Background
What was the 1918 Influenza Pandemic?
The 1918 Influenza Pandemic was a novel strain of the H1N1 flu virus. In the early 20th century, recurring yearly influenza as well as localized bouts of epidemic influenza were commonplace. Deaths from the flu were also not uncommon, particularly among the very old, the very young, and the chronically ill. But the 1918 influenza was different. Young and healthy people who could usually fight off a seasonal flu were becoming very ill and dying in high numbers. Nearly half of the flu’s victims were in their 20s and 30s.
Some medical experts theorize that the flu took advantage of younger people’s strong immune systems by causing a dangerous overreaction called a cytokine storm. When someone gets sick, the immune system sends out proteins called cytokines that tell other cells in the immune system to gather at sites of infection. This causes unpleasant but ultimately helpful inflammation. But in a cytokine storm, the body produces so many cytokines that the inflammation becomes dangerous. Since pandemic influenza usually affected the lungs most severely, cytokine storms would cause deadly swelling and fluid build up in patients’ lungs.
The 1918 flu first appeared in the spring among soldiers fighting in the First World War. At the time, many people thought the virus originated in Spain, which led to its now-outdated nickname “the Spanish Influenza.” But one of the first recorded cases of influenza actually occurred in a US soldier in Kansas. In fact, some epidemiologists today theorize the flu originated in Kansas before spreading to other parts of the world when the United States entered the war. Wherever the virus came from, the tight quarters of the barracks and trenches allowed the virus to spread easily, and the movement of troops and medics across countries and continents ensured the virus traveled worldwide.
The first wave of influenza didn't concern most American citizens much. It did not spread to many civilians and seemed to be about as virulent as the average seasonal flu. But a second, deadlier wave of the virus hit in the fall of 1918. Apparently, in moving around the world's population, the virus had managed to accrue some dangerous mutations. The peak of this second wave in the United States was the month of October, when 195,000 Americans died from the flu or its complications. In order to mitigate the spread of the flu, leaders across the country shut down schools and businesses, mandated the wearing of flu masks, and quarantined the sick.
In all, an estimated 750,000 Americans, soldier and civilian, died—more than the number of Americans lost in every 20th century war combined. The flu came and went in many communities until at least 1920, but its severity lessened with each successive wave because people developed immunity to it and because the virus itself mutated to become less deadly. However, the 1918 flu did not die out or disappear. Other strains of pandemic H1N1 influenza viruses, including the recent 2009 H1N1 “Swine Flu,” have all been “descendants” of the 1918 flu.
World War I and the University
When the United States entered World War I in spring of 1917, the University of Michigan joined the country in mobilizing to aid the war effort. Thousands of male students signed up for the Student Army Training Corps, or SATC, a federal program that allowed students to continue attending college classes while training for military service on or near campus. Contributors to the student newspaper The Michigan Daily describe UM SATC soldiers living in on-campus barracks, doing training drills in the Diag, and marching to and from classes. The newspaper also printed daily articles detailing military and diplomatic developments in the war and praising the patriotism of the troops. Female students volunteered as Red Cross nurses and participated in drives to support American soldiers and aid European civilians.
When cases of pandemic influenza first appeared among SATC members in the UM barracks in the fall of 1918, university and military leadership attempted to quarantine soldiers to prevent the spread of the disease. However, the efforts to isolate the virus did not stop it from spreading to other SATC members, students, and the community at large. Most influenza patients went to one of three hospitals in Ann Arbor—the University Hospital at UM, the Homeopathic Hospital at UM, or St. John’s Hospital. Members of the community—many of them older women, as the Michigan Daily notes—volunteered to care for the patients.
Starting in mid-October, local officials in Ann Arbor and Washtenaw County as well as the state governor issued various ordinances closing down businesses and schools to prevent the spread of pandemic influenza. Student meetings and local concerts were cancelled or postponed. The University ordered students and SATC members to wear influenza masks to protect themselves and others. Female students met to hand-make hundreds of flu masks for the campus community. The Michigan Daily featured guides for properly making flu masks out of gauze.