1918 Flu Pandemic: Study Reveals That Frail, Sickly People Were More Likely To Die of the Virus, Countering Belief That The Young, Healthy Were Equally Vulnerable

(Photo : Hulton Archive/Getty Images) Nurses care for victims of a Spanish influenza epidemic outdoors amidst canvas tents during an outdoor fresh air cure, Lawrence, Massachusetts, 1918

At least 50 million people across the globe died in the 1918 flu pandemic, making it one of history's deadliest pandemics.

1918 Flu Pandemic: Susceptibility to Infection

It has been a long-standing belief that healthy and young adults were just as vulnerable as the sick, frail, and older. However, a new study counters this belief.

As part of the study, scientists examined the skeletons of victims who died during and before the pandemic. Stress signs in the bones show that, irrespective of age, people who were already unhealthy and frail had a higher likelihood of dying in the pandemic compared to those who were not.

While the findings may not be totally surprising, they show how the attributes of individuals could affect how susceptible they are to contracting the illness.

Assistant anthropology professor Amanda Wissler from McMaster University, who is also the lead author of the study, explains that even in the case of a novel pandemic, which refers to when no one is expected to have any prior immunity, there are some people who have a higher risk of getting ill and eventually dying. This is typically affected by culture. She adds that this means that those who already have health or socioeconomic disadvantages are more vulnerable.

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Odd W-Shaped Death Curve

The flu death pattern across different age groups had a W shape, with mortality peaking at very old and very young ages. There was also another peak among young adults. This pattern was opposed to the usual "U-shaped" curve of flu outbreak deaths. Peaks were typically observed on both ends of the spectrum of ages.

The W-shape stressed that there was an unusual trend observed among the young. However, pre existing conditions were not taken into account. The authors note that the rampant death among the young and healthy adults was just anecdotal and was not supported by any concrete scientific proof.

As part of the study, the scientists looked into 81 skeletons of those who died when the flu pandemic hit Cleveland from September 1918 to March 1919. They also examined the skeletons of 288 people who died prior to the pandemic. The scientists examined the ages of death as well as lesions on the shin bones, which could have signified preexisting health conditions or physical stress.

Individuals with active shinbone lesions were the frailest. Unlike those with healed lesions, those who had active ones had a higher likelihood of dying during and before the pandemic. During the 1918 flu pandemic, their death risk was 2.7 times higher compared to those with healed bumps.

The young were not exempted from this trend. Regardless of death age, those who exhibited physical stress on their bones had a higher likelihood of dying due to the flu compared to those who were healthier.

However, it is important to note the limitations of the study. For one, the sample only covered Cleveland skeletons, which means that the results may not necessarily apply to other locales. The shinbone technique also does not shed light on the causes of the lesions.

Nevertheless, the study shows how social disparities and health could affect mortality rates in pandemic.

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