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"The second wave of the 1918 pandemic was much more deadly than the first. The first wave had resembled typical flu epidemics; those most at risk were the sick and elderly, while younger, healthier people recovered easily.

By August, when the second wave began in France, Sierra Leone, and the United States, the virus had mutated to a much more deadly form . October 1918 was the month with the highest fatality rate of the whole pandemic."

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