Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

NMHM looks back at the 1918 ‘Spanish flu’ for one Maryland county

Image of Black and white image of hospital beds lined up in rows, occupied by sick people. Emergency hospital during influenza epidemic, Camp Funston, Kansas. (NCP 1603) (Photo by: NMHM.)

The year 1918 proved to be a trying time for people overseas and at home. Still in the midst of World War I, populations were then introduced to another adversary: the “Spanish Flu.” While great medical strides had been made to prevent other deadly diseases, such as smallpox, by the time of the global outbreak of influenza in 1918, the flu virus, or H1N1, had yet to be identified.

The 1918 flu resembled a more severe cold. The symptoms included fever, pains in the head and other body parts, and fatigue. While some patients recovered, others developed more severe and deadly conditions, like pneumonia or meningitis. Perhaps the greatest threat of the 1918 flu was the contagious nature of the virus with approximately one third of the world’s population infected and an estimated 50-100 million global fatalities.

During a virtual “science café” held by the National Museum of Health and Medicine (NMHM) last month, NMHM’s Historical Collections Manager Alan Hawk discussed the rapid spread of the 1918 influenza pandemic in a case study on Montgomery County, Maryland.

In 1918, Montgomery County was transitioning from a rural farming community into a suburban area. The county had recently improved its transportation systems connecting railroads and trolley lines to Washington, D.C. for those commuting to work in the city. Less than a month after the first influenza fatality in Washington, D.C., there was an estimated 1,200 cases of influenza in Montgomery County; most cases were within five miles of the railroad or trolley lines.

As we know today, the influenza virus is easily transmitted between those in close proximity to each other, up to about six feet, making the crowded trolleys and trains a prime place for spreading the flu in 1918. This was particularly damaging to the U.S. military, as traveling military personnel often shared cramped quarters in barracks, trains, and trenches.

The devastating impact of the flu in Montgomery County and the surrounding areas drove public health officials to require the adornment of gauze masks in public, and locals to cancel events with large gatherings of people.

While a vaccine wouldn’t be developed for a few more decades, military laboratories and civilian scientists worked tirelessly in 1918 to discover the agent that caused the flu. Autopsies were performed and samples of lung tissue were forwarded to the Army Medical Museum (now NMHM) for further study and preservation. 

Along with the tissue specimens, the museum collected archival and historical materials – for example, photographs showing influenza wards like Camp Funston, Kansas, a possible ground zero for the virus in America, and medical equipment – to illustrate the devastating impact of the 1918 pandemic and the military’s medical response. 

These materials aid today’s researchers in parsing history and understanding the nature of the 1918 flu in comparison to current strains or other viruses. A virtual exhibit shows how DOD scientists used a sample of lung tissue to recreate the genetic sequence of the 1918 virus, and a new teacher’s guide compares the 1918 influenza to COVID-19. Perhaps future studies can help us identify key characteristics of the 1918 influenza pandemic and why it was so deadly.

For those interested in accessing the collections for research, visit the museum’s website.

You also may be interested in...

Report
Jan 1, 2018

MSMR Vol. 25 No. 10 - Oct 2018

.PDF | 1.03 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Contributions from the Global Emerging Infections Surveillance (GEIS) network; Brief report: Pre- and post-deployment prevalence of Staphylococcus aureus colonization among U.S. Navy submariners; Surveillance ...

Report
Jan 1, 2018

MSMR Vol. 25 No. 5 - May 2018

.PDF | 4.62 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Update: Malaria, U.S. Armed Forces, 2017; Surveillance for vector-borne diseases among active and reserve component service members, U.S. Armed Forces, 2010–2016; Diagnostic evaluation of military blood donors ...

Report
Jan 1, 2018

MSMR Vol. 25 No. 3 - March 2018

.PDF | 2.70 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Update: Malaria, U.S. Armed Forces, 2017; Surveillance for vector-borne diseases among active and reserve component service members, U.S. Armed Forces, 2010–2016; Diagnostic evaluation of military blood donors ...

