Spanish flu
Based on Wikipedia: Spanish flu
The Misnamed Catastrophe
It killed more people than the war it lived alongside. Somewhere between seventeen million and one hundred million human beings died—the range itself a testament to how overwhelmed record-keeping systems became. At its peak, bodies piled faster than cities could bury them. And the whole time, we called it by the wrong name.
The "Spanish flu" didn't come from Spain.
This is the story of the deadliest pandemic in human history, a disease that infected roughly one-third of everyone alive on Earth, and how wartime censorship created a geographic myth that has persisted for over a century.
Where It Actually Came From
The earliest documented case appeared in Haskell County, Kansas, in January 1918. A local doctor named Loring Miner watched the illness tear through his rural community and felt alarmed enough to warn the United States Public Health Service. His warning went unheeded.
By March, the disease had reached Camp Funston, a major training ground for American troops preparing to ship out to World War One. An army cook named Albert Gitchell became the official "patient zero" on March 4th, though many had fallen ill before him. Within days, over five hundred soldiers at the camp reported sick. A week later, the virus was in New York City.
The American Expeditionary Forces then carried the disease across the Atlantic. It arrived in French ports in April 1918, spreading rapidly along the Western Front before racing through Great Britain, Italy, and the rest of Europe. By May, cases had been recorded in India, North Africa, and Japan. By June, China. By July, Australia.
The first wave circled the entire planet in roughly four months.
Why Spain Got the Blame
Here's the thing about fighting a world war: you don't want your enemy to know your soldiers are too sick to fight.
Every major combatant nation—Germany, France, Britain, the United States, Austria-Hungary—censored news about the outbreak. Military commanders and government officials suppressed reports of illness to maintain morale and hide any perception of weakness. Admitting that your army was being devastated by disease would be handing valuable intelligence to the other side.
Spain wasn't fighting. As a neutral country, it had no military secrets to protect and no propaganda machine demanding optimistic headlines. When King Alfonso XIII fell ill in May 1918, Spanish newspapers reported it openly. When the disease spread through Madrid, they covered it. When over one hundred thousand Spaniards fell sick, the world read about it—because Spanish papers were the only ones actually publishing the truth.
This created a bizarre information asymmetry. From the outside, Spain appeared to be the epicenter of a terrible epidemic. Everyone else looked fine.
The Spanish, of course, knew better. They watched their neighbors supposedly healthy while their own country suffered, unable to understand why they had been singled out. Spanish health officials were genuinely confused. In October 1918, one wrote to the Journal of the American Medical Association in protest: "We were surprised to learn that the disease was making ravages in other countries, and that people there were calling it the 'Spanish grip.' And wherefore Spanish? This epidemic was not born in Spain, and this should be recorded as a historic vindication."
That vindication is still waiting.
The Blame Game
Spain wasn't the only country to have a disease named after it. The 1918 pandemic triggered a worldwide exercise in finger-pointing, with each nation blaming some foreign adversary or marginalized group.
The French initially called it "American flu"—accurate, as it turned out—before switching to "Spanish flu" to avoid antagonizing an ally. British soldiers on the Western Front called it "Flanders flu." German troops in the same trenches called it "Flemish fever." Both named it after the Belgian battlefield where so many of them were getting sick.
In Senegal, it was "Brazilian flu." In Brazil, "German flu." Poles called it the "Bolshevik disease." Russians called it the "Kirghiz disease." Some Africans called it "the white man's sickness," while white South Africans used a racial slur to call it "the negro disease."
Japan blamed sumo wrestlers who had traveled to Taiwan, dubbing it "sumo flu."
This pattern wasn't new. During the 1889–1890 pandemic, Russians called it "Chinese catarrh," Germans called it "Russian pest," and Italians called it "the German disease." Making a disease sound foreign is as old as disease itself—a way of asserting that sickness comes from somewhere else, from someone else, from people who are not us.
The World Health Organization now explicitly discourages this practice. Their 2015 guidelines on naming new diseases list "Spanish flu" under "examples to be avoided."
What People Called It Instead
Not every name blamed another country. Some names simply tried to capture the terror of experiencing something doctors couldn't explain.
In Sierra Leone, the Weekly News suggested a biblical framing, reaching back to the ancient Hebrew of Exodus: Man hu—"What is it?" The doctors were "flabbergasted," the paper noted in July 1918, and until they figured out what they were dealing with, perhaps that ancient question was the most honest name of all.
In Northern Ndebele, it was called Malibuzwe—"let enquiries be made concerning it." In Swahili: Ugonjo huo kichwa na kukohoa na kiuno—"the disease of head and coughing and spine." In Otjiherero: kaapitohanga—"disease which passes through like a bullet." In Persian: nakhushi-yi bad—"disease of the wind."
Some names carried dark humor. In Yao, spoken in parts of East Africa, it was called chipindupindu—"the disease from seeking to make a profit in wartime."
German doctors, perhaps trying to maintain calm, called it "pseudo influenza"—using the Greek word for "false." African doctors, trying to make patients take it seriously, called it "influenza vera," using the Latin word for "true."
French military physicians, with grim bureaucratic precision, simply called it "disease eleven."
The Peculiar Demographics of Death
Most flu pandemics follow a predictable pattern. They kill the very young, whose immune systems haven't fully developed, and the very old, whose immune systems have begun to fail. The middle years are generally safe.
The 1918 pandemic inverted this pattern. It killed young adults in extraordinary numbers. If you graphed mortality by age, instead of the expected U-shape—high at both ends, low in the middle—you got a W-shape. People in their twenties and thirties died at rates that made no sense.
