Syndemic
The worst of the 20th century influenza pandemics was the 1918 pandemic, where between 20-40 percent of the world’s population became ill between 40-100 million people died. More people died of the so-called Spanish flu (caused by the H1N1 viral strain) pandemic in the single year of 1918 than during all four-years of the Black Death. The pandemic had devastating effects as disease spread along trade and shipping routes and other corridors of human movement until it had circled the globe. InIndia, the mortality rate reached 50 per 1,000 population. Arriving during the closing phase of the World War I, the pandemic impacted mobilized national armies. Half of U.S. soldiers who died in the "Great War," for example, were victims of influenza. It is estimated that almost ¾ of a million Americans died during the pandemic. In part, the death toll during the pandemic was caused by viral pneumonia characterized by extensive bleeding in the lungs resulting in suffocation. Many victims died within 48 hours of the appearance of the first symptom. It was not uncommon for people who appeared to be quite healthy in the morning to have died by sunset. Among those who survived the first several days, however, many died of secondary bacterial pneumonia. It has been argued that countless numbers of those who expired quickly from the disease were co-infected with tuberculosis, which would explain the notable plummet in TB cases after 1918.
Middle Eastern theatre of World War I
Allied military losses are placed between 1,000,000 and 1,500,000 including killed, wounded, captured or missing. This includes 303,000 British Empire and French casualties in Gallipoli, 601,000 British Empire casualties in Sinai-Palestine, at least 140,000 Russian casualties in the Caucasus, and 256,000 British Empire casualties in Mesopotamia, as well as additional Russo-British losses in Persia. Most of the British casualties were non-battle casualties; total British battle casualties inflicted by the Ottomans were estimated as 264,000 by Field Marshal Lord Carver. In addition to these were over 11,000 casualties sustained by Italians fighting Ottoman-backed Senussi tribesmen in the first half of 1915 alone, with unknown losses for the Senussi themselves.