Influenza, otherwise known as the flu, has plagued humanity for centuries. Although the first widespread flu outbreak was reported by Hippocrates, a Greek physician, in 412 BC, the most memorable occurrence of the flu in history was the influenza pandemic of 1918-1919 (Cheng 360). This tragedy has been unforgettable because it happened directly after the conclusion of World War I and claimed more lives than the total number of people killed in the Great War (Billings, 1997). Experts have estimated that approximately 500 million people, which was about one-third of the world’s population at the time, were infected with influenza (“Flu Pandemic,” 2010). Of those 500 million, somewhere between 30 and 70 million died due to the influenza virus (“Flu Pandemic,” 2010). Although there are many theories about the origin of influenza in 1918, none of them have been proven. One of the most prevalent theories, however, is that the flu originated in China (Langford 473). During World War I France hired Chinese workers, who based on this theory were carriers for the influenza virus, so that their citizens could join the army (“Epicenter,” 2014). When the Chinese workers travelled to France they unintentionally passed the flu on to the towns they stopped at, which initiated the global spread of influenza and ultimately led to the pandemic of 1918-1919.
China had already been exposed to influenza before the pandemic of in 1918. According to Mark Humphries, author of the book The Last Plague: Spanish Influenza and the Politics of Public Health in Canada, in the fall of 1917 northern China suffered from an unknown respiratory illness (“Epicenter,” 2014). In addition, the victims of this sickness experienced similar symptoms to the influenza. For instance, common side effects of the flu pandemic in 1918 were a body temperature between 102 and 104 degrees, sore throat, bloodshot eyes, vomiting, shallow breath, and respiratory problems (“Fighting Influenza”). The symptoms of the influenza virus of 1917 were fever, short breaths, and pneumonia (“Epicenter,” 2014). Both illnesses also share another important characteristic, which is that they both primarily killed young adults by damaging their respiratory systems (“Flu Pandemic,” 2010). Since the 1917 flu epidemic in China and the 1918 influenza pandemic had so many identical properties, it appears as if the two viruses were the same type of illness.
The theory that the flu present in China in 1917 was a precursor to the 1918 influenza pandemic is also supported by the fact that less Chinese people were infected by the flu in 1918 compared to the rest of the world. For starters, there are not a lot of literary sources from 1918-1919 related to cases of influenza in China, which suggests that the disease was not as devastating in China as the rest of the world (Cheng 361). Based on the sources that do discuss influenza, however, the data suggests that the average number of mortalities in China due to influenza was much lower than other countries such as the United States. In Hong Kong, for example, the crude death rate due to influenza was approximately 1.3 deaths for every one thousand people, but in the United States it was about 2.5 deaths for every one thousand people (Cheng 361). According to the Report on the Working of the Chinese Post Office, Hong Kong was also considered one of the cities most affected by influenza in China (Langford 484). Since Hong Kong was one of the worst cases of the flu virus in China, it appears that the influenza pandemic was not as potent in China as the rest of the world.
Even though the Chinese were exposed to influenza at home, they were only able to spread it on a global scale because of how they were transported to France. Experts have estimated that somewhere between 94,000 to 140,000 Chinese men were employed by France and England to work while their men were abroad fighting in World War I (“Epicenter,” 2014). In December of 1917, shortly after the flu epidemic broke out in China, thousands of Chinese workers were sent to southern England and France. However, prior to leaving China, the workers lived together in barracks in the town of Weihaiwei (“Epicenter,” 2014). These barracks were a “breeding ground” for influenza because people were packed into them. While many of the workers were ill before departing for Europe, they were still sent overseas (“Epicenter,” 2014). The ships carrying the Chinese laborers followed three different routes, which depended on their destination. One route went through the Mediterranean Sea, another went through the Suez Canal, and the final one went around Cape Town, South Africa (Langford 489). For each route, however, the ships docked at numerous ports. During these stops, the Chinese workers got off the ship and purchased new supplies for the journey (Langford 489). This means that the workers most likely interacted with the locals, giving the influenza virus the chance to infect new people (“Fighting Influenza”). As the Chinese workers stopped at more ports, the number of individuals affected by influenza subsequently increased.
