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Brian Lehrer: Brian Lehrer on WNYC and with the flu raging this year worse than usual and killing and hospitalizing so many people, here's a bit of American history you may or may not know from exactly 100 years ago. There was a devastating flu epidemic, they even called it a pandemic that began in 1918 that had a profound effect on our country including at least one positive side effect.

Little remembered the flu epidemic of 1918 helped pave the way for women to get the right to vote in the 19th Amendment to the United States Constitution. Good to re-raise on the day after International Women's Day. Historian Kenneth C. Davis has a forthcoming book called More Deadly Than War: The Hidden History of the Spanish flu and the First World War. Hi, Ken welcome back to WNYC.

Kenneth C. Davis: Always a pleasure to be here, Brian. Thank you.

Brian: What did they call it the Spanish flu?

Kenneth: Well, it had nothing to do with coming from Spain. Spain was a non-combatant during World War I. Remember, World War I starts in 1914. The United States does not declare war and get involved until April of 1917. In the spring of 1918, this flu-- they didn't even call it the flu necessarily right away, this very, very fierce epidemic disease hit Madrid. Because Spain was a noncombatant, they did not censor the newspapers.

The first actual published reports of a serious epidemic that actually struck millions of people in Spain came out of Spain. They called it in Spain, the Naples Soldier and this was a neat trick of the Spanish flu. It was clearly named the Spanish Flu in many places around the world, but the Russians called it the German Pest, the Japanese call it Wrestlers Fever. In South Africa, they called it the blacks disease, or the white man's disease, depending on which side of the fence you're on. It was an extraordinary global pandemic that probably killed as many as 100 million people.

Brian: Spain was going to build a wall and Italy was going to pay for it?

Kenneth: Something like that.

Brian: How bad was this epidemic or pandemic? What's the difference between the two?

Kenneth: Well, an epidemic is usually more localized. Pandemic means universal in the sense that this spread around the globe. The reason primarily that it spread around the globe was that the world was in the midst of a global conflict, what we now call World War I, what they called the Great War back then or the war to end all wars optimistically afterwards.

As I mentioned, the United States was not involved in the war until declaring war in 1917 and really didn't send troops to Europe until the spring of 1918. It's 100 years ago, around this time, that this strange illness, this ailment is bubbling around some army camps particularly one in Kansas. What was unusual about it was that it was striking healthy, young men, soldiers in barracks and tents and they were falling with such suddenness and gasping for air and turning blue. They actually call it first, in some places, the Purple Death. It was extraordinary. Time after time, you hear doctors reporting or nurses reporting, the bodies are stacked like cordwood. It's the phrase that comes up time and time again.

Brian: You relate the flu to World War 1 again, the title of your book is More Deadly Than War: The Hidden History of the Spanish flu and the First World War. You see the war making the flu worse, and the flu affecting the course of the war. Can you talk about each?

Kenneth: Absolutely. Just to continue this out, there's no question that the real outburst of the flu in Europe comes about after American troops start landing in the spring of 1918. It's just a few weeks later.

Brian: Because they brought the bug?

Kenneth: No. Most likely they were carrying the troops that were in the cantonments, these training camps that were set up, huge training camps thrown up around the country with 50,000 men clustered together, sometimes in barracks, sometimes in tents. There's no question that it certainly started in the army spread to the troops, and as soon as those troops started moving around the world, and especially to France landing in Brest depot in France, the fuse was lit and exploded quickly.

Brian: It should have been called The American flu?

Kenneth: In some respects. No one really knows to this date where it originates. It's believed to be a variant of avian flu. There's a suggestion that it existed in China. There's a suggestion that Chinese laborers who were brought to Canada first and then moved to Europe to work, digging trenches in the war might have started it, but there's no clear. We know that in the United States, the first reported cases were in this army camp in Kansas in March of 1918.

By the way, there was no CDC then. There was no way to centralize reports and be aware that this was beginning to happen. There was a public health service, but they were preoccupied with preparing doctors for military service.

Brian: That's how the war affected the course of the flu. How did the flu affect the course of the war?

