170 influenza pandemic (1918) A demonstration of procedure for nurses at the Red Cross Emergency Ambulance Station in Washington, D.C., during the influenza pandemic of 1918, which killed millions of people and infected millions more life found in 1918 The world was a far different place in 1918 than it was earlier, even far different from 1889 The World War had caused large numbers of people to move from one country to another, from one continent to another It is fairly certain that soldiers from Europe brought the influenza virus back to America on troop ships That war-driven mobility caused the virus to move farther and more rapidly than had ever been the case Another factor was that the war had displaced large numbers of people who had to live with decreased food supplies, no sure housing, lack of medical care, and susceptibility to infections or sickness Another factor was the soldiers themselves who were cramped in barracks that were not healthy and who, because of the stress of combat, were physically susceptible to infections The influenza usually struck very quickly There are many accounts of people appearing to be perfectly healthy and suddenly, within hours, becoming completely debilitated From that point they could die, often the next day Those stricken would cough up blood The coughing was so severe that bodies that were autopsied showed serious tears of internal muscles due solely to severe coughing Pneumonia combined with the influenza, and many essentially drowned because their lungs were filled with liquid they could not be rid of In many cases, a blue tinge would develop at the ears and spread to the rest of the face, darkening it Doctors and nurses in the United States mentioned that it was often difficult to tell Caucasians from African Americans, as patients of both races would become so