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Flu Pandemic of 1918-1920

By Kerry Burns, Digital Marketing Manager for the North Carolina Museum of History

A century ago, a different epidemic wreaked havoc on North Carolina, with almost 14,000 North Carolinians succumbing to the illness. This pandemic, one of the most deadly in modern history, took place between 1918 and 1920. Nearly one-third of the planet's population became infected with this horrible sickness. The virus killed an estimated 20 to 50 million victims, including around 670,000 Americans. 

The movement of soldiers and civilians during World War I contributed to the rapid spread of the flu around the world. The first known case of the flu in North Carolina occurred in Wilmington on Sept. 19, 1918. Within a week, the city had 500 cases. From there, the disease moved across the state, eventually killing almost 14,000 Tar Heels, including 17 doctors and an unknown number of nurses. Unlike the seasonal flu we are used to today, this was a novel strain that struck quickly and had high mortality rates among young, healthy adults in addition to the young and elderly.

Vaccines and medicines for treatment and prevention, like Tamiflu, weren't around 100 years ago, so many Americans took to wearing masks in public places, such as schools and theatres. 

Numerous businesses were forced to close, due to so many employees being infected. Mail delivery and garbage pick-up were halted. Even health departments and hospitals closed up shop, only adding to the nightmare.

Image: Red Cross volunteer Pauline Koonce wore this veil while working at a Wilmington, NC, hospital during the pandemic.

People who caught this vicious virus often died within hours or days of symptoms appearing, their lungs rapidly filling with fluid, causing them to suffocate. Historian and author Alfred Crosby has been quoted as saying the virus "killed more humans than any other disease in a period of similar duration in the history of the world."