beds, to nurse the sick in the U.S. and other countries.

About 60-70% of deaths occurred in the first 14-15 weeks when the epidemic in the U.S. peaked, between September and December 1918. Dying from the flu in 1918 was not an easy way to go and caring for those sickened by the disease was nothing short of horrifying. Patients bled from the mouth, nose and eyes and their lungs filled with fluid so that many victims of the virus essentially drowned.

Because the flu attacked the respiratory system especially, patients progressively suffered from a lack of oxygen and would turn blue or sometimes almost black. Medical personnel during the war reported that they could not tell the difference between a black soldier and a Caucasian soldier who was afflicted because they turned so dark. The acute shortage of oxygen machines in the U.S. exacerbated the problem.

Doctors and nurses were further hamstrung by the dire lack of knowledge about the virus. There were no antibiotics, cleanliness was still not widely known to help fight disease, and enemas, bloodletting, and whiskey were among the favored treatments of the day.

The disease was enabled to spread also by the lack of urgency with which many officials acted. Today, disease experts and the medical community point to a fascinating case study of the flu epidemic between the cities of Philadelphia and St. Louis and how officials there reacted to the epidemic. In the fall of 1918, Philadelphia decided to hold its Liberty Loan Parade to raise war bonds for the war. It was a huge annual event. At the same time, St. Louis canceled its parade and closed all its schools and discouraged large gatherings of any sort.

Consequently, on September 28, 1918, about 200,000 Philadelphians crowded the sidewalks to see the parade. In the first 24 hours after the parade, 118 people came down with the flu. Within three days, every bed in Philadelphia’s 31 hospitals was filled. Within six weeks, 12,000 had died, within six months 16,000 had perished in Philadelphia alone. In Philadelphia the peak death rate was 719 deaths per 100,000 people, in St. Louis, less than half that: 347 deaths per 100,000.

Below is an 11-minute video about the history of the 1918 Flu Epidemic. This video was made in November 2018—about a year ago—for the 100th anniversary of the 1918 natural disaster. Eerily, as if presaging the crisis we are in today, one scientist in the video is quoted as saying that medical experts agree that there will most certainly be future global flu pandemics. The federal departments of crisis management of both the United States and Britain assessed that the two biggest threats to their respective nations were: (1) terrorist attacks, and (2) another flu epidemic. “The question is not if,” the scientist says, “it’s when.”

One other eerie historical irony: President Trump’s grandfather, Frederick Trump, died in the flu epidemic in May 1918.

VIDEO-The 1918 Flu Epidemic

(by Cambridge University)

For other health-related posts, go to

-Frontier Death

-Civil War Surgery

-Rabies on the Frontier

-Funeral Technology in the 1800s

-Cocaine Candy & Heroin Cough Syrup

-Whiskey in the Old West


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Deborah Hufford

Author, Notes from the Frontier

Deborah Hufford is an award-winning author and magazine editor with a passion for history. Her popular blog with 100,000+ readers has led to an upcoming novel! Growing up as an Iowa farmgirl, rodeo queen and voracious reader, her love of land, lore and literature fired her writing muse. With a Bachelor's in English and Master's in Journalism from the University of Iowa, she taught students of Iowa's Writer's Workshop, then at Northwestern University, Marquette and Mount Mary. Her extensive publishing career began at Better Homes & Gardens, includes credits in New York Times Magazine, New York Times, Connoisseur, many other titles, and serving as publisher of The Writer's Handbook


Deeply devoted to social justice, especially for veterans, women, and Native Americans, she has served on boards and donated her fundraising skills to Chief Joseph Foundation, Missing & Murdered Indigenous Women (MMIW), Homeless Veterans Initiative, Humane Society, and other nonprofits.  


Deborah's soon-to-be released historical novel, BLOOD TO RUBIES weaves indigenous and pioneer history, strong women and clashing worlds into a sweeping saga praised by NYT bestselling authors as "crushing," "rhapsodic," "gritty," and "sensuous." Purchase BLOOD TO RUBIES online beginning June 9. Connect with Deborah on, Facebook, and Instagram.

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