This story first appeared in Elan in February 2006. Because it was the winter time flu season I thought it would be appropriate to chronicle what happened in Northern Virginia during the worst pandemic of modern times. At the time, it never occurred to me that such a horrible event would ever happen here again. After all, the practice of medicine had advanced significantly in the intervening century. Nonetheless, here we are, a hundred years later dealing with the COVID-19 pandemic. So you might find it interesting to see how the last one happened, how people who had much less than we do coped with it, and what the government did about it a century ago.
History does repeat itself more often than we would like to admit!
What seemed like an ordinary flu outbreak in 1918 soon turned into the worst pandemic that the world had ever known. While it is often barely mentioned in history books, usually rating no more than a sentence or two, it did have a major negative impact on the entire world population. And the residents of Northern Virginia were not exempt from the terrible toll it took.
In the early fall of 1918, the mainly rural population of Fairfax and Loudoun counties was preparing for winter by harvesting and storing crops. Farming was particularly difficult that year due a labor shortage. Many of the young men who normally would be farming were away in fighting in World War I.
Meanwhile, in France, thousands of troops were stationed in a long system of trenches that marked the front lines. On one side were the French, British, and Americans. On the other side were the Germans. The wasteland in between, called “no man’s land”, was a killing field. Conditions in the trenches were brutal. Soldiers lived and fought in unimaginable filth. They waded through deep mud and water combined with human waste and blood while dodging bullets, bombs, and gas attacks.
Thousands of soldiers on both sides had been killed in this hell on earth. And few could imagine anything more horrible. But things were about to get worse with the introduction of a new disease that would ultimately account for more lives than the total lost to war wounds. Soldiers, since the beginning of history, had always been susceptible to outbreaks of life threatening diseases such as cholera and typhoid due to overcrowded and unsanitary living conditions. During any war illness often caused more deaths then combat. Now a new particularly virulent and highly contagious virus was added to the list. Known as the Spanish Influenza, it spread rapidly among the troops and the civilian population.
At home, Northern Virginians were dreading another cold and dark winter. There were serious shortages of kerosene and coal, the main fuels for heating and lighting. Many homes had wood-burning ranges in the kitchen but other rooms were heated by kerosene or coal stoves. Kerosene lamps were used for lighting. The state government was urging voluntary rationing of coal by asking that it not be burned for heat until December 1 unless it got “very cold.” Since they did not define what temperature constituted “very cold”, it was left up to the individual to decide when to start burning coal. Not too many had that luxury, because it was almost impossible to find any coal for sale. Most of it went straight to the military for the war effort. But people felt that putting up with the discomforts and inconveniences caused by the war was their patriotic duty.
In the beginning, the flu was only a concern to those who had loved ones serving in areas where it was present. There was not a great worry that it would come to the farm country of Northern Virginia. After all, it was happening “over there” and a long way from home.
Government officials issued calming statements that it would not be a problem locally. People were used to specific areas afflicted with the spread of dreadful diseases. In fact, residents of Loudoun County had just finished suffering through an outbreak of smallpox.
The Loudoun County Board of Health had quickly imposed a quarantine that prohibited public meetings and the disease was successfully contained. Therefore, most of the residents of the rural counties were not particularly alarmed by the threat of the flu. They believed it was nothing compared to the horror of smallpox. But that was about to change!
No one knows for sure exactly where the so-called Spanish Influenza started. Scholars have offered opinions and facts to establish a starting point for what became the worst pandemic ever. Some believe that it came to France from China with workers that were brought in to dig trenches. Others thought that the origination point was Turkestan. Many thought that Spain was the country of origin because some eight million Spaniards had suffered from a recent flu epidemic. However, that particular flu did not appear to have had the same degree of virulence. No matter what its origin, the disease struck far flung corners of the world almost simultaneously. This is difficult to explain given the fact that travel in 1918 took much longer than today. The ease of travel in our modern era makes the rapid global spread of a highly contagious virus more explicable
Many point to the first known U.S. cases at Fort Riley, Kansas as a starting point for the contagion. In March 1918, one soldier reported to the hospital with a fever and flu-like symptoms. Others quickly followed. In the next month over a thousand men were infected and more than forty died. In May, the survivors were sent to the battlefields in France. Shortly after their arrival, the flu spread to other soldiers. Those infected carried it to other countries as they were sent home on leave or evacuated to hospitals away from the battlefields. Even the Germans were not left out.
Returning American soldiers brought it back to the U.S. In September the disease struck many U.S. cities. It arrived in Washington, D.C. at the end of the month. Medical personnel and health department officials didn’t know what to think about this particular virus. Outbreaks of flu were not unusual, but victims rarely died unless they were elderly or very young. In this case those who seemed to be at highest risk were ages from the mid-teens to mid-thirties.
Symptoms included fevers, general aches, extreme chills, coughing, and in some cases bloody foam from the nose and mouth. In many cases it progressed to pneumonia which could be hemorrhagic. That was the main killer. The speed of the progression of the illness was particularly frightening. A person could feel fine in the morning, fall ill by midday, and be dead before daybreak of the following day.
To make matters worse, the disease was highly contagious and spread by airborne germs. Public health officials had a difficult time trying to convince a population who had just become acquainted with the idea of germs to take preventative measures. Many didn’t believe in germs because they couldn’t see them.
Next Post Coming Soon! Part II: The Flu Hits Northern Virginia and Washington, D.C.
What They Did About It and The Surgeon General's Advice.
Copyright Karen Washburn 2006