Most severe influenza outbreak of the 20th century. It apparently started as a fairly mild strain in a U.S. army camp in early March 1918. Troops sent to fight in World War I spread the virus to western Europe. Outbreaks occurred in nearly every inhabited part of the world, spreading from ports to cities along transportation routes. Pneumonia often developed quickly and killed within two days. Among the most deadly epidemics in history, it left an estimated 25 million dead; unusually, half the deaths were among 20- to 40-year-olds.
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Acute viral infection of the upper or lower respiratory tract. Influenza viruses A (the most common), B, and C produce similar symptoms, but infection with or vaccination against one does not give immunity against the others. Chills, fatigue, and muscle aches begin abruptly. The temperature soon reaches 38–40 °C (101–104 °F). Head, muscle, abdominal, and joint aches may be accompanied by sore throat. Recovery starts in three to four days, and respiratory symptoms become more prominent. Bed rest, high fluid intake, and aspirin or other antifever drugs are standard treatment. Influenza A tends to occur in wavelike annual pandemics. Mortality is usually low, but in rare outbreaks (see influenza epidemic of 1918–19) it reaches immense proportions. Most deaths result from pneumonia or bronchitis.
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