Talk:Spanish flu/Archive 2

Incubation Period
Not logged in (WB2) ...

If someone hasn't done this, will you please include something about the incubation period of the virus, AKA: in many victims there was a very long incubation period (6 or more months through the spring and summer) after initial symptoms subsided. Then, the darned thing picked back up in these same people in the fall and they all fell victim to the more severe symptoms.

Got this from that 1918 Flu book by ??; but I think its very important in sight of the probability of another outbreak of what they are begining to term as a "mutation" of the Swine Flu down in Mexico last month.

66.134.110.154 (talk) 00:04, 28 April 2009 (UTC)

Jaka mon (talk) 08:02, 29 April 2009 (UTC) RE Incubation Period: In some cases it would kill within 12 hours of exposure:  "Uniquely, it produced a deep cyanosis (blue skin) that affected the face, lips and lungs.  Somehow, the virus penetrated the deepest parts of the lung for unknown reasons.  It was known to kill some people in as little as 12 hours after contracting the virus." Also: "Death itself could come so fast.  Charles-Edward Winslow, a prominent epidemiologist and professor at Yale noted, 'We have had a number of cases where people were perfectly healthy and died within 12 hours.'  the Journal of American Medical Association carried reports of death within hours: 'One robust person showed the first symptom at 4:00pm and died by 10:00am.'


 * That actually doesn't satisfy the incubation period, as during the incubation period, one has either no symptoms or minimal symptoms until the virus becomes significantly symptomatic, yet one can still shed viral particles during incubation of many virii. Per http://www.pbs.org/wgbh/americanexperience/features/interview/influenza-shirley-fannin/ the incubation period is between 1-3 days. That eliminates the theories that Kansas was the source, as transatlantic voyages were by ship, transportation from Kansas would most likely been by train to the port of embarkation, one would be badly ill by the time one reached the port. Transatlantic voyages took between 1-3 weeks, depending on the transport at the time, a ship carrying people suffering from influenza would essentially have had all become infected and either dead or recovering by the time they arrived at their destination port. This organism is only second to a few strains of H5N1 influenza, which had a 60% mortality rate.Wzrd1 (talk) 01:41, 3 February 2012 (UTC)

Earlier of Spanish Flu's three waves may have helped immunize New York and Chicago
While a cursory reading of history have suggested that quarantine and the closing of schools explain the milder death rates in cities like New York and Chicago, the assumed facts underlying that conclusion may not bear careful historical analysis, such as that provided in http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/nov2707barry.html COMMENTARY Little evidence for New York City quarantine in 1918 pandemic Nov 27, 2007 (CIDRAP News)

In this article, a noted historian rejects the presumed existence of timely quarantine, and looks instead to the happy happenstance of herd immunity gained by exposure to the mild initial pandemic wave:

Is there another explanation for the relatively benign experiences in New York and Chicago? Possibly. Both cities experienced quite definite spring waves of influenza, which may have immunized some of the population.


 * I'm going to speculate here, but both cities have high population densities, which means the mild wave could have infected a lot more people then elsewhere, thus immunizing them from the later deadly wave. —MiguelMunoz (talk) 02:07, 22 May 2009 (UTC)

2 or 3 waves in the Spanish Flu -- second wave was the deadly one
http://www.nytimes.com/2009/04/26/world/americas/26flu.html?em -- another source about the waves.

Important, because cities that caught the first, milder wave were protected when the later deadly wave came. —Preceding unsigned comment added by 69.3.11.131 (talk) 03:33, 26 April 2009 (UTC)

New Scientist on earlier wave in Sweden, notes two vital policy implications of an earlier milder wave
1918 flu pandemic had a trial run
 * 30 January 2008
 * NewScientist.com news service

...
 * Scandinavian health statistics record an unseasonable outbreak of flu in the summer of 1918. People who caught it were only a tenth as likely to die as those stricken in the autumn, but those who did catch it were mainly young adults - a hallmark of the autumn outbreak and a strong indication that the summer virus was closely related to it

...
 * the Scandinavian figures suggest that the autumn virus spread slowly because the summer virus had already immunised many people. The team also found that the summer virus spread too fast for social distancing to work, but that the immunity it caused may have saved lives. Not every city got the summer flu and those that did may have had up to 40 times fewer deaths in the autumn.

...
 * If a pandemic behaved the same way now, this suggests we shouldn't try to avoid the first wave. Watching out for it could also give us time to make vaccine before the bad wave hits.

From issue 2640 of New Scientist magazine, 30 January 2008, page 19

http://www.newscientist.com/channel/health/bird-flu/mg19726404.900-1918-flu-pandemic-had-a-trial-run.html —Preceding unsigned comment added by 66.167.164.207 (talk) 23:32, 8 April 2008 (UTC)

100 million ?
The Stanford page says 20 to 40 million.

"The influenza epidemic that swept the world in 1918 killed an estimated 50 million people." National Archives 68.183.223.35 (talk) 21:16, 10 May 2008 (UTC)


 * At least one pair of recent, serious researchers admits to the possibility of the 100M figure being the top estimate: www.ncbi.nlm.nih.gov. NCBI. PubMed. Johnson NP, Mueller J. Updating the accounts: global mortality of the 1918-1920 "Spanish" influenza pandemic. (2002). They say that their best guess of 50M deaths could be as much as double that, given the poor state of records they were able to find.


 * The authors of the paper above give 50M as their estimated minimum mortality. They especulate that it could have been as high as 100M although the reliable estimate remains as "over 50M". 79.78.50.235 (talk) 21:51, 11 October 2008 (UTC)


 * I think we're both reading and comprehending the same article and the same conclusions. Over 50M, possibly as high as 100M. Binksternet (talk) 10:50, 12 October 2008 (UTC)


 * Here's a table of the various country and region death toll estimates that I was able to find online:


 * {| class="wikitable"

! Country/Region ! Deaths: low estimate ! Source for low estimate ! Deaths: high estimate ! Source for high estimate
 * United States
 * 500k
 * 
 * 675k
 * 
 * Canada
 * 30k
 * 
 * 50k
 * 
 * Germany
 * 686k
 * 
 * 686k
 * 
 * Norway
 * 15k
 * 
 * 15k
 * 
 * UK
 * 225k
 * 
 * 250k
 * 
 * India
 * 5M
 * 
 * 17M
 * 
 * China
 * 1M
 * 
 * 9.5M
 * 
 * Sub-Saharan Africa
 * 1.5M
 * 
 * 2M
 * 
 * Australia
 * 12k
 * 
 * 12k
 * 
 * France
 * 400k
 * 
 * 400k
 * 
 * Spain
 * 169k
 * 
 * 209k
 * 
 * Japan
 * 257k
 * 257k
 * Western Samoa
 * 7.5k
 * 
 * 7.5k
 * 
 * Russia/USSR
 * Philippines
 * 90k
 * 
 * 90k
 * 
 * Union of South Africa
 * 139k
 * 
 * 139k
 * 
 * Madagascar
 * 114k
 * 
 * 114k
 * 
 * Caribbean
 * 100k
 * 
 * 100k
 * 
 * New Zealand
 * 8k
 * 
 * 8k
 * 
 * Sweden
 * 38k
 * 
 * 38k
 * 
 * Finland
 * 25k
 * 
 * 25k
 * 
 * }
 * 114k
 * 
 * Caribbean
 * 100k
 * 
 * 100k
 * 
 * New Zealand
 * 8k
 * 
 * 8k
 * 
 * Sweden
 * 38k
 * 
 * 38k
 * 
 * Finland
 * 25k
 * 
 * 25k
 * 
 * }
 * 
 * 25k
 * 
 * }


 * Russia's data isn't known. Low estimate shown here is less than 20M. High estimate is about 40M. Note that a lot of countries and regions aren't represented. For instance, Java/Dutch East Indies has been cited as suffering 1M infections but I have no death toll or death rate data. Also note that the references here aren't very tightly vetted; they're just quick search results with only the obvious POV sites ignored.


 * The biggest unknowns in this chart are China, India and Imperial Russia/emerging Soviet Union. Some researchers argue that China had a low rate of death in the interior because of a poor network of roads and rail. Others put quite a high death estimate on China, extrapolating coastal port city death rates into total population. People are just guessing! Russia was in combat all over the map both with outsiders and internal revolutionaries, but was also plagued with influenza and encephalitis during 1918-19, the latter peaking in 1924-25. It's impossible to know for certain how many people specifically died of the flu. In India, certain region's deaths were charted in detail while others were not. There's a very wide gap between estimates. Binksternet (talk) 01:46, 11 May 2008 (UTC)

There is an inconsistency here. The world population in 1920 was 1.86 billion. but it is estimated that 2.5 to 5% of those who were infected died; with 20% or more of the world population infected, this case-fatality ratio would mean that about 0.5-1% of the whole population (roughly 50 million) died. The 50 million number is inconsistent with the percentages given. If 20% of the population contracted influenza, that would be 360 million, and if 5% of them died, that would only be 18 million deaths (which would be 1% of the population). On the other hand if 50 million people died, 50 million is 3% of 1.86 billion, not 0.5-1%. I am going to edit the article if I am not persuaded I am wrong.

Also all numbers of deaths should be accompanied by, or replaced with, percentages of the population. Who knows if 12,000 deaths in Australia is a lot or a little? By the way even if 100M died (6% of pop.) the influenza would not come close to the Black Death of the 1300s which killed about 1/3 of the worlds population. --Tomtul2 (talk) 06:22, 18 May 2009 (UTC)

The figures for Spain are grossly overestimated; 8M was 35% of the total Spanish population at the time. The reference quoted gives 8M as the number of people infected, not killed. A recent reference for the number of deaths(http://www.plataformasinc.es/index.php/esl/Noticias/Revisan-la-epidemia-de-la-gripe-Espanola-de-1918-en-Espana) gives a range between 169k and 260k. —Preceding unsigned comment added by 213.4.112.58 (talk) 12:23, 9 June 2009 (UTC)


 * Okay, thanks for pointing that out. The table has been updated. Binksternet (talk) 16:05, 9 June 2009 (UTC)

Russian flu 1889-90 immunity
I believe that "The Plague of the Spanish Lady - The Influenza Pandemic of 1918-19" (isbn=0-8371-8376-6) mentions that exposure to the Russian 'flu pandemic conferred a degree of immunity against Spanish 'flu, but I'm not sure. Can some one confirm this? --Michael C. Price talk 17:19, 20 August 2008 (UTC)

Flu worldwide progression
As of current research it is not clear whether the Spanish flu originated in North America, Europe or Asia. There are several opposing views on the topic. The picture on the progression of the disease worldwide looked quite authoritative, when I find it quite speculative. The picture was also referring to unknown unpublished, personal research. It would be better to replace this picture with a set of three pictures depicting the different hypothesis on the propagation of the pandemic during 1918-19 and according to the different possible origins. Proper citations for the figure would also be needed. 79.78.50.235 (talk) 22:26, 6 October 2008 (UTC)


 * I agree that the image assumes too much certainty. Binksternet (talk) 01:01, 7 October 2008 (UTC)


 * The uploader of this image keeps putting it back in, but the progression it shows is not certain, not agreed-upon by all experts. Binksternet (talk) 14:07, 4 May 2009 (UTC)

Given the records of the period it is difficult to have clarity on this subject. The flu progressed quickly and seemingly originating in several widespread arias. This is why the comet theory (besides being just oh so very neat!) is not completely out of hand. Frustratingly, there is no good evidence that gives us the origin of this pandemic; such evidence could save innumerable lives in the future. SG —Preceding unsigned comment added by 75.48.13.248 (talk) 00:24, 18 August 2009 (UTC)

Please use appropriate references
In the sake of the article's quality, we should make sure that we use appropriate references from reliable sources whenever possible. For example, using PowerPoint presentations as authoritative references is out of order. Also, the latest, most authoritative account of Spanish Flu's mortality comes from Jonhson and Muller's "Updating the accounts" paper. Using Science Daily as a reference for the number of deaths is not appropriate either. It is clear that 50M is currently the minimun number of deaths, with perhaps up to 100M, so the article would be better reading "over 50M people died". —Preceding unsigned comment added by 79.78.104.70 (talk) 22:18, 17 October 2008 (UTC)

Lethality patterns suggest the summer wave of the Spanish Influenza may have protected against the lethal fall wave.
Lethality patterns suggest the summer wave of the Spanish Influenza may have protected against the lethal fall wave.

"The summer wave may have provided partial protection against the lethal fall wave."

Viggo Andreasen, Cécile Viboud, and Lone Simonsen Epidemiologic Characterization of the 1918 Influenza Pandemic Summer Wave in Copenhagen: Implications for Pandemic Control Strategies MAJOR ARTICLE The Journal of Infectious Diseases 2008;197:270–278 © 2007 by the Infectious Diseases Society of America. All rights reserved. http://www.journals.uchicago.edu/doi/abs/10.1086/524065 0022-1899/2008/19702-0015$15.00 DOI: 10.1086/524065 —Preceding unsigned comment added by 69.3.11.30 (talk) 19:27, 20 October 2008 (UTC)

Listify list of victims
Unsure why survivors are really notable? Yes, insensitivity aside...
 * Oh Jolly Good you didn't die.


 * Survivors who recovered from the Spanish influenza include such luminaries as Munch and O'Keeffe: consider what the world would be like should these individuals have succumbed to the flu they suffered? I think the "Notable Survivors" section should stay as it tells the reader who was sick and yet survived to affect our world in profound ways. Sctechlaw (talk) 21:38, 25 May 2009 (UTC)

Notable casulties might be better placed in quarrantine at List of notable 1918 influenza pandemic casulties. Insert whatever the title of the article actually becomes to replace "1918 influenza pandemic". Would also think "notable" is optional (it must be notable {and reliably sourced} to be included in wikipedia).

Fictional casulties should not go in such a list. Instead a section on #In popular culture should detail significant representations of the pandemic in literature, music and film (including notable fictional figures who died because of 1918 pandemic-related causes).

The present #victims section might better provide further information on demographics of casulties. (oh wait that is probably in #Mortality section - merge and cut down a section, hooray!).

Discuss--ZayZayEM (talk) 06:14, 23 October 2008 (UTC)

imo, survivors are NOT notable and should be removed IceDragon64 (talk) 19:48, 29 April 2009 (UTC)

EXAMPLES
In which BSL 3 Labs are today Examples of H1N1 ? —Preceding unsigned comment added by 125.60.241.211 (talk) 11:03, 15 November 2008 (UTC)


 * None. It would be in a BSL-2 facility. Indeed, it's in the biosafety level article here on Wikipedia. That said, I only know of samples at CDC and USAMRIID, where it was gene mapped from samples from deceased soldiers from WWI.Wzrd1 (talk) 02:32, 3 February 2012 (UTC)

Anecdotal observations
Talking with older family members bring recollections of who died and what they had in common. Apparently the folks who got sick, went to bed, received good care and continued to take it easy during a prolonged recovery, did better than their active counterparts. The ones who recovered and promptly got up to work or take care of others often had a relapse and died. While this is obviously third hand and anecdotal, the family members born in 1917 and 1920 remember their parents talking about this. This actually seems to tie in with the people 20 to 65 being the highest mortality. They were the ones who would be expected to be active and to get back to work as soon as possible. Socsci69 (talk) 21:54, 15 November 2008 (UTC)Socsci69


 * Most likely a confused memory, not realizing or understanding that the pandemic had three waves. One would manage to recover, only to become sickened, while weakened still, by the second wave. In an ideal world, we'd have viral samples from all THREE waves and gene map them and also ascertain if the virus mutated enough that immunity from the one wave failed confer immunity to the other waves.Wzrd1 (talk) 02:01, 3 February 2012 (UTC)

Move Proposal: 1918 Influenza
Could I suggest moving this article to:
 * 1) Influenza pandemic of 1918
 * 2) 1918 influenza pandemic
 * 3) 1918 influenza
 * or at the very least:
 * 1) Spanish influenza pandemic
 * 2) 1918 Spanish influenza pandemic
 * 3) Spanish influenza pandemic of 1918?

For various reasons I am trying to keep "flu" out of influenza article titles. This is a slang term, while in perfectly common usage (and med, and med historian usage), it contains ambiguatity and is regularly used to refer to non-influenza disease (such as gastro, colds and non-influenza virals). Hopeful that part of my suggestion is non-controversial.

The article title should conatin the word "pandemic". This article is not about a form of influenza (a disease), it is not even about a strain of influenza virus (that would be H5N1). This article is about a historic event, a pandemic. the article title should accurately and correctly convey its contents and subject matter.

I would also suggest that removing "Spanish" may be overtly innacurate despite common usage. The plague has been suggested to originate from other spheres (Nth America, China). I do not see that it actually had greater impact to Spain. The only reason for such naming is that it " received greater press attention" in Spain because of lack of governmental censorship. I can see this as being controversial, and am not stuck to this being necessary criteria for the article. However contemporary and modern sources do significantly use date to identify the pandemic, and merely refer to "spanish" as a more commonfolk person's identifier.--ZayZayEM (talk) 06:07, 23 October 2008 (UTC)
 * I agree : "Spanish" is misleading.
 * I'm the former author of the French articles fr:Grippe de 1918 and fr:Pandémie de la grippe de 1918, copy of a personnal work done in 1999. By that time, I had read paper from the Institut Pasteur, especially from Dr. HANNOUN, the local expert for this issue in France. About the Spanish source theory, his paper stated that France newspaper being censored for war reasons, they were only allowed to talk about the flu in Spain, but not what she did in France. Same for all Europa. Accordingly, people of Europa misleadingly said they catched the "spanish flu". This is misleading, and should be remove from the title name to become a synonyme only. Yug (talk)  06:22, 9 January 2009 (UTC)
 * I make the move.
 * The article itself state since long time ago "The 1918 flu pandemic (commonly referred to as the Spanish flu)" in its introduction, the 'Spanish flu' title being misleading, and several user having express across time their support to a move, all encourage to do it. Yug (talk)  11:19, 12 January 2009 (UTC)
 * My vote's for "1918 influenza pandemic". You're right, "flu" is a slang term, and I was surprised to see it as the article title. Kevin (talk) 23:03, 11 February 2009 (UTC)
 * My vote, too. If you don't move it to "1918 influenza pandemic" in the next few days then I will. Not a very controversial decision, IMO. Binksternet (talk) 00:48, 12 February 2009 (UTC)
 * I think the first option, "Influenza pandemic of 1918" is more grammatically correct. SamEV (talk) 01:26, 12 February 2009 (UTC)

Myrtle Gonzalez
Her article gives (referenced) her cause of death as heart disease, and possibly indirectly from a fall from a horse. It doesn't say anything about flu. Who's right? 81.159.57.7 (talk) 20:39, 25 April 2009 (UTC)


 * All comments in the article to notable deaths and cases in real and fictional people should be deleted. WAS 4.250 (talk) 21:18, 25 April 2009 (UTC)

No. It is interesting and gives one a sense of scope. To one doing research on this subject it can be a valuable jumping off point. It was people, after all, who had this decease and it had an effect on history. I think it would be unwise to remove this section. SG —Preceding unsigned comment added by 75.48.13.248 (talk) 00:30, 18 August 2009 (UTC)

Obscure event?
"In the United States, Great Britain and other countries, despite the relatively high morbidity and mortality rates that resulted from the epidemic in 1918-1919, the Spanish flu remained a relatively obscure event until the rise in public awareness of bird flu and other pandemics in the 1990s and 2000s."

(See beginning of cultural impact ). Citation or no citation, I think this statement is horseshit. I think a lot of people were aware of 1918 before 1990 in the UK. —Preceding unsigned comment added by 82.10.238.89 (talk) 00:09, 26 April 2009 (UTC)

To be fair though, back at the time it simply known as the Great Flu Epidemic, 'a lot of people' today probably assume that the 'pandemic' is an entirely different event, at least those that aren't up to date with modern hyperbole may. 86.5.0.241 (talk) 12:44, 27 April 2009 (UTC)

The original statement must have been written by a young person! I am only 48, but was perfectly well aware of the Spanish flu, and the huge numbers killed- almost certainly several times the number killed in WW1. The event cannot be called obscure.124.197.15.138 (talk) 08:41, 6 July 2012 (UTC)

Origins of the 1918 Pandemic: The Case for France
NPR provides: Origins of the 1918 Pandemic: The Case for France at http://www.npr.org/templates/story/story.php?storyId=5222069 ...


