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In the spring and summer of 1918, a new flu outbreak, dubbed Spanish Influenza, moved with soldiers from the European battlefields of World War I to the homefront. By September, the flu began to exact a toll on the civilian population; in the month of October alone, 195,000 Americans died of the disease. In total, more than 500,000 Americans succumbed to the flu that year, more than all the combat casualties in all the wars of the 20th century. Globally, the death toll has been estimated at anywhere between 20 and 40 million people.