Kenneth: Well, there are clearly cases where, in one notable example, the British fleet couldn't sail. Too many men were sick. The King of England was sick himself. The Royal Navy could not sail out of port because so many sailors were sick. Perhaps more significantly in June of 1918, when we think that the flu season should be over half a million German soldiers were sick. They were unable to mount a major counter offensive in June of 1918. Would that have affected the outcome of the war? Hard to know. It's speculation. It certainly had an impact at that moment, as the mass numbers of the United States troops hadn't really begun to arrive yet.

Brian: Now, you do refer in the book to the flu indirectly helping to get the 19th Amendment passed giving women the right to vote. How did they relate?

Kenneth: I think it's important to realize that we often think about history and put things in boxes that the war is over here and the flu is over here. These things were a conflagration that came together and they were inseparable. There's no question that the malnutrition, the crowding of troops, refugees in cities all contributed to the spread of this incredibly virulent disease.

One thing that it did, clearly, combined with the war was bring women into the workforce. Nurses, factory workers, women were in a way that we think of as the Rosie the Riveter of World War II were doing the same things in World War I. In Europe, you had the Sally's the Salvation Army nurses handing out coffee and doughnuts to the doughboys, Red Cross Angels.

Thousands and thousands of women were going out into the workforce and going into frontlines of combat. When they came back, they had all the more reason to say, "We deserve the vote." One of the famous protests of the time during the war is the sign showing Kaiser Wilson in front of the White House. These are the first protests at the White House, were by suffragettes. There's a very famous picture at the Library of Congress.

Brian: Woodrow Wilson, they called him Kaiser Wilson?

Kenneth: Kaiser Wilson, the war was on. Wilson was, of course, talking about democracy and how Germans should be free. The women were saying, "There are 20 million of us who want democracy." There's no question that the war and the flu and suffrage issues all come together. Of course, a year after the war is over the 19th Amendment is passed.

Brian: If we had 2018 medical technology, would the flu of 1918 have been as deadly?

Kenneth: Let's see. It's hard to say of course because they didn't even know what a virus was in 1918. It was the dawn of true medical miracles in somewhat some ways. There were now vaccines for certain bacterial infections, cholera, smallpox, and typhus. Yellow fever had been largely conquered, although it's making a comeback in Brazil. There was this tremendous growth of medical knowledge at the time, but still a lot of people who thought disease came from bad air and dirt and dust. The knowledge was so backwards, then it's hard to make that--

As I said they hadn't seen a virus yet. It was too small. It couldn't be filtered by the means that they could filter bacteria. Virus wouldn't be seen until 1930. These are really important distinctions. I mentioned there's no federal agency that's monitoring health around the country quite the way the CDC does. The Public Health Service at that time was mostly concerned before the war with monitoring the immigrants who were coming in at Ellis Island. You see these men in their uniforms checking teeth. Then they got very involved, of course, with preparing doctors. There was no requirement to report flu until later in 1918 when they did see these cases growing with extraordinary speed.

There's no question that today, a government body would recognize, report and be astonished by the number of cases that were going on around the country.

Brian: Last thing, your book is a national and international take on the flu of 1918, 1919. Was it a New York thing? Do you get local in this book at all?

Kenneth: Oh, absolutely. There's a lot about New York because in some ways, New York, even though the numbers were very high, maybe 30,000 died in New York of the flu, and most of them clustered in a very short period in the fall of 1918, when it really exploded, but New York had a much better hospital system than most cities around the country. The medical facilities were better. Interesting that you see Philadelphia, which was really hard hit, closed its schools, its churches and it didn't seem to do any good at all.

New York City children were told to come to school. They thought they would be better cared for in school than at home, interesting perspective on it from that, but there were also fines for spitting on the subway. There are accounts of men being taken down to the Jefferson Market Courthouse in the West Village, which was still a courthouse, not a library, and paying $1 fine because they'd spit on the subways because spit spread death. That was the slogan. Many, many people, the real image of the period is the surgical mask, the gauze mask that was supposed to help and in most cases did nothing.

Brian: Historian Kenneth C. Davis whose forthcoming book is called More Deadly Than War: The Hidden History of the Spanish Flu and the First World War. So interesting. Thank you so much.

Kenneth: It's always a pleasure, Brian. Thank you.

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