How the 1918 pandemic spurred developments in virology and vaccines

Why the 1918 flu killed between 50 and 100 million people

The 1918–1920 flu pandemic (once called, incorrectly, the Spanish flu) killed quickly and in huge numbers, with estimates of the global death toll ranging from 50 to 100 million people. Several factors contributed to the high mortality rate: lack of antibiotics, the global disruption of World War I, and more.

Human records of influenza stretch back more than two millennia

Accounts of flu-like illness appear as early as 412 BCE, when Hippocrates described a sudden wave of cough and fever. Centuries of recurring outbreaks culminated in the first clearly documented pandemic in 1580, spreading from Asia into Europe and Africa.

Human records of influenza stretch back more than two millennia

Accounts of flu-like illness appear as early as 412 BCE, when Hippocrates described a sudden wave of cough and fever. Centuries of recurring outbreaks culminated in the first clearly documented pandemic in 1580, spreading from Asia into Europe and Africa.

Europe’s first recorded influenza pandemic swept the continent in 1580

The 1580 influenza pandemic, traced from Asia to Africa and into Europe, became the first flu outbreak clearly documented across the continent—killing tens of thousands and highlighting influenza’s potential for rapid global spread.

In 1933, the influenza virus was first identified through 'ferret flu' experiments, which proved that the disease was viral—not bacterial.

Hear firsthand stories from Americans who lived through the 1918 flu pandemic

This video shares personal accounts from survivors of the 1918 influenza epidemic, capturing memories of sickness, loss, and resilience. Their voices offer a glimpse into how ordinary people experienced one of history’s deadliest pandemics.

A timeline of major pandemics from 1899–2025

Modern pandemics have been defined by the race between globalization (which increases risk) and the development of new medicines. The Great Influenza epidemic claimed some 50 million lives, and the COVID-19 pandemic killed more than 7 million. In between, diseases like Ebola, cholera, AIDS, and more have devastated communities.

The flu vaccine has evolved alongside discoveries of new virus strains

After influenza B was identified in 1940, researchers created a two-strain vaccine by 1942. The WHO later built a global surveillance system to track mutations, enabling vaccines to be updated annually to target the strains most likely to circulate.

Before vaccines, there was 'variolation': what was it?

Before the technology behind vaccinations was discovered, some keen observers of medicine around the globe noticed how previous infections could impact future ones. Learn about the techniques early physicians used before they had vaccines.

A novel H1N1 influenza strain sparked a 2009 global pandemic

First detected in Mexico, the 2009 “swine flu” pandemic infected up to 1.4B people worldwide. While mortality rates were lower than earlier pandemics, the outbreak still caused more than 150,000 deaths.

The 1957 and 1968 influenza pandemics caused millions of deaths worldwide

The 1957 H2N2 pandemic spread from East Asia, killing more than 1M globally, while the 1968 H3N2 pandemic began in Hong Kong and caused a similar toll, with both strains rapidly moving across continents.

Small genetic changes that accumulate over time force flu vaccines to be updated regularly.

Hollywood's efficient response to the Spanish flu made it a filmmaking destination

In 1918, the Great Influenza epidemic killed more than 675,000 Americans. Los Angeles was one of the first cities to shut down movie theaters, most of which were independently owned and couldn’t afford the revenue loss. The results were twofold: the quick response meant that Hollywood could bounce back faster than other film hubs, and it also contributed to the rise of vertical integration as studios stepped in to purchase the flailing theaters.

Major genetic shifts in flu viruses can spark global pandemics

Antigenic shift happens when two different influenza viruses infect the same host and swap genetic material. The result is a brand-new subtype of influenza which, if easily spread among people, can trigger a worldwide pandemic.

Visualizing the genetics of SARS-CoV-2

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, began with an outbreak in Wuhan, China in December 2019, and rapidly spread worldwide in early 2020. On March 11, 2020, the World Health Organization declared COVID-19 a global pandemic, leading to widespread lockdowns, travel restrictions, and economic disruptions.

