This resource pack supports the Spanish Flu simulator at http://resources.modelling4all.org/spanish-flu/teacher-guide-to-spanish-flu-simulation. More people died from the 1918-1920 Spanish Influenza pandemic than there were casulties as a result of the First World War. This world-wide epidemic caused by influenza viruses led to between 50 and 100 million deaths in 1918 and 1919 (as much as 1 of every 18 people). Many researchers have suggested that the conditions of the war significantly aided the spread of the disease. And others have argued that the course of the war (and subsequent peace treaty) was influenced by the pandemic.

1. Resource Pack
The 1918-1920 ‘Spanish’
Influenza Pandemic
Developed for World War One Centenary: Continuations and Beginnings by Ken Khan, Kate
Lindsay & Richard Marshall, University of Oxford (August 2012). Free, high quality educational
resources on new perspectives of the First World War. http://ww1centenary.oucs.ox.ac.uk.

2. Introduction
More people dies from the 1918-1920 Spanish Influenza
pandemic than there were casulties as a result of the First
World War. This world-wide epidemic caused by influenza
viruses led to between 50 and 100 million deaths in 1918
and 1919 (as much as 1 of every 18 people).
Many researchers have suggested that the conditions of
the war significantly aided the spread of the disease. And
others have argued that the course of the war (and
subsequent peace treaty) was influenced by the
pandemic.

3. All the following resources are brought together
to support the Spanish Flu Simulator – a
computer model to help explore this pandemic.
http://resources.modelling4all.org/spanish-
flu/teacher-guide-to-spanish-flu-simulation

4. Lecture
Prof Frank Snowden, Pandemic Influenza, Ch. 4. Lecture 20 from the series
Epidemics in Western Society since 1920 from Open Yale. Available under CC
BY-NC-SA. Available as video, audio and text.
http://resources.modelling4all.org/spanish-flu/teacher-guide-to-spanish-flu-
simulation

5. Article
Barry. J. M. (2004)The site of origin of the 1918 influenza pandemic and its
public health implications. Journal of Transatlantic Medicine. 20 January
2004. (2.3). Available under CC BY.
http://www.translational-medicine.com/content/2/1/3

6. Interview
Death on the eve of Armistice. Michael Palin interviews Professor John
Oxford, exploring conditions at the end of the Great War and the impact of
influenza on the Armistice. Available via OpenLearn, Open University as CC
BY-NC-SA. Also available as audio and text.
Questions discussed:
• How significant was the influenza outbreak on the casualties at the end of
the First World War?
• How did [the outbreak] begin?
• What did they know about the epidemic at the time and […] were they
able to contain it successfully?
• What measures could they take or did they try to take to contain it?
• At that stage was there anything they could do, do they have any vaccine?
http://www.open.edu/openlearn/history-the-arts/history/world-
history/death-on-the-eve-armistice

7. Images and Photographs

8. A monster representing an influenza virus hitting a man over the head as he sits in his armchair.
Available via the Welcome Library, London, as CC-BY-NC-SA
‘A-TICH-OO!! Good evening I’m the new Influenza’.
Pen and ink drawing by E. Noble, c. 1918.

9. Original caption: ‘Emergency hospital during influenza epidemic, Camp Funston, Kansas.’ Available via Otis
Historical Archives National Museum of Health and Medicine as CC-BY-NC-SA
Camp Funston experienced the first significant outbreak of the disease in the United States. In March 1918,
1100 men became ill, of whom 38 died. The flu returned in November, probably when this photograph was
taken: at the height of this second wave, around 6-7000 men were ill, swamping the Base Hospital and
necessitating the setting up of emergency wards such as the one pictured.

10. Original caption: ‘Cleaning up after the flu’. Available via Otis Historical Archives National Museum of Health and
Medicine as CC-BY-NC-SA
Disinfection of hospital blankets following outbreak of Spanish Influenza. From a scrapbook created by Gertrude
Smith documenting her service as a nurse from 1918 to 1921 at Camp Mills, Long Island; Camp Pike, Arkansas;
Walter Reed; and Camp Eustis, Virginia. Mostly photographs of nurses, hospitals, and patients, including images
of the 1918 influenza epidemic.

11. Enlisted Men's Tents. X Section. Base Hospital, Camp Jackson, Columbia, South Carolina. Available via Otis
Historical Archives National Museum of Health and Medicine as CC-BY-NC-SA
Emergency Hospital during Influenza Epidemic, September and October 1918. The flu arrived at Camp Jackson
in mid-September, shortly after outbreaks of measles and meningitis. The Base Hospital was soon filled to
capacity, and large areas of the camp had to be turned into an extension of the hospital. Over 5,000 patients
were eventually treated, of whom at least 300 died.

