(KWTX) Editor's note: The Spanish flu pandemic in 1918 was the most severe in recent history, killing at least 50 million worldwide, more than the total number of deaths in World War I, which claimed about 40 million military and civilian lives. The H1N1 virus with genes of avian origin infected an estimated 500 million people, the U.S. Centers for Disease Control and Prevention says. About 675,000 people died in the U.S. Mortality was highest among those younger than five, 20-40 years old and 65 and older. But medicine had much less to offer in 1918 that it does in 2020. There were no tests for influenza in 1918, vaccines did not exist and antibiotics had not been developed. Such measures as intensive care support and mechanical ventilation weren't available. Coordinated pandemic plans did not exist, and communications, by comparison, were primitive. What follows is a story that first appeared on KWTX.com in December 2017 that details the impact of the 1918 epidemic in Central Texas.
In December 1917 the first cases of H1N1 flu were cropping up in places scattered across the globe, but initially no one was concerned.
By early March 1918, when the first case of flu was officially reported at Fort Riley, Kan., the outbreak, spreading as fast as prairie wildfire, turned into the deadliest pandemic in human history that over a two-year period claimed tens-of-millions of lives.
Albert Mitchell, an Army company cook, reported to the infirmary at Camp Funston, Kan., (a Fort Riley satellite camp) on March 11, 1918, where he complained of a slight headache, a mild sore throat, loss of appetite, aching muscles and a low-grade fever.
The camp doctor ordered Mitchell to spend the day in his bunk.
By mid-day 107 soldiers at the camp had reported themselves ill and within two days that number grew to more than 520.
Generally, Mitchell's case is believed to be the first identified and reported, but some European scientists say they can trace the first case to an Army hospital in France at about the same time.
Whatever the case, the powerful and lethal strain of influenza raced through Army camps where quarters were cramped, populations were large and transient and sanitary conditions were questionable at best and then onto the communities that surrounded the camps.
Between 1918 and 1920 the outbreak claimed more lives than all those, both military and civilian, during World War I.
In fact, many of those military casualties never got out of the country but died at training camps and debarkation stations spread around the U.S. long before they ever saw battle.
And death came to those who normally would have survived such an infection.
Flu normally kills the very young, the very old and those with underlying conditions and compromised immune systems, the U.S. Centers for Disease Control and Prevention says.
But in the 1918 pandemic it was young, strong, active people in their 20s, 30s and 40s, who were dying and by the thousands every day.
Waco was not spared
Waco physician Dr. Tim Martindale wrote a paper in January 2016 on the worldwide influenza pandemic and how it affected Waco and the troops assigned to Camp MacArthur, which covered 10,700 acres of farmland in what is now northwest Waco.
Martindale said while the impact the disease had on Central Texas was bad, it was not nearly as terrible as it was elsewhere.
"During 1918 there were 930 cases of Spanish flu reported at Camp MacArthur and 202 of those soldiers died," Martindale said.
He added many soldiers who trained at Camp MacArthur died of the flu once they got to the battlefields in France.
It was not an uncommon site to see soldiers marching down Austin Avenue, in Waco, escorting a horse-drawn wagon carrying a flag-draped casket to the railroad station for a lonely ride home.
"Waco was not spared. Records are difficult to find due to war, confusion over the flu and the government's preferring little transparency," Martindale wrote in the 2016 paper.
"In the city, between 280 and 500 citizens died of the flu," Martindale said.
"Local and military doctors cooperated to increase sanitation and quarantine the sick (and) facilities were overrun and coffins stacked up at the roughest times.
At the time, "Waco Mayor Ed McCullough closed schools, theaters and movie houses.
"The efforts and education of physicians and community leaders rendered the flu less severe in Waco than in many other places," Martindale said.
"There were so many things that they need…"
Some Waco residents were on the front line of the fight to keep those infected with the virus alive.
"And then I know when the flu came how the sick boys (felt) and folks would ask 'Please go cheer them up.' And we did -- We'd go," Marguerite Cooper recalled in an oral history she did with researchers from Baylor.
Cooper and others would volunteer to visit sick soldiers at the hospital at Camp MacArthur to try to keep their spirits up, she said.
"I escaped having the flu that time, for which I was very thankful," she said.
"They'd give us a mask (and we'd) go in and maybe say howdy to them and try to help something, send a letter home to someone.
"There were so many things that they need you — they want done, but are not always done for them because there's nobody to do it," so she and her girlfriends pitched in
"It must have been a providential stroke…"
Some who lived through the pandemic locally, but were spared the illness questioned in later years why they didn't get sick.
Noted Texas folklorist Martha Lena Emmons graduated from Baylor and later came back for a 10-year stint on the faculty.
"I had my father with me, and I was teaching at Maypearl, Texas, and I remember when I was asked that I said, 'Oh, well, all I can attribute it to is eating onions and staying happy.'
"But I've often just thought it must have been a providential stroke because I don't know what could have happened if I had had to have the flu right there with my father an invalid and with me, and we were in that little apartment there.
"And it would have been awful for him to have taken the flu from me, don't you see?" Emmons said.
"Oh, by the way, that was a terrific plague…"
On June 22, 1972, Texas Supreme Court Justice the late Robert W. Calvert spoke with Drs. Lyle C. Brown and Thomas L. Charlton as part of the Baylor University oral history project and during his talk he recounted his experience with the plague.
"Yes. My sister died in the 1918 influenza epidemic -- quite young—9-years-old, as I recall," Calvert said.
"Oh, by the way, that was a terrific plague -- that influenza epidemic in 1918.
"If you didn't live through it at the time or haven't read about it, (it affected) people, particularly in a congested area like Army camps, and you could say this home where everybody' s thrown into the melting pot, so-to-speak, lots of people died," Calvert said.
"All they ever had was aspirin
"I held eight or nine boys in bed while they died with pneumonia; with the flu," said William Mills Cox in an interview he did with researchers from the Baylor University History Department as part of an oral history project.
Cox, who born in Dublin and went to College Station to study, was, at the time, working in the campus hospital at Texas A&M University.
"The cadets that had the flu were put in the A&M infirmary, and they started a duty roster of hospital orderlies," Cox recalled in the March 10, 1981 interview.
"And they put me on the orderly list from five in the afternoon until midnight.
"All they (those who fell ill) ever had was aspirin. That's all they could do for them, which is a pretty good experience for a 17-year-old kid," Cox remembered.
The "scourge ravaged the earth"
Then by 1920, as fast as it showed up, the flu disappeared.
The virus struck in three different waves starting in March 2018.
The pandemic peaked in the U.S. during the second wave in the fall of 1918, which was responsible for most of the deaths in the United States.
The third wave subsided by the summer of 1919.
Since 1918, the world has faced pandemics in 1957, 1968 and 2009, all of which were far less severe and far less deadly than 1918 outbreak.
A report entitled "The Virus", published by scientists at Stanford University, says: "In the two years that this scourge ravaged the earth, a fifth of the world's population was infected.
"It infected 28-percent of all Americans. An estimated 675,000 Americans died of influenza during the pandemic, ten times as many as in the world war," Stanford researchers wrote.
Of the U.S. soldiers who died in Europe, half of them fell to the influenza virus and not to the enemy and those battlefield deaths due to flu happened on both sides of the conflict.