The flu regularly migrates between pigs, chickens and humans. Whenever it does, the poorly adapted flu is unusually lethal.
The misnamed Spanish flu seems to have killed by triggering a strong immune response. That response is called a cytokine storm. Which means that the stronger your immune system, the more likely you were to be hit hard. It therefore killed the reverse of the groups that normally get killed by diseases.
There is also some evidence that people who experienced the "Russian flu" of 1889-1890 had some level of protection from the Spanish flu.
There's a surprising amount of well-intentioned but misinformed speculation in this thread.
"We don't know" is the best answer to a lot of the questions about Spanish flu. What we do know is that it disproportionally killed young, healthy people who could go from no symptoms to dear in 24 hours. There's a lot of speculation as to why. I've seen medical experts theorize this is likely due too a cytokine response, meaning basically that a healthy immune system goes nuts. Apparently there are other diseases that have fit this pattern.
The mortality rate is estimated at about 3%. Influenza is 0.1%. Coronavirus is somewhere between those.
Best guess of why the second wave was so deadly was due to a mutation that likely happened in Europe.
It's true we have things we didn't in 1918 but we still have surprisingly few tools to combat viruses. Fun fact: only one virus has had a cure developed and that was Hepatitis-C in recent years. To be clear, vaccines != cures.
We also have problems we didn't have in 1918, specifically mobility of people. It's that mobility combined with people being highly contagious while being asymptomatic that makes this particular diseases such a challenge.
the 1918 flu pandemic caused a cytokine storm, which is hypothesized to have caused so many otherwise healthy people to die. if there's cytokine activity that's another parallel to the Spanish flu.
Nope, the first wave of the flu only killed older people and people with a low immune system. Just like the corona virus. The Spanish flu hit in three waves. The first like this one. The second wave hit the younger. The third wave hit the rest.
Bacterial Pneumonia was not the novel danger of the "Spanish" flu; They cytokine storm it caused in perfectly healthy people was horrifying, with perfectly healthy people who would normally fight off any flu dying from this one. A lot of young twenty somethings, strong people who were not malnourished died from it.
Hell, people got cytokine storms from COVID-19 and we still can only treat it if we catch it really early, otherwise it's still a great way to die for a normal person.
Spanish Flu is on list. And it killed 50 to 100 MILLION. Way, way more than the typical yearly flu did in the two years it was active. And probably more than all the years since, combined.
It also killed many healthy people possibly due to auto immune. Verse typical influenza which only weakens body so other normally non-lethal factors are enough to kill.
Correct. Note that there were multiple waves of the Spanish Flu. First wave was fairly mild and hit the young and elderly. Second wave hit the middle aged and wiped out a chunk of the population.
The third wave was slightly worse than the first but much less deadly than the second - I couldn't find much detail about it when I last tried.
Several theories on why it turned out this way, none of them relevant to the current situation though.
Primarily death was due to bacterial pneumonia, the cytokine storm likely accelerating the deterioration of the lungs. That particularly viral strain may have been more dangerous, but overall the current pandemic is comparable in death rates.
It would seem during the Spanish flu your best chance of survival was being in a location where strict quarantine and travel restrictions were imposed so the health system was able to cope with those who did contract the virus.
The places with the highest fatality rates were those with poor or non-existent health services or where people didn't seek medical assistance.
The mortality rate in the US was around 0.5%, <1% in East Asia, but 5% in India and as high as 20% in some Pacific nations. Iran's current Covid-19 mortality rate is quite comparable to the Spanish Flu around 14%.
People died from the Spanish flu because they were malnourished and because the general conditions were bad. The Spanish flu would be nothing like that if it happened today ... In Europe at least.
> was it actually a fairly bad flu that wreaked havoc on a war-torn population?
No, because those affected worst by it were young adults in relatively good health. Small children and the elderly were proportionally spared. The prevailing theory for why Spanish flu killed more healthy young adults was because it was an over-reaction of the immune system itself that was most harmful:
It is definitely the case that the war led to many young adults being moved around the world and kept in close quarters, which certainly exacerbated the spread and effect of the pandemic.
Swine flu killed a couple hundred thousand only 10 years ago or so. There were a pair of flu pandemics each lasting about a year, one in the 1950s, and one in the 60s. Each of those killed a million.
The Spanish flu killed like ?? tens of millions, also in a year or two.
There was a more protracted pandemic that killed a million around 1910-1920, but it wasn't a flu.
People keep comparing this to the Spanish flu, but there was a big difference between this and the Spanish flu: most people who died from Spanish flu actually died from bacterial infections and other complications. Back then, antibiotics weren't really a thing yet.
The misnamed Spanish flu seems to have killed by triggering a strong immune response. That response is called a cytokine storm. Which means that the stronger your immune system, the more likely you were to be hit hard. It therefore killed the reverse of the groups that normally get killed by diseases.
There is also some evidence that people who experienced the "Russian flu" of 1889-1890 had some level of protection from the Spanish flu.
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