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Unveiling the Deadly 1918 Spanish Flu Pandemic

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Introduction: Unveiling the Deadly 1918 Spanish Flu Pandemic

This report is going to cover the discussion about the infectious disease Influenza. Influenza or flu, is known to be a virally transmitted contagious disease that is highly contagious amount humans. The Influenza virus causing the disease usually infects the throat, nose, and often lungs. The symptoms can vary from mild to deadly. It is also evident that vaccination can help prevent outbreaks due to influenza every year. The people affected by the disease show symptoms like cough, fever, body or muscle aches, headaches, sore throats, fatigue, and even diarrhoea and vomiting in some cases.

The study mainly analyses the scenario faced by the outbreak of Influenza that occurred in various parts of the world and is popularly known to be "Spanish Flu," which took a shape of the pandemic in 1918. It became the historical flu in terms of having a sign of peak mortality rate and related environmental factors causing the spread of the disease within various communities. The study was mainly recorded from three cities in North America, getting insight into the relationship between the peak activity of the flu and the change in the environmental temperature. 

Definition of an outbreak

An outbreak is a situation of sudden arising of a particular disease that affects a community, geographical area, or many countries at a time with several disease cases. According to the case study, done by Basar, (2019), it was found that the condition can last for days or a few weeks and even several years. The disease of Influenza has been informed to occur at the same time of the year in various parts of the world. It is seen to have distinct patterns in the temperate regions of the planet. "Spanish Flu" occurred in 1918 and is known to be more lethal and less predictive in terms of other annual flu.

The 1918 H1N1 flu virus

Figure 1: The 1918 H1N1 flu virus

According to previous outbreaks caused by the strain "H1N1" of the influenza virus, which was found to be deadly, the "Spanish Flu" showed a different rate of mortality and virulent factor despite having similar structural similarities (Mijwil et al. 2022). It was found that specific receptors present on the surface of the human cells which had been recognized by the viral receptor allowed viral entry.

Outline how the diagnosis of the etiological agent was confirmed

The disease "Spanish Flu" is found to infect humans along with other animals like birds, and other vertebrates. However, there is no particular test or diagnostic method is available for this condition of "Spanish Flu". Due to this reason, healthcare providers have to depend on the external signs and symptoms shown by the potential patient. Rapid and often mutations are shown by the virus failing the antiviral drugs and the effectiveness of previous vaccines. As the mutations caused to change in the specificity of the receptor binding site on the hoist cell with the virus based on which the vaccines and drugs are been designed (Aassve et al. 2021). These mutations, also make the researchers difficult to find out s specific way to diagnose this disease. 

Diagnostic steps for the unknown influenza virus strain

Figure 2: Diagnostic steps for the unknown influenza virus strain

The entire viral genome is sequenced in the year 2005 by scientists. The etiological agent has been collected from the frozen lung tissue which has been founded in Alaska and the viral RNA has been recovered from that. The expression of the A/H1N1 influenza virus along with the conserved HA gene has been observed to show high expressions in the lungs and epithelial tissue (Golshani et al. 2022). Apart from this, the influenza strain H1N1 also shows some specific expression in the brain tissue has also been observed. Most of the viral strains do not cross the Blood Brain barrier but this has been observed in the case of the Spanish flu agent (Proquest.com, 2022). This is also one reason behind its high lethality. 

Case definition

The case study is generally based on the role of the ambient temperature and its relation with the outbreak of the influenza virus. The section of the study has been taken from the Spanish flu pandemic in the year 1918. The annual flu season has been mostly stable across the temperate regions of the globe. The zoonotic nature of the varial agent (Influenza virus) has provoked scientists to study the movement pattern of animals (Staub and Floris, 2021). As per the case study, it has been stated that the Influenza virus mainly affects the entire globe at different time zone throughout the year. The effect of the virus mainly depends upon the latitude.

Distribution of influenza virus across the globe

Figure 3: Distribution of influenza virus across the globe

It has also been mentioned that the tropical regions of the globe are mainly get affected by the influenza virus because the virus is mainly observed to be circulated at the equator. Low humidity has also been discussed as a factor in increasing the survival of influenza strains (da Costa et al. 2020). The case study also discusses the temperature of temperate and tropical regions of the globe as being a major factor which influences the infection of the influenza virus in individuals in a repetitive way. The 1918 Spanish flu pandemic has also been discussed in the case study. That strain of influenza has been considered one of the most virulent strains of the virus.

Descriptive epidemiology of the outbreak

The Spanish flu outbreak was one of the most devastating pandemics encountered in history. The novel pathogen of the pandemic was the Influenza virus A/ H1N1 strain. According to Javaid et al. (2021), it has been estimated that the virus has infected almost one-third population of the world. The origin of the 1918 influenza virus pandemic is remaining elusive.

Mortality rate of people infected with influenza virus in the US in 1918

Figure 4: Mortality rate of people infected with influenza virus in the US in 1918

It has also been estimated that more than 675000 people have died of the infection in the United States in less than two years. The early wave of the pandemic has been observed in the autumn of 1918. The infection was first identified in the spring season of 1918 in military personnel. According to a report by Cdc.gov (2019), it has been also been estimated that the rate of mortality was high in children yonder than 5 years old. People between 20 to 40 years and older than 65 years also show a higher risk of infection. The unique feature of the pandemic was that healthy individuals between the age group 20 to 40 have shown a high rate of mortality.

Management plan


The prevention of the transmission of the influenza virus and other infectious diseases generally requires multi-faceted approaches. The virus and infection may occur from one person to another in a community as well as in their households too. The measures which must be taken to avoid infection from such viral strains mainly include the administration of viral vaccines respective to the virus. For example, here we are discussing the influenza virus, and the population must be administered the influenza vaccine.

Measures for reducing infectious diseases

Figure 5: Measures for reducing infectious diseases

An individual must follow their respiratory hygiene and should also monitor their cough etiquette. Individuals must take precautions regarding adherence to infection control. The implementation of engineering infection control and environmental infection control measures will be taken into consideration. A range of administrative policies and practices must be followed to minimise the exposure of infectious agents ( Javaid et al. 2021). The healthcare sectors and hospitals should follow these measures to stay away from infectious diseases and to prevent their spread.

Apart from this, availability of proper testing and diagnosis in almost every part of the world is one of the most crucial measures for the prevention of infectious diseases (CDC, 2019). Diagnosis of the infection at the right time will lead to a reduction in the severity of the infection. introduction of new and advanced testing kits and machines for diagnosis will also help in the prevention of diastases. 


Control for infectious disease is a kind of practice which is mainly administered to reduce the transmission of infection from one person to another. The infectious disease can also be spread from a healthcare professional to patients or vice versa (CDC, 2019). In order to minimise the transmission, individuals should follow everyday habits, which will help them prevent the spread of infectious diseases.

Control and prevention of infectious diseases

Figure 6: Control and prevention of infectious diseases

Washing hands is one of the most important control measures to be practised while coming home from outside and having food. The second one is the use of proper control standards in case of the healthcare professionals and workers. Precautions from the airborne tiny droplets by covering of mouth while sneezing and coughing. According to Javaid et al. (2021), it has been stated that most healthcare-associated infections are mainly cured and prevented by practising good hand hygiene.

Implementation of the hand hygiene programmes introduced by the WHO

Figure 7: Implementation of the hand hygiene programmes introduced by the WHO

As stated above, cleaning hands at the right time and in the right way is one of the primary methods to prevent the spread of infectious diseases. According to Aassve et al. (2021), It has been estimated that almost 50% of avoidable infections can be controlled by the implementation of the hand hygiene programmes introduced by WHO.

Prevent recurrence

The Spanish flu has been taken palace in the year 1918 the science and technology at that time were not that advanced there was no such area of virology research. There was no vaccine to control the pandemic at that time (Brauer et al. 2019). People were mostly dependent on non-pharmaceutical interventions such as good personal hygiene, quarantine, isolation and the use of disinfectants has helped people to tackle the deadly virus at that time. Apart from this, the people also avoided public gatherings. One of the most impart characteristics of infectious disease is the recurrence of the infection (Aassve et al. 2021). The recurrence is also of various kinds, but in case of the recurrence of the infection may lead to various factors. 

Preventions for controlling infectious diseases

Figure 8: Preventions for controlling infectious diseases

The introduction of passive immunity in the body is one of the best ways to prevent the recurrence of the infection in the body. The antibodies generated in the body due to the primary infections are stored in the body for a certain period (Soo et al. 2020). It has been also been stated that antibodies have used form time ago for the prevention as well as the treatment of infectious diseases. The recurrence of viral infections is very frequent due to the rapid changes in their genetic materials (Aassve et al. 2021). The viral spikes get mutated very rapidly and due to that the antibodies generated in the body do not recognise the viral particles and they get infected again and again. High-dose intravenous immunoglobulin helps in the treatment of viral infections and provides extra immunity to immunocompromised individuals (Zhu et al. 2020). Apart from this, monitoring changes in the viral pathogen mutation by the researcher and scientist and keep studying their mutations will help in the prevention of the recurrence of infection.


