<P> When an infected person sneezes or coughs, more than half a million virus particles can be spread to those close by . The close quarters and massive troop movements of World War I hastened the pandemic, and probably both increased transmission and augmented mutation; the war may also have increased the lethality of the virus . Some speculate the soldiers' immune systems were weakened by malnourishment, as well as the stresses of combat and chemical attacks, increasing their susceptibility . </P> <P> A large factor in the worldwide occurrence of this flu was increased travel . Modern transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease . </P> <P> In the United States, the disease was first observed in Haskell County, Kansas, in January 1918, prompting local doctor Loring Miner to warn the U.S. Public Health Service's academic journal . On 4 March 1918, company cook Albert Gitchell reported sick at Fort Riley, an American military facility that at the time was training American troops during World War I, making him the first recorded victim of the flu . Within days, 522 men at the camp had reported sick . By 11 March 1918, the virus had reached Queens, New York . Failure to take preventive measures in March / April was later criticised . </P> <P> In August 1918, a more virulent strain appeared simultaneously in Brest, France; in Freetown, Sierra Leone; and in the U.S. in Boston, Massachusetts . The Spanish flu also spread through Ireland, carried there by returning Irish soldiers . The Allies of World War I came to call it the Spanish flu, primarily because the pandemic received greater press attention after it moved from France to Spain in November 1918 . Spain was not involved in the war and had not imposed wartime censorship . </P>

Where did the influenza epidemic first occur in 1918