 * John Oxford, a professor of virology at Queen Mary's School of Medicine in London, holds to a different theory: the British Empire nurtured the disease.


 * The British army had an enormous training camp set up in Etaples, France. On any given day, 100,000 soldiers were milling around. Many were on their way to World War I's Western Front; others, wounded, sick, and often prisoners, were on their way back. The camp had 24 hospitals alone and a team of fearful — but curious — pathologists. They recorded post mortems on everything that came their way. "They were worried, even at that stage, in 1916, about the possibility of infectious disease decimating the British army, as had happened in the past with typhus and cholera," says Oxford.


 * Then, just after the Battle of the Somme in the winter of 1916-1917, dozens of soldiers at the camp fell ill, complaining of aches, pains, cough and shortness of breath. Mortality was high at 40 percent, and some also had what later became known as a telltale sign of the killer flu: Their faces were tinged a peculiar lavender color, a condition known as heliotrope cyanosis.


 * Two months later, says Oxford, a similar outbreak was reported near London at Aldershot, site of one the biggest barracks in the army. Aldershot pathologists eventually published studies in The Lancet medical journal pinpointing the origin of the 1918 pandemic to Etaples and Aldershot.

... —Preceding unsigned comment added by 69.3.11.131 (talk) 03:38, 26 April 2009 (UTC)

An article from American History magazine details part of the 1918 flu's effects in America. Some newspapers even used it to whip up anti-German sentiment, blaming the Huns for the plague. 1918 Spanish Influenza Outbreak: The Enemy Within —Preceding unsigned comment added by Historychaser (talk • contribs) 17:14, 28 April 2009 (UTC)

Other resources
US Government archive documents & photos:

--VelcroWarrior (talk) 22:29, 28 April 2009 (UTC)

† dead?
In the 'Victims' 'Notable fatalities' section I think the use of "†" to signify the date of death for the victim is not very politically correct considering that many victims were not Christian. Why not use simply 'd' instead?--Xania talk 22:29, 28 April 2009 (UTC)


 * It looks a lot like an outdated execution tool, one used as a symbol for a major world religion, but it's really a Dagger (typography). ;^)
 * As such, it's politically acceptable. Binksternet (talk) 00:24, 29 April 2009 (UTC)

It is traditional and generally understood. SG —Preceding unsigned comment added by 75.48.13.248 (talk) 00:34, 18 August 2009 (UTC)

Contradiction?
What is the contradiction refered to in the message stuck on the page? Is the the fact that one part of the page quotes that the Central Powers suffered more than the Allies, whereas another confidently states that both sides suffered equally? IceDragon64 (talk) 19:59, 29 April 2009 (UTC)

Secondary Infections
If you look at some of the most recent research from the CDC, the Spanish Flue deaths were mostly caused by secondary bacterial infections. This article should have a section about this and a reference to the CDC article. Here is the link: http://www.cdc.gov/eid/content/14/8/1193.htm —Preceding unsigned comment added by Timbo79 (talk • contribs) 03:10, 30 April 2009 (UTC)

Waves
This article appears to say nothing about the multiple waves of varying severity and different seasons. —Centrx→talk • 03:40, 30 April 2009 (UTC)

Graphic of the three waves, plotted against stock market
http://bespokeinvest.typepad.com/.a/6a00d8349edae969e201156f63219b970c-popup

from

http://bespokeinvest.typepad.com/bespoke/2009/04/1918-spanish-flu-and-the-market.html —Preceding unsigned comment added by 69.3.11.188 (talk) 14:27, 30 April 2009 (UTC)

Earlier mild wave in summer 1918 helped immunize Copenhagen
Brundage JF, Shanks GD.

Deaths from bacterial pneumonia during 1918–19 influenza pandemic.

Emerg Infect Dis [serial on the Internet]. 2008 Aug [date cited]. Available from http://www.cdc.gov/EID/content/14/8/1193.htm

DOI: 10.3201/eid1408.071313

The Journal of Infectious Diseases 2008;197:270–278 © 2007 by the Infectious Diseases Society of America. All rights reserved.

DOI: 10.1086/524065 MAJOR ARTICLE

Epidemiologic Characterization of the 1918 Influenza Pandemic Summer Wave in Copenhagen: Implications for Pandemic Control Strategies

Viggo Andreasen,1

Cécile Viboud,2 and

Lone Simonsen3,a

1Department of Sciences, Roskilde University, Roskilde, Denmark; 2Fogarty International Center and 3National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland

Background.

The 1918–1919 A/H1N1 influenza pandemic killed 50 million people worldwide. Historical records suggest that an early pandemic wave struck Europe during the summer of 1918.

Methods. We obtained surveillance data that were compiled weekly, during 1910–1919, in Copenhagen, Denmark; the records included medically treated influenza‐like illnesses (ILIs), hospitalizations, and deaths by age. We used a Serfling seasonal regression model to quantify excess morbidity and mortality, and we estimated the reproductive number (R) for the summer, fall, and winter pandemic waves.

Results.

A large epidemic occurred in Copenhagen during the summer of 1918; the age distribution of deaths was characteristic of the 1918–1919 A/H1N1 pandemic overall. That summer wave accounted for 29%–34% of all excess ILIs and hospitalizations during 1918, whereas the case‐fatality rate (0.3%) was many‐fold lower than that of the fall wave (2.3%). Similar patterns were observed in 3 other Scandinavian cities. R was substantially higher in summer (2.0–5.4) than in fall (1.2–1.6) in all cities.

Conclusions.

The Copenhagen summer wave may have been caused by a precursor A/H1N1 pandemic virus that transmitted efficiently but lacked extreme virulence. The R measured in the summer wave is likely a better approximation of transmissibility in a fully susceptible population and is substantially higher than that found in previous US studies. The summer wave may have provided partial protection against the lethal fall wave.

Received 13 April 2007; accepted 5 July 2007; electronically published 10 January 2008. Reprints or correspondence: Viggo Andreasen, Dept. of Sciences, Roskilde University, DK‐4000 Roskilde, Denmark

Cited by ... —Preceding unsigned comment added by 69.3.11.188 (talk) 15:20, 30 April 2009 (UTC)

Delayed CNS damage
I remember a science show on TV that mentioned central nervous system damage thought to have come from the 1918 flu pandemic. The symptoms included sufferers unable to move their limbs consciously, i.e. a doctor could lift their arms up 45 degrees and they would just stay there and not fall back. Also, they looked like they were in a coma but 'wide awake', if that makes any sense. There were meant to be 10s if not 100s of thousands of sufferers worldwide, all of whom survived the pandemic unscathed. The symptoms started about 2 or 3 years after 1918 and have never been seen since. I think it was on Horizon; they had contemporary film footage of the sufferers and their doctors. Can anyone else remember this? Does the condition have a name? Has there been any proven link to the 1918 pandemic? If so, should it get a mention in the article?--ML5 (talk) 11:56, 1 May 2009 (UTC)


 * It is theorized that many cases of encephalitis lethargica were due to autoimmune damage to the brain from the 1918 influenza virus. http://en.wikipedia.org/wiki/Encephalitis_lethargica mentions it as well. The film starring Robin Williams called Awakenings is based on the real world experience of doctor Oliver Sacks. But, such is still theories, largely untested, though some brain samples of victims of encephalitis lethargica (donated after death) did show viral RNA from the 1918 influenza virus. In the vernacular, "The jury's still out".Wzrd1 (talk) 02:09, 3 February 2012 (UTC)

Move?
No consensus Parsecboy (talk) 10:34, 9 May 2009 (UTC)


 * Move need: 1918 flu pandemic → 1918 influenza pandemic — Reason: flu is a slang term, influenza is more correct. '1918 influenza pandemic' is currently a redirect to '1918 flu pandemic'. Yug (talk)  13:29, 1 May 2009 (UTC)


 * Oppose. Flu is the most commonly used term, even in the press and other reliable sources.  It's a stretch to call it slang. --Born2cycle (talk) 22:18, 1 May 2009 (UTC)


 * Oppose use Spanish Flu instead. 76.66.202.139 (talk) 04:24, 2 May 2009 (UTC)
 * 'Spanish flu' is exclude, this name is misleading, that's why experts avoid it. Wikipedia is an encyclopedia, accuracy is more important than popular believes, which an encyclopedia have to destroy. Yug (talk)  12:55, 2 May 2009 (UTC)
 * WP:COMMONNAME use common name instead of obscure professional name. 76.66.202.139 (talk) 04:54, 3 May 2009 (UTC)
 * Ah, but see also Naming conventions (precision). "Spanish flu" is woefully ambiguous. Sceptre (talk) 08:39, 3 May 2009 (UTC)
 * WP:PRIMARYTOPIC Not in common usage it isn't. Otherwise every article page would be disambiguated, and nothing would exist at primary names. 76.66.202.139 (talk) 14:33, 3 May 2009 (UTC)
 * How is it ambiguous? Is there an example of another large scale outbreak that was normally titled the "Spanish flu".  I'm not asking about other outbreaks of the flu in Spain, but can you give an example of another outbreak that was, and remains, widely called the "Spanish flu" (without qualification).  For instance, is there a notable book with "Spanish flu" in the title, that didn't talk about the 1918 event.  If I'm wrong about this, and "Spanish flu" is an ambiguous term, then we should create a disambiguation page, with links to all the notable flu pandemics that were known simply as "Spanish flu".   --Rob (talk) 05:33, 5 May 2009 (UTC)


 * Oppose use Spanish Flu instead, since this is the most notable usage. --Michael C. Price talk 15:31, 2 May 2009 (UTC)
 * Support per swine flu → swine influenza and avian flu → avian influenza precedent. Sceptre (talk) 20:21, 2 May 2009 (UTC)
 * Support We can have a redirect, but the main article should have the full name. --McSly (talk) 20:25, 2 May 2009 (UTC)
 * Oppose, and use Spanish Flu instead.. Regardless of what we name it, all references in the article should be updated to be consitent.  Notice how the exact text "1918 flu pandemic" exists only once in the entire prose of the article.  The exact text "flu pandemic" exists in the prose, but only as part of "Russian flu pandemic".  So, not only is "1918 flu pandemic" not a standard/common name outside Wikipedia (which is what really counts), but it's not even common here.   The world knows what the "Spanish flu" is.  There are lots of terms in the English language that are used, but shouldn't be taken literally.  We're supposed to figure what the common English term is, and not decide what it should have been.  I notice Spanish Wikipedians have it right with es:Gripe española.  As long as we make clear, right at the start, that the "Spanish flu" didn't come from Spain, and isn't literally Spanish, then there's no misinformation.  --Rob (talk) 15:27, 4 May 2009 (UTC)
 * Then it shouldn't really be at "Spanish flu" then. Sceptre (talk) 22:55, 4 May 2009 (UTC)
 * Support, no need to use a slang term when both titles are perfectly understandable to our readers. Tim Vickers (talk) 23:23, 4 May 2009 (UTC)
 * Support. We can use any number of redirects to accommodate casual usage. The article should have a tightly-defined name. Binksternet (talk) 00:32, 5 May 2009 (UTC)

I Support a move, but Oppose this one. Specifically, as SamEV mentioned above, moving it to "Influenza Pandemic of 1918" is more grammatically appropriate. Thoughts? ~ Amory (talk) 00:40, 5 May 2009 (UTC)

Initial wave in 1918 outbreak began as a mild form of influenza
Researchers can't agree on severity of swine flu outbreak  By TONY PUGH McClatchy Newspapers

http://www.kansascity.com/444/story/1174048.html

...
 * Lee Harrison, a professor of epidemiology and medicine at the University of Pittsburgh, agreed that preliminary data suggests the outbreak won't become a world pandemic, but he cautioned that the 1918 outbreak began as a mild form of influenza.


 * "It wasn't until it came back the following flu season that you really saw a real devastating pandemic in terms of death," Harrison said of the 1918 influenza. The second and third waves of the 1918 outbreak killed about 50 million people worldwide..


 * Harrison said it would take more work and time to determine the mortality rate from the current outbreak, but that "it does appear to be low and it doesn't appear to be in range with the 1918 pandemic. But again, it's a rapidly evolving situation and in 1918, it was the second wave that was particularly nasty."

... —Preceding unsigned comment added by 69.3.11.51 (talk) 03:56, 2 May 2009 (UTC)


 * What I had always read about the 1918 epidemic is that the first wave was mild, but it mutated into a deadly form when it hit the trenches of WWI. There, the evolutionary pressures began to favor a deadly strain rather than a mild case. The new strain went around the world a second time, but anyone who caught it the first time was immune. I'm surprised this information is missing from the article, especially since it's relevant to the current outbreak. I read this in a long New Yorker article about the epidemic many years ago, but I don't have a reference right now. —MiguelMunoz (talk) 07:11, 4 May 2009 (UTC)


 * Okay, I found the reference and put it in. —MiguelMunoz (talk) 05:30, 5 May 2009 (UTC)

Recognition of the second wave of 1918, 1957, and 1968 most salient to predicting possible paths of swine flu.
The fact that pandemics come in waves is fundamental to predicting the possible paths whenever a new and mild pandemic strain, like the swine flu, emerges.

In fact, multi-waves seems the rule, not the exception.


 * ... Andrew Pekosz, associate professor of immunology and microbiology at Johns Hopkins University Bloomberg School of Public Health, says it's important to keep in mind that the 2009 H1N1 virus is new, which means no one has immunity to it. He points out that the three outbreaks in the last century that were caused by new viruses -- in 1918, 1957 and 1968 -- started with a mild wave followed by more severe waves months later. Scientists dig for lessons from past pandemics http://www.cnn.com/2009/HEALTH/04/30/swine.flu.1918.lessons/index.html

http://www.cnn.com/2009/HEALTH/05/07/swine.flu.future/ —Preceding unsigned comment added by 66.167.95.139 (talk) 17:21, 7 May 2009 (UTC)

The CNN article proceeds to the obvious implications for predicting the possible future course of the Swine Flu hybrid:


 * 4. In the fall, could we have a pandemic like we had in 1918?


 * At a press briefing last week, World Health Organization spokesman Gregory Hartl brought up the specter of the 1918 pandemic, which killed more than half a million people in the United States. "In 1918, that pandemic started out as a very mild case of disease in the spring of 1918. ... Cases of the disease almost completely disappeared over the summer, only to reappear in the autumn of 1918 with the vengeance which we all know," he said. "So even though we might be only seeing mild cases now, we cannot say what will happen in the future." Learn more about the swine flu »


 * But many experts believe it's highly unlikely there would be an outbreak anything like 1918. First of all, scientists have a much better understanding of infectious diseases, and health care has improved greatly since 1918. Secondly, the 2009 H1N1 lacks a gene that is present in highly virulent flu viruses, such as the one in 1918.

http://www.cnn.com/2009/HEALTH/05/07/swine.flu.future/index.html?section=cnn_latest

Although the swine flu does not yet include a lethality gene, such genes are already present in H5N1, which is endemic in poultry and pigs all along the Pacific Rim. In Indonesia a variant of H5N1 better adapted to pigs has already been found, and that variant is still deadly in mice and ferrets. The possibility of a pig catching both the contagious swine flu and the lethal H5N1 bird flu and mixing them are obvious. The offspring virus could be a second wave that is both human-contagious and deadly. This mixing is by no means certain, and may even be unlikely, but underlies the caution with which public health authorities approach the possible future course of swine flu.

In each of the four major pandemics since 1889 (1889, 1918, 1957, 1968) a spring wave of relatively mild illness was followed by a second wave, a few months later, of a much more virulent disease
http://www.cnn.com/2009/HEALTH/04/30/swine.flu.1918.lessons/index.html

Scientists dig for lessons from past pandemics By Caleb Hellerman CNN Senior Medical Producer Decrease font Decrease font Enlarge font Enlarge font

(CNN) -- If there's a blessing in the current swine flu epidemic, it's how benign the illness seems to be outside the central disease cluster in Mexico. But history offers a dark warning to anyone ready to write off the 2009 H1N1 virus.


 * In each of the four major pandemics since 1889, a spring wave of relatively mild illness was followed by a second wave, a few months later, of a much more virulent disease. This was true in 1889, 1957, 1968 and in the catastrophic flu outbreak of 1918, which sickened an estimated third of the world's population and killed, conservatively, 50 million people. [emphasis added]

...

—Preceding unsigned comment added by 66.167.95.139 (talk) 17:31, 7 May 2009 (UTC)

Don't forget the huge 1928 Scarlet Fever pandemic. SG —Preceding unsigned comment added by 75.48.13.248 (talk) 00:35, 18 August 2009 (UTC)

And from http://www.usatoday.com/news/health/2009-05-09-swine-winter_N.htm :

Swine flu likely to return to U.S. next winter ...


 * "If you draw parallels to previous flu pandemics, the pattern has always been a mild epidemic in the early summer or late spring, then you see a larger epidemic in the winter," said Dr. Luis Z. Ostrosky, an associate professor of medicine and epidemiology in the division of infectious diseases at the University of Texas Medical School in Houston. "If this were to follow the pattern of previous outbreaks, we would see it again in the winter."


 * Ostrosky was referring to 1918 (Spanish flu pandemic), 1957 (Asian flu) and 1968 (Hong Kong flu).


 * This pattern of an initial "herald wave" followed by a second wave is common in the flu world.


 * "Sometimes we will see a little spike of flu towards the end of the season with that turning up next year. Maybe that's what this is. That would be very typical," said Dr. John Treanor, a professor of medicine and of microbiology and immunology at the University of Rochester Medical Center. "My guess would be that if this virus does not end up causing significant disease in the northern hemisphere over the summer, it will certainly do so in the fall."


 * So far, some of the most affected nations have been in North America and Europe, but the flu is spread more easily in the winter, and it's already fall in the Southern hemisphere. Experts fear public health systems could be overwhelmed if swine flu and regular flu collide in major urban populations, according to the Associated Press.


 * "You have this risk of an additional virus that could essentially cause two outbreaks at once," Dr. Jon Andrus, of the Pan American Health Organization's headquarters in Washington, D.C., told the wire service.


 * Two separate flu strains could also mutate into a new strain that is more contagious and dangerous. "We have a concern there might be some sort of reassortment, and that's something we'll be paying special attention to," World Health Organization spokesman Dick Thompson told AP.


 * In North America, the summer should slow down the spread of swine flu; neither viruses nor bacteria survive well at temperatures above 70 degrees Fahrenheit, explained C. Ed Hsu, an associate professor of public health informatics at the University of Texas School of Health Information Sciences at Houston and associate director of health informatics at the Center for Biosecurity and Public Health Preparedness at the University of Texas School of Public Health.


 * How and when the flu spreads is dependent on other factors as well: the fitness and efficiency of the virus itself along with its innate ability to replicate; the susceptibility of the host; and the environment, which includes not only the weather, but also human behavior (for example, groups of people confined together inside, making it easier for the virus to jump from person to person).


 * If a particular virus is especially robust, the weather and other environmental factors may play a lesser role.


 * "It may not care what the environment is like, because it doesn't need that assistance, or it may depend on environmental factors. It could go either way," Treanor said.


 * And while influenza virus needs a warm human body to replicate, it seems to sustain itself better in airborne respiratory droplets when it's cold, Horovitz said. Hence, the sneeze heard around the world.


 * "But, if it does go away, it will come back, he added. "I would be pretty sure of that."


 * A fall/winter resurgence may or may not be more virulent, said Ostrosky.


 * "We've been very lucky so far that it's appearing to be mild, at least in the U.S., as far as virulence and susceptibility to antivirals is concerned," he said. "It could change. That's one of the concerns."


 * "The severity depends on whether [and how] the genotype of the virus reassorts itself," Horovitz added. The reassortment may be so minimal as to make no clinical difference, or it could assert itself in entirely new ways."


 * But a vaccine will likely be ready by the time a second wave hits, Ostrosky noted, and the world is prepared in other ways as well.


 * "We have completely sequenced the genome of the virus, and it shows low virulence at this point. We know about it. We can prepare," he said. "If nothing else, this has been an extraordinary exercise in preparation."

