And you thought this flu season was bad

Some 500 million people infected.

Somewhere between 50 and 100 million dead, or three to five percent of the world’s population. More fatalities in one year than from 100 years of the Black Death. More deaths in six months than from AIDS in 24 years.

The winter of 2017-18 has seen a higher than usual incidence of influenza across the United States, bringing death to more than 40 children as well as a number of adults. Most of the fatalities are from the H3N2 virus, which is particularly resistant to flu vaccine.

But while any deaths from contagious disease, particularly those of children, are tragic, the pandemic that started 100 years ago was catastrophic.

It was the so-called Spanish flu.

In the United States, it was first noted at Fort Riley, Kansas, in January 1918. The highly infectious disease spread wildfire-like around the world, attacking people everywhere, including the Pacific Islands and the Arctic.

The name “Spanish flu” took hold because Spain was not at war in 1918, and therefore was not under wartime news censorship. Nations fighting in World War I restricted news coverage about the disease for military reasons, while Spain’s journalists were free to write about it. Based on the news coverage, it seemed therefore that Spain was particularly hard hit.

More military personnel were killed in World War I by the Spanish flu, an H1N1 virus, than by combat.

Armies of all nations were particularly hard hit, with cramped quarters, the conditions of trench warfare, troop mobility and malnutrition all wreaking their damage.

In the United States, the infection rate reached 28 percent. Between 500,000 and 675,000 people died.

The group most likely to die from the disease was pregnant women. Of hospitalized women during the outbreak, according to 11 separate studies, the death rate ranged from 23 to 71 percent. Of the survivors, 26 percent lost their child.

The mortality rate in some other regions was jaw-dropping: In India, 17 million dead, about five percent of that nation’s population. In Tahiti, 13 percent of the population, and in Samoa, 22 percent of the population, within just one or two months. Entire Alaskan communities were wiped out.

But unlike most other pandemics, the spread was of short duration. Two waves occurred in 1918, and then suddenly it was almost extinct.

Spanish flu was particularly virulent. The normal death rate from influenza is about 0.1 percent of those who catch it. In contrast, Spanish flu claimed one in five people who became infected, or 20 percent.

Some censorship of news about the 1918 flu occurred in the United States, although not as much as in Europe. But there were other reasons as well why it has come to be known as the “forgotten epidemic.”

For one, coverage of the war crowded news of the disease off the front pages. For another, the fact that the epidemic was of relatively short duration kept it under the radar.

Some of its symptoms resembled those of more exotic diseases, like typhoid and cholera, and it took a while for the nation and the world to realize what they had on their hands.

In addition, the second wave of the disease, which hit in late 1918, was far deadlier than the first, and lasted only a few weeks. It was over before the nation’s attention could be focused on it, although its fatality rate proved very high.

That second wave coincided with the November armistice that ended the fighting of World War I and which once again upstaged the disease.

The Spanish flu has been called “the greatest medical holocaust in history.”

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