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The effect of the influenza epidemic was so severe that the average life span in the US was depressed by 10 years. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years (Taubenberger). People were struck with illness on the street and died rapid deaths. One anectode shared of 1918 was of four women playing bridge together late into the night. Overnight, three of the women died from influenza (Hoagg). Others told stories of people on their way to work suddenly developing the flu and dying within hours (Henig). One physician writes that patients with seemingly ordinary influenza would rapidly "develop the most viscous type of pneumonia that has ever been seen" and later when cyanosis appeared in the patients, "it is simply a struggle for air until they suffocate," (Grist, 1979). Another physician recalls that the influenza patients "died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth," (Starr, 1976). The physicians of the time were helpless against this powerful agent of influenza. In 1918 children would skip rope to the rhyme (Crawford):

The origins of this influenza variant is not precisely known. It is thought to have originated in China in a rare genetic shift of the influenza virus. The recombination of its surface proteins created a virus novel to almost everyone and a loss of herd immunity. Recently the virus has been reconstructed from the tissue of a dead soldier and is now being genetically characterized. The name of Spanish Flu came from the early affliction and large mortalities in Spain (BMJ,10/19/1918) where it allegedly killed 8 million in May (BMJ, 7/13/1918). However, a first wave of influenza appeared early in the spring of 1918 in Kansas and in military camps throughout the US. Few noticed the epidemic in the midst of the war. Wilson had just given his 14 point address. There was virtually no response or acknowledgment to the epidemics in March and April in the military camps. It was unfortunate that no steps were taken to prepare for the usual recrudescence of the virulent influenza strain in the winter. The lack of action was later criticized when the epidemic could not be ignored in the winter of 1918 (BMJ, 1918). These first epidemics at training camps were a sign of what was coming in greater magnitude in the fall and winter of 1918 to the entire world.

The effect of the influenza epidemic was so severe that the average life span in the US was depressed by 10 years.

"The 1918 has gone: a year momentous as the termination of the most cruel war in the annals of the human race; a year which marked, the end at least for a time, of man's destruction of man; unfortunately a year in which developed a most fatal infectious disease causing the death of hundreds of thousands of human beings. Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there. Now it must turn with its whole might to combating the greatest enemy of all--infectious disease," (12/28/1918).

riers, along trade routes and shipping lines. Outbreaks swept through North America, Europe, Asia, Africa, Brazil and the South Pacific (Taubenberger). In India the mortality rate was extremely high at around 50 deaths from influenza per 1,000 people (Brown).

With the military patients coming home from the war with battle wounds and mustard gas burns, hospital facilities and staff were taxed to the limit. This created a shortage of physicians, especially in the civilian sector as many had been lost for service with the military. Since the medical practitioners were away with the troops, only the medical students were left to care for the sick. Third and forth year classes were closed and the students assigned jobs as interns or nurses (Starr,1976). One article noted that "depletion has been carried to such an extent that the practitioners are brought very near the breaking point," (BMJ, 11/2/1918). The shortage was further confounded by the added loss of physicians to the epidemic. In the U.S., the Red Cross had to recruit more volunteers to contribute to the new cause at home of fighting the influenza epidemic. To respond with the fullest utilization of nurses, volunteers and medical supplies, the Red Cross created a National Committee on Influenza. It was involved in both military and civilian sectors to mobilize all forces to fight Spanish influenza (Crosby, 1989). In some areas of the US, the nursing shortage was so acute that the Red Cross had to ask local businesses to allow workers to have the day off if they volunteer in the hospitals at night (Deseret News). Emergency hospitals were created to take in the patients from the US and those arriving sick from overseas.

“The Black Death” Even before the “death ships” pulled into port at Messina, many Europeans had heard rumors about a “Great Pestilence” that was carving a deadly path across the trade routes of the Near and Far East. (Early in the 1340s, the disease had struck China, India, Persia, Syria and Egypt.) However, they were scarcely equipped for the horrible reality of the Black Death. “In men and women alike,” the Italian poet Giovanni Boccaccio wrote, “at the beginning of the malady, certain swellings, either on the groin or under the armpits…waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.” Blood and pus seeped out of these strange swellings, which were followed by a host of other unpleasant symptoms–fever, chills, vomiting, diarrhea, terrible aches and pains–and then, in short order, death. The Black Death was terrifyingly, indiscriminately contagious: “the mere touching of the clothes,” wrote Boccaccio, “appeared to itself to communicate the malady to the toucher.” The disease was also terrifyingly efficient. People who were perfectly healthy when they went to bed at night could be dead by morning. Did You Know? Many scholars think that the nursery rhyme “Ring around the Rosy” was written about the symptoms of the Black Death.

The Black Death arrived in Europe by sea in October 1347 when 12 Genoese trading ships docked at the Sicilian port of Messina after a long journey through the Black Sea. The people who gathered on the docks to greet the ships were met with a horrifying surprise: Most of the sailors aboard the ships were dead, and those who were still alive were gravely ill. They were overcome with fever, unable to keep food down and delirious from pain. Strangest of all, they were covered in mysterious black boils that oozed blood and pus and gave their illness its name: the “Black Death.” The Sicilian authorities hastily ordered the fleet of “death ships” out of the harbor, but it was too late: Over the next five years, the mysterious Black Death would kill more than 20 million people in Europe–almost one-third of the continent’s population.