Since being unlocked, this article is greatly improved
I would hope that an article of this importance would not lightly be denied the input of those with possibly pertinent information.

The genius of Wikipedia is unleashed only when there is contribution, correction and revision, not when there is censorship. —Preceding unsigned comment added by 66.167.95.139 (talk) 00:29, 8 May 2009 (UTC)

50–100 million again
Another good source says "Total deaths were estimated at ≈50 million and were arguably as high as 100 million." The source is: Just putting that out there for all the editors who would prefer an estimate of ~50 million. Binksternet (talk) 04:00, 9 May 2009 (UTC)
 * Centers for Disease Control and Prevention. Jeffery K. Taubenberger and David M. Morens. 1918 Influenza: the Mother of All Pandemics, January, 2006.
 * Centers for Disease Control and Prevention. Johnson NP, Mueller J. Updating the accounts: global mortality of the 1918-1920 "Spanish" influenza pandemic., 2002 Spring.

Contradiction?
In one part of the article it states that: "Among the conclusions of this research is that the virus kills via a cytokine storm (overreaction of the body's immune system) which explains its unusually severe nature and the concentrated age profile of its victims. The strong immune systems of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults caused fewer deaths."

But in this part of the article it states that: "Some researchers speculate that the soldiers' immune systems were weakened by malnourishment, and the stresses of combat and chemical attacks, increasing their susceptibility to the disease."

Is this a contradiction or not? If both is true than that would mean that weaker people would easier catch the flu, but would survive and that stronger healthier people wouldn't catch the flu as easily but if they did they would have a much higher risk of death. —Preceding unsigned comment added by 85.226.156.198 (talk) 16:40, 10 May 2009 (UTC)

Notable Victims
A number of people on that list were not victims of the Spanish Flu. Read some of their profiles. UStars (talk) 04:08, 11 May 2009 (UTC)


 * Like who? Examples would be useful. (Just in case: note that the "Victims" section consists of two lists, "Notable fatalities" and "Notable survivors".) Shreevatsa (talk) 04:23, 11 May 2009 (UTC)


 * Well Louis Botha, Myrtle Gonzalez, and Francisco de Paula Rodrigues Alves are all listed as fatalities of the Spanish Flu. And read their profiles. Not one of them three died from the illness. UStars (talk) 04:35, 11 May 2009 (UTC)


 * Yeah, seems there's something to be sorted out for the first two, because we have sources on this page (available online) that claim these died of the flu and sources on the other page (not available online) which claim heart disease. As for the third, it does say he died of Spanish flu, but you've just added a contradictory line saying he died of a heart attack :P Shreevatsa (talk) 04:51, 11 May 2009 (UTC)
 * Is that necessarily contradictory? 'flu places a strain on the heart and respiratory system.--Michael C. Price talk 07:30, 11 May 2009 (UTC)
 * Looking at Botha's bio I see it says "While other speculative theories of his death may exist they remain speculative and entirely unsubstantiated. " So there exists some doubt that he did die of "just" a heart attack. --Michael C. Price talk 07:36, 11 May 2009 (UTC)

In The Plague of the Spanish Lady by Collier (1974), Botha is listed as dead from Spanish Flu if that's any help. --talk

Gustav Klimt's biographers all list him as having died of a stroke, not the flu. Of course this does not mean that Klimt's death was not secondary to the flu, but still this Klimt/flu connection needs a better, more verifiable citation. The Times article cited lists no authority for its claim that Klimt died "in the first wave", and as this claim conflicts with several biographers having Klimt dying of a stroke, it should be considered suspect. Sctechlaw (talk) 21:33, 25 May 2009 (UTC)


 * The original addition of Klimt to the list came here . The edit summary mentioned the Times article but did not include a footnote in the text. The Klimt entry was deleted twice by an IP with no explanation whatsoever.  I added it back (as a vandalism issue) and added the original editors reference which I located on Google.  I also found several other websites referencing Klimt’s death by Spanish flu.


 * It was pointed out to me that the wiki article Gustav Klimt mentions a different cause of death (stroke and pneumonia). This claim is unsourced although one of the external links to the article mention this (without providing its source).  Since many victims of the flu were originally diagnosed with pneumonia, I am not surprised that there are conflicting reports and that original obituaries are reconsidered. Barry's "The Great Influenza" cleary makes the case that there was initially much confusion as to what was killing people.


 * Since you claim “several biographers having Klimt dying of a stroke”, perhaps you can change the Klimt article, remove the pneumonia reference, and provide a proper reference (book and page number). At this point, however, the Times reference is the only one in play.


 * At present, there are 35 victims listed for which there is no reference whatsoever. Shall we remove all of them?  Tag each listing?  Tag the entire section? Tom (North Shoreman) (talk) 23:11, 25 May 2009 (UTC)

Tom you offer good advice, even with sarcasm, therefore I changed the Klimt page to add two cites that corroborate the stroke and subsequent pneumonia as his cause of death. Klimt had a stroke while on his regular constitutional, went in hospital, developed pneumonia, then died. Perhaps this is why people became confused. It is always possible he contracted the influenza virus while in hospital, however I could not find evidence of this. Stroke victims often develop pneumonia without regard to circulating virii, and since there is no evidence currently that Klimt contracted the SF, I think he should be removed from the flu's victim list until we find out otherwise. —Preceding unsigned comment added by Sctechlaw (talk • contribs) 04:12, 26 May 2009 (UTC) Sctechlaw (talk) 04:18, 26 May 2009 (UTC)


 * Sounds fine to me. I have no problem with deleting Klimt based on your documentation.  There are numerous internet references to his death by swine flu, but none that I've seen that compete with published biographies. Tom (North Shoreman) (talk) 13:25, 26 May 2009 (UTC)

I removed reference to Egon Schiele dying three days after his wife died of the flu. While it is a tragic, poignant bit of information, it is nowhere near the level of importance to be included in an article like this. The information is at the Egon Schiele article, where it belongs. Taquito1 (talk) 02:24, 7 December 2009 (UTC)

World War II casualty comparison
I removed the statement that the 1918 flu killed "more than double the number killed in World War II." The number of people killed by WWII is estimated 50-72 million. 96.10.251.86 (talk) 17:29, 12 May 2009 (UTC)

Terrific explanation of waves, with charts
http://scienceblogs.com/effectmeasure/2009/05/swine_flu_lessons_from_past_pa.php#more


 * The spate of swine flu articles in The New England Journal of Medicine last week included an important "Perspective, The Signature Features of Influenza Pandemics — Implications for Policy," by Miller, Viboud, Baliska and Simonsen. These authors are familiar to flu watchers as experienced flu epidemiologists and analysts of archival and other data. Analysis of archival data is sometimes described as archeo-epidemiologic research. In their NEJM article Miller et al. summarize what they see as some common features in the three flu pandemics of the last century (so the generalization that there are no generalizations about flu pandemics may have some exceptions; I won't pursue the paradoxes that result). The pertinence for the current swine flu outbreak is striking.

...


 * Of most interest for the present circumstance is the consistent appearance of successive waves of disease:


 * The third feature, a pattern of multiple waves, characterized all three 20th-century pandemics, each of which caused increased mortality for 2 to 5 years (see chart). The lethal wave in the autumn of 1918 was preceded by a first wave in the summer that led to substantial morbidity but relatively low mortality in both the United States and Europe. Recent studies suggest that these early mild outbreaks partially immunized the population, decreasing the mortality impact of the main pandemic wave in the fall of 1918. In the United States, the 1957 influenza A/H2 pandemic had three waves in the United States, with notable excess mortality in the nonsuccessive winter seasons of 1959 and 1962 — the latter being 5 years after the initial emergence of the pandemic strain. From 1968 through 1970, Eurasia had a mild first influenza season, with the full effects on morbidity and mortality occurring in the second season of pandemic-virus circulation. The reasons for multiple waves of varying impact are not precisely understood, but they probably include adaptation of the virus to its new host, demographic or geographic variation, seasonality, and the overall immunity of the population. The occurrence of multiple waves potentially provides time for health authorities to implement control strategies for successive waves. (Miller et al., NEJM [cites omitted])


 * NEJM.pandemic.jpg


 * The NEJM swine flu articles appear to be free access. They are all worth reading

(citing http://h1n1.nejm.org/ )

—Preceding unsigned comment added by 64.105.0.128 (talk) 19:42, 12 May 2009 (UTC)

Nationalistic Bias?
Why is there a section headed "US Government response"? During 1918-1920 the US wasn't a major world power, so why should emphasis be put on the response of that particular country? Why not have "Swedish Government response" or "Chilean Government response"? Not only that but the information regarding the US Government response is quite vague and doesn't really say anything that hasn't already been pointed out or suggested in the rest of the article. Calicojack100 (talk) 10:53, 15 May 2009 (UTC)


 * Not only was the US a major power at that time, it was the country that researched flu the most at that time. WAS 4.250 (talk) 21:37, 15 May 2009 (UTC)


 * If it is the case that the US researched flu the most then i guess it should state that in the "US Government response" section and give citations. As it stands this section only states that Americans possibly carried the infection due to the draft and that there were no changes in US government or corporations due to the pandemic. Nothing noteworthy is actually said about the US Government response to the situation. So once again i claim that this section is redundant. And just for the sake of clarity the five major powers at the start of the twentieth century (or Great Powers as they were referred to at the time) were Great Britain, Russia, France, Germany and Japan (in that order). It was only after the conclusion of the First World War and the resulting treaties of Versailles and St-Germain in 1919 (though it should be noted that the USA was excluded from signing the 1920 Treaty of Trianon) that the United States became one of the chief arbiters of the new world order. So i guess you are correct with that point - but only just - one could say that the USA was an emerging Super Power.  Calicojack100 (talk) 01:29, 16 May 2009 (UTC)
 * This section entitled "US Government response" also ends with this strange sentence "Political and military events were little affected as the disease affected both sides alike." Both sides of what? Both sides of the American Government? What is it discussing in relation to the US Government? Unless this section clearly defines the noteworthy response of the Woodrow Wilson administration then it should be deleted. Or for the sake of neutrality the response of other countries should also be stated for comparison. Calicojack100 (talk) 08:14, 16 May 2009 (UTC)


 * The Wiki strategy is to add relevant sourced data and make it better - so feel free to add stuff. We do not delete content just because it needs improving. WAS 4.250 (talk) 14:28, 16 May 2009 (UTC)


 * We don't even delete content that is already there even if it's not relevant and in itself unsourced (the article cited is not concerned with the response of the Government during 1918-1920)? Why are you defending such a badly written excerpt? The heading is "US Government Response", yet the paragraph that follows says nothing of the Governments response. The only way to improve it would be to delete it or to conduct research into what the Government did back in 1918 in reaction to the pandemic. Your reasoning suggests that anyone can start a random entry and then its up to other editors to improve it rather than delete it. I'm unclear of whats behind your defense of this section. Is it because you think I'm coming across unpatriotic, so therefore you have to take a pole position? Please read the section i refer to and consider my OBJECTIVE criticisms, or perhaps you could explain what you consider to be noteworthy or relevant about the section under scrutiny.

 US Government response

The Great Influenza spread fear around the world, exacerbated by governments and health officials downplaying the pandemic. While the panic from World War I was dwindling, governments attempted to keep morale up by spreading lies and dismissing the influenza. On September 11, 1918, Washington officials reported that the Spanish Influenza had arrived in the city. The following day roughly thirteen million men across the country lined up to register for the war draft, providing the influenza with an efficient way to spread. However, the influenza had little impact upon institutions and organizations. While medical scientists attempted to discover a cure or vaccine, there were virtually no changes in the government or corporations. Political and military events were little affected as the disease affected both sides alike.
 * For me the wiki strategy has always been Be Bold With Your Editing. Anyway, i have no intention of deleting it, although i have marked it for possible improvements.Calicojack100 (talk) 15:58, 16 May 2009 (UTC)


 * Hello, no need to delete the section. Just rename it to "Governments response" or something like that. Add information about other countries. I'm sure that the responses were not identical (after all the decease is also called "Spanish flu" simply because there was no censorship in Spain so clearly the states policies had an impact). As WAS 4.250 mentioned don't hesitate to edit the section if you don't like it. I'm sure we'll have a few back and forth, but we should be able to find a solution everyone likes.--McSly (talk) 16:32, 16 May 2009 (UTC)


 * In light of the recent Swine Flu fears it may be interesting to look into how different countries reacted to the pandemic back then. Although if indeed a lot of the information was covered up then sources could be unreliable and it could be quite a job to dig them all out. Yet it could be interesting work. Calicojack100 (talk) 16:51, 16 May 2009 (UTC)


 * Actually, little of that section relates to the reference it cited, I've removed the whole thing for now. Tim Vickers (talk) 20:01, 18 May 2009 (UTC)

The mortality/case-fatality rates don't add up.
The Wikipidia article states: "The global mortality rate from the 1918/1919 pandemic is not known, but it is estimated that 2.5 to 5% of those who were infected died; with 20% or more of the world population infected, this case-fatality ratio would mean that about 0.5-1% of the whole population (roughly 50 million) died."

The world population at the time was roughly 1800 million (http://www.census.gov/ipc/www/worldhis.html), so 50 million deaths is 2.8% of the world population, not the article's estimate of 0.5-1%.

The article references the CDC: http://www.cdc.gov/ncidod/eid/vol12no01/05-0979.htm

According to the CDC source, "An estimated one third of the world's population (or ≈500 million persons) were infected and had clinically apparent illnesses (1,2) during the 1918–1919 influenza pandemic."

That's one third, or 33% (or 27.8% if you use the more accurate estimate of world population), not the article's estimate of 20%, but this underestimation is insignificant compared to the case-fatality rate. The CDC source further says, "Case-fatality rates were >2.5%, compared to <0.1% in other influenza pandemics (3,4). Total deaths were estimated at ≈50 million (5–7) and were arguably as high as 100 million (7)."

For total deaths to reach as high as 50-100 million, the case-fatality rate must be as high as 10-20% (50-100 million deaths out of 500 million infected), not the CDC's estimate of 2.5%. That sounds more like the rate in the U.S. It must have been much higher worldwide. IHTFP (talk) 05:24, 18 May 2009 (UTC)

Mortality Formatting
When reading through the Mortality section of this article I was presented with this:As many as 17 million died in India, about 5% of India's population at the time. In Japan, 23 million persons were affected, and 390,000 died. In the U.S., about 28% of the population suffered, and 500,000 to 675,000 died.

The formatting of this information for each country is inconsistent and thus confusing. India is #dead, %infected; Japan is #infected, #dead; U.S. is %infected, #dead. This data would be easier to understand if it was homogenized. —Preceding unsigned comment added by 58.179.41.55 (talk) 20:44, 1 June 2009 (UTC)

Mortality Inaccuracy
The accuracy of this page is all over the place. For example. It states 50-100 million dead from 500 million infection (5-10%) then states mortality as 10-20%, then later states 2-20%. There needs to be consistency. The easiest thing to base the mortality rate would simply be to use estimated deaths and estimated infections world wide (where most sources appear to agree on). Therefore 5-10% mortality rate. Or to find a credible source and use their estimate. But as it stands, we have 3 different mortality rates in the first 2 sections. Is there any object to change them all to 5-10%? - Rowan - 23 July 2009 —Preceding unsigned comment added by 203.219.145.229 (talk) 14:30, 22 July 2009 (UTC)


 * 50-100 million dead from 500 million infected is 10-20%, not 5-10%. Check your arithmetic. IHTFP (talk) 22:54, 12 September 2009 (UTC)

IS THIS FLU THE CURRENT SWINE FLU??
This flu (Influenza A H1N1) seems to be the same of the current flu, wth no one says a thing about it here??? 187.39.0.75 (talk) 20:03, 20 August 2009 (UTC)


 * Short answer - NO. H1N1 is a "category" of virus types, there are many "strains" or variants of this category or type, with more emerging all the time.  Most of the strains emerge in bird populations, with some occasionally originating in some mammals.  The 1918 strain originated in birds, while the current strain originated in pigs.  So, these strains have many common features under a microscope, but they are not the same.  WBardwin (talk) 20:21, 20 August 2009 (UTC)


 * I see...well they could be a little more specific then. Thanks a lot for the reply though. 187.39.0.75 (talk) 00:48, 21 August 2009 (UTC)

Origin of the 1918 Flu Pandemic according to the History Channel
In a History Channel documentary about the 1918 Flu Pandemic, it said that the soldiers in Fort Riley contracted an early version of the Virus via smoke fumes from a burning pile of animal manure. Then, when they were shipped over to Europe, the Virus mutated to become more lethal.

What I find interesting about this is the Heat Resistance Factor: The Virus survived the combustion process to become transmitted through the smoke. --Arima (talk) 22:57, 22 September 2009 (UTC) x z —Preceding unsigned comment added by 67.82.140.237 (talk) 02:00, 17 October 2009 (UTC)

Three waves seen to 1918 and 1957 influenza pandemics
":...


 * Lone Simonsen, an epidemiologist at George Washington University, said she expected a third wave in December or January, possibly beginning in the South again.


 * “If people think it’s going away, they can think again,” Dr. Simonsen said.


 * Based on death rates in New York City and in Scandinavia, she has argued that both 1918 and 1957 had mild summer waves followed by two stronger waves, one in fall and one in midwinter."

"Signs That Swine Flu Has Peaked"

By DONALD G. McNEIL Jr.

Published: November 20, 2009

http://www.nytimes.com/2009/11/21/health/21flu.html —Preceding unsigned comment added by 68.165.11.27 (talk) 02:05, 23 November 2009 (UTC)

Causes
Dont know if anybody watches the show Q.I. but they seemed to claim that one of the causes were ducks? any truth in this? —Preceding unsigned comment added by 86.44.18.162 (talk) 06:34, 10 January 2010 (UTC)

[]

[]

[]

MAYBE IT CAME FROM SPACE. This is an idea I think should be mentioned. And for several reasons:

1. It's interesting. Hey... SPACE! 2. It is a real theory. Even if you don't like it, it is a real theory. 3. Did I mention SPACE?

There are links just above regarding this idea.Gingermint (talk) 05:34, 19 January 2010 (UTC)

The whole section about the out of space origin lacks sources (those given are not about that, have no link and can't be found, and the only one that does talk about it is on a personal site). That's just wrong, I suppose it's a prank. 87.64.36.241 (talk) 22:40, 4 March 2011 (UTC)

Some of the sources are there showing that panspermia is a legit theory in general. NASA even supports the possibility that life or its components may have come from space. Panspermia.org, an article in "The Guardian", Dr. Chandra Wickramasinghe of Cardiff Uni. all either support or at least concede the possibility of the 1918 pandemic having originated from space. Then there was the program on the History Channel which dealt nearly exclusively on this. It may be a relatively new idea (a few decades) but it is a legit theory with many scientists saying a) Panspermia might be the cause for all or some life on Earth and several other scientists saying b) the virus that caused the 1918 flu may very well have come elsewhere.Coinmanj (talk) 05:42, 5 March 2011 (UTC)


 * At most this is a very minor view, held by an extremely small group of experts. This being the case, the theory should not get more weight than it deserves relative to the mainstream ones. Binksternet (talk) 06:04, 5 March 2011 (UTC)

I wasn't trying to give it more weight than the other theories but I did want to provide enough info on it to show that it isn't some crackpot theory. Coinmanj (talk) 06:24, 5 March 2011 (UTC)
 * Out of curiosity, I did some googling for panspemia in combination with flu. Some of the hits I got may be useful. Here's a few which look likely:, , , . Wtmitchell (talk) (earlier Boracay Bill) 06:46, 5 March 2011 (UTC)

I checked the references we have so far : In light of the proposed sources, I think that a couple of sentences about Chandra Wirckramasinghe having proposed that theory, with a link to the panspermia article, would be enough to present the idea. These references would then indeed support what is written (I'd suggest leaving the reference about panspermia in general being a theory to the panspermia article itself then). Aside from Chandra Wickramasinghe and his co-authors, apparently there isn't any other well known epidemiologist or astrophysicist who seem to support panspermia as a cause to the Spanish flu. 87.64.40.139 (talk) 17:30, 6 March 2011 (UTC)
 * , ], [, ], [, and  - all those articles are either written by Chandra Wickramasinghe or are directly based upon his articles.
 * explains that panspermia exists as a theory (no reference to the flu)
 * explains that the flu reached Alaska (no reference to panspermia, nor about the flu reaching Alaska after the continental US being a surprising phenomenon explained by the panspermia theory, and it doesn't support the idea that flu spread everywhere at once, on the contrary, see the quote: "Although influenza had reached most communities in the United States by late September, the disease did not hit Alaska until late in the fall. This delay allowed public officials to create an influenza policy before the pandemic hit.")


