1918 Spanish Flu Pandemic

The 1918 flu pandemic (January 1918 – December 1920) was an unusually deadly influenza pandemic, the first of the two pandemics involving H1N1 influenza virus (the second being the 2009 flu pandemic). It infected 500 million people across the world, including remote Pacific islands and the Arctic, and killed 50 to 100 million of them—three to five percent of the world's population —making it one of the deadliest natural disasters in human history. To maintain morale, wartime censors minimized early reports of illness and mortality in Germany, Britain, France, and the United States; but papers were free to report the epidemic's effects in neutral Spain (such as the grave illness of King Alfonso XIII), creating a false impression of Spain as especially hard hit— thus the pandemic's nickname Spanish flu.

Most influenza outbreaks disproportionately kill juvenile, elderly, or already weakened patients; in contrast the 1918 pandemic killed predominantly previously healthy young adults. Modern research, using virus taken from the bodies of frozen victims, has concluded that the virus kills through a cytokine storm (overreaction of the body's immune system). The strong immune reactions of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults resulted in fewer deaths among those groups.

Historical and epidemiological data are inadequate to identify the pandemic's geographic origin. It was implicated in the outbreak of encephalitis lethargica in the 1920s.