12. Original caption: ‘Influenza Avenue’. Available via Otis Historical Archives National Museum of Health and
Medicine as CC-BY-NC-SA
Emergency tented accommodation for Spanish Influenza patients at a military hospital in America. From a
scrapbook created by Gertrude Smith documenting her service as a nurse from 1918 to 1921 at Camp Mills,
Long Island; Camp Pike, Arkansas; Walter Reed; and Camp Eustis, Virginia. Mostly photographs of nurses,
hospitals, and patients, including images of the 1918 influenza epidemic.

13. Original caption: ‘Tent settlement during the influenza epidemic, mess time.’ Available Available via Otis
Historical Archives National Museum of Health and Medicine as CC-BY-NC-SA
Emergency tented accommodation for Spanish Influenza patients at a military hospital in America. From a
scrapbook created by Gertrude Smith documenting her service as a nurse from 1918 to 1921 at Camp Mills,
Long Island; Camp Pike, Arkansas; Walter Reed; and Camp Eustis, Virginia. Mostly photographs of nurses,
hospitals, and patients, including images of the 1918 influenza epidemic.

14. Original caption: U.S. Army Camp Hospital No. 45, Aix-Les-Bains, France, Influenza Ward No. 1. Available
Available via Otis Historical Archives National Museum of Health and Medicine as CC-BY-NC-SA
Men in beds with rudimentary privacy provided by sheets. The scale of the outbreak is apparent from the
closeness of the beds and the numbering of the influenza ward: presumably there were others in the same
hospital.

15. U.S. Army Field Hospital No. 29. Interior view of influenza ward. Hollerich, Luxembourg. 7th December
1918. Available Available via Otis Historical Archives National Museum of Health and Medicine as CC-BY-NC-SA
Note rudimentary nature of emergency accommodation: men have to sleep on folding camp beds. Patients
and orderly (standing right) are all wearing masks.

16. Original caption: 'Second Street Home during the epidemic, nearly one hundred and ten nurses slept in or
around this house.‘ Available Available via Otis Historical Archives National Museum of Health and Medicine as
CC-BY-NC-SA
Temporary nursing accommodation during the Spanish Influenza Epidemic at a military hospital in America.
From a scrapbook created by Gertrude Smith documenting her service as a nurse from 1918 to 1921 at Camp
Mills, Long Island; Camp Pike, Arkansas; Walter Reed; and Camp Eustis, Virginia. Mostly photographs of nurses,
hospitals, and patients, including images of the 1918 influenza epidemic.

17. Men wearing masks during the Spanish Influenza epidemic. Available via Library and Archives Canada as CC-
BY-NC-SA
Simple cloth masks soon became compulsory for infected and uninfected alike, though were of doubtful
utility in preventing the spread of the disease. Man on left possibly wearing Canadian Service Dress trousers,
so a military group. Photograph taken in 1918.

18. Red lung pneumonia. Available Available via Otis Historical Archives National Museum of Health and Medicine
as CC-BY-NC-SA
Much of the medical research on the disease was conducted in military hospitals. Painting for study purposes of
the partially dissected lungs of Pte. H.D. Cauvel, MDBH 76 [Herman Ore Cauvel, Medical Division Base Hospital
76], died October 8, 1918 from influenza and pneumonia: ‘the picture shows the red lung type of pneumonia, a
type of pneumonia which was peculiar to the pandemic’.
Labelled ‘Base Laboratory | Hospital Centre Vichy | A.E.F. [American Expeditionary Force’. Artwork by Lt.
William Schwarz of the Army Medical Museum.

19. ‘Symptomatology of the Influenza Epidemic’. Available Available via Otis Historical Archives National Museum
of Health and Medicine as CC-BY-NC-SA
Tabulation of the various influenza symptoms recorded at American army camps in 1918. The most common
were sudden onset, prostration, high temperature, headache, conjunctivitis, coryza (cold symptoms) and
cough.

20. ‘Influenza Pandemic. Mortality in America and Europe during 1918 and 1919’. Available Available via Otis
Historical Archives National Museum of Health and Medicine as CC-BY-NC-SA
Chart plotting deaths from influenza, expressed as an annual rate per 1000. Statistics gathered from New York,
London, Paris, and Berlin.
Created 20th August 1919.