 * If there is no further input, I'll change that soon. I looked more into the subject, and basically what makes it sound serious is in large part the fact that it appeared in the Lancet (http://www.thelancet.com/journals/lancet/article/PIIS014067360313440X/fulltext).  However, it is often misrepresented, as it is not an article of the Lancet itself, but part of the 'correspondence' section, which is not peer-reviewed (and thus no more than the opinion of its authors) (http://download.thelancet.com/flatcontentassets/authors/lancet-information-for-authors.pdf). Frankly, the material is not convincing, and imo the most attention it should get is a mention at best. 87.64.23.202 (talk) 22:25, 12 March 2011 (UTC)

Requested move

 * The following discussion is an archived discussion of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section. 

No consensus to move. Vegaswikian (talk) 03:37, 4 December 2010 (UTC)

1918 flu pandemic → Spanish influenza — It's the most common name in English. I pick "influenza" over "flu" because (a) the latter is something of a slang term and (b) the term influenza is unambiguous and well-used in this context. The current title is suprising: many people have heard of the Spanish flu and its outbreak coincident with the end of the First World War, but will they recognise it as the "1918 flu pandemic"? And lest anybody argue that the proposed title is misleading, it is not: it was the Spanish-publicised flu, not the Spanish-born flu. The bad press for Spain is not such a bad thing after all, indicating freedom of the press. 216.8.134.159 (talk) 16:22, 24 November 2010 (UTC)

Survey

 * Feel free to state your position on the renaming proposal by beginning a new line in this section with  or  , then sign your comment with  . Since polling is not a substitute for discussion, please explain your reasons, taking into account Wikipedia's policy on article titles.


 * Oppose The existing title is I think more common, and for people who have not heard of the epidemic is less likely to cause confusion. "Flu" isn't that bad a term, I recognise "influenza" might be more encyclopedic, but that's a secondary issue. PatGallacher (talk) 21:27, 24 November 2010 (UTC)
 * Suggest Spanish Flu, as it is the common name for the pandemic and shorter than the suggested title, which is somewhat less common, but both of which are more common than the current title. 76.66.194.212 (talk) 04:27, 25 November 2010 (UTC)
 * Oppose Would support moving it to 1918 influenza pandemic otherwise it is good where it is. Doc James (talk · contribs · email) 09:29, 25 November 2010 (UTC)
 * Thank you everyone for not turning this into the flame war I feared it would be. D O N D E groovily   Talk to me  01:28, 27 November 2010 (UTC)

Discussion

 * Any additional comments:


 * Comment I think "1918 influenza pandemic" would be best. Spanish flu is not really correct as it did not start in Spain and the Spanish did not call it the Spanish flu. Things were name by one population to insult another. Doc James  (talk · contribs · email) 16:28, 24 November 2010 (UTC)
 * Actually the name wasn't an attempt to insult anyone. As Spain wasn't involved in WW1, they weren't censoring the reports like every other country. Countries that were at war only knew about the outbreak in Spain and didn't realize it was in their own countries. They genuinely thought the flu was Spanish.


 * Comment Not sure, as both terms are widely used. With regard to Spanish usage as made above by Doc James, the Spanish do appear to actually call it "Spanish flu"; the Spanish Wikipedia article is at Gripe española. The Celestial City (talk) 19:11, 24 November 2010 (UTC)
 * This site said the spanish at the time called it the French Flu  Doc James  (talk · contribs · email) 22:15, 24 November 2010 (UTC)


 * Google Scholars: 5,380 hits for "Spanish influenza" vs. 437 hits for "1918 flu pandemic"
 * Google Books: 28,800 hits for "Spanish influenza" vs. 539 hits for "1918 flu pandemic"
 * —Srnec (talk) 20:10, 29 November 2010 (UTC)
 * The above discussion is preserved as an archive of the proposal. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

Moved trivia here
Refs are needed to prove notability. Ie has a book about the 1918 flu history talked about these a notable works wrt this flu..
 * The NBC television Show The Event, focused on the arrival of human-like extraterrestrial beings from a failing star system trying to create room on Earth for their own people, utilize a strand of the 1918 Spanish flu as a bio-weapon to kill off the human population. —Preceding unsigned comment added by 65.7.210.144 (talk) 03:12, 21 May 2011 (UTC)
 * One of the few major works of American literature dealing largely with the Spanish flu is Katherine Anne Porter's Pale Horse, Pale Rider.
 * In 1935 John O'Hara wrote a long short story, "The Doctor's Son", about the experience of his fictional alter ego during the flu epidemic in a Pennsylvania coal mining town.
 * In 1937 American novelist William Keepers Maxwell, Jr. wrote They Came Like Swallows, a fictional reconstruction of the events surrounding his mother's death from the flu.
 * Mary McCarthy, the American novelist and essayist, wrote about her parents' deaths in Memories of a Catholic Girlhood.
 * Bodie and Brock Thoene's "Shiloh Legacy" series led off with an account of the Spanish flu in New York and Arkansas in their novel In My Father's House (1992).
 * In 1997 David Morrell's short story "If I Die Before I Wake"—dealing with a small American town during the second wave—was published in the anthology Revelations, which was framed by Clive Barker.
 * The thriller novel "The First Horseman", written by Jim and Carolyn Hougan under the pseudonym John Case, deals with a fictitious scenario in which a journalist discovers that a group of cultists-terrorists are planning to unleash the Spanish flu upon the world.
 * The 2001 album "For the Birds", by Irish band The Frames, includes a track named "Santa Maria". Written by oscar winner Glen Hansard, the song poetically describes the last days in the life of painter Egon Schiele, as he lies in bed with his wife, knowing they are both about to die from the Spanish flu.
 * In 2006 Thomas Mullen published a novel called The Last Town on Earth about the impact of the Spanish flu on a fictional mill town in Washington.
 * In 2005 the Canadian television series ReGenesis presented fictional research into the Spanish Flu and Encephalitis Lethargica.
 * In the 2005 novel Twilight, main character Edward Cullen was dying of the pandemic when he was turned into a vampire in 1918.
 * In 2008, Dennis Lehane's novel "The Given Day" described the pandemic from the point of view of one of the novel's protagonists Boston police officer Danny Coughlin; and also from the point of view of protagonist Luther Laurence, a black hotel houseman in Tulsa.
 * In Canadian fantasy author Sean Cummings's 2010 novel Funeral Pallor, the character Tim Reaper is responsible for having been the cause of the pandemic.
 * Canadian playwright Kevin Kerr's play Unity 1918 deals with the effect of the 1918 Flu Pandemic on the small town of Unity, Saskatchewan. Doc James  (talk · contribs · email) 17:47, 12 April 2011 (UTC)

Dead link
During several automated bot runs the following external link was found to be unavailable. Please check if the link is in fact down and fix or remove it in that case!


 * http://darwin.nap.edu/books/0309095042/html/60.html
 * In 1918 flu pandemic on 2011-05-25 02:46:42, Socket Error: 'A connection attempt failed because the connected party did not properly respond after a period of time, or established connection failed because connected host has failed to respond'
 * In 1918 flu pandemic on 2011-06-02 02:53:39, Socket Error: 'A connection attempt failed because the connected party did not properly respond after a period of time, or established connection failed because connected host has failed to respond'

--JeffGBot (talk) 02:54, 2 June 2011 (UTC)

fixed.--Neuroghost (talk) 10:41, 12 June 2011 (UTC)

Dr. Chandra Wickramasinghe and his theory about source
Dr. Chandra Wickramasinghe's idea about the 1918 flu virus coming from space is... very unorthodox to say the least. Considering that (I believe) most of the scientists in the relevant fields would not consider his idea to be even marginally supported by evidence, much less Science's current understanding of life's origin & evolution and the astrochemical processes as currently understood, I will mention in the article that "Current scientific theories and available evidence do not support Dr. Wickramasinghe's idea". I don't believe anyone will object to this (although it would probably be better to simply remove this "source theory"), even though Dr. Wickramasinghe was an associate of Dr. Fred Hoyle, who gave a notable contribution to cosmology (but was also in the habit of stepping outside of his scientific field and having very "unorthodox" ideas (to say the least... See Fred Hoyle's Article & Talk Page)).--Neuroghost (talk) 08:01, 12 June 2011 (UTC)

2009 flu pandemic
I don't understand this phrase in the lead, "(the follow-up was the 2009 flu pandemic)." According to Harrison's (for example), there were 3 other epidemics or pandemics (1933-35, 1946-47, and 1977-78). The 2009 pandemic was nowhere near as lethal as the 1918 epidemic. I don't think the lead should equate the 1918 and 2009 pandemic like that.--Nbauman (talk) 03:17, 21 September 2011 (UTC)

Medical effects
There is a fundamental contradiction between the introduction and the history section. The first one makes the logically compelling point that most victims were young and fit - precisely because their vigorous immune systems were more vulnerable to the flu. Yet the history section states that "Some speculate the soldiers' immune systems were weakened by malnourishment, as well as the stresses of combat and chemical attacks, increasing their susceptibility". That is completely contrary - as well as admittedly speculation. I suggest the deletion of this speculation.124.197.15.138 (talk) 08:45, 6 July 2012 (UTC)

U.S. HHS headlines three waves in lead paragraph on its Spanish Flu page
HHS has a compelling condensed history of the Spanish Flu, complete with tabs and multi-media, published at http://1918.pandemicflu.gov/

Citation to this work (and especially to the key feature of the three-wave structure) has been overlooked (regrettably) in the current article.

— Preceding unsigned comment added by 67.101.66.222 (talk) 02:45, 8 December 2007‎ (UTC)

Proposed 2008 WHO pandemic guidelines include waves
CIDRAP on WHO's new pandemic-phase guidance

Via CIDRAP: WHO's draft pandemic flu guidance revises phases. Excerpt:

The World Health Organization (WHO) has drafted a revised pandemic influenza preparedness plan that updates the definitions of pandemic phases and puts more emphasis on the social and economic effects of a global epidemic, among other changes.

The plan, intended to replace the existing one published in 2005, aims to present "simpler and more precise definitions" of the six pandemic phases and groups them to emphasize planning and preparedness considerations. The draft also defines "post-peak" and "possible new wave" phases.

— Preceding unsigned comment added by 68.166.204.30 (talk) 14:18, 11 November 2008‎ (UTC)

Recent Australian study seeks reasons 2nd and 3rd waves were more deadly
(The most obvious hypothesis, of course, is that the virus had evolved into a more deadly form.)

This article suggests that some may have been inoculated by earlier exposure to common flu. If so, this a seasonal live-virus vaccine like Flumist or the Russian seasonal live vaccine might provide some pandemic protection.

=
1918 Spanish flu records could hold the key to solving future pandemics http://curevents.org/showthread.php?s=fb82b05d9451aecf7aba69e85e4d3b22&t=4776

Ninety years after Australian scientists began their race to stop the spread of Spanish flu in Australia, University of Melbourne researchers are hoping records from the 1918 epidemic may hold the key to preventing future deadly pandemic outbreaks.

This month marks the 90th anniversary of the return of Australian WWI troops from Europe, sparking Australian scientists' race to try and contain a local outbreak of the pandemic, which killed 50 million people worldwide.

Researchers from the University of Melbourne's Melbourne School of Population Health, supported by a National Health and Medical Research Council grant, are analysing UK data from the three waves of the pandemic in 1918 and 1919.

They hope that modern high-speed computing and mathematical modeling techniques will help them solve some of the questions about the pandemic which have puzzled scientists for close to a century.

Professorial Fellow John Mathews and colleagues are analysing the records of 24,000 people collected from 12 locations in the UK during the Spanish flu outbreak including Cambridge University, public boarding schools and elementary schools.

He says gaining a better understanding of how and why the virus spread will help health authorities make decisions about how to tackle future pandemics.

"In the 1918/19 pandemic, mortality was greatest among previously healthy young adults, when normally you would expect that elderly people would be the most likely to die,'' Professor Mathews says "We don't really understand why children and older adults were at lesser risk.

"One explanation may be that children were protected by innate immunity while older people may have been exposed to a similar virus in the decades before 1890 which gave them partial but long-lasting protection.

"Those born after 1890 were young adults in 1918. They did not have the innate immunity of children and as they weren't exposed to the pre-1890 virus they had little or no immunity against the 1918 virus. We can't prove it but it is a plausible explanation."

Another striking feature is that the pandemic appeared in three waves, in the summer and autumn of 1918 and then the following winter.

One theory being examined to explain why some people were only affected in the second or third wave is that because of recent exposure to seasonal influenza virus they had short-lived protection against the new pandemic virus.

"The attack rates in the big cities weren't as high and this is probably because many people had been exposed to ordinary flu viruses, giving short-lived immunity,'' he says.

"In the English boarding schools, where there was social demarcation, children were probably less exposed to seasonal influenza viruses in earlier years; without that protection, pandemic attack rates were much higher than in ordinary government elementary schools.

"If we can provide a detailed time course of epidemics and the attack rates at different times, that information can be extremely useful in determining how a future pandemic might progress,'' says Professor Mathews.

He says initial findings point strongly to the value of short-lived immunity to provide protection or partial protection against the early waves of a virus.

This is particularly important when considering the stockpiling of drugs and vaccines to protect the community against a virus.

"The early implications of our study are that there may be benefit in providing short-lived immunity that is broadly based rather than specific,'' he says.

"If another flu pandemic were to come along and you have a vaccine, it may be better to use it even if it is against a different sub-type of the virus."

Source: University of Melbourne http://www.physorg.com/news145530214.html

— Preceding unsigned comment added by 68.166.204.30 (talk) 14:24, 11 November 2008‎ (UTC)

Folding in some new views
Museomed added some new points of view but the text was poorly integrated and written in poor English in this Good Article so I am bringing the additional text here for discussion. New text is shown in bold:
 * Most victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or weakened patients. The flu pandemic was implicated in the outbreak of encephalitis lethargica in the 1920s, although other researchers doubt this relationship. [McCall S; Vilensky JA; Gilman S; Taubenberger JK (May 2008). “The relationship between encephalitis lethargica and influenza: a critical analysis”. J Neurovirol 14(3):177-85.]
 * The pandemic lasted from June 1917 to December 1920, spreading even to the Arctic and remote Pacific islands. Between 50 and 100 million died, making it one of the deadliest natural disasters in human history. but it is interesting to note that other researchers determinate that most of the deaths (68.2%) happened patients between 14 and 44 years, as for example in Paris.Erkoreka A., (February 2010). “The Spanish influenza pandemic in Occidental Europe (1918-1920) and victim age”. Influenza and other Respiratory Viruses 4(2): 81-89.
 * Although the first cases were registered in the continental U.S. and the rest of Europe long before getting to Spain, the 1918 pandemic received its nickname "Spanish flu" because Spain, a neutral country in WWI, had no censorship of news regarding the disease and its consequences. Spanish King Alfonso XIII became gravely ill and was the highest-profile patient about whom there was coverage, hence the widest and most reliable news coverage came from Spain, giving the false impression that Spain was most affected. But if it should be noted that the first pandemic wave (from May 1918), which had been mild in other parts of Europe, affected severely Spain. That's why the name of the Spanish flu that became known worldwide since the summer of 1918 is also justified by the significant mortality that occurred in June and July in Spain.Erkoreka A (2009). “Origins of the Spanish Influenza pandemic (1918-1920) and its relation to the Firs World War”. J Mol Genet Med 3(2): 190-194

— Preceding unsigned comment added by Binksternet (talk • contribs) 13:23, 26 January 2011‎ (UTC)

"World War I did not cause the flu"
In this edit, User:DFY889 remarked that this assertion seemed odd. It seems odd to me as well, but it's been in the article with minor wording changes for a long time. It seems to have been initially added by an anon as an unsupported insertion saying "While World War I didn't cause the flu" in this June 2006 edit; that may have come from here. I'll leave it up to more frequent editors of the article to come to a consensus about changes to this article assertion. Wtmitchell (talk) (earlier Boracay Bill) 21:27, 29 May 2012 (UTC)
 * I did away with that nonsense, though it's still an awkward lead in. ~ Amory ( u  •  t  •  c ) 18:28, 29 March 2013 (UTC)

"1 to 3 percent of the population."
From the opening paragraph:

''The 1918 flu pandemic. . . killed 50 to 100 million of them—1 to 3 percent of the world's population''.

These two figures (the number of the deaths and the percentage) can't both be accurate. If 50 million represented one percent of the world's population in 1918-20, then the world's population would have been 5 billion, which we know is not correct. We know that the world's population was between 1.5 and 2 billion at this time. If the death toll was indeed 50-100 million, then that would have been more like 3-7% of the world's population. Conversely, if the 1-3% proportion is correct, then the death toll was more like 15-45 million. 108.254.160.23 (talk) 18:31, 23 February 2013 (UTC)
 * It looks like the deaths were updated but nobody changed the percent. Using a population of 1.86 billion in 1920, I conservatively put 3-5. ~  Amory ( u  •  t  •  c ) 18:25, 29 March 2013 (UTC)

Edit request on 29 March 2013
Please change the link: http://www.census.gov/population/international/data/idb/worldhis.php to http://www.census.gov/population/international/data/worldpop/table_history.php because the first link is outdated and no longer valid. Source: U.S.Census Bureau

148.129.129.173 (talk) 17:07, 29 March 2013 (UTC)
 * ✅ Thanks. I'll note that the concern over percentages in the section above is definitely valid. ~  Amory ( u  •  t  •  c ) 18:06, 29 March 2013 (UTC)

Aspirin and vitamin C.
"The vitamin C-associated increases, however, appeared to be blocked when the vitamin was given simultaneously with aspirin (900 mg). Similar findings were observed in guinea-pigs, where in addition faecal excretion of vitamin C was found to be significantly increased when the vitamin was administered together with aspirin. These results suggest that aspirin may impede gastrointestinal absorption of vitamin C."

http://www.ncbi.nlm.nih.gov/pubmed/6811490

The aspirin blocking the body's ability to absorb vitamin C on top of the already existing problem of malnutrition would give those infected the appearance of scurvy. Vitamin C is crucial to the imune system.


 * ‎EpicNoob1983 - Can you please explain why this has anything to do with the 1918 flu pandemic - i'm confused about its relevance. ps - you can easily sign your edits by putting four tilde (~) after your comment. Andrewgprout (talk) 23:13, 5 July 2013 (UTC)

NOT a natural disaster
In the lede the following is asserted:

"making it one of the deadliest natural disasters in human history"

with a link to the Wikipedia article on Natural Disasters, which, in turn, specifically states:

A natural disaster is a major adverse event resulting from natural processes of the Earth; examples include floods, volcanic eruptions, earthquakes, tsunamis, and other geologic processes.

