Flu strikes camp

Attendants care for patients in the segregated Service Battalions during the pandemic flu outbreak of October 1918. Each patient had 100 square feet of floor space in an attempt to prevent the spread of the flu. (U.S. Army photos)

hospital commander dead

This is what the headline would have looked liked in the post's newspaper, The Castle, in October of 1918 when the Spanish flu ripped through Camp Humphreys [now Fort Belvoir] and killed nearly 1,500 Soldiers, including Lt. Col. Chas E. Doerr, the camp surgeon and commanding officer of the hospital.

The pandemic lasted about five weeks and afflicted 4,237 Soldiers, nearly crippling the camp before it ran its course, according to Gus Person, Fort Belvoir historian.

"As the epidemic progressed, and the cases became too numerous to be handled at the base hospital, temporary wards were opened in other parts of the camp," said Person.

Camp Humphreys was just a tiny snapshot of what was happening around the world, Person said.

The 1918 flu pandemic, which is still considered the most destructive pandemic in history, killed more than 40 million people worldwide in just 18 months.

Although close to 90 years ago, there are many similarities to how a flu pandemic would be handled today and certainly many lessons that can be learned.

The best defense then and now
"The prevention of the disease is quite simple and consists of avoiding the disgusting habit of coughing into another's face," said Lt. Col. Isaac Brewer, the new hospital commander in a self-written article featured in The Castle on Sept. 18, 1918.

Around that same time, the hospital commander also put out a statement from the Surgeon General that offered ways of preventing the flu, which restated the above and included recommending those with flu-like symptoms stay away from others until 10 days after they return to normal.

With all of the medical advancements since then, these two methods still remain the best pieces of advice.

According to the World Health Organization Influenza Handbook for Journalists, personal hygiene and "social distancing" are the non-medical approaches to decelerate the pandemic's reach.

Social distancing reduces the opportunities for exposure. The WHO says although social distancing alone won't stop people from getting the flu during a pandemic, but it will slow the pandemic's spread.

For hygiene, the recommendations are the same as Brewer's - everyone should cover their mouth when coughing or sneezing and carefully dispose of tissues. They further recommend frequently washing hands.

Lessons learned
Two important lessons learned from the 1918 pandemic are that age may not play a large factor in who is afflicted; and that although the more densely populated areas will have higher numbers of cases, they can be mitigated with isolation.

First, the 1918 pandemic dispels the idea the flu largely affects the very young, the very old and those with weakened immunities. Most of the victims of the 1918 pandemic were young, healthy adults, said Person.

Second, according to Person, the incidence of the flu was higher and varied with the density of the white population, and lower among the African American troops, which is largely related to isolation.

He said the white troops were housed in crowded barracks while the African American troops were quartered in pyramidal tents with better ventilation. Because of this, a significantly lower number of African American Soldiers contracted the Spanish flu.

Consequently, the current pre-pandemic planning encourages everyone to "shelter in place" in the event of a flu outbreak, a contemporary form of isolation.

According to the Department of Health and Human Services, U.S. residents should plan to stay home, away form others to avoid contamination for two weeks and should keep emergency supplies (food, water, medications, etc.) on hand.

Brewer said in 1918, "We will be able to control if every man in the camp will do his part. His part will not require any work or hardship."

Even though close to a century ago, Brewer's guidance still resonates today, and though medicine is certainly better and living conditions have much improved, if each person plans ahead and heeds the advice of the World Health Organization and the Center for Disease Control, there will be far fewer casualties in any future pandemic.

For more information about the WHO and the CDC and pandemic influenza, visit their Web sites at www.who.int/en and www.cdc.gov.