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Signs & Symptoms of the Spanish Influenza

According to Stanford University's "The 1918 Influenza Pandemic," The Spanish flu killed between 20 to 40 million people worldwide--the deadliest outbreak of infectious disease in history. Some of its symptoms were of the usual flu variety: fever, aches and pains, coughs and general malaise. Some symptoms, however, were unique to this particular strain of influenza, attacking young, healthy men and women with rapid, devastating consequences.

  1. Swiftness of Onset

    • Though many the symptoms of the Spanish flu were similar to those of other influenzas, their intensity and swiftness of onset baffled health workers. "According to the PBS documentary, "Influenza 1918," "People could be healthy in the morning and dead by nightfall." The 1918 Surgeon General of the Army, Victor Vaughn put it this way: "If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear from the face of the earth within a few weeks."

    Flu-Like Symptoms

    • Body aches, muscle and joint pain and headache accompanied by sore throat and an unproductive cough was how the Journal of American Medicine (JAMA, 1/25/1919) characterized the early symptoms of the disease. Fever, from 100 to 104 degress F was another common symptom. In addition, excess sneezing would cause mucous membranes to hemorrhage in many patients, making nosebleeds a common sight in 1918. According to an October 13, 1918 article in JAMA, constipation seemed to be the most common gastro-intestinal ailment, though there were also cases of vomiting and diarrhea.

    Symptoms Unique to the Spanish Flu

    • The severity of symptoms often led to fatal, secondary complications, including pneumonia. An entry in the British Medical Journal (BMJ) of July 13, 1918 read, "The pneumonia would often appear after a period of normal temperature with a sharp spike and expectorant of bright red blood.The lobes of the lung became speckled with 'pneumonic consolidations'." According to the article, toxemia and vasomotor depression produced by these pneumonias were the main reasons for so many fatalities. Another unusual symptom of the Spanish flu was a marked increase in mental disturbance. An article in the January 25, 1919 JAMA reads, "the frequency of mental disturbances accompanying the acute illness in the epidemic has been the subject of frequent comment."

    Unusual Pathologies and Strange Age Range of the Dead

    • In a 1998 interview with PBS, virologist Dr. Jeffery Taubenberger discussed some of the more unusual aspects of the outbreak. According to Dr. Taubenberger, some people died quickly after coming down with flu symptoms, a very unusual pathology of influenza cases. Others would die within two or three days after the onset of symptoms from lung hemorrhages filling their lungs with blood. And some victims would drown from fluid filling their lungs, though showing no signs of inflammation--a very unusual finding when edema is present. Stranger still, the victims of this pathology were young, healthy people. Influenza usually kills the very young or elderly with compromised immune systems. According to "Swine Flu Spy: 2009 Swine Flu vs.1918 Spanish Flu (H1N1) Pandemic," it was the strong immune systems of the young and healthy that ultimately killed them.

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