Death came calling

90 years ago, flu pandemic killed millions

90 years ago, flu pandemic killed millions

October 03, 2008|By JULIE E. GREENE

Share your memories If you remember the 1918-1919 flu epidemic in the Tri-State area, we'd like to hear from you. Please share your story by contacting staff writer Julie E. Greene at; or 800-626-6397, ext. 2320, or mail your story to Julie Greene, c/o The Herald-Mail, P.O. Box 439, Hagerstown, MD 21741.

Ethel Bovey was only 3 when her sister and grandmother died in the great flu pandemic of 1918, but she remembers seeing her 13-year-old sister laid out in a pink dress and white stockings, in that "white thing" she'd later learn was a coffin, in the family parlor.

The whole family was ill in October 1918, though it was believed some of them, like Bovey, had pneumonia rather than the flu, said the 93-year-old resident of Martinsburg, W.Va.

Barely recovered, her father returned to work at Auburn Wagon Works on the corner of Race and Charles streets in Martinsburg. Except instead of making farm wagons, the company switched to making coffins because they were in such high demand and short supply, Bovey said.


"He was ill and went back home for a few days. It was more than he could take," Bovey said.

A frightening infection

The Great Pandemic of 1918-1919 consisted of three waves of flu that resulted in an estimated 30 million and 50 million deaths worldwide, including about 675,000 Americans, according to a U.S. Department of Health and Human Services Web site about the pandemic at

About 400 deaths occurred in Washington County, according to a research report compiled by Mindy Marsden, former executive director of the Washington County Historical Society. That was a little less than 1 percent of the county's population of 59,694.

Typically, the flu kills the very young and the very old, but the 1918-19 epidemic claimed many people in between those groups who were healthy.

There is increasing evidence, through animal studies, that the immune systems of these healthy people overreacted. The immune system produced so many small molecules to defend against infections that the body's other systems shut down and the lungs filled with fluid, causing people to die of pneumonia, said Michael Shaw, associate director for laboratory science in the influenza division for the Centers for Disease Control and Prevention.

Many death certificates during the flu epidemic listed a secondary infection, pneumonia, as the cause of death though that person might have succumbed to pneumonia after being weakened by the flu, Shaw said.

Frantic treatment

Medical professionals didn't really know what to do to treat the outbreak that started in 1918.

The flu passed from person to person so quickly that some communities, including those in Washington County, closed schools and places of amusement and discontinued public meetings in an attempt to contain the outbreak. Marsden's research showed that among canceled events were the Great Hagerstown Fair (two days before it was scheduled to open), the Alsatia Mummers Parade and Halloween trick-or-treating.

Marsden's review of Hagerstown newspapers from the time found ads for patent medicines and questionable health advice, even from trained professionals.

A frequent ad for a flu remedy was Vicks VapoRub, which Bovey remembers being used on her when it was believed she had pneumonia during the epidemic. Vicks was spread on the chest with cotton flannel laid atop to create heat and help the VapoRub so the vapors could be breathed.

VapoRub was so popular that supplies would run out, Bovey said.

"If some was available, word spread quickly that such-and-such a drugstore had it," she said.

Another old home remedy that Bovey heard about was boiling onion, putting it in a bag and laying the bag on the chest.

The flu studied

At the time of the 1918 flu pandemic, medical professionals believed the influenza was caused by a bacteria, Pfeiffer's bacillus, according to the Great Pandemic Web site. That theory was challenged during the pandemic because autopsies did not turn up the bacteria.

Doctors and scientists determined it was spreading through contact with droplets from the nose and throat, through coughing and sneezing.

Two years ago the CDC, working with the Army, did a study about the 1918 virus, using tissue samples from an Eskimo woman whose body was preserved in permafrost in Alaska, Shaw said.

To confirm they had found the right flu strain, scientists compared the woman's to that of preserved autopsy samples from Army recruits who died from the 1918 influenza, Shaw said. While the strain was not a true avian flu, it was close, meaning it mutated from an avian flu, Shaw said. The mutation allowed the strain, H1N1, to bind to human cells.

That's another reason there's been so much current concern about the potential for avian influenzas to affect humans, Shaw said. Since 1997, the avian strain H5 has caused about 240 human deaths in Asia and Africa. The strain has migrated to Europe and has killed birds there but not yet humans.

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