COVID-19 vaccine breakthroughs are driving efforts toward a universal flu shot

mRNA and other technologies used for COVID-19 vaccines are being applied to influenza research. Scientists hope these advances will lead to a universal flu vaccine that protects against multiple strains and reduces the need for yearly shots.

Learn the history and science of influenza in 'This Podcast Will Kill You'

In their flu episode, cohosts Erin Welsh and Erin Allmann Updyke unpack influenza's biology, history, and impact—explaining everything from past pandemics to modern vaccines, all with their trademark mix of science and storytelling.

The Spanish flu had a major impact on the 1919 NHL season

Just two years after the National Hockey League was officially formed, its champion was playing the PCHA champion for the Stanley Cup. The series was tied, going into the deciding Game 5, when all but three NHL players fell ill with the Spanish flu. No champion was crowned that year.

The COVID-19 pandemic led to a decrease in immunizations in the US and worldwide

Public health funds and resources that were diverted to COVID-19 response reduced efforts to combat polio and vaccinations for polio and other diseases declined during the pandemic, putting more people at risk for polio.

The virus was officially described for the first time in 1789

Michael Underwood, an English physician and surgeon, was the first to describe the disorder, noting it caused disability in the lower extremities in children. Large-scale outbreaks of the disease were not observed until the late 19th century.

An overview on germ theory, the crucial framework developed by Louis Pasteur

Germ theory of disease is based on the concept that many diseases are caused by infections with microorganisms, typically only visualized under high magnification. Read this general overview to understand the basic framework which allowed for development of vaccines.

Explore a technical look at the measles virus and its toll on humanity through the ages.

Measles reached global transmission during the 15th- and 16th-century Columbian exchange

Devastating diseases like smallpox, influenza, measles, and other viruses were largely introduced into the Western Hemisphere beginning with the 1492 arrival of Christopher Columbus and the ensuing age of exploration.

A 1954 outbreak at a Boston boarding school allowed scientists to isolate the measles virus and formed the basis for the first measles vaccine.

Improved 19th-century sanitation meant kids encountered polio later, with worse results

Almost all children likely used to contract poliovirus, but scientists suggest that when infants encountered it very early in life—due to poorer conditions and hygiene—they still had some maternal protection from pregnancy or through breastmilk, so the symptoms were more flu-like.

Variola: the second-deadliest virus on Earth

Because it was declared eradicated in 1980, many forget smallpox is one of history's deadliest diseases—in its final century, it's estimated to have claimed 500 million lives. This 11-minute video from production studio Kurzgesagt takes a look at...

Explore 3D models of some of the most dangerous viruses, allowing us to understand these and other pathogens in new ways.

COVID accelerated antibiotic resistance

The COVID-19 pandemic was caused by a virus, and viruses can’t be treated with antibiotics. But recent research finds that COVID patients were given a tremendous amount of antibiotics, contributing to the problem of antibiotic-resistant bacteria. Why? This NPR feature sheds light on an unexpected side effect of the pandemic.

Live virus vaccines predated polio—that's how we vaccinate against smallpox

Since 1796, smallpox vaccines have used a live poxvirus related to smallpox. Yellow fever vaccines have used a live weakened form of the virus responsible for yellow fever since 1937.

Penicillin is considered one of history’s greatest medical breakthroughs

Experts widely rank penicillin’s discovery among the most important advances in medicine. It launched the antibiotic era, transformed once-deadly infections into treatable illnesses.

The rise of telemedicine: A post-pandemic analysis

Before COVID-19, telemedicine remained on healthcare's periphery; however, the pandemic thrust it into the limelight, transforming how we approach medical care. This comprehensive review published by Press Ganey dives deep into the evolution,...

Explore this interactive visualization of illnesses known to jump from animals to people, and learn how these zoonotic diseases spread.

Jonas Salk developed the first successful polio vaccine—and tested it on himself

The American medical researcher developed the inactivated virus vaccine from 1952 to 1955 and proved that it could prevent disease. He tested the virus on himself and his family in 1954 and then carried out formal clinical trials on more than 1.3 million children.