In the article and even in the talk sections on Natural Disasters, they specifically exclude plagues and such. Therefore, this article should NOT directly contradict another Wikipedia article that it links to....it's just too easy for a reader to see that one of them is "wrong". Just omit the word NATURAL in the natural disaster, and eliminate the link and the article will make sense. Thanks  N0w8st8s (talk) 10:09, 19 September 2013 (UTC)n0w8st8s
 * Good point, feel free to make the correction yourself.--McSly (talk) 14:56, 19 September 2013 (UTC)

Spanish Flu called as such due to wartime censorship?
No authentic citation given. Links to "channel 4" which doesn't contain reference to this fact. — Preceding unsigned comment added by 198.84.225.29 (talk) 22:23, 1 October 2013 (UTC)

Is paragraph beginning "On 16 September 2008" somewhat redundant?
About para. On 16 September 2008, the body of British politician and diplomat Sir Mark Sykes was exhumed to study the RNA of the flu virus in.. is it necessary in this context - many were disinterred and this exhumation failed and was unsuccessful so why mention here? FactoProphyl (talk) 13:05, 21 October 2013 (UTC)

Removed contradiction tag
I removed the contradiction tag, as susceptibility of soldiers to infection and the higher fatality rate among the strongest immune response groups are totally different subjects and do not contradict current medical understandings of the mortality and morbidity rates and causes of influenza.Wzrd1 (talk) 20:17, 16 December 2013 (UTC)

Theories
It appears the geographical origin of the pandemic has been pinpointed. If I was one to pun, I'd say this was a US fowl, not just mere horseplay. Paradoctor (talk) 11:30, 17 February 2014 (UTC)
 * http://phys.org/news/2014-02-evolution-flu-viruses-textbooks-history.html
 * http://dx.doi.org/10.1038/nature02759
 * "It is now clear that most of its genome jumped from birds very close to 1918 in the Western Hemisphere, and there is a suggestion that it was North America in particular." [...] "the animals we keep for food and eggs may be substantially shaping the diversity of these viruses"

Aspirin role in high mortality of Spanish flu pandemic
The evidence of the role of aspirin in the high mortality experienced in the USA by people victim of the Spanish flu was pointed by homeopaths as the time of the epidemic itself. The observations of these homeopaths were gathered in an article of W. A. Dewey published in the Journal of American Institute of Homeopathy in may 1921 (http://pdf.lu/PBkd) soon after the end of the epidemic (December 1920). It is certainly the high training of homeopaths to make clinical observations on their patients which explain their 90 years advance in making a diagnosis that classical medecine has only proposed in 2009. Gérard Gaspard (talk) 08:10, 24 November 2014 (UTC)

Horton Foote play
I'd like to suggest an addition to the section on the flu in popular culture. (I'd put it in myself, but the article is semi-protected.) Suggested entry to read:
 * In the play 1918 by Horton Foote, the presence and threat of the flu (and the tragedy it ultimately causes) is a major element of the plot. The 1979 play was made into a film, released in 1985, which was subsequently edited for broadcast by PBS as the last part of the miniseries "The Story of A Marriage".  — Preceding unsigned comment added by AnneTG (talk • contribs) 02:05, 13 December 2014 (UTC)

Plot spoilers in Popular Culture section
In the paragraph on Downton Abbey in the Popular Culture section, the final sentence about Matthew dying in a car accident in 1921 is a gratuitous plot spoiler that has no relevance to the article and should be removed. Furthermore, I would argue that Lavinia Swire's death from the 'flu ought not to be given away either, as this is also a major spoiler and, while relevant, is an unnecessarily specific detail for the purpose of the section. It would be sufficient to say this: "The final episode of series two of British televison drama Downton Abbey references the pandemic when several major and minor characters fall ill with Spanish influenza in April 1919." This would actually be more enlightening in terms of describing the program's treatment of the historical subject (i.e. several characters are infected), without giving away the key plot outcome.

Aramando (talk) 23:58, 25 January 2015 (UTC) Aramando
 * Red information icon with gradient background.svg Not done: please establish a consensus for this alteration before using the template. Also see WP:CENSOR and WP:SPOILER.  B E C K Y S A Y L E S  00:14, 26 January 2015 (UTC)

Japan
"In Japan, 257,363 deaths were attributed to influenza by July 1919, giving an estimated 0.425% mortality rate, much lower than nearly all other Asian countries for which data are available." This sentence has at least two problems. Obviously they don't mean "mortality rate," which would imply over 60 million *infected* Japanese (of whom 234 out of 235 survived). Plus the claim may be factually incorrect; see: http://wwwnc.cdc.gov/eid/article/19/4/12-0103_article — Preceding unsigned comment added by 65.130.93.117 (talk) 19:32, 6 February 2015 (UTC)

Numbers?
The introduction says 50 to 100 millions and 3 to 5 percent. It is obvious that these numbers do not match. — Preceding unsigned comment added by 46.115.33.144 (talk) 13:46, 12 July 2013 (UTC)


 * The discussion leading to these figures was here: Talk:1918_flu_pandemic/Archive_2. I think the figures are reasonably correct, with the 3% figure best represented as 2.5%. Apparently someone rounded it. Binksternet (talk) 14:02, 12 July 2013 (UTC)

Another problem which I would put in the numbers section is the claim that the disease killed mainly young adults, rather than the young or older adults. But this is not borne out by the graph given on the page. Spanish flu was still much more fatal for young children and older people, it is just that it showed higher than normal levels of fatal for those in early and mid adulthood. Whilst I accept that this is a picky point, I think we should strive for accuracy and the claim, as currently presented is inaccurate. — Preceding unsigned comment added by MTAllenby (talk • contribs) 16:34, 1 February 2014 (UTC) I notice that despite raising this point in February 2014 the article still contains an obviously factually incorrect statement. Considering that this is supposed to be a key article this is disappointing.

Numbers are still wrong. Case fatality rate was ~2.5% which means 2.5% of infected people died. This is what citation 31 says. This number appears to have been wrongly applied as the percent of 'total world population' that died. And it looks like that person tried back-calculate the case-fatality rate and got an erroneous number that the flu killed 15-20% of infected, a number which has no reference and is not found on other reputable sources. — Preceding unsigned comment added by 140.107.59.86 (talk) 18:56, 13 October 2014 (UTC)

Numbers are still wrong (30 April 2015). According to the cited source, the case fatality rate was ">2.5%", instead of the 20% that is mentioned. This seems like a significant error. 145.109.9.227 (talk) 16:10, 30 April 2015 (UTC)

Correct me but if 500 million were infected and the fatality rate was 3- 5% would'nt that be 15 to 25 million died ? Patricia Daniels and Stephen Hyslop writing for National Geographic Almanac of world history claimed that 500 million died. 3 rd edition page 25. wherever did they get that number.
 * Reliable secondary sources use footnotes to indicate where they get their information.

Semi-protected edit request on 1 May 2015
Popular Culture section Spanish flu was used as a cover up of a more lethal disease in the Atlantis Gene Novel and series by A.G. Riddle.

"The Spanish Flu (that’s what we’ve sold the world on, how we’ve “branded” the pandemic) has moved to every country in the world. Only a few islands have been spared. It’s killed countless millions so far. It kills the strong, sparing the weak, unlike any other flu epidemic."

Riddle, A. G. "THE TOMBS OF ATLANTIS." The Atlantis Gene.

http://www.agriddle.com/Atlantis-Gene/facts#sp

Daedaluseffect (talk) 19:56, 1 May 2015 (UTC)
 * Red information icon with gradient background.svg Not done for now: Neither the author nor the book/series seems to have a wikipedia page at this time. Need sources to show that this book is particularly notable, if you can find something like a bestsellers list or critical reviews, that could suffice Cannolis (talk) 20:28, 3 May 2015 (UTC)

Remove misleading insert re. origins of the pandemic virus
"Astrobiologists Chandra Wickramasinghe and Fred Hoyle believe that some component of the 1918 flu pandemic arrived to earth by meteorite; as the first to be infected were birds. In 2005 frozen bodies containing the flu were discovered by Armed Forces Institute of Pathology in Alaska, revealing that a new virus had recombined genes with an old virus, making a deadlier hybrid influenza responsible for the 1918 epidemic."

Problems here:


 * Wickramasinghe and Hoyle are notable practitioners of fringe science.
 * The only source is to Journal of Cosmology, which has serious controversies around its credibility.

While this might be an interesting insert to an article on panspermia, I think including it here is inappropriate.

I propose that edit be removed. 2001:470:1F11:62A:64F7:F8C9:EC6:7BF6 (talk) 14:56, 1 April 2015 (UTC)

Adding SPER for visibility; it's been a month now. 2001:470:1F11:62A:684A:8A48:E5DE:5A41 (talk) 02:19, 5 May 2015 (UTC)
 * Red information icon with gradient background.svg Not done: please establish a consensus for this alteration before using the template.  Edgars2007  (talk/contribs) 20:22, 5 May 2015 (UTC)


 * God bless you Wikipedia, where a garbage edit by a banned user gets to linger for months at a time in the name of process and procedure. I just remembered why I RTVed myself before.2001:470:1F11:62A:1C98:771E:C4C:3AF8 (talk) 01:28, 11 May 2015 (UTC)

Broken Reference Link
Just drawing attention to a broken link: reference 67 leads to an SQL error. http://www.swvic.org/digby/1919flu.htm has some of the info from what the link was referencing. 71.191.220.181 (talk) 02:21, 7 June 2015 (UTC)

Semi-protected edit request on 4 June 2015
Under Section 2.2, Patterns of Fatality Please insert the following two paragraphs (with two references):

A worldwide effect changed the world in 1918. A study conducted by He et al used a mechanistic modelling approach to study the three waves of the 1918 influenza pandemic. They tried to study the factors that underlie variability in temporal patterns, and the patterns of mortality and morbidity. Their analysis suggests that temporal variation in transmission rate provide the best explanation and the variation in transmission required to generate these three waves is within biologically plausible values [1].

Another study by He et al used a simple epidemic model, to incorporate three factors including: school opening and closing, temperature changes over the course of the outbreak, and human behavioral changes in response to the outbreak to infer the cause of the three waves of the 1918 influenza pandemic. Their modelling results showed that all three factors are important but human behavioral responses showed the largest effects [2].

References:

1. He D, Dushoff J, Day T, Ma J, Earn DJ. Mechanistic modelling of the three waves of the 1918 influenza pandemic. Theor Ecol. 2011; 4: 283-288. doi: 10.1007/s12080-011-0123-3.

2. He D, Dushoff J, Day T, Ma J, Earn DJ. Inferring the causes of the three waves of the 1918 influenza pandemic in England and Wales. Proc Biol Sci. 2013; 280(1766):20131345. doi: 10.1098/rspb.2013.1345.

Alicechiu2000 (talk) 02:04, 4 June 2015 (UTC)
 * Yes check.svg Done (talk to) TheOtherGaelan('s contributions) 19:02, 13 June 2015 (UTC)

Horton Foote play
(Repeating this suggestion that I made on 02:05, 13 December 2014, because it seems to have just vanished between 19:56, 1 May 2015 and 00:44, 2 May 2015 without any note indicating why it was deleted. If it was inappropriate, please advise; in the absence of explanation, I'm assuming it was deleted in error.)

I'd like to suggest an addition to the section on the flu in popular culture. (I'd put it in myself, but the article is semi-protected.) Suggested entry to read:
 * In the play 1918 by Horton Foote, the presence and threat of the flu (and the tragedy it ultimately causes) is a major element of the plot. The 1979 play was made into a film, released in 1985, which was subsequently edited for broadcast by PBS as the last part of the miniseries "The Story of A Marriage".

AnneTG (talk) 03:07, 13 October 2015 (UTC)
 * I'm sorry your original suggestion disappeared, . Horton Foote is well-known and his play 1918 is part of the The Orphans' Home Cycle and notable in itself. I've made the edit for you, although it would be nice if you could make a note here of the source you used to find out about the PBS miniseries. Wikipedia only has an article for the 1957 Finnish 1918 (film) - the 1985 film directed by Ken Harrison is and could probably have its own article. --RexxS (talk) 12:54, 26 October 2015 (UTC)
 * I'm sorry your original suggestion disappeared, . Horton Foote is well-known and his play 1918 is part of the The Orphans' Home Cycle and notable in itself. I've made the edit for you, although it would be nice if you could make a note here of the source you used to find out about the PBS miniseries. Wikipedia only has an article for the 1957 Finnish 1918 (film) - the 1985 film directed by Ken Harrison is and could probably have its own article. --RexxS (talk) 12:54, 26 October 2015 (UTC)

Semi-protected edit request on 14 March 2016
Hello, I am an influenza virologist currently completing my PhD. I suggest editing two things in the "Hypothesis about source" in the 1918 flu pandemic article.

First, please change "Some hypothesized the flu originated in the Far East." to "Some hypothesized the flu originated in East Asia." The term "Far East" is quite antiquated (and has racist undertones) and should be replaced by "East Asia".

Second, a new study came out in January 2016 showing that there is no evidence that the 1918 virus originated from Chinese laborers/soldiers. Please include the following at the end of the "Hypothesis about sources" section:

A scientific investigation published in 2016 found no evidence that the 1918 virus was imported to Europe from Chinese and Southeast Asian soldiers and workers. In fact, there is evidence that the virus had been circulating in the European armies for months and potentially years before the 1918 pandemic.

Source: http://www.jcma-online.com/article/S1726-4901%2815%2900261-0/pdf

Thank you for your assistance.

Virologist123 (talk) 21:32, 14 March 2016 (UTC)
 * Yes check.svg Done  B E C K Y S A Y L E S  06:48, 15 March 2016 (UTC)

Added information about life expectancy
At the beginning of the article, I added three sentences about global life expectancy in the early twentieth century and the 1918 flu pandemic's affect on it. Life expectancy was not mentioned in the article and I thought it was a relevant part of the disturbance regime, particularly the magnitude aspect, as it helps demonstrate the severity of the pandemic. Snowbird225 (talk) 17:26, 12 April 2016 (UTC)

Before Sunrise by Mickhail Zoshchenko
Perhaps under In Popular Culture include the reference made to the pandemic in Mikhail Zoshchenko's experimental autobiography "Before Sunrise". In the section "January the Twelfth", Zoshchenko recounts how his mother died to the Spanish flu. The vignette appears to take place in St. Petersburg. The book is quite hard to find, so a pertinent quote is: "My mother lies in bed. She's delirious. The doctor said she has the "Spanish flu"-a horrible influenza from which people are dying in every home" (72, 1974 tr. Kern). Perhaps the addition could read:

Mikhail Zoshchenko's says in his autobiography Before Sunrise that his mother died of the Spanish flu in 1918. She had become delirious, feverish, and exhausted before her death. A doctor tells Zoshchenko that the disease is killing people in that fashion in every home in St. Petersburg. Natures Colours (talk) 14:34, 7 June 2016 (UTC)

Mention can be added to In Popular Culture that Spanish Flu is the central topic in the novel White Plague by James Abel: http://www.jamesabelauthor.com/books/white-plague-mm

External links modified
Hello fellow Wikipedians,

I have just modified 16 one external links on 1918 flu pandemic. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
 * Added archive https://web.archive.org/web/20110604144218/http://www.pasteur.fr/infosci/conf/CRC/Grippe_CRC.ppt to http://www.pasteur.fr/infosci/conf/CRC/Grippe_CRC.ppt
 * Corrected formatting/usage for http://ec.europa.eu/research/profiles/index_en.cfm?p=1_oxford
 * Added archive https://web.archive.org/web/20111006093032/https://www.xtimeline.com/evt/view.aspx?id=65022 to http://www.xtimeline.com/evt/view.aspx?id=65022
 * Added archive https://web.archive.org/web/20101222041002/https://xtimeline.com/timeline/Timelines-of-Great-Epidemics to http://www.xtimeline.com/timeline/Timelines-of-Great-Epidemics
 * Added archive https://web.archive.org/web/20100114205358/https://www.xtimeline.com/ to http://www.xtimeline.com
 * Added archive https://web.archive.org/web/20091102151942/http://thejakartaglobe.com:80/home/looking-through-indonesias-history-for-answers-to-swine-flu/337976 to http://thejakartaglobe.com/home/looking-through-indonesias-history-for-answers-to-swine-flu/337976
 * Corrected formatting/usage for http://www.pandemicflu.gov/general/greatpandemic.html
 * Added archive https://web.archive.org/web/20090110182940/https://www.ballaratgenealogy.org.au:80/digby/1919flu.htm to http://www.ballaratgenealogy.org.au/digby/1919flu.htm
 * Corrected formatting/usage for http://www.translational-medicine.com/content/2/1/3
 * Corrected formatting/usage for http://virus.stanford.edu/uda/
 * Corrected formatting/usage for http://www.cdc.gov/ncidod/EID/vol12no01/05-0979.htm
 * Corrected formatting/usage for http://www.cdc.gov/ncidod/EID/vol12no01/05-0979.htm
 * Added archive https://web.archive.org/web/20080327214955/http://ww3.startribune.com:80/blogs/oldnews/archives/43 to http://ww3.startribune.com/blogs/oldnews/archives/43
 * Added archive https://web.archive.org/web/20070122062720/http://www.news.wisc.edu:80/13360.html to http://www.news.wisc.edu/13360.html
 * Added archive https://web.archive.org/web/20081002154157/http://www.scientistlive.com:80/lab/?/Opinion/2008/09/16/21042/Exposure_to_1918_influenza_virus_activates_memory_B-cells/ to http://www.scientistlive.com/lab/?/Opinion/2008/09/16/21042/Exposure_to_1918_influenza_virus_activates_memory_B-cells/
 * Added archive https://web.archive.org/web/20090805170405/https://nmhm.washingtondc.museum:80/exhibits/1918killerflu/1918_killer_flu1.html to http://nmhm.washingtondc.museum/exhibits/1918killerflu/1918_killer_flu1.html

When you have finished reviewing my changes, please set the checked parameter below to true or failed to let others know (documentation at ).

Cheers.— InternetArchiveBot  (Report bug) 17:11, 8 November 2016 (UTC)

Spread of viruses over much larger areas than "to those close by"
The section "Spread" states in the first sentence that "when an infected person sneezes or coughs, more than half a million virus particles can be spread to those close by." However, recent research by MIT professor Dr. Lydia Bourouiba suggests sneezes can be carried throughout an entire building via air circulatory systems. Here is a link to Dr. Bourouiba's description of her findings. Thom W Blair III (talk) 02:40, 1 January 2017 (UTC)

External links modified
Hello fellow Wikipedians,

I have just modified one external link on 1918 flu pandemic. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
 * Added tag to http://demog.berkeley.edu/~andrew/1918/figure2.html
 * Added archive https://web.archive.org/web/20090910134149/http://1918.pandemicflu.gov/ to http://1918.pandemicflu.gov/

When you have finished reviewing my changes, you may follow the instructions on the template below to fix any issues with the URLs.

Cheers.— InternetArchiveBot  (Report bug) 16:46, 14 June 2017 (UTC)

Mortality
The section claims that "an estimated 10% to 20% of those who were infected died" with no citation. However, the CDC article cited in the next sentence reads: "Case-fatality rates were >2.5%, compared to <0.1% in other influenza pandemics" and cites two sources for this information. The sources are: Marks G, Beatty WK. Epidemics. New York: Scribners; 1976. Rosenau MJ, Last JM. Maxcy-Rosenau preventative medicine and public health. New York: Appleton-Century-Crofts; 1980.

It says in the article that "...this flu killed...more in a year than the Black Death killed in a century", that "3% to 6% of the entire global population died" and "current estimates say 50–100 million people worldwide were killed". But in the article of the Black Death (https://en.wikipedia.org/wiki/Black_Death#Death_toll) it says that "It killed some 75 to 200 million people in Eurasia" and " In crowded cities, it was not uncommon for as much as 50% of the population to die". So apparently the Black death may have killed more people than the Spanish Flu and it was far more deadly so i think the claim that the Spanish Flu killed more in a year than the Black Death killed in a century is inaccurate or misleading and thus its deletion should be considered. Thinker78 (talk) 20:37, 17 February 2017 (UTC)
 * Red information icon with gradient background.svg Not done: please establish a consensus for this alteration before using the template. jd22292 (Jalen D. Folf) (talk) 21:50, 15 August 2017 (UTC)

Semi-protected edit request on 25 August 2017
I was came to the Spanish Flu wiki page in order to find out more about this pandemic after reading the William Maxwell novel 'They Came Like Swallows' therefore I suggest that within the 'In Popular Culture' section the following line is changed from:

Twentieth-century fiction includes at least three novels with the flu pandemic as a major theme: Katherine Anne Porter's Pale Horse, Pale Rider, Thomas Mullen's The Last Town on Earth, and Thomas Wolfe's Look Homeward, Angel.

to

Twentieth-century fiction includes at least four novels with the flu pandemic as a major theme: Katherine Anne Porter's Pale Horse, Pale Rider, Thomas Mullen's The Last Town on Earth, Thomas Wolfe's Look Homeward, Angel and William Maxwell's They Came Like Swallows. Radgeboy (talk) 13:57, 25 August 2017 (UTC)
 * Red information icon with gradient background.svg Not done for now: There should be reliable sources to establish that Maxwell's novel is notable on its own before being added to this section. Eggishorn (talk) (contrib) 14:51, 25 August 2017 (UTC)

Origin theory

 * I saw on a television program that this virus started as a mixture of parts of a human flu virus and a pig flu virus; neither could infect the other's host, but both could infect ducks, including both viruses at the same time. And the camp kept pigs and ducks to turn cooking and catering waste into meat. Anthony Appleyard (talk) 05:18, 27 August 2017 (UTC)

Within context of other large pandemics
I think The Atlantic newsmagazine is generally first-rate journalism. The following article puts the 1918 pandemic in context as compared to two earlier pandemics, and also as compared to WWI. It's an article about different potential ELE's (extinction level events). Cool Nerd (talk) 18:57, 19 December 2017 (UTC)

Human Extinction Isn't That Unlikely, The Atlantic, Robinson Meyer, April 29, 2016.

