evidence: Inside the swift, deadly history of the Spanish Flu pandemic [...] The Spanish flu strain killed its victims with a swiftness never seen before. In the United States stories abounded of people waking up sick and dying on their way to work. The symptoms were gruesome: Sufferers would develop a fever and become short of breath. Lack of oxygen meant their faces appeared tinged with blue. Hemorrhages filled the lungs with blood and caused catastrophic vomiting and nosebleeds, with victims drowning in their own fluids. Unlike so many strains of influenza before it, Spanish flu attacked not only the very young and the very old, but also healthy adults between the ages of 20 and 40. [...] As the crisis reached its zenith, the medical services began to be overwhelmed. Morticians and gravediggers struggled, and conducting individual funerals became impossible. Many of the dead ended up in mass graves. The end of 1918 brought a hiatus in the spread of the illness and January 1919 saw the beginning of the third and final phase. By then the disease was a much diminished force. The ferocity of the autumn and winter of the previous year was not repeated and mortality rates fell.