Horse-drawn carts plied the streets with a call to bring out the dead in the city where bodies lay unburied for days. The afflicted died by the thousands, and survivors lived in fear. But this wasn't medieval Europe being stalked by the Black Death. This was Philadelphia, October 1918, and the city was under siege from a new variant of one of mankind's oldest specters: influenza.

The flu lurking in the midst of this patriotic fervor, however, would prove far more lethal than trench warfare and poison gas. Most alarming was the fact that the disease ravaged previously healthy young adults in their 20s and 30s: the men and women who worked the factories, cleaned the streets, tended the sick — and fought the wars.

Many assumed, wrongly, that the flu had originated in Spain, where 8 million fell ill during a wave of relatively mild flu that had swept the globe in the spring of 1918. Because Spain was neutral and its press uncensored during the war, it was one of the few places in Europe where news about the epidemic was being reported. Whatever its origins, the flu was taking a toll on frontline troops. Commander Erich von Ludendorff blamed the disease for the failure of Germany's major spring offensive.It was a grievous business, he said,having to listen every morning to the chiefs of staff's recital of the number of influenza cases, and their complaints about the weakness of their troops.

Influenza wasn't Ludendorff's only obstacle. General JohnBlack Jack Pershing, commander in chief of the American Expeditionary Forces in Europe, pushed relentlessly to build up troop strength. The U.S. Army had fewer than 100,000 soldiers when it entered the war — the general's plans called for approximately 4 million. The Americans would not simply plug holes in the British and French lines. The AEF would stand alone, and march to victory under the American flag. To do that, Pershing needed more men, more materiel. Always, endlessly, more.

Back home, the ramp-up hit a snag. On March 4, 1918, the Army installation at Camp Funston, Kan., reported a single case of flu. Before the end of the month, 1,100 men had been hospitalized, and 20 percent of those men developed pneumonia. Flu spread rapidly among Army camps as troops were rushed through on their way to the front. But the outbreak had subsided by summer, and it looked like the worst was over.

It wasn't.

Only a Matter of Hours
Camp Devens, 35 miles northwest of Boston, was seriously overcrowded. Built to house 36,000 troops, it contained more than 45,000 in early September 1918. The flu struck there with a suddenness and virulence that had never been seen before.These men start with what appears to be an ordinary attack of LaGrippe or Influenza, and when brought to the Hosp. they very rapidly develop the most vicious type of Pneumonia that has ever been seen, wrote Roy Grist, a doctor at the Camp Devens hospital.Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured man from the white….It is only a matter of hours then until death comes….We have been averaging about 100 deaths per day….We have lost an outrageous number of Nurses and Drs.

Flu victims were wracked by fevers often spiking higher than 104 degrees and body aches so severe that the slightest touch was torture. Cyanosis was perhaps the most terrifying hallmark of the pneumonia that often accompanied this flu. A lack of oxygen in the blood turned one's skin a bluish-black — leading to speculation that the Black Death had again come calling.

While Devens tried unsuccessfully to contain the outbreak, a similar situation was developing at Commonwealth Pier, a naval facility in Boston. Flu was reported there in late August, but the war would not wait. Sailors were shipped out to New Orleans, Puget Sound and the Great Lakes Naval Training Station near Chicago. Josie Mabel Brown was a young Navy nurse living in St. Louis, Mo., when she was called to duty at Great Lakes.There was a man lying on the bed dying and one was lying on the floor, she said of her first visit to a sick ward.Another man was on a stretcher waiting for the fellow on the bed to die….We wrapped him in a winding sheet and left nothing but the big toe on the left foot out with a shipping tag on it to tell the man's rank, his nearest of kin, and hometown….Our Navy bought the whole city of Chicago out of sheets. There wasn't a sheet left in Chicago. All a boy got when he died was a winding sheet and a wooden box; we just couldn't get enough caskets.

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