<P> More recent investigations, mainly based on original medical reports from the period of the pandemic, found that the viral infection itself was not more aggressive than any previous influenza, but that the special circumstances (malnourishment, overcrowded medical camps and hospitals, poor hygiene) promoted bacterial superinfection that killed most of the victims typically after a somewhat prolonged death bed . </P> <P> Historical and epidemiological data are inadequate to identify the pandemic's geographic origin . It was implicated in the outbreak of encephalitis lethargica in the 1920s . </P> <P> To maintain morale, wartime censors minimized early reports of illness and mortality in Germany, the United Kingdom, France, and the United States . Papers were free to report the epidemic's effects in neutral Spain (such as the grave illness of King Alfonso XIII). This created a false impression of Spain as especially hard hit, thereby giving rise to the pandemic's nickname, "Spanish Flu". </P> <P> Historian Alfred W. Crosby recorded that the flu originated in the U.S. state of Kansas, and popular writer John Barry echoed Crosby in describing Haskell County, as the point of origin although already in late 1917 there had been a first wave in at least 14 US military camps . </P>

Where does the name of the spanish flu come from
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