From 1918 to 1919, an influenza pandemic is estimated to have killed 50–100 million people as it spread from the United States to Canada, Europe, Africa, Asia and the Far North. Cases appeared among Canadian soldiers in France in the spring of 1918, and major outbreaks occurred in Canadian training camps near Montréal and Toronto in August. The H1N1 virus thought to have caused the disease spread quickly to the civilian population, killing many young adults, especially pregnant women. With so many doctors and nurses serving overseas, and with no national health department to track the disease, limited knowledge of its cause, no vaccine to prevent it or antibiotics to deal with the pneumonia and other respiratory diseases that followed, stricken communities depended on individuals, families and volunteers to care for the sick. The pandemic highlighted the need for more health care professionals and facilities and more medical research, and was a factor in the creation of Canada’s federal Department of Health in 1919.