Meanwhile, in a panic, healthy people did all they could to avoid the sick. Doctors refused to see patients; priests refused to administer last rites. Shopkeepers closed stores. Many people fled the cities for the countryside, but even there they could not escape the disease: It affected cows, sheep, goats, pigs and chickens as well as people. In fact, so many sheep died that one of the consequences of the Black Death was a European wool shortage. And many people, desperate to save themselves, even abandoned their sick and dying loved ones. “Thus doing,” Boccaccio wrote, “each thought to secure immunity for himself.”

Contents “The Black Death” Understanding the Black Death God’s Punishment? Facebook Twitter Google Print Cite Article Details: Black Death Author History.com Staff Website Name History.com Year Published 2010 Title Black Death URL http://www.history.com/topics/black-death Access Date April 16, 2014 Publisher A+E Networks Introduction The Black Death arrived in Europe by sea in October 1347 when 12 Genoese trading ships docked at the Sicilian port of Messina after a long journey thro

the Black Sea

Even before the “death ships” pulled into port at Messina, many Europeans had heard rumors about a “Great Pestilence” that was carving a deadly path across the trade routes of the Near and Far East.

The Black Death arrived in Europe by sea in October 1347 when 12 Genoese trading ships docked at the Sicilian port of Messina after a long journey through the Black Sea.

Strangest of all, they were covered in mysterious black boils that oozed blood and pus and gave their illness its name: the “Black Death.”

Blood and pus seeped out of these strange swellings, which were followed by a host of other unpleasant symptoms–fever, chills, vomiting, diarrhea, terrible aches and pains–and then, in short order, death.

“In men and women alike,” the Italian poet Giovanni Boccaccio wrote, “at the beginning of the malady, certain swellings, either on the groin or under the armpits…waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.”

The people who gathered on the docks to greet the ships were met with a horrifying surprise: Most of the sailors aboard the ships were dead, and those who were still alive were gravely ill.

Some people coped with the terror and uncertainty of the Black Death epidemic

Some upper-class men joined processions of flagellants that traveled from town to town and engaged in public displays of penance and punishment: They would beat themselves and one another with heavy leather straps studded with sharp pieces of metal while the townspeople looked on. For 33 1/2 days, the flagellants repeated this ritual three times a day. Then they would move on to the next town and begin the process over again

There is no specific treatment for those with yellow fever beyond good nursing and supportive care. The disease, however, is completely preventable. People can be rendered immune to the virus through vaccination, and outbreaks can be contained by eliminating or controlling mosquito populations. Thanks to such measures, the great yellow fever epidemics of the late 19th and early 20th centuries are no more. Nevertheless, the disease is still present in tropical Africa and South America, where access to vaccine is sometimes lacking

An infectious disease, yellow fever infects humans, all species of monkeys, and certain other small mammals. The virus is transmitted from animals to humans and among humans by several species of

An infectious disease, yellow fever infects humans, all species of monkeys, and certain other small mammals. The virus is transmitted from animals to humans and among humans by several species of mosquitoes. Yellow fever is one of the great epidemic diseases of the tropical world, and in earlier centuries it was one of the great plagues of the New World. At one time the tropical and subtropical regions of the Americas were subjected to devastating epidemics, and serious outbreaks occurred not only as far north as Philadelphia, New York, and Boston but also as far away as Spain, France, England, and Italy.

tious disease, yellow fever infects humans, all species of monkeys, and certain other small mammals. The virus is transmitted from animals to humans and among humans by several species of

Vibrio cholerae, the bacterium that causes cholera, is usually found in food or water contaminated by feces from a person with the infection. Common sources include: Municipal water supplies Ice made from municipal water Foods and drinks sold by street vendors Vegetables grown with water containing human wastes Raw or undercooked fish and seafood caught in waters polluted with sewage

severe diarrhea.

When, for instance, a stranger called Andrew Hogson died from plague on his arrival in Penrith in 1597, and the next plague case followed twenty-two days later, this corresponded to the first phase of the development of an epidemic of bubonic plague. And Hobson was, of course, not the only fugitive from a plague-stricken town or area arriving in various communities in the region with infective rat fleas in their clothing or luggage. This pattern of spread is called ‘spread by leaps’ or ‘metastatic spread’. Thus, plague soon broke out in other urban and rural centres, from where the disease spread into the villages and townships of the surrounding districts by a similar process of leaps.

The Italian writer Boccaccio said victims often "ate lunch with their friends, and ate dinner with their ancestors in paradise."

The Europeans often ate stale or diseased meat because refrigeration had not yet been invented.

Europeans were susceptible to disease because many people lived in crowded surroundings in an era when personal hygiene was not considered important.

Cities began to build hospitals and enforce standards for sanitation.

The devastation of the plague led to advances in medicine.

People were advised to not bathe because open skin pores might let in the disease.

Some Europeans believed the plague was a sign from God. Groups known as flagellants tried to atone for the sins of the world by inflicting punishments upon themselves. The flagellants also had a tendency to persecute Jews and even clergymen who spoke out against them. Eccentric and unusual people were often charged with witchcraft and sorcery. Pope Clement VI condemned the flagellants, but they continued to reappear in times of plague.

Unbeknownst to the city's inhabitants, all the necessary ingredients for an unprecedented health disaster were now in place.

the Caribbean refuges brought Yellow Fever. Philadelphia's ravenous mosquitoes provided the perfect vehicle for spreading the disease by first lunching on an infected victim and then biting a healthy one

first fatalities appeared in July and the numbers grew steadily.