Would this Kill me in the 1800s: Influenza

I am not the only one who has been drawing parallels between Covid-19 and our current crisis and the 1918 influenza pandemic. So, for those curious, I thought I would talk about some of the similarities and differences, as well as how the flu was treated prior to 1918. If, like so many, discussions of the flu and Covid-19 cause you anxiety, please proceed with caution, or come back on Friday when I have something else to talk about.

First of all, Covid-19 is NOT the flu. While it presents with flu-like symptoms (headache, fever, cough, etc), it’s actually a form of SARS. The first known case of Severe Acute Respiratory Syndrome was only diagnosed in February of 2003; this is a baby virus. By contrast, the first known case of what we today identify as influenza dates back to the 1580s. Where SARS came from and how it turned into Covid-19 is the subject for an entirely different website. For right now, we’re just going to focus on your “basic” flu–none of this H1N1, bird flu nonsense. Just your standard, run-of-the-mill, down and out for a week and then back on your feet kind of flu.

While the oldest known case of the flu is from the 1500s, we have records of illnesses with similar symptoms dating as far back as 500 BC. While primarily a respiratory disease, it can also sometimes cause nausea, vomiting, and diarrhea. This is rare, however. More commonly, it can cause complications or secondary infections, such as pneumonia, bronchitis, and ear infections. Being viral in nature, antibiotics are useless against the disease, but may be prescribed to treat one of these secondary infections.

With so little available to treat the flu today, how did our ancestors cope with it in the days before aspirin and antivirals?

You might be surprised to learn their treatments weren’t much different than those we use today: bed rest, fluids (water and vegetable broth), cold compresses, and willow bark tea. Curious about that last one? Willow bark contains salicin, which works like aspirin, and has been recognized for millennia for its pain and fever reducing qualities.

Outside of pandemic situations, most doctors were not overly concerned about “la grippe” (so-called in France because it would “grab hold” of patients suddenly

. It was still known to hit older people and children harder; people who were already unwell still died at higher rates. But in a time when the average expected age was between 40-60, death was a fact of life. Families frequently had between 8-12 children, knowing that half of them wouldn’t live to adulthood–and the flu was honestly the least of their worries most of the time. Accidents, measles, scarlet fever, yellow fever, cholera, typhoid, typhus, and smallpox were far more dangerous.

What about prevention? Doctors didn’t start thinking they should maybe consider washing their hands until the mid-1800s, and it wasn’t until the 1940s that it went into common practice in the general public.

You’re going to love this: Stay home. 

That’s it. That’s how our ancestors controlled influenza outbreaks.*

The more things change, the more they stay the same.

Aspirin wasn’t developed on a commercial level until the 1890s, and the dosage was still questioned in 1918**. It’s theorized that up to half of the Spanish Flu deaths were because doctors were giving their patients too much aspirin in an effort to bring down stubborn fevers, causing liver and kidney failure.

The actual flu virus wasn’t isolated until 1933, and the first vaccine wasn’t approved by the FDA until the 1940s. Because the vaccine evolves and changes so quickly, our vaccines also have to evolve rapidly. From one year to the next, doctors can only guess at which strains of the flu will be most common for that season. Sometimes–like with the 2019/2020 flu season–they guess wrong. Even if they don’t pick the right strains, the vaccine does usually make the illness less severe for those who have been vaccinated, making it safer for people with conditions like asthma. It also helps create herd immunity,*** which protects people with autoimmune disorders or other diseases or allergies that prevent them from being vaccinated themselves.

If you’re mad because you got your vaccine and still got the flu this year, then I promise: it would be worse without that immunity. When you were infected, your body already had antibodies at the ready to fight it off. It’s like the difference between arriving in a new city with and without your smart phone. Without your smartphone, you don’t know where your hotel is. You can’t call an Uber, and you don’t know what neighborhoods you shouldn’t be walking through alone. You’re open to pick pockets or assault by walking through these dangerous areas. You can get lost or injured, or, if you failed to check the weather, you’ll be soaked and freezing. You might be able to ask for directions from a stranger, but who knows how reliable that is? What if you don’t speak the same language?

With your smart phone, you’re prepared. You know that you need to bring a heavier jacket than you’re used to. You know your hotel is in a good area, and you can call a ride or even take public transit because you’re able to look up the schedule. When those pickpockets come for you on the city bus, you’re prepared because you read an article about it at the bus stop.

Is it fool proof? No. But it gives you a much better chance.

Stay safe. Stay at home. And wash your hands.

Further Reading:
CDC SARS timeline
A brief history of influenza
Timeline of Influenza
Medical uses of willow bark
History of hand washing

*For an entertaining look at this policy in 1918 and how it saved lives in California, see the video below:

**Having done a great deal of research on the 1918 flu for an upcoming novel, I can do a post–or series of posts–on the pandemic, if there is interest. If you’d like to see more on this subject in particular, please like this post or leave a comment below with any specific questions you would like to see addressed.

***Obviously, most healthcare websites are focusing on Covid-19 at the moment. However, the same basic practices also apply to influenza. Herd immunity is how we defeated smallpox, polio, scarlet fever, measles, and a whole host of other diseases that are now coming back thanks to the anti-vax movement disrupting herd immunity.

Like what you see? Check out Let’s play “Would this kill me in the 1800s?”

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