In 1918 an Influenza outbreak (Spanish Flu) began which would eventually infect 500 million people (1/3 of the world’s population) and prove fatal to 50 million making it far more deadly then even World War I (estimated 15-19 million dead) which would end that same year.

The name “Spanish Flu” is misleading and results from Spain’s neutrality during World War I. While the Spanish media dutifully reported on the extent of the pandemic on its citizenry the press in Germany, France, UK and the US downplayed, even censored, the same in their own countries (while reporting on the flu in Spain) in the interests of maintaining morale and patriotism in the face of war.

The international readership of the media were led to believe that Spain was the epicenter of this pandemic. The name sticks to this day. Unlike typical Flu infections, the Spanish Flu exacted a significant toll among young adults 25-34. Of these the worst hit were pregnant women. Approximately ¼ of all pregnant women who survived lost the child. This has been explained by the “cytokine storm” an immune response triggered by the virus that can be dangerous in those with strong immune systems. In 1918 viruses were still undiscovered so researchers tried testing vaccines against Bacillus influenzae, as well as strains of pneumococcus, streptococcus, staphylococcus and Moraxella catarrhalis. These baccterial vaccines had no chance of working against an influenza virus since identified as H1N1.

In 1919 President Woodrow Wilson collapsed while negotiating the end of World War I at the Versailles Peace Conference in April in Paris. Historians believe he was weak due to the flu which was still rampant in Paris. While tremendous advances in the world’s understanding and treatment of the flu have occurred these same viruses continue to pose a serious threat to public health.

The Centers for Disease Control and Prevention (CDC) is our front line defense against future pandemics. They are involved in global influenza surveillance; monitoring and tracking flu activity as well as preparing candidate vaccine viruses that can be used to make the necessary vaccine. They are also conducting cutting edge research on both human and animal viruses in the laboratory to increase our understanding of these viruses.