Incorrect date
First paragraph under "History" states the first diagnosis in Kansas was in March 2018. Should be 1918. — Preceding unsigned comment added by 63.123.140.114 (talk) 20:27, 31 January 2018 (UTC)
 * ✅, thanks! ~ Amory  (u • t • c) 21:07, 31 January 2018 (UTC)

Spanish Flu
Ive always known this to be called Spanish Flu. Is there anyway it can be put in the title? Because when i searched for 1918 flu, the link came up. When i typed in Spanish flu the same link came up, but it could confuse someone into thinking there was 2 x 1918 flu that year because there was no distinction i could read from the search page about the link.

Maybe "1918 flu also known as Spanish Flu", or something like that.

What do you think?Cornersss (talk) 17:35, 28 January 2018 (UTC)


 * Yes, I agree that we should include the common name. I've also read that the reason it was called "Spanish Flu" was because of lack of wartime censorship in Spain!


 * Maybe we can include "also known as . . " in our lead. And going with what a variety of references say and dependent on what they say, an explanation of how it got this name in the body of our article.  Thanks for bringing this up!  I have a couple of other projects in the meantime.  Please feel free to jump in and do this yourself.Cool Nerd (talk) 19:28, 8 February 2018 (UTC)

year later, recurrence in Winter of 1919-1920 had considerable higher death toll than for a normal flu season
https://academic.oup.com/jid/article/195/7/1018/800918

That's what this article is saying. Please see Fig. 2. Cool Nerd (talk) 19:32, 8 February 2018 (UTC)

Problematic paragraph in Legacy-section
"In Spain, sources from the period explicitly linked the Spanish flu to the cultural figure of Don Juan. The nickname for the flu, the "Naples Soldier", was adopted from Federico Romero and Guillermo Fernández Shaw's operetta, The Song of Forgetting (La canción del olvido), the protagonist of which is a stock Don Juan type. Davis has argued the Spanish flu–Don Juan connection served a cognitive function, allowing Spaniards to make sense of their epidemic experience by interpreting it through a familiar template, namely the Don Juan story.[99]"

By itself, this paragraph does not make sense. It does not follow from this text that Spaniards could "make sense" of the pandemic experience by linking it to the figure of a mythical womanizer and libertine. This either needs to be expanded on and explained (as I assume the text referenced does) or be deleted, as in its current form it is merely a bizarre distraction. 82.176.221.176 (talk) 16:10, 12 February 2018 (UTC)

Semi-protected edit request on 10 June 2018
Please add the video game Vampyr as a popular culture reference to the outbreak. 2601:589:8000:2ED0:8F9:8E1A:FC8B:A27E (talk) 01:18, 10 June 2018 (UTC)

❌ Vampyr is probably a better candidate for an In Popular Culture reference than what was in the existing section, which was mostly unsoureced with references for a few extremely trivial mentions. But In Popular Culture sections are a magnet for unsourced garbage, so I've just removed the section entirely. Vampyr at least has the flu pandemic as an important element of the setting, but it doesn't appear to be central to the plot (unless the flu causes vampirism? if so, I'm missing that detail in the article). Vampyr may be less garbagy than the other IPC garbage, but it's not great. Plantdrew (talk) 03:02, 11 June 2018 (UTC)

Requested move 3 June 2018

 * The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section. 

The result of the move request was: Moved to Spanish flu. There is a general consensus that "Spanish flu" is the common name and the article should be moved. However, there is no consensus whether to include the year, but as it was not included in the original proposal and several posters pointed out that the year is not necessary for recognition nor part of common name, I'm moving this to "Spanish flu" without prejudice. Finally, since sources are mixed with capitalization of "flu", we defer to MOS and use lowercase. No such user (talk) 08:37, 14 June 2018 (UTC)

1918 flu pandemic → Spanish Flu – WP:COMMONNAME. I can only speak for the US, but this is the common name of the event (Please comment if it isn't in your part of the world). I get that it's an inaccurate name, but so is Boston Massacre. The lede can give proper context, and indeed it already does. Previous move requests and discussions: Talk:1918_flu_pandemic/Archive_2 and Talk:1918_flu_pandemic/Archive_2 Brightgalrs (/braɪtˈɡæl.ərˌɛs/)[ᴛ] 17:40, 3 June 2018 (UTC)
 * Partial support — “1918 flu pandemic” gets 123,000 results on Google, whilst “Spanish flu” gets 939,000 results. “Spanish flu” is definitely the most common name. I should note, however, that the “f” in “Spanish flu” is not capitalized, so the article would have to be moved to Spanish flu, not Spanish Flu. Inter qwark talk  contribs 13:09, 5 June 2018 (UTC)
 * Partial support - as above. Dreamy Jazz (talk) 13:30, 5 June 2018 (UTC)


 * Oppose. The year is critical for recognizability.  1918 Spanish flu would be better, but I would oppose that, as the flu article is at Influenza.  I prefer 1918 Spanish influenza pandemic, at 31 characters, it is less than one line on the standard output.  --SmokeyJoe (talk) 04:36, 6 June 2018 (UTC)
 * I think adding the year would be alright, but Flu -> Influenza is too much editorializing. You're missing the point of "Spanish Flu" being the common name. It's the common name even if it doesn't align with Influenza's title. Brightgalrs (/braɪtˈɡæl.ərˌɛs/)[ᴛ] 15:18, 6 June 2018 (UTC)
 * Support move to 1918 Spanish flu, as per above. --IJBall (contribs • talk) 16:41, 8 June 2018 (UTC)
 * Comments Spanish flu research exists. Also this proposal should include List of 1918 flu pandemic cases (to List of Spanish flu cases or whatever). Brightgalrs (/braɪtˈɡæl.ərˌɛs/)[ᴛ] 16:10, 6 June 2018 (UTC)
 * Spanish flu research exists. That supports the move, right? Inter qwark talk  contribs 18:43, 6 June 2018 (UTC)
 * Well, maybe. But I mentioned it because it should probably be consistent with this article's title, either way. Brightgalrs (/braɪtˈɡæl.ərˌɛs/)[ᴛ] 19:37, 6 June 2018 (UTC)
 * Well, as the kids put it: True dat. Inter qwark talk  contribs 20:13, 6 June 2018 (UTC)


 * Support nom's original proposal as well as 's proposed titles. Spanish flu has the benefit of being concise but still unambiguous (as far as I know). I'm not sure that adding the year really differentiates the topic from any other, but maybe it increases the recognizability. Ajpolino (talk) 22:28, 6 June 2018 (UTC)
 * Oppose Ten years ago I would have agreed, but I think more and more I've seen this referred to as the 1918 flu than just the Spanish Flu. I suppose 1918 Spanish Flu is more common, but I think that implies other Spanish flus.  At any rate, I don't think there's a clear COMMONNAME, so the current title is a good one. ~  Amory  (u • t • c) 00:58, 9 June 2018 (UTC)
 * Support Spanish flu (with "flu" lower cased). This still appears to be the WP:COMMONNAME in modern searches, such as 21st-century Google books results. vs. .--Cúchullain t/ c 17:35, 11 June 2018 (UTC)
 * support per Pubmed--Ozzie10aaaa (talk) 12:30, 13 June 2018 (UTC)


 * The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

Are we overstating worldwide death rate?
Our article currently states:

'and resulted in the deaths of 50 to 100 million (three to five percent of the world's population),'

Link seems broken.


 * Link still broken, should be removed. — Preceding unsigned comment added by 92.201.52.186 (talk) 21:38, 4 November 2018 (UTC)

---

and yet, this source states:

' .  .  .  one third of the world's population (or ≈500 million persons) were infected and had clinically apparent illnesses (1,2) during the 1918ï¿½1919 influenza pandemic. The disease was exceptionally severe. Case-fatality rates were >2.5%,. . .  '


 * Notice it's saying 2.5% of the people who got sick. Okay, let's dive in and try to get it right. Cool Nerd (talk) 19:52, 9 February 2018 (UTC)

---

Estimates of influenza related mortality have continued to climb as we develop better surveillance and detection methods. Of note is the difference between viral case-fatality rates and overall mortality (e.g. due to subsequent bacterial pneumonia, cardiac stress, etc.) which can be due to many complications resultant from the initial viral infection. This applies even to current influenza seasons. Estimates of 1918 influenza associated mortality have expanded with more recent estimates. The 2013 source is not in conflict with the 2006 source, as they are discussing two different numbers. -Udorn1972 (talk), 8/4/18

section is misleading
This section, "In 2007, analysis of medical journals from the period of the pandemic[17][18] found that the viral infection itself was not more aggressive than any previous influenza, but that the special circumstances of the epidemic (malnourishment, overcrowded medical camps and hospitals, poor hygiene) promoted bacterial superinfection that killed most of the victims, typically after a somewhat prolonged death bed.[19][20]"

This section is misleading and needs clarification, for example what duration a somewhat prolonged death bed is. One of the quoted references states 6-7 days for New Zealand and "more than half" in more than 10 for the US. There is also some confusion as the 4 provided references all say different things. Reference 18, "An epidemic of pneumococcus broncho-pneumonia", contradicts what is said here.

Also, the phrase "not more aggressive" is not inline with the references quoted which specifically said it was not "highly transmissable" comparatively. I guess it comes down to if you are saying that it was not more aggressive in spread, or more aggressive in toll on the body. It's not clear. From the reference "For many infectious agents, explosive epidemics indicate high transmissibility. While the 1918 pandemic progressed quite rapidly, our results indicate that 1918 pandemic influenza A/H1N1 was not highly transmissible relative to other influenza subtypes8,11 and infectious agents2". When you look at the virus reconstruction in monkeys which is mentioned later, it was much more aggressive to the body and destructive than a modern flu virus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745659/ "Our results depict a scenario where early during infection there was an accelerated up-regulation of the inflammasome by the 1918 virus in addition to the numerous cell death related genes that were up-regulated during infection with the 1918 virus but down-regulated during VN/1203 infection. These events represent important differences in the host response to these viruses and likely contribute to the severity and lethality of disease associated with 1918 virus infection."..."Our present results also showed that VN/1203 caused significant pathology, but that 1918 infection generated more severe and sustained tissue damage. "

The bacterial superinfection reference is misleading as that is what usually causes most flu deaths anyway. I feel, as one paper mentioned, it's important to recognize the role secondary infections in disease complication, but for all intents and purposes the references from 1918 and 1919 stated the speed at which pneumonia developed. Check out reference 18 again. The paragraph here is contradictory.

Lastly, it probably should be stated in this paragraph that most papers agree we have stop gap measures such as vaccines and Tamiflu that may prevent an epidemic like this from happening again. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019839/

Sspeed1 (talk) 21:11, 13 February 2019 (UTC) sspeed1

Semi-protected edit request on 23 Jan 2019
We are planning the following edits
 * Removing the broken link for Michael Worobey
 * I would also like to suggest you change the name of his university to the official "University of Arizona" ("Arizona University" is not a name used even colloquially). --Gplasky (talk) 19:52, 3 May 2019 (UTC)
 * Attaching the hyperlink to Pacific Islands in its first mention in the second line and removing it from the subsequent mention
 * Fix inconsistencies with capitalisation of Pacific Islands
 * Under subheading 'deadly second wave' add citation for last sentence in first paragraph

Atms113 (talk) 04:07, 23 January 2019 (UTC)

Disagreement with the move to "Spanish flu"
I will admit upfront that I am not overly familiar with the arcane of Wikipedia voting but the "consensus" in June 2018 to revert the name from "1918 influenza pandemic" is not greater than the consensus that in 2009 agreed to create the more accurate and less offensive name of 1918 influenza epidemic.

The arguments for the change that I see are that:
 * 1) "Spanish flu" has more Google hits and by Wikipedia policy it seems to be the "common name" (reference is made to "Boston Massacre" also being inaccurate)
 * 2) The addition of Spanish merely implies that it was first reported in Spain
 * 3) People can read the accurate version of events in the lead

The counterarguments are: (numbered list below edited to clear up and summarise new information gathered in the exchanges further below. MiG-25 (talk) 06:11, 12 August 2018 (UTC))


 * 1) This is not a case of insisting that horses be discussed under "Equus ferus caballus". If we think "influenza" is too uncommon, "1918 flu" is readily recognisable and lay language. The "Boston Massacre" comparison is not so relevant given that no alternative name is well-known. In addition, the title does not immediately condemn the English, a title such as "English massacre of Bostonians" would illustrate the issue better.
 * 2) Alternatives to "Spanish flu" are by no means obscure (as opposed to a case like "horse" vs. "equus ferus caballus"); Google search results yield 721,000 for "Spanish flu", but also 173,000 for "1918 flu" and "210,000" for "1918 flu"
 * 3) the numbers from PubMed given in the vote above are wrong: in medical literature, "1918 influenza" seems to be much more common than "Spanish flu" vs.
 * 4) Adjectives of origin applied to diseases are simply inappropriate, as acknowledged in WHO guidelines . While these guidelines don't apply ipso facto to old diseases, the principle is clear. To add insult to injury, in this particular case, the adjective of origin is particularly inaccurate. Otherwise, we could have the "American HIV pandemic" and other ridiculous titles. After all, the USA was the first country where AIDS was widely reported, even if we can trace its origins back to African jungles. Note that Spanish Wikipedia uses the title "1918 Influenza Pandemic". The expression "Spanish flu" also exists in Spanish but there is plenty of emphasis on setting the record straight. (see also my rebuttals to Rjensen's claims below that the term is used widely and without comment in Spanish sources).
 * 5) Given the use of redirects in Wikipedia, why would we have to keep an offensive and scientifically and historically inaccurate title which we then proceed to correct in the first sentence? This is not about a different interpretation of historical events. This is demonstrably false.

For the reasons above, which essentially reflect the consensus reached in 2009 (see archives), I would like to revert this page to "1918 flu pandemic" or any other version that does not include the word Spanish. The lead should be altered to explain that the pandemic was commonly referred to as "Spanish flu" because of the consequences of censorship that we all know about.

Of course, I am open to discussing anyone's points on this. Maybe I'm being overly sensitive. However, if nobody replies within a week, I will revert to the old title and modify the lead accordingly.

MiG-25 (talk) 02:56, 28 July 2018 (UTC)

PS: I'm not sure how to interpret the daily views graph... but I may have to withdraw my opposition despite my arguments above, given that the change of name brought about massively increased visitor numbers?

MiG-25 (talk) 03:22, 28 July 2018 (UTC)


 * The unsourced assumption here is that using the word "Spanish" is some sort of regional bias.  Says who? The fact is reliable sources--professional scholars specializing on the topic-- routinely use it in their scholarly journals, across the globe, with the approval of editors, editorial boards, authors and the scholarly community. I have never seen a complaint. Historical Abstracts List dozens of articles in major scholarly journals from across the world, such as 1) in Italian scholarly journal: "La Grippe Espagnole En Italie, 1918-1920" Nuova Rivista Storica (April 2015) ["The Spanish Flu in Italy, 1918-1920]; 2) In Portuguese/Brazil scholarly journals you have: "A gripe espanhola em Sorocaba e o caso da fábrica Santa Rosália, 1918: contribuições da história local ao estudo das epidemias no Brasil." Historia, Ciencias, Saude Manguinhos (June 2017) ["Spanish Flu in Sorocaba and the case of the Santa Rosália factory, 1918: local history contributions to the study of epidemics in Brazil."]. 3) in Slovenian scholarly journal: "Epidemija v šo lskih klopeh. Primer španske gripe leta 1918 v osrednjeslovenskem prostoru." Kronika: casopis za slovensko krajevno zgodovino (2017) ["A Case Of Spanish Flu In 1918 In Central Slovenia"] 4) in medical history journals: "The Spanish Influenza Pandemic of 1918-1919: Perspectives from the Iberian Peninsula and the Americas" Bulletin of the History of Medicine (Spring 2016). 5) in military history scholarly journal, "Pale Rider: The Spanish Flu of 1918 and How It Changed the World." in Journal of Military History'' (July 2018). etc etc Rjensen (talk) 03:42, 28 July 2018 (UTC)


 * Thank you Rjensen. The problem is, indeed, that "Spanish flu" and its translations are common, even in Spanish! However, they are all misleading as to the nature of the disease and its origin. Titles such as "1918 flu pandemic" are perfectly fine for both scientific and popular publications,  so why not this Wikipedia article? The 100-year anniversary has prompted calls for getting some more facts right about the disease starting with its popular denomination, and prominent organisations like the CDC and the WHO make a point of labelling it 1918 influenza pandemic as part of educational efforts. Wikipedia, one of the world's most influential and unstated educators, decided to do the opposite? Again, I'd be interested in knowing what the effect of moving the article would have on searches and ways to avoid impacting that aspect. MiG-25 (talk) 06:52, 31 July 2018 (UTC)


 * Even if those arguments were put forward in the discussion I don't think they would sway the consensus. The applicable naming guidelines is WP:COMMONNAME and, specifically, WP:POVNAME: Sometimes that common name includes non-neutral words that Wikipedia normally avoids (e.g. the Boston Massacre or the Teapot Dome scandal). In such cases, the prevalence of the name, or the fact that a given description has effectively become a proper noun (and that proper noun has become the usual term for the event), generally overrides concern that Wikipedia might appear as endorsing one side of an issue.
 * The evidence provided by Ozzie10aaaa and Cuchullain, and now by Rjensen, demonstrates that "Spanish flu" is the prevailing term even in Google Books and Pubmed, so I don't think that the assertion that it is "offensive" holds scrutiny. I don't even think that any layman who knows about the event reads much into "Spanish" adjective as you claim; it's just a title attached to an event. It's as much Spanish as Russian roulette is Russian or China syndrome is Chinese. No such user (talk) 09:03, 3 August 2018 (UTC)


 * Thank you No Such User. I am not sure a "consensus" of 5 or 7 out of 9 people for a page visited by 3,000 people daily should trump a more careful consideration of the arguments. Below some counters to your own points as you mentioned them:


 * Given the examples put forward, extant Wikipedia policies are being stretched to the limit to apply in this case. Boston Massacre as a title is, for most people unfamiliar with the details, rather harmless vis-à-vis English people... If the title were "English murders in Boston", then we would be comparing apples and apples. I had never heard of the Teapot Dome scandal and, after a quick read, the relevance to this topic escapes me. The abundance of American political issues and the name of the policy POVNAME suggest that this policy may be better suited to politically charged subjects, not to scientific ones, and also that perhaps the creators were not considering properly a global readership.


 * Trying to read laypeople's minds is rather hard... We do know, however, that adjectives of origin relate strongly to the people at the origin. Russian Roulette was first mentioned in a Russian novel by a Russian author and, being a game, first mention could conceivably equate with origin. The Russian Wikipedia also has no problem using it. The China syndrome is not quite the same as "the Chinese syndrome" and the substance of the topic is so clearly not related to Chinese people (or any people) that again it's unsuitable as a comparison.


 * Alternatives to "Spanish flu" are by no means obscure (as opposed to a case like "horse" vs. "equus ferus caballus"); Google search results yield 721,000 for "Spanish flu", but also 173,000 for "1918 flu" and "210,000" for "1918 flu"
 * The numbers from PubMed given in the vote above are wrong : in medical literature, "1918 influenza" seems to be much more common than "Spanish flu" vs. Similar results apply to Google books vs..