Report
Jan 1, 2018

MSMR Vol. 25 No. 9 - September 2018

.PDF | 1.17 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Contributions from the Global Emerging Infections Surveillance (GEIS) network; Brief report: Pre- and post-deployment prevalence of Staphylococcus aureus colonization among U.S. Navy submariners; Surveillance ...

Report
Jan 1, 2018

MSMR Vol. 25 No. 11 - Nov 2018

.PDF | 1.06 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Contributions from the Global Emerging Infections Surveillance (GEIS) network; Brief report: Pre- and post-deployment prevalence of Staphylococcus aureus colonization among U.S. Navy submariners; Surveillance ...

Report
Jan 1, 2018

MSMR Vol. 25 No. 4 - April 2018

.PDF | 1.08 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Update: Malaria, U.S. Armed Forces, 2017; Surveillance for vector-borne diseases among active and reserve component service members, U.S. Armed Forces, 2010–2016; Diagnostic evaluation of military blood donors ...

Report
Jan 1, 2018

MSMR Vol. 25 No. 1 - January 2018

.PDF | 784.31 KB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Review of the U.S. military's human immunodeficiency virus program: a legacy of progress and a future of promise; Update: Routine screening for antibodies to human immunodeficiency virus, civilian applicants ...

Report
Jan 1, 2018

MSMR Vol. 25 No. 2 - February 2018

.PDF | 985.98 KB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Update: Malaria, U.S. Armed Forces, 2017; Surveillance for vector-borne diseases among active and reserve component service members, U.S. Armed Forces, 2010–2016; Diagnostic evaluation of military blood donors ...

Report
Jan 1, 2017

MSMR Vol. 24 No. 12 - December 2017

.PDF | 1.45 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Insomnia and motor vehicle accident–related injuries, active component, U.S. Armed Forces, 2007–2016; Seizures among active component service members, U.S. Armed Forces, 2007–2016; Brief report: Prevalence of ...

Report
Jan 1, 2017

MSMR Vol. 24 No. 10 - October 2017

.PDF | 1.16 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Measles, mumps, rubella, and varicella among service members and other beneficiaries of the Military Health System, 2010-2016; Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, ...

Report
Jan 1, 2017

MSMR Vol. 24 No. 7 - July 2017

.PDF | 1.18 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Skin and soft tissue infections, active component, U.S. Armed Forces, 2013–2016; Age-period-cohort analysis of colorectal cancer, service members aged 20–59 years, active component, U.S. Armed Forces, 1997–2016 ...

Report
Jan 1, 2017

MSMR Vol. 24 No. 6 - June 2017

.PDF | 1.12 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Incidence of Campylobacter intestinal infections, active component, U.S. Armed Forces, 2007–2016; Incidence of nontyphoidal Salmonella intestinal infections, active component, U.S. Armed Forces, 2007–2016; ...

Report
Jan 1, 2017

MSMR Vol. 24 No. 11 - November 2017

.PDF | 1.52 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Pregnancies and live births, active component service women, U.S. Armed Forces, 2012–2016; Contraception among active component service women, U.S. Armed Forces, 2012–2016; Complications and care related to ...

Report
Jan 1, 2017

MSMR Vol. 24 No. 2 - February 2017

.PDF | 1.31 MB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Incident diagnoses of leishmaniasis, active and reserve components, U.S. Armed Forces, 2001–2016; Incidence rates of malignant melanoma in relation to years of military service, overall and in selected ...

Report
Jan 1, 2017

MSMR Vol. 24 No. 1 - January 2017

.PDF | 998.69 KB

A monthly publication of the Armed Forces Health Surveillance Branch. This issue of the peer-reviewed journal contains the following articles: Update: Malaria, U.S. Armed Forces, 2016; Diabetes mellitus, active component, U.S. Armed Forces, 2008–2015 introduction of the virus in the Western Hemisphere, 1 January 2016; Rates of Chlamydia trachomatis ...

Skip subpage navigation
Refine your search
Last Updated: July 11, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery