The Skeletons of 1918 Flu Victims Provide Insight Into Who Was Most Likely to Perish
Usually, the very young, the elderly, and the unwell die from the flu. According to legend, this made the 1918 virus remarkable because it killed both healthy young individuals and those who were frail or had chronic illnesses just as quickly.
The virus was indiscriminate, killing at least 50 million individuals, or between 1.3 and 3 percent of the world’s population, according to doctors of the time. Good health and youth were no defense for those in the prime of life. In contrast, 0.09 percent of the population died from Covid.
However, a research that was released on Monday in the Proceedings of the National Academy of Sciences questions that prevailing theory. Researchers found that persons with chronic illnesses or nutritional inadequacies were more than twice as likely to die as those without such disorders, regardless of age, according to evidence found in the skeletons of people who perished in the 1918 outbreak.
Although the 1918 virus did kill some children, the article argues that this is not unusual given the general rule that infectious diseases tend to kill the weaker and sicker persons the most quickly.
The study’s author and anthropologist Sharon DeWitte of the University of Colorado, Boulder, said the conclusion had a clear message: “We should never expect any nonaccidental cause of death to be indiscriminate.”
According to J. Alex Navarro, a flu pandemic historian at the University of Michigan, the research of skeletons makes for “a fascinating paper and a very interesting approach to studying this issue.”
Amanda Wissler, an anthropologist at McMaster University in Ontario and the paper’s lead author, expressed her interest in allegations that the 1918 virus killed young, healthy people just as readily as persons with pre-existing diseases. In those days, TB was a common disease among young adults, and there were no vaccinations or medications for common pediatric illnesses.
The mystery surrounding who actually perished from the illness, however, contributed to the idea that health was no defense. The death curve for the flu had an odd W-shape. Mortality curves are typically curved like a U, showing that older persons and babies with underdeveloped immune systems have the highest death rates.
The death rate for those between the ages of 20 and 40, as well as for infants and the elderly, skyrocketed in 1918, giving rise to the W. According to multiple contemporaneous reports, it seemed to show that young adults were very vulnerable regardless of whether they were well or suffering from a chronic illness. The flu killed anybody and everyone.
An distinguished pathologist, Colonel Victor Vaughn, detailed a scenario at Massachusetts’ Fort Devens in one report. In his journal entry, he described seeing “hundreds of young men in uniforms of their country, coming into the wards in groups of 10 or more.” By daybreak, he continued, “the dead bodies are stacked about the ward like cord wood.”
According to what he wrote, the influenza epidemic “was taking its toll of the most robust, sparing neither soldier nor civilian, and flaunting its red flag in the face of science.”
Drs. Wissler and DeWitte, who have conducted related studies on the Black Death, recognized a technique to test the young people theory. People who have experienced chronic conditions like cancer or tuberculosis, as well as other stressors like nutritional deficiency, may develop little bumps on their shin bones.
According to Peter Palese, a flu expert at the Icahn School of Medicine at Mount Sinai, determining fragility by searching for those bumps “is quite legitimate” as a strategy.
The Cleveland Museum of Natural History provided the researchers with skeletons. Each person’s name, age of death, and date of death are included in the collection of 3,000 people’s remains that are housed in sizable drawers in a huge room.
As she studied the shin bones of 81 people who died in the epidemic and ranged in age from 18 to 80, Dr. Wissler remarked that she treated the remains “with great respect.” Twenty-six of them ranged in age from 20 to 40.
The researchers also looked at the bones of 288 persons who passed away prior to the epidemic for comparison.
The findings were unmistakable: Whether young adults or elderly individuals, those whose bones indicated they were fragile at the time of infection were by far the most vulnerable. Although many healthy people also perished, the likelihood of death was significantly higher for those who had a preexisting chronic illness.
Dr. Arnold Monto, an epidemiologist and retired professor from the University of Michigan School of Public Health, agreed that this made logical. However, he noted that while the current study makes “an interesting observation,” the skeletons were not drawn at random from the population, making it challenging to pinpoint the risk associated with frailty.
Dr. Monto stated, “We are not used to the fact that younger healthy adults are going to die,” which frequently happened during the 1918 pandemic.
According to Dr. Palese, the W-shaped fatality curve of the 1918 flu has a plausible explanation. He explained that this indicates that those over the age of 30 or 40 had most likely been exposed to a virus comparable to it and were therefore somewhat protected. Adults under the age of 20 were not exposed.