In addition to being transported west from China in ships, the Chinese workers were also sent to France by train across Canada. At the beginning of 1918, German ships began patrolling the Indian Ocean more frequently (Langford 489). As a result, the French had to find an alternative route to get the Chinese workers to Europe. The solution came from Canada because the Canadian government gave permission for the Allies to transport people across Canada by train and board ships in Halifax to cross the Atlantic Ocean (“Epicenter,” 2014). However, due to the tense atmosphere in Canada caused by World War I, the movement of Chinese workers across the country was kept hidden from the Canadian public (“Epicenter,” 2014). In order to ensure the Chinese workers safety, the Canadian government put army bodyguards on the trains. Based on medical records from 1918, approximately 3,000 of the 25,000 Chinese laborers on the trains were ill with symptoms of influenza (“Epicenter,” 2014). They then passed the disease on to the Canadian bodyguards, and thus the virus began spreading across Canada and eventually into the United States (“Epicenter,” 2014). While most of the Chinese workers made it to Europe, hundreds of those suffering from influenza died during the journey (“Epicenter,” 2014). The Chinese laborers who did survive in France, however, continued infecting the people around them with influenza. As time passed, influenza reached the front lines of the battlefield and troops fighting on both sides became carriers of the disease.
While the vast travels of the Chinese workers transported the influenza virus to various locations, its worldwide spread would not have been possible if not for World War I. The trenches used in the Great War were perfect environments for the flu to thrive (Billings, 1997). Since the soldiers in trenches were tightly packed together, if one soldier got sick there was a good chance that he would infect the other troops around him. This process occurred on both sides of the war. When World War I ended in 1918, the soldiers returned home as carriers of influenza. They then passed it on to their loved ones, colleagues, classmates, etc. Before long, influenza spread throughout the world, even reaching isolated settlements such as those in Alaska (“Flu Pandemic.” 2010).
Without the vast extent of human travel between 1917 and 1919, the influenza pandemic could not have happened. If the Chinese workers had been consistently transported on one route to France, the spread of the flu could have been limited. Since the laborers were not contained though, it gave influenza an opportunity to prosper outside of its original environment. Therefore, the significant amount of human travel during and after World War I altered the overall health of humanity. In addition, the influenza pandemic initiated the future development of vaccines as a way of preventing viral infection. Though vaccines had been used before 1918, doctors at the time believed that influenza was bacteria, not a virus, so they tried to cure it with antibiotics opposed to a vaccine (“Fighting Influenza”). Because of the devastation caused by the influenza pandemic, doctors became focused on understanding how the disease could infect so many people worldwide. In the 1940’s, the scientists work paid off when the first licensed flu vaccine was released (“Flu Pandemic,” 2014). The trend of creating new vaccines for the flu has continued to this day. However, our advanced medical technologies do come at a cost. Just like our vaccines have evolved, so too has the flu. It is constantly adapting to the new vaccines and antibiotics that are made each year, making our technological advancements ineffective. Though humanity can develop innovative vaccines today, it is unclear if in the future man will be able to outlast the flu and prevent another pandemic.
Billings, Molly. “The Influenza Pandemic of 1918.” Human Virology, Stanford University, June 1997, virus.stanford.edu/uda/. Accessed 2 Nov. 2016.
Cheng, K. F. “What Happened in China During the 1918 Influenza Pandemic?” International Journal of Infectious Diseases, vol. 11, no. 4, July 2007, pp. 360-64.
“Fighting Influenza.” Flu.gov, United States Department of Health and Human Services, www.flu.gov/pandemic/history/1918/the_pandemic/fightinginfluenza/. Accessed 2 Nov. 2016.
History.com Staff. “China Epicenter of 1918 Flu Pandemic, Historian Says.” History.com, A+E Networks, 2014, www.history.com/news/china-epicenter-of-1918-flu-pandemic-historian-says. Accessed 2 Nov. 2016.
—. “1918 Flu Pandemic.” History.com, A+E Networks, 2010, www.history.com/topics/1918-flu-pandemic. Accessed 2 Nov. 2016.
Langford, Christopher. “Did the 1918-19 Influenza Pandemic Originate in China?” Population and Development Review, vol. 31, no. 3, 2005, pp. 473–505. www.jstor.org/stable/3401475.