Thus, it can be concluded that the 1918 Spanish flu was the deadliest in human history. The causal agent behind the delish pandemic was the 1918 H1N1 influenza flu virus. A special group of scientists and virologists has searched the virus and its genomic sequences to understand the activity and pattern of the viral infection and the hidden secrets of the virus. This has been very helpful for humankind to get prepared for any future pandemics. There are many management plans have been discussed in the study. The implementation of the plans, measures and control initiatives will help in the reduction of the transmission of infectious agents.

Reference list

Aassve, A., Alfani, G., Gandolfi, F. and Le Moglie, M., 2021. Epidemics and trust: The case of the Spanish Flu. Health economics, 30(4), pp.840-857.

Aassve, A., Alfani, G., Gandolfi, F. and Le Moglie, M., 2021. Epidemics and trust: The case of the Spanish Flu. Health economics, 30(4), pp.840-857.

Basar, A., 2019. The Role of Ambient Temperature and Influenza Outbreaks: A Case Study of the 1918 Spanish Flu Pandemic (Doctoral dissertation, College of Charleston).

Brauer, F., Castillo-Chavez, C., Feng, Z., Brauer, F., Castillo-Chavez, C. and Feng, Z., 2019. Challenges, opportunities and theoretical epidemiology. Mathematical Models in Epidemiology, pp.507-531.

Cdc.gov 2019, 1918 Pandemic Available at: https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html#:~:text=It%20is%20estimated%20that%20about,occurring%20in%20the%20United%20States. [Accessed on: 10.02.2023]

da Costa, V.G., Saivish, M.V., Santos, D.E.R., de Lima Silva, R.F. and Moreli, M.L., 2020. Comparative epidemiology between the 2009 H1N1 influenza and COVID-19 pandemics. Journal of Infection and Public Health, 13(12), pp.1797-1804.

Golshani, S.A., Zohalinezhad, M.E., Amoozegar, F. and Farjam, M., 2022. Spanish Flu in Tehran from 1918 to 1920. Archives of Iranian Medicine, 25(1), p.71.

Javaid, W., Ehni, J., Gonzalez-Reiche, A.S., Carreño, J.M., Hirsch, E., Tan, J., Khan, Z., Kriti, D., Ly, T., Kranitzky, B. and Barnett, B., 2021. Real-time investigation of a large nosocomial influenza A outbreak informed by genomic epidemiology. Clinical Infectious Diseases, 73(11), pp.e4375-e4383.

Mijwil, M.M., Al-Mistarehi, A.H., Zahran, D.J., Alomari, S. and Doshi, R., 2022. Spanish Flu (Great Influenza) 1918: The Tale of The Most deadly Pandemic in History. Asian Journal of Applied Sciences (ISSN: 2321–0893), 10(2).

Proquest.com 2022 The Role of Ambient Temperature and Influenza Outbreaks: A Case Study of the 1918 Spanish Flu Pandemic Available at: https://www.proquest.com/openview/e94cda02afbb669ab55ce76f81409a4a/1?pq-origsite=gscholar&cbl=18750&diss=y [Accessed on: 10.02.2023]

Soo, R.J.J., Chiew, C.J., Ma, S., Pung, R. and Lee, V., 2020. Decreased influenza incidence under COVID-19 control measures, Singapore. Emerging infectious diseases, 26(8), p.1933.

Statista.com 2007, Influenza mortality rates during the Spanish Flu pandemic in select US states from 1915 to 1919 Available at: https://www.statista.com/statistics/1103622/mortality-rate-per-us-state-spanish-flu/ [Accessed on: 10.02.2023]

Staub, K. and Floris, J., 2021. Down memory lane: Unprecedented strong public and scientific interest in the" Spanish flu" 1918/1919 during the COVID-19 pandemic. Influenza and Other Respiratory Viruses, 15(2), pp.318-319.

Xiao, J., Shiu, E.Y., Gao, H., Wong, J.Y., Fong, M.W., Ryu, S. and Cowling, B.J., 2020. Nonpharmaceutical measures for pandemic influenza in nonhealthcare settings—personal protective and environmental measures. Emerging infectious diseases, 26(5), p.967.

Zhu, Y., Chen, L., Ji, H., Xi, M., Fang, Y. and Li, Y., 2020. The risk and prevention of novel coronavirus pneumonia infections among inpatients in psychiatric hospitals. Neuroscience bulletin, 36, pp.299-302.

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