Why? Scientists still debate this a century later.
One theory involves the immune system itself. Young, healthy adults have robust immune responses. In some cases, their bodies may have overreacted to the virus, triggering what's called a "cytokine storm"—an immune response so violent that it destroys the body it's trying to protect. The healthier you were going in, the harder your immune system might have fought, and the more damage it might have done.
Another theory points to the conditions of war. Young men were the soldiers. They lived in overcrowded trenches and barracks, in conditions of poor hygiene and chronic malnutrition. Many victims didn't die from the flu itself but from secondary bacterial infections—pneumonia that took hold in lungs already weakened by the virus. In an era before antibiotics, these infections were almost uniformly fatal.
The disease progressed terrifyingly fast. Patients developed a distinctive "dusky heliotrope" coloring—a blue-violet tinge to their faces as their lungs failed and oxygen levels dropped. This led to one of the more chilling names for the pandemic: "the purple death."
The Three Waves
The pandemic struck in three distinct waves, each with its own character.
The first wave, in the spring of 1918, was relatively mild. In the United States, roughly seventy-five thousand flu-related deaths occurred in the first six months of the year—elevated, but not catastrophically so. Many people got sick. Most recovered. Some historians believe this initial wave helped prepare survivors' immune systems for what came next, though this remains controversial.
Then came autumn.
The second wave, from September to November 1918, was apocalyptic. The virus had mutated into something far more lethal. Mortality peaked simultaneously across fourteen different European countries in October and November—a synchronicity that still puzzles researchers, since diseases typically spread outward from a point of origin rather than striking everywhere at once.
In Philadelphia, the city held a parade to support the war effort in late September despite warnings from public health officials. Within seventy-two hours, every hospital bed in the city was full. Within a week, 2,600 people were dead. Within six weeks, more than twelve thousand.
A third wave followed in the winter and spring of 1919, less severe than the second but still deadly. By the time the pandemic finally burned itself out in 1920, it had killed more people than four years of industrialized warfare.
Competing Origin Theories
Kansas is the conventional answer to "where did it start?" but scientists and historians have proposed alternatives.
Virologist John Oxford has argued that the pandemic began at a British military camp in Étaples, France—a massive staging area and hospital complex that treated thousands of soldiers, including many poison gas victims. The camp also kept pigs nearby, and poultry was regularly brought in to feed the troops. Oxford believes a precursor virus jumped from birds to pigs to humans in this perfect incubator of cross-species contact. He points to a mysterious respiratory illness that struck Étaples in late 1916, with symptoms matching the later pandemic.
Others have looked to China. In 1993, Claude Hannoun of the Pasteur Institute—then the world's leading authority on the Spanish flu—argued that a precursor virus likely originated in China before mutating in the United States and spreading globally through Allied troop movements. In 2014, historian Mark Humphries suggested that ninety-six thousand Chinese laborers recruited to work behind British and French lines might have carried the disease to Europe. A respiratory illness had swept through the regions of China where these workers were recruited in late 1917.
The Chinese origin theory has a strange piece of supporting evidence: China itself was one of the least affected regions during the pandemic. If the virus had been circulating in Chinese populations before 1918, those populations might have developed partial immunity. When the pandemic struck, they were already prepared.
But a 2016 study in the Journal of the Chinese Medical Association pushed back. Chinese and Southeast Asian workers in Europe had mortality rates comparable to other Allied troops—about one in a thousand—suggesting they weren't carrying anything their European counterparts weren't equally exposed to. The study found evidence that the virus had been circulating in European armies for months, possibly years, before the pandemic proper began.
Recent genetic analyses suggest the virus likely did have a North American origin, though the evidence isn't conclusive. What is clear is that the H1N1 subtype of the influenza A virus—the specific pathogen responsible—appears to have assembled itself from component parts sometime around 1915, years before anyone noticed it.
We may never know for certain where the deadliest pandemic in human history actually started. We only know that it wasn't Spain.
A Children's Rhyme
In the playgrounds of 1918, children skipped rope to a song adapted from an earlier flu pandemic:
I had a little bird,
Its name was Enza.
I opened the window,
And in-flu-enza.
The pun captures something about how people processed the incomprehensible. A century later, researchers studying pandemic responses would note the same phenomenon—dark humor, wordplay, and absurdity as coping mechanisms when the scale of death exceeds the human capacity for grief.
What We Know Now
The 1918 pandemic was caused by an H1N1 influenza virus—the same family of viruses responsible for the 2009 "swine flu" outbreak, though far more lethal. Scientists didn't identify influenza viruses until the 1930s, so everyone who lived through the 1918 pandemic did so without understanding what was killing them.
The name "influenza" itself comes from Italian, reflecting a medieval belief that the disease was caused by the influence of the stars—an astrological explanation for an inexplicable plague. The French called it la grippe, meaning "the grip" or "the grasp," a name that captures the feeling of being seized by something invisible.
In 1918, people grasped for explanations. Some blamed the war itself—the smoke from explosives, the poison gases, the stress on the human body. Some blamed miasmas, the "bad air" that previous generations had blamed for cholera and plague. Some blamed Spain. Some blamed God.
They were fighting something they couldn't see, couldn't understand, and couldn't name correctly. And in two years, it killed between seventeen million and one hundred million of them—a range so vast it tells you how overwhelmed the world's counting systems became.
The next pandemic won't be called the "Spanish flu." The World Health Organization will make sure of that. But the impulse to blame someone else, to make disease foreign, to point fingers at the outbreak in the next country while hiding the outbreak in your own—that impulse seems harder to cure than the flu itself.