The history of germ theory, which explains that illnesses are caused by microorganisms

For centuries, the miasma theory, which held that illnesses were caused by clouds of "bad air" produced by decaying organic matter, was the accepted explanation for the spread of disease. The development of microscopes and the subsequent technology to isolate bacteria and test disease spread in mice greatly contributed to contagionists overturning miasmatists.

Volcanoes in the 1340s likely helped trigger the Black Death

The "bubonic plague" that wiped out roughly half of Europe and Asia originated from many factors. Recent research suggests volcanic eruptions contributed as well. The "aerosol" effects of matter released from eruptions likely prompted famine and accelerated the spread of infected fleas riding on grains avoiding spoilage.

Oxford scientists turned Fleming’s mold discovery into medicine

In 1939, a team at Oxford—including Howard Florey, Ernst Chain, and Norman Heatley—revived Fleming’s forgotten discovery. Using makeshift equipment like bedpans and milk churns, they purified enough penicillin to prove it could treat deadly infections.

Explore a 3D model of the influenza virus

This interactive 3D model reveals the influenza virus’s structure—its outer coat and spike proteins—and compares it with other well-known viruses, offering a clear view of how flu differs from pathogens like HIV or coronaviruses.

Why we don't have an answer for the common cold

Since a landmark study of the common cold in 1925, researchers have learned much more about the seasonal ailment. Despite continuous study, people still contract colds for similar periods of time at the same rate with the same symptoms, and there's no vaccine. This article explains how the many viral strains make it hard to control.

Diphtheria was once a leading childhood killer before antibiotics and vaccines

In 18th- and 19th-century outbreaks, some New England families lost as many as eight children to diphtheria, and fatality rates in hospitals often topped 60%. The invention of antitoxins, penicillin, and vaccines dramatically reduced deaths.

Penicillin’s discoverer predicted antibiotic resistance

Alexander Fleming’s discovery of penicillin revolutionized modern medicine. But the same man who pioneered the development of antibiotics also recognized that bacteria could make sntibiotics obsolete if they were used irresponsibly. This story sheds light on Fleming’s discovery—and on his prophetic warning about antibiotic resistance.

Dr. William Gorgas eradicated yellow fever in Panama, crucial to canal construction

The disease was one of the factors hampering the French effort to build the canal. Gorgas' experience elsewhere in the Caribbean had taught him that good drainage and quaranting patients were essential, and he would eventually apply mosquito prevention tactics on a mass scale.

View this timeline of polio milestones and vaccine development

Polio has a long history in art and medicine, dating back centuries. It includes a representation of an apparent polio survivor with a shriveled leg in ancient Egyptian art. See milestones in the history of polio in this timeline.

The business models behind vaccines

Watch experts weigh in on the prevailing business models of vaccine production, including how the Covid-19 pandemic has disrupted the industry for good in this 20-minute video from Financial Times.

View a collection of historical documents about molecular biology's history

The collection features materials related to those involved in the discovery of DNA and provides historical context for the discoveries of RNA, various viruses, and important bioproteins. The items include photographs, business correspondence, manuscripts, and scientific instruments.

See the evolution of Ebola vaccine and treatment development.

Edward Jenner, the father of vaccinations

The British physician was the first to attempt to inoculate someone from smallpox using its milder cousin, cowpox. His innovations and documentations would prove crucial to the deployment of widespread vaccinations.

Measles infection, which was nearly universal during childhood in prevaccine era, was described by the Persian physician Rhazes in the 10th century as "more to be dreaded than smallpox."

Explore the history of antibiotics with 'This Podcast Will Kill You'

The show blends medical history with storytelling and science. In Episode 50, the hosts trace the dramatic origins of antibiotics—from Fleming's moldy petri dish to Florey's wartime labs—and explore their lasting impact on health.

Watch how viruses like Ebola can spill over from animals to humans—and vice-versa.

Bird Flu is spreading—what does that mean for us and other species?

The rapid global spread of H5N1 bird flu—from remote Antarctic islands to US farms—shows how animal spillover, driven by human activity and ecological disruption, is accelerating pandemic risk across species long before sustained human transmission begins.