What the 1918 ‘Spanish flu’ tells us about Ebola

When the Spanish flu hit in 1918, it hit hard and fast."This has all sorts of implications for pandemics that are happening now or might be threatening to happen," Siddharth Chandra says. (Credit: iStockphoto)

The 1918 influenza virus killed 50 million people worldwide, and now scientists are hoping to apply the lessons learned to fight diseases like Ebola.

The pandemic, also known as the “Spanish flu,” claimed 675,000 lives in nine months in the United States alone. Of the total killed, as many as 20 million were in India.


“If we get another flu pandemic and it infects tens of millions in the US, killing half a million people, that’s going to be worse than anything that’s happened to us in at least the last 50 to 100 years,” says Siddharth Chandra, director of the Asian Studies Center at Michigan State University.

Chandra and Eva Kassens-Noor, assistant professor of urban and transport planning, studied weekly death rates in 213 districts from nine provinces in India, information contained in reports from the sanitary commissioner’s office.

They found that the virus entered India in Bombay, which experienced a three-week flu wave and a peak death rate of 54.9 people per 1,000. As it spread east, the flu epidemic lengthened to eight weeks and fewer people died.

Simply put: when the flu hit, it hit hard and fast.

Will Ebola get worse?

“This has all sorts of implications for pandemics that are happening now or might be threatening to happen,” Chandra says. “In scenarios resembling the 1918 pandemic as it unfolded in India, locations close to an entry point will have extremely short windows of time to deal with a virulent pathogen, placing emphasis on the emergency management of a short and severe wave of illness.”

Possibly a severe wave like the Ebola virus in West Africa, he says.

According to the World Health Organization, there have been 9,216 confirmed, probable, and suspected cases of Ebola in seven countries and 4,555 deaths. While Ebola is far less contagious than the flu and it’s not moving as quickly, if there had been 9,000 cases of the 1918 flu, there would’ve been fewer than 900 deaths, Chandra says.

“One of the things this research could shed light on: are viruses like the Ebola virus going to get less virulent or more virulent as they move on?”

Find the full study in the journal BMC Infectious Diseases.

Source: Michigan State University