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.
World War I prisoners of war in Germany
Cemeteries for deceased prisoners were gradually opened near the camps. It was a point of honour for the survivors to take care of their comrades’ final resting places. Most often, each nationality had its own reserved patch. In certain camps, such as Gardelegen, veritable monuments were erected. Roger Pelletier motivated his comrades: “Doesn’t it fall to us, who have known them, to all of us here who are their great family, to raise, in the cemetery where they rest, a monument of the French soul that, spreading above them like an aegis, will be above our dead, when we have left, as a memory and a goodbye?” Wilhelm Doegen estimates the number of dead in the camps at 118,159 but serious doubts surround this number, notably because Doegen failed to take certain diseases into account. Also according to Doegen, Russia suffered the heaviest losses (perhaps explained by the poorer nutrition of Russians, most of whom did not receive packages from their families) with a little over 70,000 dead, followed by France with 17,069 deaths, Romania with 12,512, and then Italy and the United Kingdom.