title: Death from 1918 pandemic influenza during the First World War: a perspective from personal and anecdotal evidence.
abstract: The Meuse-Argonne offensive, a decisive battle during the First World War, is the largest frontline commitment in American military history involving 1.2 million U.S. troops. With over 26,000 deaths among American soldiers, the offensive is considered "America's deadliest battle". The Meuse-Argonne offensive coincided with the highly fatal second wave of the influenza pandemic in 1918. In Europe and in U.S. Army training camps, 1918 pandemic influenza killed around 45,000 American soldiers making it questionable which battle should be regarded "America's deadliest". The origin of the influenza pandemic has been inextricably linked with the men who occupied the military camps and trenches during the First World War. The disease had a profound impact, both for the military apparatus and for the individual soldier. It struck all the armies and might have claimed toward 100 000 fatalities among soldiers overall during the conflict while rendering millions ineffective. Yet, it remains unclear whether 1918 pandemic influenza had an impact on the course of the First World War. Still, even until this day, virological and bacteriological analysis of preserved archived remains of soldiers that succumbed to 1918 pandemic influenza has important implications for preparedness for future pandemics. These aspects are reviewed here in a context of citations, images, and documents illustrating the tragic events of 1918.
authors: Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands; Military Medicine Historical Research Society, The Netherlands.
authors: Peter C
authors: PC
authors: Wever
authors: Leo
authors: L
authors: van Bergen
mesh_terms: D005060:Europe / Q000453:epidemiology; D049673:History, 20th Century; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000266:history* / Q000401:mortality*; D008889:Military Personnel / Q000706:statistics & numerical data; D058873:Pandemics / Q000266:history; D014481:United States / Q000453:epidemiology; D047828:World War I
keywords: 1918 Pandemic influenza; First World War; Spanish influenza; mortality; risk factors; secondary bacterial pneumonia