<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 . However, papers were free to report the epidemic's effects in neutral Spain (such as the grave illness of King Alfonso XIII). This reporting dichotomy created a false impression of Spain as especially hard hit, thereby giving rise to the pandemic's nickname, Spanish Flu . In Spain, a different nickname was adopted, the Naples Soldier (Soldado de Nápoles), which came from a musical operetta (zarzuela) titled La canción del olvido (The Song of Forgetting), which premiered in Madrid during the first epidemic wave . Federico Romero, one of the librettists, quipped that the play's most popular musical number, Naples Soldier, was as catchy as the flu . </P> <P> The site of the very first confirmed outbreak was at Camp Funston, Fort Riley, Kansas, then a military training facility preparing American troops for involvement in World War I . The first victim diagnosed with the new strain of flu on Monday, March 11, 1918, was mess cook Private Albert Gitchell . Historian Alfred W. Crosby recorded that the flu originated in Kansas, and popular writer John Barry echoed Crosby in describing Haskell County, Kansas, as the point of origin . </P>

Where does the name spanish flu come from
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