What Are the Symptoms of the Spanish Flu of 1918?

The Spanish Flu Epidemic of 1918 traveled the globe, killing approximately 20 million to 40 million people. Some researchers, notably Donald Burke, professor of international health at Johns Hopkins, say the death toll is as high as 100 million, but due to the primitive information systems of the time and the lack of medical knowledge regarding the illness, deaths were not accurately reported.

Waves

• The first wave of the Spanish influenza came in the spring of 1918. Howard Markel, director of the Center for the History of Medicine at the University of Michigan, states that the symptoms of the disease were mild. The later waves, in the fall and winter of 1918, recorded the highest death tolls in new and re-infected patients.

Routine Symptoms

• The early wave of the flu included typical yearly flu symptoms including a high fever (102 to 104 degrees), body aches, coughing, exhaustion and, in some patients, diarrhea and vomiting.

High Temperatures

• The fevers returned when patients relapsed in later disease waves. Some doctors noted violent nosebleeds and bloodshot markings in the whites of the eyes.

Skin Pigmentation

• Doctors chronicling the event in the U.S. Public Health Report recorded: "Two hours after admission they have Mahogany spots over the cheek bones." These spots covered the entire face shortly before death several hours later.

Breathing Difficulties

• Flu patients also had breathing difficulties. Pathologists found the victims had swollen lungs and evidence of pulmonary hemorrhages, according to the U.S. Department of Health and Human Services.