 * Most (if not all) human languages/peoples have been prone to ascribing rude/dirty/disease-ridden things to foreigners. An example that comes to mind in English is French exit, which is clearly labelled as "offensive" in the Wiktionary. While I think it's futile and largely unnecessary to "clean up" languages of all their rude/offensive connotations, I believe that perpetuating the consequences of this in Wikipedia is highly inappropriate.


 * I would appreciate any pointers for organising a revote/reconsideration of this move. MiG-25 (talk) 13:57, 5 August 2018 (UTC)
 * we do not have a single RS or even a popular source that says "Spanish" in the term is offensive. Spanish speakers and Spanish books and journals use the term regularly.  The "offensive" bit is 100% unsourced speculation. Rjensen (talk) 14:03, 5 August 2018 (UTC)


 * Rjensen, please look up the arguments in the 2009 consensus on this same page that decided to name the article "1918 influenza pandemic". Also, please refer to the 2015 guidelines of the WHO that explicitly seeks to avoid naming diseases after countries (and other elements). If you can read any Spanish, please have a look at this El Pais article, too, which notes a number of Spanish doctors opposed the naming of the disease from the very beginning. All the other sources I have referenced so far give you the idea that it is not right to name the deadliest disease known to humankind after a country/people which had no more role in its appearance than anyone else. I believe the content and spirit of the WHO guidelines is reason enough to revisit the applicability of POVNAME for this article. MiG-25 (talk) 07:00, 6 August 2018 (UTC)


 * The proposal violates the WHO recommendation which states: "The best practices apply to new infections, syndromes, and diseases that have never been recognized or reported before in humans, that have potential public health impact, and for which there is no disease name in common usage. They do not apply to disease names that are already established." As for the  El Pais article I did read it--it mentions only one person a century ago: "Let it be evident that, like a good Spaniard, I am opposed to this idea of Spanish fever," protested a doctor named García Triviño in a Hispanic medical journal.  The term is used today by experts in Spain: see La gripe espanola: La pandemia de 1918-1919 (Madrid: Centro de Investigaciones Sociológicas, 1993) by Beatriz Echeverri Davila.  Rjensen (talk) 07:40, 6 August 2018 (UTC)


 * Frankly, I did not see that part. It seems incongruous to explicitly acknowledge that such denominations as Spanish flu are not flattering at all, and then avoid using the alternative names that already exist. In any case, there is no "Spanish influenza" (or any other kind) in the ICD-11; so the WHO does not have anything to rename in this regard. As to the baffling insistence that Spaniards must be perfectly happy with the denomination and there's nothing offensive about it, all Spanish sources I have seen emphasize sooner or later that the disease has nothing to do with Spain, and express exasperation with its naming. In addition to that El Pais article entitled "The False Origins of the Spanish Flu"; there are plenty of examples. From another Spanish newspaper of record: "Each country used a different term... usually blaming one another. In Senegal it was the Brazilian flu; in Brazil, the German flu, and in Poland the Bolshevik flu. And, because powerful countries were calling it the Spanish flu, that's how it stayed." From a documentary in Spanish national TV entitled: "They called it the Spanish flu" . From Spanish magazines: "The Spanish authorities and press protested in vain. The war was won by the Allies and the flu was stuck with the name they chose. So, on top of infecting 8 million Spaniards (out of a population of about 20 million) and kill some 300,000 of them, this pandemic left Spain with the stigma of naming one of the most infernal plagues in history", or: "The Spanish flu: the flu that did not start in Spain". . Echeverri's title that Rjensen mentions is a provocative play on words: her book focuses exclusively on the impacts of the pandemic in Spain. You can also note the page of one of the most famous Spanish epidemiologists, who avoids it in his personal page even though he was forced to include it in the title of one of his best publications, probably following a similar policy to the one here in Wikipedia.


 * I consider it well-established that the title as it stands is offensive/unflattering as well as inaccurate, and all of this probably unnecessarily so given that sufficiently common names like "1918 flu" can be used. The only remaining thing is whether my esteemed fellow editors would like to let other considerations trump this, and what reasons they would like to adduce. MiG-25 (talk) 05:22, 12 August 2018 (UTC)

I also agree, it's a misleading name. Voj 2005 (talk) 11:39, 11 November 2018 (UTC)

Perhaps "Spanish Flu" is popular nomenclature among historical sources, but among virology publications it is most definitely not the preferred title. Influenza researchers call it the influenza pandemic of 1918, or something similar. User:Udorn1972 (talk) 11-12-18 —Preceding undated comment added 18:21, 12 November 2018 (UTC)


 * I agree. It's a dreadfully misleading, outdated name-as the intro explains!-and my impression is it's now decreasingly popular, especially in scientific discussion-plenty of articles now don't use it in the title. I think the move to "Spanish flu" as a title was not an improvement. Blythwood (talk) 08:05, 6 May 2019 (UTC)

New citation suggestion
Hello, I'd like to suggest adding a citation to this page, of my 2017 popular science/history book "Pale Rider: the Spanish flu of 1918 and how it changed the world". I'm aware I have a conflict of interest in suggesting this, but the book is the first for a general public that takes the story in any detail beyond the US and western Europe - drawing on both primary and secondary sources - and it also updates the story for the centenary. I would welcome other editors' advice on this. Lauraspinney (talk) 10:20, 29 May 2019 (UTC)

Spain !?
Redundant information ? Then where is the connection to Spain mentioned in our article ? "Did the Spanish flu come from Spain ?" - Is a question very many put but few knows the answer to. So again - where in this article do we have anything on its name ? At row 2045 ? or something ? Boeing720 (talk) 01:39, 6 June 2019 (UTC)


 * Your ping wasn't successful, and I easily could have missed this. Please see Help:Ping for information about how they work.  As for your question, check out the article's lead.  Besides all that, there's still the problem of the language added, both in tone and grammar.  –Deacon Vorbis (carbon &bull; videos) 02:02, 6 June 2019 (UTC)


 * OK Deacon, I surrender totally. My mistake & sorry. I've seen the part of the Spanish King etc. Now that is, I read the lead before my contribution too. Obviously not good enough.

However, the question "Did the Spanish flu begin in Spain ?" is actually common when this disease is mentioned. I'm 54, and can't really say if it's for 15 or 20 years I have known the reason for the name of this horrific flu. (Which my grandmothers etc spoke about at occasions when I was younger, but they had no knowledge about the name, I think - or I never asked) Before age of 30 (or something) I didn't know the reason for the name (and it's the same in my native language "Spanska sjukan" - or almost, correct translation would be "the Spanish disease", but anyway Spain-related. I've known the reason for quite some time now, but haven't had any source. Not until the other day, as I read a popular history magazine from 2015. Then I thought "I wonder if Wikipedia explains this" (the military censorship but not in neutral Spain etc). As I missed it the first time - obviously, I still think this could be improved somehow. But of course you are right about my hasty addition. Sorry. About the pinging - I simply copied the latest ping-version I've received - Talk:Flag of Canada. Boeing720 (talk) 15:31, 6 June 2019 (UTC)


 * PS - on the ping. I receive an alert of having pinged you. I'm not the one wgo is most acquainted with such matters. Boeing720 (talk) 15:39, 6 June 2019 (UTC)

Semi-protected edit request on 9 August 2019
On the bottom of the "Devastated Communities" section change 4.85 percent to 4.85% to be consistent with the other percents. ElderGnomeChild (talk) 15:15, 9 August 2019 (UTC)


 * ✅ –Deacon Vorbis (carbon &bull; videos) 15:19, 9 August 2019 (UTC)

Death Toll
Here is what the sources say on the death toll:
 * "The 1918–1919 influenza pandemic killed more people in absolute numbers than any other disease outbreak in history. A contemporary estimate put the death toll at 21 million, a figure that persists in the media today, but understates the real number. Epidemiologists and scientists have revised that figure several times since then. Each and every revision has been upward. Frank Macfarlane Burnet, who won his Nobel Prize for immunology but who spent most of his life studying influenza, estimated the death toll as probably 50 million, and possibly as high as 100 million. A 2002 epidemiologic study also estimates the deaths at between 50 and 100 million (Johnson and Mueller, 2002)."
 * "The 1918–1919 influenza pandemic killed more people in absolute numbers than any other disease outbreak in history. A contemporary estimate put the death toll at 21 million, a figure that persists in the media today, but understates the real number. Epidemiologists and scientists have revised that figure several times since then. Each and every revision has been upward. Frank Macfarlane Burnet, who won his Nobel Prize for immunology but who spent most of his life studying influenza, estimated the death toll as probably 50 million, and possibly as high as 100 million. A 2002 epidemiologic study also estimates the deaths at between 50 and 100 million (Johnson and Mueller, 2002)."

Knobler cites Mueller. Here is what he has to say


 * "...A 1991 paper revised the mortality as being in the range 24.7-39.3 million. This paper suggests that it was of the order of 50 million. However, it must be acknowledged that even this vast figure may be substantially lower than the real toll, perhaps as much as 100 percent understated."
 * "...A 1991 paper revised the mortality as being in the range 24.7-39.3 million. This paper suggests that it was of the order of 50 million. However, it must be acknowledged that even this vast figure may be substantially lower than the real toll, perhaps as much as 100 percent understated."

I believe the two cited sources are saying the estimate should be "probably 50 million and perhaps as high as 100 million." ---- Work permit (talk) 15:24, 20 August 2019 (UTC)

Arizona University?
In Spanish Flu research, the college is called the University of Arizona. No one calls it Arizona University. 2601:248:5181:B860:135:C82C:4214:8721 (talk) 02:26, 15 November 2019 (UTC)

Edit request: Small phrasing change (speculation)
In the introductory paragraph "This has led to speculation [...] Thus in 1918, China was spared from the worst ravages of the pandemic," starts by introducing the idea as uncertain, but then words it as having occurred. I would change "was" to "would have been". Small nitpick. Could someone do this? — Preceding unsigned comment added by Ceci N'Est Pas Un Contributeur (talk • contribs) 21:26, 28 November 2019 (UTC)

Less affected areas
Information to be added... because the current information is out-of-date and because I spent three years (2013-2016) travelling and conducting research to shed more light on what happened in these important areas (China, Russia). As I wrote in my suggested addition, the widely quoted 1991 Patterson & Pyle estimate for the death toll in Russia was, to quote them, a "shot in the dark" - they had no real data to work with. That is why my actual Russian data represent an improvement. With regards to China, the same authors were extrapolating from other countries and again had no local data to work with; I did. This is the second time I've tried to update this section and had my request refused (the first time without explanation). My name is not Linney but Spinney, as correctly spelled in my suggested addition, which I have now modified (below). If the citations are not correctly formatted, I would appreciate some help in doing so. Thank you!

The death toll in Russia has been estimated at 450,000, though the epidemiologists who suggested this number called it a "shot in the dark". If it is correct, Russia lost roughly 0.2% of its population, meaning it suffered the lowest influenza-related mortality in Europe. This seems unlikely, given that the country was in the grip of a civil war, and the infrastructure of daily life had broken down. Data collected in Odessa, the most scientifically advanced Russian city at the time, and epidemiological analyses conducted in the 1950s, suggest that Russia's death toll was closer to 1.2%, or 2.7 million people

Estimates for the death toll in China have ranged from 1 million to 9 million, a range which reflects the lack of centralised collection of health data at the time. Iijima assumed that the flu arrived at the ports, and that poor communications prevented it from penetrating the interior, but contemporary newspaper and post office reports, as well as reports from missionary doctors, suggest that it did penetrate the interior and that it was bad there. The Chinese death toll may never be known, however. Lauraspinney (talk) 17:57, 26 December 2019 (UTC)


 * You've stated that there is information in the article which is out of date. You have proposed here information that you say 'updates' the incorrect information, but you have not given the passage from the article which your proposed text is meant to replace . That is required for a substitution of text to be considered. Please provide the text which is to be replaced. If this is to be a straight addition to the article, then the text needs to be modified. It currently uses Wikipedia's voice to make certain assertions ("This seems unlikely, given that the country was in the grip of a civil war, and the infrastructure of daily life had broken down.") Those claims cannot be made using Wikipedia's voice, they need to be properly attributed to the author(s) making them. Regards, Spintendo  20:54, 26 December 2019 (UTC)

Less affected areas
Information to be added. Spintendo, may I just laud your rigour and say that I wish it had been applied to the rest of the Spanish flu article, where theories are aired that are entirely speculative and have nothing other than circumstantial evidence to back them up (I'm referring to theories that favour one origin of the pandemic over any other, since there is no way of choosing between these currently). I have no theory, by the way. I'm just trying to provide better - though certainly not definitive - information. When I originally made my addition, there was existing text on China and Russia in this section. It has since been removed, again for reasons that have not been explained, but that I suspect have to do with the intervention and subsequent blocking of a sockpuppet. I hope the following passes muster. The point is that, until my book, Russia and China were considered to have been lightly affected. My information suggests that was not the case.

The death toll in Russia has been estimated at 450,000, though the epidemiologists who suggested this number called it a "shot in the dark". If it is correct, Russia lost roughly 0.2% of its population, meaning it suffered the lowest influenza-related mortality in Europe. This is unlikely, according to the science journalist Laura Spinney, given that the country was in the grip of a civil war, and the infrastructure of daily life had broken down. Data collected in Odessa, the most scientifically advanced Russian city at the time, and epidemiological analyses conducted in the 1950s, suggest that Russia's death toll was closer to 1.2%, or 2.7 million people

Estimates for the death toll in China have ranged from 1 million to 9 million, a range which reflects the lack of centralised collection of health data at the time. Iijima assumed that the flu arrived at the ports, and that poor communications prevented it from penetrating the interior, but contemporary newspaper and post office reports, as well as reports from missionary doctors, collected by Spinney, suggest that it did penetrate the interior and that it was bad there. The Chinese death toll may never be known, however. Lauraspinney (talk) 23:12, 26 December 2019 (UTC)


 * ✅, I reworded a couple of sentences. – Thjarkur (talk) 00:01, 27 December 2019 (UTC)
 * Thanks Þjarkur but the references aren't working correctly. Ref 22 does not link to my book, Pale Rider (please see ref in text above).

81.29.176.246 (talk) 20:07, 27 December 2019 (UTC)

A reference needs correcting in the following two paragraphs (the Spinney one doesn't currently work - I hope I've put it in the right format now; please help/advise if not). Also the text on China is currently inaccurate, since it doesn't capture the ongoing debate over that country. I think it's important to say why this debate exists (because there was no centralised collection of health data in China at the time; this was the warlord period). If a reference is needed for this latter statement, either Iijima or Spinney could be given.

The death toll in Russia was estimated at 450,000 in 1991, though the epidemiologists who suggested this number called it a "shot in the dark". If it is correct, Russia lost roughly 0.2% of its population, meaning it suffered the lowest influenza-related mortality in Europe. Another study considers this number unlikely given that the country was in the grip of a civil war, and suggests that Russia's death toll was closer to 1.2%, or 2.7 million people.

The Chinese death toll may never be known, because there was no centralised collection of health data in China at the time. Some estimates suggest it was mild there, but these assume that the flu arrived at the ports and that poor communications prevented it from penetrating the interior. Other studies suggest these assumptions are not valid.



Lauraspinney (talk) 16:35, 29 December 2019 (UTC)

The ref tag as it was formatted by Thjarkur has been corrected (it was not displaying because the ref tag name ":0" was already engaged by another reference). Whether or not the text that this ref tag was placed under is incorrect, I'll leave for them to fix. Spintendo 18:58, 29 December 2019 (UTC)
 * Sorry for that, I had worked on this in my sandbox and didn't notice the clash. Have fixed. Dazoutti added "to 2.7 million" to Russia but did not explain whether this was information from the cited source, feel free to add again if this is what the cited source says. – Thjarkur (talk) 19:49, 29 December 2019 (UTC)

Journal Article Confirms Experimental Bacterial Meningitis Vaccine Administered at Fort Riley Shortly Before First 1918 Flu Outbreak
Following meningitis outbreaks in 1917, the U.S. military attempted to develop a bacterial meningitis vaccine cultured in horses which they began administering experimentally in multiple series from late 1917 through February 1918 to soldiers at Fort Riley, Kansas where shortly thereafter the first known incidences of "Spanish Flu" were documented. The first case was Albert Gitchell who reported his illness on March 4, 1918. The administration of experimental vaccinations is confirmed by a journal article obtained from the National Institute of Health published by Dr. Frederick L. Gates, M.D., U.S. Army Medical Corp. from the Base Hospital at Fort Riley, Kansas, in cooperation with The Rockefeller Institute for Medical Research, New York, entitled "A Report on Antimeningitis Vaccinations and Observations in Agglutinins in the Blood of Chronic Meningococcus Carriers," The Journal of Experimental Medicine, Vol. XXVIII, submitted for publication July 1918. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2126288/pdf/449.pdf Brom4880 (talk) 21:19, 18 January 2020 (UTC)

Semi-protected edit request on 6 February 2020
The calculation of the mortality rate is wrong here: "In the U.S., about 28% of the population of 105 million became infected, and 500,000 to 675,000 died (4.8 to 6.4 percent)."

If 28% of the population became infected, that is 29,400,000 people. 500,000 to 675,000 of those people dying is 1.7 to 2.3 percent Asg1986 (talk) 20:39, 6 February 2020 (UTC)
 * I took that percentage out for now. It looks like a misplaced decimal point. By my math, those numbers come to 0.48 to 0.64 percent of the 105 million population (or as you say, 1.7 to 2.3 percent of the infected population). Pinging User:Eric Kvaalen who added this to the article earlier today. &#8209;&#8209; El Hef  ( Meep? ) 20:54, 6 February 2020 (UTC)
 * Thanks for pinging me. You're right. I used the Google Search box at the top of my browser to do the division, and just did (5)/105 and (675)/105, and then used the answers without thinking enough about where the decimal point should go! It's strange that the death rate was ten times lower than worldwide. I've fix'd it now. By the way, you could have just fix'd it yourself, but I'm glad that you pointed out my error to me., I mean percent of the total population. Eric Kvaalen (talk) 09:27, 7 February 2020 (UTC)
 * What is so strange? I could find only two places where both infected/deaths are known (USA and Japan), and they have consistent mortality rates! --Ilya-zz (talk) 08:48, 8 February 2020 (UTC)
 * It's true that the percentage of those affected who died was similar in Japan and in the US (at least 1.7% in Japan and between 1.7 and 2.3% in the US). But this is a lot lower than the figure of 10% or 20% at the beginning of the section Spanish flu. Actually, what I meant was that it's strange that the percentage of the whole population that died was so low, (much lower than the 3 to 6 percent in the lede) but that's because a low percentage of those who caught the illness in Japan or the US died. Eric Kvaalen (talk) 11:50, 11 February 2020 (UTC)

Text added by obvious sockpuppet
A user is determined to add some badly written text about China to the article. They have used at least two different usernames to add it: see and. Those accounts were created on 20 and 25 September this year. A third account may be connected having made related edits:. This user's current account has a username relating to pornography which is also inappropriate. Taputa (talk) 12:00, 8 December 2019 (UTC)

First of all, I'm the user who added the text that you keep deleting [1 ], and I am not the same person as User:Lauraspinney or User:Interracial-is-best. Second of all, please show me an objection you have to the text I made. I have cited the following sources in support of what I wrote


 * https://www.sciencedirect.com/science/article/pii/S1201971207000355
 * https://www.jstor.org/stable/3401475?seq=1#metadata_info_tab_contents
 * https://journals.sagepub.com/doi/10.1177/0968344513504525
 * https://www.history.com/news/china-epicenter-of-1918-flu-pandemic-historian-says
 * https://www.nationalgeographic.com/news/2014/1/140123-spanish-flu-1918-china-origins-pandemic-science-health/
 * https://books.google.com/books?id=k79_8QX8n44C&printsec=frontcover&dq=The+Spanish+Influenza+Pandemic+of+1918-1919:+New+Perspectives&hl=en&newbks=1&newbks_redir=0&sa=X&ved=2ahUKEwiu9oW2qafmAhVSIqwKHayhBQMQ6AEwAHoECAYQAg#v=onepage&q=China&f=false

