Death Toll from Pandemic Flu 1918-19 U.S. 675,000 Worldwide 50,000,000+ 1957-58 U.S. 70,000 Worldwide 1-2,000,000 1968-69 U.S. 34,000 Worldwide 700,000+ Now let’s look at what history tells us

Influenza Deaths in Kansas October 1918 Massive increase in deaths due to influenza Similar spikes were repeated all over the country Of the 3 pandemics in the 20th century, 1918 was undoubtedly the most severe. Here’s an example. - Deaths from all causes - Deaths from influenza www.pandemicflu.gov

Jeffery K Taubenberger MD PhD What Experts Say (1) The Spanish influenza pandemic of 1918-19, which caused ≈ 50 million deaths worldwide, remains an ominous warning to public health.* Background & Bio: Distinguished scientist who led the team (at the Armed Forces Institute of Pathology) that reconstructed the GENOME of the 1918 virus. Taubenberger published his first findings in 1997, showing that the 1918 virus was a pure avian flu virus. It was a bombshell, because coincidentally the first H5N1 avian flu human outbreak happened that year in Hong Kong. Prior to Taubenberger’s work, scientists thought pandemic flu came ONLY from reassortment of avian with human flu viruses. They did not think it was possible for avian flu to directly jumped to humans and cause a pandemic. His findings shocked the scientific community, showing how little we know about flu. Today, a lot of work has been done, but knowledge of the basic virology of flu remains patchy. The full sequence of the 1918 virus was completed in 2005, from autopsy samples from 2 soldiers plus one woman in Alaska, victims of the 1918 pandemic. Jeffery K Taubenberger MD PhD National Institute of Health *1918 - The Mother of All Pandemics, Emerging Infectious Diseases, 2006

1918 - The Mother of All Pandemics Flu fatality usually highest in infants and elderly 1918 unusual peak for those aged 20-40 Not seen in other pandemics

1918 - The Mother of All Pandemics 675,000 Americans died of the flu in 1918-19 Almost half were healthy young adults Death tolls especially high in crowded army camps Today’s schools and campuses pose similar hazards

The 1918 pandemic killed more Americans than all combat deaths in all wars in American history since 1775.* Every single city, county, and state suffered from a shortage of caskets * Statistical Summary: America's Major Wars, Louisiana State University Libraries.

1918 - The Mother of All Pandemics Falling mortality from infectious diseases in 20th century 1918 pandemic overshadowed all other infectious diseases combined Optional Crude Infectious Disease Mortality Rate in the United States from 1900 Through 1996, Armstrong, JAMA 1999

1918 - The Mother of All Pandemics 3 waves in 18 months Second wave most severe Optional

In comparison, HIV/AIDS ‘only’ killed 25 million in 25 years. Worldwide, the 1918-19 pandemic killed 50-100 million* people in 18 months. In comparison, HIV/AIDS ‘only’ killed 25 million in 25 years. The Johnson study estimated at least 50 million people died, but said that they may have underestimated the true figures by 100%. The 50-100M is now frequently used by respectable scientists like Taubenberger and Osterhaus. * Johnson NP, Updating the accounts: global mortality of the 1918-1920 "Spanish" influenza pandemic, Bulletin of History of Medicine 2002

1918 - The Mother of All Pandemics All theaters closed, Seattle Japanese schoolgirls wearing masks, Tokyo 1918

1918 - The Mother of All Pandemics Optional Tent ‘hospitals’ Spraying the streets with disinfectants

1918 - The Mother of All Pandemics The saddest picture of all. Case fatality among Alaskan adults reached almost 100% in some places. Many orphanages sprung up in 1919. In Brevig mission, 72 or 80 adults died within 5 days. Survivors were too weak to bury the dead. When help finally arrived, they buried the bodies in a mass grave in the permafrost. 80 years later, tissue samples taken from one of these bodies yielded enough RNA fragments to complete the work on reconstructing the full genome of the 1918 virus. Flu Orphans, Alaska 1919 In some places, almost all adults died