21. Documentary film
We Heard the Bells. The Influenza of 1918. A Presentation Of The U.S.
Department Of Health And Human Services, Centers For Medicare &
Medicaid Services. In the public domain.
http://archive.org/details/gov.hhs.cms.006719

22. Personal accounts, documentary film
The Last Days of Okak. 1985. Produced by the National Film Board of Canada.
Available under a custom license.
“Only grass-covered ruins remain of the once-thriving town of Okak, an Inuit
settlement on the northern Labrador coast. Moravian missionaries
evangelized the coast and encouraged the growth of Inuit settlements, but it
was also a Moravian ship that brought the deadly Spanish influenza during
the world epidemic of 1919. The Inuit of the area were decimated, and Okak
was abandoned. Through diaries, old photos and interviews with survivors,
this film relates the story of the epidemic, with its accompanying horrors, as
well as examining the relations between the natives and the missionairies.”
Full record: http://www.onf-nfb.gc.ca/eng/collection/film/?id=16164
Available at: http://apsts.alberta.ca/video/watch/2qPkzCS4J78rSRNWJrEQno

23. Personal account, oral history
“Please, Let Me Put Him in a Macaroni Box” The Spanish Influenza of 1918
in Philadelphia. Available via OER Commons. Fair use for Educational
purposes.
In 1918 and 1919 the Spanish influenza killed more humans than any other
disease in a similar period in the history of the world. In the United States a
quarter of the population (25 million people or more) contracted the flu;
550,000 died. In the early 1980s, when historian Charles Hardy did interviews
for the Philadelphia radio program “The Influenza Pandemic of 1918,” he was
struck by the painful memories as many older Philadelphians recalled the
inability of the city to care for the dead and dying. In these excerpts from
Hardy’s radio program, Clifford Adams, an African American from the South;
Anna Lavin, a Jewish immigrant; Anne Van Dyke and Elizabeth Struchesky; and
Louise Abruchezze, an Italian immigrant, discussed their shared experience in
Philadelphia—shocked by the scale of the influenza outbreak, none could
fathom the lack of respect shown for those who had died.
http://www.oercommons.org/libraries/please-let-me-put-him-in-a-macaroni-
box-the-spanish-influenza-of-1918-in-philadelphia

24. Personal account, oral history
“He’ll Come Home in a Box”: The Spanish Influenza of 1918 Comes to
Montana. Available via OER Commons. Fair use for Educational purposes.
In a 1982 interview with Laurie Mercier, Loretta Jarussi of Bearcreek,
Montana, described how people would pass through that tiny town
seemingly healthy, only to be reported dead two days later. Her father went
undiagnosed for many weeks and had plans to go to a nearby hot springs to
rest. She believed that her father’s death was averted only because the son of
the local doctor was an army doctor who recognized flu symptoms that others
missed.
http://www.oercommons.org/libraries/hell-come-home-in-a-box-the-
spanish-influenza-of-1918-comes-to-montana

25. Personal account, oral history
“There Wasn’t a Mine Runnin’ a Lump O’ Coal”: A Kentucky Coal Miner
Remembers the Influenza Pandemic of 1918–1919. Available via OER
Commons. Fair use for Educational purposes.
Kentucky coal miner Teamus Bartley was interviewed at ninety-five years of
age and vividly recalled the impact of the flu pandemic on his community.
With a dearth of healthy laborers, the mines shut down for six weeks in 1918
and miners went from digging coal to digging graves.
http://www.oercommons.org/libraries/there-wasnt-a-mine-runnin-a-lump-o-
coal-a-kentucky-coal-miner-remembers-the-influenza-pandemic-of-1918-
1919

26. Report, 1920
[Ministry of Health], Report on the Pandemic of Influenza, 1918-19. Reports
on Public Health and Medical Subjects. No. 4 (London: HMSO, 1920).
Available via FluWeb Influenza Database as CC BY-NC-SA.
A downloadable book from 1920 from the Ministy of Health, London.
Individual chapters catalogued and available to download as PDF files.
Part I. Deals with Influenza in Great Britain and Ireland, and will be found to
be a contribution of exceptional interest and suggestiveness
Part II. Presents an account by the former of the incidence of Influenza in
Europe and the Western Hemisphere, and by the latter of its incidence in
Australasia and parts of Africa and Asia.
Part III. contains 12 special papers reporting inquiries into different aspects of
Influenza as it occurred in the UK.
http://influenza.sph.unimelb.edu.au/MOH_TOC.php