Langford, Humphrey, KF Cheng, Saunders-Hastings, Killingray, among many other authors have supported the China origin hypothesis for the 1918 flu pandemic. I have cited published peer-reviewed, multidisciplinary papers that have supported this view. What exactly is wrong with what I wrote? I see you complain about the quality of writing and word choice. Well then, please improve it for me. English is not my first language, so if you think what I wrote needs improvement, please fix incorrect word-choices, grammar, or poor sentence structures. Other than that? What other problem is there with what I wrote? Laputa-skye (talk) 00:16, 9 December 2019 (UTC)


 * Two users, created days apart less than three months ago, both adding exactly the same large chunk of text, are very obviously sockpuppets. I therefore do not trust that it is accurate. You need to make the case here for why the article suddenly needs to be significantly changed. Taputa (talk) 08:10, 14 December 2019 (UTC)
 * Both accounts have also edited Boxer Rebellion, so 2 in common out of the 12 and 5 articles the accounts have edited. If one looks at both sets of contributions, one sees that when one account is active, the other is not. Taputa (talk) 16:47, 14 December 2019 (UTC)


 * If you're going to make sockpuppetry allegations, then you should open a case at WP:SPI and do so properly, rather than continuing to edit war. –Deacon Vorbis (carbon &bull; videos) 17:00, 14 December 2019 (UTC)

I have just reinserted the paragraphs in question. I don't see anything wrong with the English. I don't see in what way the editor's name has something to do with pornography (as Taputa says), nor what that has to do with whether his or her edit should be accepted. There was argument about whether it should be in the lede, but in the end he or she put that paragraph lower down, and then it was still deleted. I think it was unfair, and a case of people ganging up on someone. If someone has some objections to these paragraphs, then improve them, don't just revert! Eric Kvaalen (talk) 16:35, 11 February 2020 (UTC)

Semi-protected edit request on 9 February 2020
For clarity, in the "Aspirin Poisoning" section change: "They questioned the universal applicability of the aspirin theory, given the high mortality rate in countries such as India, where there was little or no access to aspirin at the time compared to the rate where aspirin was plentiful."

to: "They questioned the universal applicability of the aspirin theory, given the high mortality rate in countries such as India, where there was little or no access to aspirin at the time compared to the death rate in regions where aspirin was plentiful." Sfletchertaylor (talk) 01:26, 9 February 2020 (UTC)
 * Yes check.svg Done Eggishorn (talk) (contrib) 00:32, 28 February 2020 (UTC)

Timeline
I think a section clearing describing the spread of the outbreak from the start to the finish could really benefit the article. There's already quite a bit of the info in the article but it's in many different sections and seems incomplete. I appreciate that it'd be more helpful if I actually started doing this myself but I really don't feel skilled enough to do it. Perhaps there's someone else who is more able? — Preceding unsigned comment added by Ivanivanovich (talk • contribs) 09:46, 28 February 2020 (UTC)

Less affected areas
Information to be added

The death toll in Russia has been estimated at 450,000, though the epidemiologists who suggested this number called it a "shot in the dark". If it is correct, Russia lost roughly 0.2% of its population, meaning it suffered the lowest influenza-related mortality in Europe. This seems unlikely, given that the country was in the grip of a civil war, and the infrastructure of daily life had broken down. Data collected in Odessa, the most scientifically advanced Russian city at the time, and epidemiological analyses conducted in the 1950s, suggest that Russia's death toll was closer to 1.2%, or 2.7 million people

Estimates for the death toll in China have ranged from 1 million to 9 million, a range which reflects the lack of centralised collection of health data at the time. Iijima assumed that the flu arrived at the ports, and that poor communications prevented it from penetrating the interior, but contemporary newspaper and post office reports, as well as reports from missionary doctors, suggest that it did penetrate the interior and that it was bad there. The Chinese death toll may never be known, however. Lauraspinney (talk) 15:45, 22 December 2019 (UTC)

Reply 22-DEC-2019
Regards, Spintendo  07:43, 23 December 2019 (UTC)
 * The page parameter has not been included with the Linney source.
 * The citations are not formatted according to how a majority of sources in the article are, per WP:CITEVAR.
 * Reasons have not been provided for why the requested material should be added.

Hello, I am wondering if the percentages stated about Russia are correct. If the numbers of 0.2% or 450,000 people, and 1% or 2.7 million people were correct, that would put the Russian population at that time at 225-270 million, higher than now (approx 145 million) and much higher than reported at that time (60-80 million). So I'm guessing that either the absolutes or the percentages here are wrong. Lennartbj (talk) 16:56, 1 March 2020 (UTC)

More on Death Toll
I propose to change the layout of quotes about mortality. The minor reason is that (Knobler, 2005) only quotes (Johnson and Mueller, 2002); what is the purpose to refering to them both at the same place?! (Currently this is [43][5] in Spanish_flu.)

The second reason is that (Patterson and Pyle, 1991) is also misquoted in the text of the article, as 40–50 instead of their “24.7–39.3”, with “the prefered number 30”. (I copy these quotes from Johnson and Mueller, 2002, p.108; cannot find the original paper now.)

--- The major reason is that (Johnson and Mueller, 2002) seems very questionable. They write:

The tables represent the compilation of our knowledge of the pandemic.

So let’s look in their tables, and compare these tables with their conclusions:

CONCLUSION: the global total is 31.6–38.5 million deaths. This more or less matches the estimate 24.7–39.3 of (Patterson and Pyle, 1991, p.15, as quoted in Johnson and Mueller; currently [3] in the list of references).

So: the numbers 50–100 millions in the conclusion of Johnson and Mueller are taken out of thin air. (Similarly for their total for Asia! In their table they give the total for Asia 26M – 36M, while the summation gives 4+18.5+1.5+1.35=25.35; 9.5+18.5+1.5+2.65=32.15.  This gives a discrepancy of 650,000–3,850,000 taken out of thin air.)

CONCLUSION: Quoting the (sensationalistic?) global totals from Johnson and Mueller leads to a massive overblow of scientifically obtained data.

Proposal: Replace direct references to Johnson and Mueller by the table above, with the global total of 31.6–38.5 million appended. Mention their (sensational) claims of 50M and 100M as a complementary information, next to this table. --Ilya-zz (talk) 10:23, 8 February 2020 (UTC)

Hi Laura. What do you say about the above? I see there's a quote in the article from your book that somewhat contradicts it: "“In terms of single events causing major loss of life, it surpassed the First World War (17 million dead), the Second World War (60 million dead), and possibly both put together." Eric Kvaalen (talk) 15:48, 11 February 2020 (UTC)

I sent e-mail to Laura and she replied, giving me a new 2018 reference, so I have edited the article to include its estimate, which is only 17 million. Eric Kvaalen (talk) 16:41, 14 February 2020 (UTC)
 * please could someone just sort this out? Thanks.   It’s 25th Feb today and still no correlation between the lede and the Mortality section.  Lede has 50 million odd dead out of 500 million infected.  1st para of Mortality section has WHO saying 2-3% of those infected and then contradicts itself with approx 30 million deaths or 1.7% of the then world pop. It’s rather a mess, but altho it’s all historic, due to the coronavirus thing it’s actually of high importance.  Boscaswell   talk  10:41, 25 February 2020 (UTC)
 * I agree with the proposal of presenting Johnson and Muellers table. We should also note their 50m, possible 100m number but if this number is not the most reliable number we should not default to using it as the sole number in the lede.  The lede itself is misleading since the only numbers quoted are the two highest numbers from one source. ---- Work permit (talk) 20:58, 1 March 2020 (UTC)

Case-fatality ratio
This article lists infection and fatality totals as follows:

"It infected 500 million people around the world... The death toll is estimated to have been 40 million to 50 million, and possibly as high as 100 million"

"It is estimated that approximately 30 million were killed by the flu, ... Other estimates range from 17 to 55 million fatalities."

By these numbers, the case-fatality ratio would be 3.4-20%, which doesn't comport with the 2-3% case-fatality ratio cited by the WHO in the article. — Preceding unsigned comment added by Ykessler (talk • contribs) 18:12, 26 February 2020 (UTC)

The WHO document cited by the article in turn cites another document, which itself is also not the source of the case-fatality ratio being reported. The ultimate source appears to be this 2006 paper by Jeffery K. Taubenbergerand David M. Morens: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291398/. The authors give the case-fatality ratio as "greater than 2.5 percent" rather than a specific value or even a range. Their estimate is in turn based on three other sources for number of infections and number of deaths, but they combine the numbers from the sources in ways which produce inconsistent and unreliable results for case-fatality ratios and mortality rates.

This section probably needs a good deal of untangling after exploring the various sources. Here is a twitter thread discussing some of the issues: https://twitter.com/ferrisjabr/status/1232052631826100224 73.122.251.195 (talk) —Preceding undated comment added 19:20, 28 February 2020 (UTC)

I think this is quite a serious oversight. Is there something an occasional editor can do? (bring this to attention?) Jonsku99 (talk) 17:44, 3 March 2020 (UTC)

Same strain or not?
There is some confusion in the section Deadly second wave.

"In the trenches, natural selection was reversed. Soldiers with a mild strain stayed where they were, while the severely ill were sent on crowded trains to crowded field hospitals, spreading the deadlier virus."

"The fact that most of those who recovered from first-wave infections had become immune showed that it must have been the same strain of flu."

Was it the same strain or not? Even if there is disagreement on this, the section should state as such rather than simply stating two contradictory theses one after the other.

It's also conceivable that strains were similar enough that the immune system response worked, but if so, this should be explained. Of course, it's possible to find contradictory expert sources, but internal consistency should be maintained. --100.4.146.206 (talk) 21:00, 10 March 2020 (UTC)

The numbers dont add up
The WHO report they use as a source is not about the Spanish Flu, but simply mentions it in passing. It does indeed say 2-3% of those infected died, but gives no source for this, and also claims this represents 20-50 million people.

The trouble with that is the higher range of this estimate (50 million as 2% of total cases) gives a figure of 2.5 billion total cases. Which is higher than the entire population of the world at the time!(1.8 billion).

So something is clearly amiss.

Worse still, the WHO is the only source we have found so far that claims a death toll of 20 million. Most sources, such as the CDC (and see here ), broadly agree that between 50 million and 100 million people died of the Spanish Flu (although one recent study wildly differs, see below). In order for 50-100 million deaths to be 2-3% of total cases there would have had to be 2.5 billion – 5 billion cases. JustSwanzy (talk) 08:13, 11 March 2020 (UTC)JustSwanzy

Chinese version of the article
The Chinese version of the article has been redacted so as not to mention any link with China. I am not a native Chinese speaker and do not feel my language level is good enough to add the mentions and sources redacted in the Chinese version of the article.

Furthermore, the Chinese version of the article actually blames Spain for the 1918 outbreak. Such rewriting of history and spread of misleading information is not worthy of a Wikipedia article. — Preceding unsigned comment added by 223.16.166.214 (talk) 09:46, 29 January 2020 (UTC)

how about: The Prohibition Pandemic? Robbiekabali (talk) 19:21, 8 March 2020 (UTC)

I believe that it should continue to be called Spanish Flu. It is the name people know the pandemic from, and has been that name for more than 100 years. We should not let political correctness change things that don’t need to be changed. PJM70 (talk) 14:58, 15 March 2020 (UTC)
 * It's not about political correctness, it's about facts. This pandemic started in Kansas, NOT SPAIN. To call it Spanish Flu is literally lying to readers. Jade Phoenix Pence (talk) 17:06, 21 March 2020 (UTC)Jade Phoenix Pence
 * fact: it's been called Spanish Flu for over 100 years... this is an encyclopedia, not an editorial magazine. 24.19.85.12 (talk) 10:31, 23 March 2020 (UTC)

I found this article yesterday while seeking more information on pandemic diseases, in relation to current Corona Virus news.

I did a search for 1918 epidemic and found this article, which however is headed in large print as Spanish Flu.

As long as Search works for Any valid search string containing a year from 1917 through 1920 and either epidemic or pandemic, and possibly World War One and Great War, I really Don't care what top large print declares.

I heard of Spanish Flu as a child, I am now 72.

I suggest we accomodate Every popular reference:

World War One/1918 Deadly Influenza/Spanish Flu Epidemic/Pandemic

Ain't Pretty, But it Works. FritzYCat (talk) 04:14, 18 March 2020 (UTC)

To facilitate Search, make it

World War One/1918 Deadly Influenza/Spanish Flu Epidemic/Pandemic FritzYCat (talk) 04:53, 18 March 2020 (UTC)

This has been the name for well over a hundred years. It is the name used in medical books, other encyclopaedias, school text books. This is simply someone trying to exploit a current political position to act as a history revisionist. Lawrecenull (talk) 01:58, 20 March 2020 (UTC)

Opposed to history revision. Egberts (talk) 02:10, 21 March 2020 (UTC)


 * OPPOSE* to well established history with politically-correct history revisionist. Egberts (talk) 02:12, 21 March 2020 (UTC)


 * OPPOSED** to a minor historical revisionist effort.  Egberts (talk) 02:13, 21 March 2020 (UTC)

Please leave the article as 'Spanish Flu'. Shortsighted emotions are being weaponized to create bable. It is selfish to burden others by changing established words. It is in my opinion far more reasonable to take the task apon yourself and change the conotation. Trapless (talk) 16:07, 21 March 2020 (UTC)

The leftists never stop. Never. Spanish Flu is what I was taught in pathology, no need to change it due to Trump Derangement Syndrome F. L.  (talk) 01:08, 22 March 2020 (UTC)
 * it isn't leftists pushing revisionism. I'm a "leftist" and think this is silly. 24.19.85.12 (talk) 10:33, 23 March 2020 (UTC)

Wrong death rate
The 2.5% death rate mentioned at the end of the "Around the globe" in Mortality is erroneous and is contradictory to the No. of deaths/No. of cases in the same study (which gives ≈10% CFR). Read more here: |Covid-19 Is Not the Spanish Flu 2001:8F8:1333:956C:7983:AF6E:29FB:76FD (talk) 21:32, 15 March 2020 (UTC)
 * ✅ - Yes - *entirely* agree - text now removed from the main article until better text/refs determined - please see related discussion above at => "Talk:Spanish flu" - thanks. Drbogdan (talk) 01:33, 16 March 2020 (UTC)

Could we add a comparison with other flu pandemics?
Template:Notable flu pandemics may be useful for our readers, and I'm sure few more phrases wouldn't be amiss. Ain92 (talk) 17:17, 19 March 2020 (UTC)

Semi-protected edit request on 20 March 2020
Some racists said the flu originate from China after Trump said Chinese virus. It is quite offensive.Please let me delete the sentence and there is no evidence prove their idea. LEOLEONIUNIU (talk) 01:21, 20 March 2020 (UTC)
 * Red information icon with gradient background.svg Not done for now: please establish a consensus for this alteration before using the template.  Eve rgr een Fir  (talk) 01:24, 20 March 2020 (UTC)

Legacy 2019–20 coronavirus pandemic
I added a sentence regarding the 2019–20 coronavirus pandemic today, which has been reverted by Deacon Vorbis for being "vague". I don't see why that's a reason to remove it; it certainly can be made less vague by building upon it and expanding it. I think the connection is clearly there, and relevance is easily checked by how many sources are making the connection. Adding my proposed addition to the Legacy section below.Renerpho (talk) 13:13, 13 March 2020 (UTC)

Comparisons have also been drawn between the Spanish flu pandemic and the 2019–20 coronavirus pandemic, in particular when it comes to the recommendation of social distancing.
 * A few comments. First, being vague is definitely a reason not to include something.  If a comparison was made, what was it?  Is it a valid comparison?  It's like saying, "A comparison  has  been made between apples and oranges, particularly in regards to their appropriateness in fruit salad."  It's so generic as to be meaningless.
 * This is potentially a bit too soon as well; it's obvious to want to do this based on current events, but is there anything specific to the current pandemic that makes the comparison particularly worth mentioning versus comparisons to others? If there is something worth saying here (and there very well might be), it might be more appropriate in an article on the current outbreak, making the comparison to a historical event&mdash;at least until things have quieted down some and it can be given at least a  historical perspective. –Deacon Vorbis (carbon &bull; videos) 13:27, 13 March 2020 (UTC)
 * Thanks, I see what you mean (the apple analogy was clear). I'll leave it out and see if it's worth thinking about alternatives. Renerpho (talk) 14:42, 13 March 2020 (UTC)


 * Oppose, accurate medical terminology does not equate colloquial and general recognition. Wikipedia is for the many, not the few. If you want to be a page 20 search result, go ahead and change it. DrJMDaniels (talk) 00:52, 20 March 2020 (UTC)

Oppose Jercroat (talk) 02:27, 21 March 2020 (UTC)

Oppose move. Seems very contentious. Thus, suggest leaving as is: it is already named, so let it stand. Scooter262 (talk) 14:37, 21 March 2020 (UTC)

Proposal to move this to 1918 Chinese Flu
Per reputable sources, this disease originated in China. https://journals.sagepub.com/doi/full/10.1177/0968344513504525 and https://www.nationalgeographic.com/news/2014/1/140123-spanish-flu-1918-china-origins-pandemic-science-health/

205.175.106.240 (talk) 20:34, 18 March 2020 (UTC)

Oppose - and not bothering to say why. Carptrash (talk) 20:37, 18 March 2020 (UTC)
 * Can you be bothered to update the [unreliable source] tag in the main text at least? Or you are ok with murkying it out with a disingenuous tag? 205.175.106.240 (talk) 21:02, 18 March 2020 (UTC)
 * No way, per WP:COMMONNAME.  Eve rgr een Fir  (talk) 21:25, 18 March 2020 (UTC)
 * I think he's actually trying to make an indirect point to you all, showing how silly the "b-but the Spanish flu didn't originate in Spain!" arguments are in the move discussion section above, rather than attempting to make a serious proposal to move the article to this name. Read between the lines, everyone. -- benlisquare T•C•E 23:02, 18 March 2020 (UTC)


 * Oppose There is no strong argument in favor of a change other than that a date is more specific and often used in common reference. Thus, the only reasonable change would be to '1918 Spanish Flu'. If the name of a country or place is racist then there would be definite issues when making a map and labeling everything as 'X'. There could be no Irish pubs, Mexican food, British cars, Canadian bacon, French dresses, or Italian leather. It's a strong attack on the integrity of the English language, our ability to communicate, and even our ability to think using clearly defined conceptual symbols and representations. Wikipedia is one of the greatest collections of human knowledge ever assembled, and to submit to usurption by such politically driven agenda would be a grave corruption of its use and purpose. JeffreyAlexanderMartin (talk) 01:58, 19 March 2020 (UTC)


 * Oppose Let's not change history. 108.2.160.186 (talk) 04:52, 20 March 2020 (UTC)
 * Oppose historical revisionism. VoidVoice (talk) 08:29, 21 March 2020 (UTC)
 * Oppose Historical revisionism similar to the poll above.TheDarkMaster2 (talk) 11:56, 21 March 2020 (UTC)

Opposed
There is obviously a political agenda behind moving (renaming) this page. There are countless examples of the mainstream media calling it the Chinese Coronavirus and the Wuhan virus. Only when President Trump called it the Chinese Coronavirus did the media start calling it racist. Wikipedia should remain apolitical.§L. Sanford — Preceding unsigned comment added by 2605:6000:1806:607D:3820:4DF6:B630:361F (talk) 04:17, 21 March 2020 (UTC)
 * We do not need two threads on the same topic,. please comment in the thread above about moving the article.Slatersteven (talk) 08:12, 21 March 2020 (UTC)
 * Depends on whether the two topics have different arguments yes?TheDarkMaster2 (talk) 11:59, 21 March 2020 (UTC)
 * No, as it is arguing about the same change. Having multiple threads on the same topic just makes it hard to judge consensus.Slatersteven (talk) 12:25, 21 March 2020 (UTC)

Lua error messages
The article is currently throwing up a load of Lua error messages. Can someone with the required knowledge fix this? It doesn't look good in a high traffic article.-- ♦Ian Ma c M♦  (talk to me) 13:27, 21 March 2020 (UTC)
 * Looks like my edit earlier in the day broke something and reverting it twice fixed it. Though if it is still broken, please ping me and I can try to reworded it and temporarily split the citation.  --Super Goku V (talk) 20:02, 21 March 2020 (UTC)