The Greatest Plague in History
As Britain prepares its defences against swine flu, Chris Paton takes a look back at the devastation caused by one of its fiercest ancestors
It is a fact of history that the most successful aggressors ever to wage war against the British population have never been the bullets and bombs of a foreign power, but deadlier enemies at the microscopic level. For centuries all manner of plagues have visited these shores, including smallpox, bubonic plague and cholera, but nothing could prepare Britain for a final sting in the tale at the end of the First World War.
Spanish Flu was a deadly influenza virus which unleashed itself upon the world in 1918 with a terrible vengeance. In India alone it killed more people within the country in a single year than the world suffered casualties throughout the entire war, and more people died from it across the planet than during the Black Death of the mid 14th century. For the first time in Britain since civil registration began in 1837, the death rate in the country from 1918 to 1919 surpassed that for births.
The virus first appeared in the trenches of France in the spring of 1918, and was initially mistaken for pneumonia by the malnourished and battle weary troops. Soldiers complained of fever like symptoms, headaches and sore throats, but whilst a few died, most recovered within a few days, giving it the disarmingly innocent name of ‘the three day fever’. By the summer the situation had deteriorated, with sufferers from the mystery ailment now dying in great numbers. Symptoms accelerated from mild headaches and dizziness to coughing fits and nosebleeds, coupled with a change of skin colour in the face caused by what became known as ‘heliotrope cyanosis’, where the lungs filled with fluid and deprived the victim of oxygen. As death soon followed, the new name of ‘Blue Death’ was given to the affliction.
With heavy restrictions on reporting in the countries at war, it fell to neutral Spain to freely report the sudden onslaught of this strange new epidemic, which affected everyone from the ordinary man on the street to King Alphonse XIII. Quickly identified as a new strain of influenza, the press dubbed the virus ‘Spanish Flu’; many years later it would be reclassified as the H1N1 flu strain.
Far from originating in Spain, it is believed that the first known patient to contract the flu was a cook named Albert Gitchell at an American army base in Kansas, picking it up from poultry at the fort, though it likely had an earlier Chinese origin. With the United States having entered the war in 1917, the virus easily found a gateway to Europe a year later, arriving at Brest and Bordeaux, and within months it had affected the world population as far field as India and Japan.
On the British lines some 226,000 soldiers fell ill from May to August 1918, with a further 87,000 incapacitated by the end of the war. Many were sent to the military hospital camp at Etaples, but rather than facilitating a recovery, the camp, a busy hub at the heart of Allied operations, became a breeding ground for the pathogen which found rich pickings from the thousands of people presented for treatment for various war inflicted injuries. By June the British naval fleet at Scapa Flow had also succumbed, but by now the viral assault on mainland Britain had already commenced.
The flu hit the British population in three waves. The first mild attack occurred from March to August in 1918, the second and deadliest wave hit from September to December, and the third and final during the first half of 1919.
Glasgow saw the first major civilian outbreak in May, with the virus imported into the city’s harbour, spreading beyond Clydeside to the slums of the Gorbals and Govan. During the eight week outbreak there were few deaths, with most fatalities in fact caused by pneumonia which followed infection. By July, collieries in Newcastle were experiencing seventy per cent absentee rates, and up to a quarter of the Lancashire mills workforce was incapacitated. In Manchester the situation was soon so serious that all schools were closed on July 18th, but here too the mortality rate was equally low, with just 322 deaths out of 100,000 cases. At Bramley in Hampshire, a thousand German prisoners of war had to be taken to civilian hospitals within the area for treatment.
Whilst previous experiences of epidemics informed local medical officers of the need to isolate cases as quick as possible, there was no overall Ministry of Health to co-ordinate a response, it not being established until 1919. As such, the quality of care across Britain varied, as officials in town halls sought desperately for information on the mystery illness. But with the severity of the virus not yet realised, the population considered it as nothing more than a serious nuisance, advised by their local doctors to rest and to take quinine to relieve any symptoms.
Unlike the normal seasonal flu which had been in the country for centuries, Spanish Flu was different in that it did not discriminate by age, hitting young adults particularly hard. The initial mild wave had ironically helped in many ways to protect part of the population, allowing them to develop a degree of immunity prior to the more virulent wave about to be unleashed. By August, the flu threat appeared to be receding, but on September 12th the Prime Minister Lloyd George was suddenly infected and forced to cancel many engagements, showing that the reports of the virus’s retreat were perhaps too optimistic.
On the war front, the tide had now switched to the Allies’ favour. Following the Amiens offensive of August, the German advance had been reversed, but as the Allies took advantage of the turn of events, disturbing medical reports of new wave of flu were beginning to surface in army camps in northern France. The situation escalated dramatically with a massive outbreak on September 8th at Camp Devens near Boston in the United States. Soldiers admitted for hospital treatment were within hours of arrival developing cyanosis, coupled with a severe attack of pneumonia. Within a month 14,000 men had been admitted and over 750 had died, and many began to speculate that the Germans had launched some form of germ warfare on the American homeland from hidden U-Boats off the coast. An American troop ship carrying 9000 men to Europe fell to the new strain, and soon after arriving at Brest, hundreds of the soldiers were dead. Within days the virus had spread throughout the Allied ranks and had infected the German Army.
As before, it was Glasgow that first recorded the onslaught of this new strain in Britain, with the city’s medical officer noting in the Glasgow Herald of October 3rd that there had been 66 deaths from flu and a further 65 from pneumonia, the new wave having been imported from another American troop ship docked at the Clyde. This escalated to 450 deaths just nine days later. London soon followed, recording almost 95 deaths a day. This second wave of influenza was clearly much more devastating than the earlier attack, and panic began to hit local authorities, with Cheltenham College for example locking its children within the building to prevent them from entering the town. By the end of October over 1400 policemen in London were afflicted, and the hospitals were brimming with patients.
The newspapers of the time did their best to offer useful advice. On November 3rd, the News of the World suggested people should wash the inside of their noses with soap and water each night, to force themselves to sneeze very morning and night, and to “eat plenty of porridge.” In some towns the streets were sprayed with chemicals to try to disinfect them, and smoking bans were listed in factories, with the belief that tobacco smoke could stop the virus transmitting. On November 5th, the director general of the Army Medical Services in France received a letter from the War Office suggesting that an increase in fats within the diet might help malnourished British troops, suggesting that “bacon should be issued with breakfast at least three times a week, and that dripping should be utilized as much as possible.”
By early November virtually every village and town in Britain had endured an outbreak, with 200 deaths a week in Sheffield, and 1500 a week in London alone. The Local Government Board could do little more than advise people to stay in bed if they became infected, and the British Red Cross was stretched to breaking point, with many nurses paying the ultimate price for their efforts to help. To make matters worse, the end of hostilities in Europe on November 11th saw many impromptu street parades and victory celebrations, which only added to the problem, with the public openly congregating and freely spreading the pathogen. Manchester, which had escaped the second wave up to this point, saw a sudden dramatic escalation in the death rate within a week of the Armistice celebrations, and soldiers from the Labour Corps were soon detailed to help with the burial effort. By the end of December, the second attack had mercifully receded.
The first signs of a third wave began to appear in late December 1918, as hundreds of thousands of demobilised British servicemen returned from Europe, with the war now over. As the winter chill set in and snow hit the streets, by February 1919 it was clear that Britain was once more in the grips of an epidemic of deadly proportions. Handbills were printed and distributed warning that the virus could be spread by coughing, sneezing and even speaking to other people. Despite its ferocity, this third attack was not as severe as the previous, but that was cold comfort to those who continued to lose their lives.
As disturbing as the resurgence of flu was a wave of suicides in the country, with many suffering from the virus taking their lives, including many doctors who had despaired at the levels of mortality being dealt with on a daily basis. In fact these mental health effects of the flu were soon recognised as ‘psychoses of influenza’, and found to be caused by the virus attacking the nervous system.
By the time the third wave had ended, 5000 more Londoners had died, and a further 1000 in Manchester. Ironically, many of those who had developed an immunity to the second wave after the first hit them in the previous year had little protection against the newly mutated third form of the virus. There were further additional cases beyond the three waves, but by mid 1920 the mystery flu had finally disappeared as silently as it had first arrived. The total number of those killed in Britain by all three waves was 228,000, with hundreds of thousands more spread across the British Empire. Today the H1N1 virus strain still exists, but is found only in pigs, with humans having long developed an immunity.
Whilst the 1918 pandemic was a terrifying experience at the time, it has become Britain’s forgotten plague, with the military sacrifices of the First World War dominating the history books, and no memorials stand for those who lost their lives to it. But for those who survived the flu, it was a tragic experience that they would never forget for the rest of their lives.
COMMENT: For a superb account of the Spanish Flu pandemic, read Mark Honigsbaum's Living With Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918 (Macmillan, 2009) available on Amazon at https://www.amazon.co.uk/Living-Enza-Forgotten-Pandemic-Macmillan-ebook/dp/B0023ZLNNS/.
Chris
My next 5 week Scotland 1750-1850: Beyond the OPRs course starts May 4th - see www.pharostutors.com/details.php?coursenumber=302. My next book, Tracing Your Scottish Family History on the Internet, at http://bit.ly/ChrisPaton-Scottish2 is out shortly, also available are Tracing Your Irish Family History on the Internet (2nd ed) at http://bit.ly/ChrisPaton-Irish1 and Tracing Your Scottish Ancestry Through Church and State Records at http://bit.ly/ChrisPaton-Scotland1. Further news published daily on The Scottish GENES Facebook page, and on Twitter @genesblog.
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