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In July 1918, as the deadliest pandemic in modern history swept across the globe, the editors of the *Sierra Leone Weekly News* reached for an ancient Hebrew phrase to describe what they were witnessing. The doctors, they wrote, were “flabbergasted,” and rather than calling the disease influenza, perhaps they should call it *”Man hu”* — “What is it?” It was a fitting question. The virus killing people by the tens of millions was so poorly understood, so aggressively hidden from public view, and so thoroughly forgotten afterward that it would take another pandemic, a century later, to drag it back into widespread consciousness.
A Pandemic Born in the Shadow of War
The 1918–1920 flu pandemic — caused by the H1N1 subtype of the influenza A virus — emerged near the end of World War I, and the war shaped everything about how the world experienced it. The earliest probable cases were documented in March 1918 in Haskell County, Kansas, with further cases appearing in France, Germany, and the United Kingdom in April. By the time it was over, an estimated 500 million people — nearly a third of the global population — had been infected. Death toll estimates range from 17 million to 50 million, and possibly as high as 100 million.
The war didn’t just coincide with the pandemic; it actively made it worse. Wartime conditions created ideal environments for a respiratory virus to thrive and spread. Overcrowded military camps and hospitals, malnourishment among soldiers and civilians alike, and poor hygiene set the stage. Most victims didn’t die directly from the virus itself — they died from bacterial superinfection, a secondary illness that followed a typically prolonged period of decline. The war’s machinery ground on even as the sick filled every available bed.
The Lie Baked Into the Name
Here is one of history’s more elegant ironies: the pandemic was not Spanish. It did not originate in Spain. Spain was simply the only country that talked about it openly.
The belligerent nations of World War I — Britain, France, Germany, the United States — were operating under wartime censorship, suppressing bad news to maintain morale and military readiness. Spain, as a neutral country, had no such propaganda apparatus to manage. Its newspapers freely reported on the epidemic sweeping through the population, creating the impression that Spain was uniquely afflicted. On June 2, 1918, *The Times* of London ran a dispatch from Madrid describing “the unknown disease” striking over 100,000 people. Three weeks later, the same paper noted that “everybody thinks of it as the ‘Spanish’ influenza.” Three days after that, an advertisement appeared in *The Times* selling tablets to prevent “Spanish influenza.”
The Spanish themselves were well aware of the injustice. A Spanish official, writing in October 1918 to the *Journal of the American Medical Association*, protested: “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.” The censorship had been so complete that Spain’s own health officials didn’t realize their neighbors were equally devastated. The World Health Organization, in guidelines first published in 2015, now lists “Spanish flu” as an example of the kind of culturally stigmatizing name that should be avoided.
A World That Named Its Fear
The names different peoples gave the pandemic are a kind of cultural archaeology, each one revealing how communities tried to make sense of catastrophe by locating it somewhere outside themselves. British soldiers called it “Flanders flu.” German soldiers used “Flemish fever.” In Senegal it was the “Brazilian flu”; in Brazil, the “German flu.” In Poland, it was the “Bolshevik disease”; in Russia, the “Kirghiz disease.” Japanese authorities blamed sumo wrestlers returning from Taiwan, calling it “sumo flu.” The French press initially called it “American flu” but switched to “Spanish flu” rather than antagonize an ally.
In Spain itself, the pandemic was sometimes called *Soldado de Nápoles* — the Naples Soldier — after a popular song from a theatrical production, *zarzuela*. In Africa, some called it “a white man’s sickness,” while in South Africa, white populations used a racial slur to name it in the opposite direction. The Otjiherero-speaking people of southern Africa called it *kaapitohanga* — “disease which passes through like a bullet.” The Yao named it *chipindupindu*, meaning “disease from seeking to make a profit in wartime.”
These names tell us something important: everywhere it struck, people tried to frame the pandemic as something that came from somewhere else, something foreign and other. No one wanted to claim it.
The Unusual Killer
Most influenza outbreaks follow a predictable pattern, hitting the very young and the very old hardest. The 1918 pandemic was different. It showed an unusually high mortality rate among young adults — a fact that puzzled scientists and added to the terror. Researchers have proposed several explanations, including a six-year climate anomaly that may have affected the migration of disease vectors and increased transmission through bodies of water. However, it should be noted that the claim of disproportionate young adult mortality has itself been contested by some researchers.
What is less disputed is the catastrophic role of wartime conditions in amplifying the death toll. The overcrowded camp and military hospital at Étaples, France — a site later theorized by virologist John Oxford as possibly central to the pandemic’s development — treated thousands of victims of poison gas attacks and other casualties. It also housed a piggery and regularly brought in poultry to feed troops. Oxford’s team suggested a precursor virus may have mutated from birds to pigs in such environments before finding its way to humans. The conditions of total war, in other words, may have helped build the very pandemic that outlasted it.
What We Still Don’t Know
A century later, the origin of the 1918 flu remains genuinely unsettled. Historian Alfred Crosby pointed to Kansas; a 2018 study led by Michael Worobey cast doubt on that, finding evidence of a broader North American origin without being conclusive. Political scientist Andrew Price-Smith found archival data suggesting the pandemic may have begun in Austria in early 1917. Virologist John Oxford’s work pointed to the Étaples camp in France as a likely incubation site. Claude Hannoun of the Pasteur Institute argued in 1993 for a precursor virus from China that mutated near Boston. Historian Mark Humphries, writing in 2014, raised the possibility that 96,000 Chinese laborers mobilized to work behind Allied lines may have carried a predecessor illness — one that had struck northern China in November 1917 — though no tissue samples from that outbreak survived for modern analysis.
The question of why some regions seemed less affected remains murky, too. China, for instance, appears to have experienced a comparatively mild 1918 flu season — but researchers note this finding is disputed due to the scarcity of reliable data from the Warlord Period.
The pandemic killed tens of millions, reshaped the world’s population, and was then — partly because it was sandwiched between a world war and the Roaring Twenties, partly because of the very censorship that enabled it to spread — largely forgotten by popular memory. It took another pandemic, another century, and another global reckoning with mass death to remind us it had happened at all.
Sources
– This article is a synthesis of the Wikipedia article on Spanish flu (en.wikipedia.org/wiki/Spanish_flu), which itself cites the underlying scholarship. Readers wanting primary sources should follow that article’s reference list.
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