A separate, but related event to the Great War, was the great 1918 flu pandemic. This deadly flu virus attacked more than one-third of the world’s population, and within months had killed more than 50 million people – three times as many as the World War I – and did it more quickly, than any other illness in recorded history. Unlike other flu outbreaks which happen every year and vary in severity, this particularly flu virus attacked young, healthy adults, aged between 20-40. There was no cure, no vaccine and little support that medicine could provide. It affected 200,000 British troops, 400,000 French and 500,000German troops.
The origins of this virulent new strain of the flu are still unknown. It was first observed in Fort Riley, Kansas, USA, and is believed to have been accidentally carried to Europe by infected American forces personnel. One in every four Americans had contracted the influenza virus. The disease spread rapidly through the continental US, Canada and Europe. It eventually reached around the globe, partially because many were weakened and exhausted by the famines of the World War.
It was nicknamed ‘Spanish flu’ as the first cases were in reported in Spain’s uncensored press. Newspapers during World War One, were censored, (Germany, the United States, Britain and France all had media blackouts on news that might lower morale) so although there were influenza (flu) cases elsewhere, it was the Spanish cases that hit the headlines. In Spain some 8 million people infected in May 1918 and one of the first casualties was the King of Spain. In Spain they called it ‘French Flu’.
In three waves the Spanish Influenza epidemic of 1918-1919, infected 500 million people across the world, including remote Pacific islands and the Arctic, and killed 50 to 100 million of them. This was three to five percent of the world’s population, making it one of the deadliest natural disasters in human history. This particular virulent strain of flu was unusual, as it was most deadly for those between the ages of 20 to 35, making war veterans among the most susceptible. It was distinct in that it had a rapid onset and it was not unusual for victims to die within hours. Another oddity was that the influenza appeared most deadly during the Summer months of the Northern Hemisphere, rather than the Winter.
TOWARDS the end of 1918, a new nursery rhyme started to be heard in playgrounds across Britain, sung by skipping schoolchildren: “I had a bird, its name was Enza. I opened the door and in-flu-enza.” Like many such rhymes, its chirpy cadenc,e hid a far more macabre reality.
In 1918, the virus struck with fearsome speed, often killing its victims within hours of the first signs of infection. Eyewitness accounts of the time describe how a commuter began to cough and never made it home and how four women sat down to play bridge one evening and three were dead by the morning.
“Those afflicted were first aware of a shivery twinge at breakfast,” says Juliet Nicolson in The Great Silence 1918-1920, Living In The Shadow Of The Great War. “By lunchtime their skin had turned a vivid purple. By evening, before there was time to lay the table for supper, death would have occurred.”
It was the violence of the death which struck many. Lungs became inflamed and filled with blood so that sufferers literally drowned in their own body fluids. In a letter dated September 29, 1918, Glasgow physician Professor Roy Grist described the disease as “the most vicious type of pneumonia that has ever been seen” and recorded what he was seeing: “Two hours after admission, they have mahogany spots over the cheek bones and a few hours later you can begin to see the cyanosis (blueness due to lack of oxygen) extending from their ears and spreading all over their face. It is only a matter of a few hours then until death comes and it is simply a struggle for air until they suffocate. It is horrible.” As well as the viciousness of the virus there was another aspect to this flu strain which made it stand out, baffling the doctors of the day. While influenza generally proves fatal for the young, sick and elderly, the 1918 variety seemed to affect those who were fit and healthy. The highest death rate was among those aged 20 to 34 – the same generation that had just lost so many lives in the trenches. Scientists now believe that those with the strongest immune systems were the ones to die because those immune systems went into overdrive, producing an overreaction to the virus which led to death.
It soon became apparent that this was no ordinary flu and a few months later a more virulent strain had emerged. Doctors believed those who had contracted the earlier virus would be immune to this bout – but they were wrong.
In Britain, Glasgow was the first city to be affected in May and by June it had spread to London. By November, death figures reported in the newspapers were growing: “London County, 2,458; London outer ring, 1,705; Sheffield, 465; Leicester, 260; Hull, 220.”
In Britain coverage of the flu, was initially scant because of a reluctance to publicise a fatal disease to a public already saturated with news of mortality.
Britain was also woefully under-prepared for the outbreak. Britain’s Chief Medical Officer Sir Arthur News- Holme initially told Britons to simply carry on, advising just a few pointers: avoid sneezing and coughing in public, carry plenty of fresh handkerchiefs, wash hands regularly and gargle with disinfectant mouthwash. A mixture of mustard and Bovril was thought to boost the immune system, as was alcohol. It was only later – as the death toll mounted – that many schools, theatres and dance halls were closed and people were urged to stay at home. Streets were sprayed with chemicals and people wore anti-germ masks. Some councils insisted that cinemas be emptied every few hours to allow windows to be opened and halls aerated.
Hospitals were spilling over with the sick and dying, while some wards had to close because all the nurses were struck down. Some towns demanded signed health certificates before strangers could enter. There was a shortage of coffins, morticians and grave-diggers. Funerals had to be limited to 15 minutes. Other countries and states brought in their own legislation. In Arizona handshaking was outlawed. In France, spitting became a legal offence. US President Woodrow Wilson contracted the disease while negotiating the Treaty of Versailles and the Austrian painter Gustav Klimt died in its first wave.
Vaccines were available but had no effect on those already infected while millions died from secondary bacterial infections, which we would now treat with antibiotics.
In Hull, the outbreak began during the last week of June 1918 and lasted for almost a year. During the period June 1918 to May 1919, a total of 1,261 deaths were recorded as being due to influenza, whilst deaths ascribed to pneumonia and broncho-pneumonia were considerably above the average for the previous ten years. The disease was not confined to the congested and crowded districts of the City, which indicated that insanitary conditions had no direct casual relationship with its incidence; it was prevalent in all parts and the person attacked were representative of every section of the community. The disease abated somewhat on two occasions during the twelve months that it was active. The first occasion being during August and September when four deaths only occurred over a period of eight weeks. The second occasion was much shorter in duration, deaths from influenza, declining in January until only one death was recorded during the last week of that month, but the figures rose again during February. The peak of the epidemic was in October and November when over a five week period, there were 684 deaths, representing a little over half the total deaths during the whole epidemic period. The disease was so widespread that it was considered no benefit would accrue from closing schools. However, letters were sent to the proprietors of cinemas and other places of entertainment advising them on the ventilation and disinfection of their premises. Handbills were distributed to the public detailing precautions which could be taken, and these were supplemented by the Health Visitors when they called on mothers in the poorer and more overcrowded parts of the City. Patients were removed to hospitals and houses were fumigated on request. Prophylactic vaccine was also made available to medical practitioners who wished to use it.
The ‘Spanish flu’ would kill over 228,000 people in Britain and between 50-100 million people worldwide. The following are some examples how the flu was reported locally.
Hull Daily Mail 1 July 1918
At least a dozen persons in different parts of the Rossendale valley have
succumbed to pneumonia, following the disease [influenza]. On Saturday Pte
James Caine (30), Lancashire Fusiliers, died at 3, Turner’s Buildings, Stacklands,
Bacup, from pneumonia after only a few days’ illness. He had served with the
colours for nearly four years, and leaves a widow and five young children.
Private James H. Bell and Mrs Bell, of Edward Street, Haslingden, have lost three
out of four young children in ten days as a result of measles and the epidemic. All
the elementary schools at Bacup and Rawtenstall are to be kept closed for
another week, and all the factories, workshops, picture houses etc in Bacup,
Waterfoot and Rawtenstall are being disinfected as fast as possible.
(Identical report appeared in Yorkshire Post and Leeds Intelligencer 1 July 1918)
Yorkshire Post and Leeds Intelligencer 2 July 1918
THE INFLUENZA EPIDEMIC
Report includes the following…
‘…The wife and the father of Air Mechanic Pepperday, R.A.., Plantation Street,
Bacup, have died from the effects of the disease whilst the soldier was at home
Yorkshire Post and Leeds Intelligencer 3 July 1918
‘…Yesterday the death occurred at 9, Wellington street, Britannia, Bacup, of
Frances Barlow (15), a mule spinner at a local mill, and daughter of Lce-Corpl
James Barlow, R.E. who is in France. She had been ill only a few days from
pneumonia succeeding influenza. Her two sisters are ill with the same malady.
Patrick Walsh (58), one of the founders of the Bacup Irish Club, died yesterday
from the disease…’
Birmingham Post 6 July 1918
MANY DEATHS THROUGHOUT THE COUNTRY
(reports of deaths throughout the UK includes the following)
Two more deaths following influenza were reported at Bacup, one being a
woman who had been married only a few months. It has been decided that the
Rawtenstall elementary school shall remain closed until August 6.