What is the Spanish flu?

Influenza virus is a virus that generally tends to affect the lower and upper respiratory tract. Some species of this virus, which is divided into many subspecies, show the ability to cause disease in humans, while some subspecies only cause disease in other living species. Being a member of orthomyxovirus family, influenza virus is generally divided into 4 subgroups, A, B, C and D. Influenza A virus is a virus with 2 surface antigens called hemagglutinin (H) and neurominidase (N) on its surface. Influenza A virus can cause changes in these surface antigens, causing repeated disease in humans. Sometimes they are important because changes in the surface antigens of this virus can result in global epidemics.

Spanish flu is a pandemic that affected approximately 1/3 of the world population between 1918 and 1919 due to the influenza virus. Influenza virus is found mainly in goose-like bird species. This virus passes on to humans through pigs.

Apart from the Spaniards who gave their name to the pandemic, European countries such as France, England and Italy were also heavily hit during the Spanish flu pandemic. The Spanish flu, which tends to affect people of all ages, is an epidemic that has had very severe consequences due to its severe course in people of extreme age, such as children and the elderly.

The first case of Spanish flu is thought to have occurred in the spring of 1918. During that period, the serious illness of the soldiers of European countries in the First World War brought to mind the idea that the underlying cause could be an epidemic. The epidemic, which spread from Europe to North Africa towards the end of May, later spread to India and as of July this year to China and Australia, affecting the whole world.

What are the symptoms of Spanish flu?

In the first wave of Spanish flu, which is generally thought to occur in 3 waves, flu-like symptoms were generally detected in people who got the disease. The second wave of the epidemic, which started as of August, was fatal, and a mutation of the virus during the first wave was blamed as the underlying cause of this course change.

The second wave of Spanish flu, which lasted for about 6 months, constitutes the worst period of Spanish flu in European countries that are struggling with food and other resources due to the impact of the world war. It is thought that the number of people who lost their lives in this period of the epidemic peaked and the second wave started simultaneously in different parts of the world.

The symptoms that occur in people due to the Spanish flu and can follow a fatal course are generally as follows:

• Nose bleeding
• Pneumonia
• Encephalitis (Inflammation of the brain tissue)
• Fever exceeding 40 degrees
• Kidney problems such as nephritic syndrome
• Coma


During the course of the pandemic, these life-threatening symptoms have caused severe consequences in all segments of the society, regardless of any class difference.


How many people died in the Spanish flu epidemic?

In the Spanish flu epidemic, an influenza virus pandemic, the number of people infected with the disease is estimated to be close to 500 million. The number of people who lost their lives due to this epidemic is thought to be over 50 million.

Lack of treatment for the disease caused the healthcare professionals, who continued to work for that time, to resort to improvised treatment practices aimed at relieving only the symptoms occurring in individuals. The soldiers who got sick during the war and then returned to their homeland and caused the spread of the disease in those regions also played an important role in the aggravation of the course of the pandemic.

Following the recognition of the epidemic by the existing authorities at that time, studies on measures to be taken against the epidemic in Europe began as of August 1918. It has been made mandatory to report suspected cases, and strict monitoring of the disease in environments where people are together, such as schools or military campuses, is one of the steps taken to prevent the spread of the Spanish flu.

European countries, which decided to tighten the measures as of October, stopped the activities of businesses such as cinemas and theater halls, where people came together. At the same time, European countries, which took measures regarding Sunday rituals, added to their decisions that the sermons should not be longer than 5 minutes.

Cleaning and disinfecting social living spaces such as streets, churches and workshops has been one of the most important steps taken to prevent the epidemic. Regulating and reducing the number of passengers in public transport is another important step taken to prevent the spread of the disease.

Scientists have thought that there are many reasons why people continue to die from Spanish flu despite the precautions taken. Bacterial infections, measles, malaria and nutritional deficiencies added to the Spanish flu are among the reasons that lead to the fatal course of this disease.

Despite precautions, the Spanish epidemic could not be prevented, leading to various public health initiatives. Soap and clean water were provided to patients with poor conditions, sewage works gained speed, and the decisions taken were published in the newspaper to raise awareness of the public. In areas where the death toll has increased excessively, special areas where the corpses of people who lost their lives from Spanish flu are collected have been determined and ceremonies such as funerals are prohibited.

Approximately 25 million people died in the first six months of the Spanish flu pandemic. In this epidemic consisting of 3 waves, the second wave, which occurred especially between November and December of 1918, was the period when the death rates of the Spanish flu epidemic were the highest. Apart from the lack of any specific treatment for this disease, some improvised treatments tried at that time may have also paved the way for the fatal course of the disease in some people. Some health authorities of the period, which recommended extremely high doses of aspirin to people with Spanish flu, caused the death of patients due to reasons such as internal bleeding.

By December 1918, the epidemic came to a halt in many parts of the world. The Australian government, which decided to abolish pandemic measures in the early months of 1919, paid for these decisions with 12000 new cases. The end date of the epidemic for the northern hemisphere is May 1919. The third wave started in Japan towards the end of 1919 and the Spanish flu epidemic ended in 1920 in this country.

The Spanish flu epidemic of 1918 took its place in history as a major infectious disease with high mortality rates that resulted in catastrophic global scale. Samples taken from soldiers who died of the Spanish flu caught and were frozen and stored provided the opportunity to analyze the disease-causing virus. The Spanish flu also provided important information and experience to the future on what measures can be taken to protect public health during epidemic periods, how to ensure hygiene conditions and how to monitor patients with radiation studies.

After the Spanish flu, the influenza virus that caused this disease began to follow a less fatal course by undergoing various mutations. The most common subtypes of this virus, which is now referred to as seasonal flu epidemics, are detected and included in your flu vaccine. Bacterial pneumonia cases added to the Spanish flu, which was an important cause of deaths during the Spanish flu period, are among the diseases that can be controlled with appropriate antibiotic treatment today.


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