Spanish influenza refers to the influenza pandemic of 1918, during which an estimated 20 million people died worldwide. The Spanish influenza virus was an H1N1 type flu virus. Unlike to most flu viruses, which affect infants, the elderly and people with weakened immune systems, the H1N1 virus affected young, healthy individuals. It is thought that the virus created such an immune reaction from the affected patient that it completely overwhelmed the immune system, increasing the mortality rates for infection.
General Symptoms
Patients with the Spanish influenza initially suffered from the same symptoms as patients with other influenza infections, including fevers, chills, body aches, muscle aches and inflammation. Spanish flu then progresses in severity. Patients with high fever became delirious and had other changes in their mental status. Dehydration from frequent vomiting and diarrhea was also prevalent. The respiratory symptoms were worse than in patients with seasonal influenza.
Respiratory Symptoms
Patients with Spanish flu developed runny nose, sore throat and cough. The coughing came in spasms so severe they would sprain the abdominal and chest muscles, and occasionally produced blood-tinged sputum. Patients developed pneumonia, with rapid breathing, respiratory distress and cyanosis (bluish tinge of the skin resulting from lack of or decreased oxygen). Some patients developed pulmonary hemorrhage, or bleeding into their lungs, which eventually lead to their deaths. The other leading cause of death was bacterial pneumonia, which developed in patients already severely weakened by the flu virus.
Hematologic Symptoms
There is evidence that the H1N1 virus seen during the Spanish influenza pandemic had some of the characteristics of other hemorrhagic fever viruses. Namely, there were patients who exhibited increased bleeding tendencies, with nosebleeds, easy bruising and bleeding from the mouth and into the lungs. Some physicians reported their patients were having intestinal bleeding, and showed signs of petechial hemorrhage (pinpoint bruises from the capillaries of patients with increased bleeding tendencies).
