"It wasn't always that quick, either," Higgins said. "And along the way, you had symptoms like fingers and genitals turning black, and people reporting being able to literally smell the body decaying before the patient died."
At the time, limited scientific and medical knowledge led some - including prominent governmental health officials -- to identify the cause of the disease to arcane notions such as the wrath of an angry God, swamp gas or electricity in the air.
"This notion of swamp gas, or miasma, is like something out of the Middle Ages," said Higgins. "To have that put out in 1918, by public officials, no less, is really spooky. And remember, prominent, influential members of America's religious community have recently invoked the theory of an angry God to explain both 9-11 and Katrina's assault on a sinful city."
Medical knowledge, research findings and pharmaceutical developments provide some hope that 21st century Americans might not suffer the fate of their forebears, but Higgins said that survival might depend on the simple concept of community planning.
In studying the metropolitan areas around the state of Pennsylvania, Higgins found that the areas that suffered the lowest mortality rates included Bethlehem, which benefited from the resources provided by the then-prosperous Bethlehem Steel.
"At the time, Bethlehem Steel produced more munitions than Great Britain and France combined, and the plant could not afford to shut down for illness," Higgins said. "At the height of the epidemic, the federal, state, and local governments came together with the company to invest in a makeshift emergency hospital right on the premises to care for their workers as well as a strict quarantine. As a result, there were only about 100 deaths from the flu, which struck thousands in Bethlehem."
By contrast, Philadelphia found itself much less prepared for an epidemic, and the strapped with a corrupt head th