Influenza Epidemic in the Civil War?

Influenza Epidemic in the Civil War?


During the American Civil War, army camps on both sides were ravaged horribly by disease, and able-bodied men died in large numbers. Many diseases are cited, including typhoid, smallpox, TB, dysentery, cholera, measles, “black measles” etc.

I have been studying the case of a Confederate camp in Hopkinsville, Kentucky that had horrendous fatalities (300 out of 2000) during the winter of 1861-62. The epidemic was said to be “black measles.” The pattern of deaths that occurred in each unit stationed there indicated that a moderately contagious and very lethal disease was involved.

There are official descriptions of conditions that prevailed there, letters written from men in the camp, and accurate records of the dates of deaths that occurred in each regiment. I could find no evidence for assuming that the disease known then as “black measles” had anything to do with modern measles, and it seems unlikely that typhoid, dysentery or other cited causes could kill as fast and efficiently as the data indicates. The disease does not seem to have spread into the surrounding civilian population, so close and sustained contact must have been the mode of transmission.

It seems incredible to me that an endemic (in 19th century America) disease like measles could in the space of a few weeks cut down hundreds of able-bodied men, as it did at Hopkinsville, or tens of thousands on both sides as claimed during the four years of war. The typical explanation – that these were isolated rural folk never exposed to the disease – is demonstrably not true. One simply does not find serious outbreaks, killing many adults in small rural communities when someone brought the virus in, as supposedly happened in aboriginal contexts. But in 19th century America (and also in the UK) it has been shown that it was children mainly at risk from measles. On the other hand, there are many examples of various “fevers,” thought to be malarial or typhoid, that killed people across the South in the decades prior to the Civil War. Could there have been a virulent flu that only reached its horrible lethal potential when men were jammed together in close quarters in military camps?

In searching the literature on flu epidemics, I found one described as “worldwide” in 1857-59. This reinforced my idea that a strain of flu could have been the real culprit in many of these camp epidemics, with pneumonia doing the actual killing, and measles getting the blame because of its occurrence in a few individuals who had not had it. The descriptions of “black measles” from the Civil War sound uncannily like the following of the lethal stage of the Spanish Flu of 1918: “The victim would get the flu, and then get a secondary infection. His lungs would fill with fluid, preventing him from breathing, and his face would turn blue as he died drowning in his own fluids. The color of the people's faces was so striking they called it 'heliotrope cyanosis.' "

Late 19th century medical texts describe a similar process of patchy coloration that occurred in “black measles [which is] extremely fatal.” Another stated that “death may occur before the rash is thrown out.” A 1908 text described the “purple blotches on the body and face [of those with] the so-called ‘black measles’. Fortunately, such cases are now seldom encountered.”

Further, I found several instances of soldiers in the 1860s who stated they had measles in the past, yet still fell ill with black measles. Feeling that the evidence for flu was fairly good, I wrote to Jeffrey Taubenberger of the National Institute of Health, who was unconvinced, as was his colleague David Morens, a measles specialist who cited the lethal epidemics of measles among aboriginals. I continue to believe however that measles in the US in 1861 could not have possibly killed tens of thousands of young men, many from cities and towns in the North as well as the South.

This study has been published in Journal of Civil War Medicine Oct.-Dec. 2013.

William Meacham
Research Fellow 1980-2012
Centre of Asian Studies
University of Hong Kong

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