Spanish Influenza – 100 years on

One hundred years ago this month, as the Great War was coming to an end, another desperate fight was raging. The Spanish Flu is hardly remembered now, but at the time it was globally devastating.

A deadly pandemic

Influenza Pandemic: Mortality in America and Europe during 1818 and 1919.

October 1918 saw a peak in the number of deaths from Spanish Influenza, however it lasted far longer than a month. The Spanish Flu appeared in the spring of 1918 as a widespread fairly mild illness, but returned in the late summer or autumn as a deadly infection, and had one last wave before gradually beginning to peter out in the spring of 1919.

The “Spanish” Flu apparently got its name in the English speaking world from news articles about the disease’s ravages in Spain. The virus was just as common elsewhere but it was under-reported. Countries that were engaged in the Great War did not report the full effects- presumably for fear of undermining morale. Spain, as a neutral country, was able to freely report the truth. The result was a perception that Spain was particularly hard hit. The Influenza was called by other names around the world including La Grippe, the French Flu, and in Spain, The Naples Soldier (Soldado de Napoles) after a popular song which was supposed to be as catchy as the flu!

Point of origin

Experts are unsure where the disease came from, although the trenches of France and an Army camp in Kansas are both possibilities. It is certain that the large numbers of soldiers gathered in camps contributed significantly to the spread of the disease. Wartime conditions that included poor nutrition and inadequate housing also made people more susceptible to the infection. By the end, the Spanish Flu had stretched right around the planet. No one, even on remote pacific islands or in isolated arctic villages was exempt.

A devastating effect

Excerpt from Death Certificate. Source Ancestry Library Edition

In an era before antibiotic treatments the Spanish Flu had a devastating effect because it caused severe infection in the lungs leading to pneumonia, respiratory failure and death. An estimated 500 million people were infected from 1918-1919 and between 20 million and 100 million died.

The virus that caused the “Spanish” Flu was 1918 H1N1 Influenza. In 2009 another H1N1 pandemic outbreak, referred to as the Swine Flu, caused huge concern to governments and health organisations. Fortunately it turned out to be a much less lethal variety than the 1918, having a different mode of infection. The most recent estimates suggest that 2009 H1N1 still killed 284,500 people, mainly in the developing world.

Closer to home

The National Archives, Kew has a letter, dated 28 October 1918, which describes the situation in London. The text reads:

My Dearest Welsh

Just another to keep you going & trust it will find you well again I’m afraid news are somewhat slack as I’ve not received any more letters yet from you dearie but hope to soon.
Things here are in a terrible state this new fleu as they term it is quite a plague & taking people off as they walk along the streets in fact the undertakers cant turn the coffins out or bury the people quick enough there’s families of 6 & 7 in one house lay dead its really terrible dear & makes one quite nervous of going out nearly every house along here the doctors are in constant call but thank God so far we have escaped & I do pray that we shall be spared from having it for your dear sake I had a dose in July & don’t want it any more I’ve not been out with Ruby for nearly a fortnight as she’s been down with Chickenpox but she’s going on O.K. but how she caught [it] is a marvel to me

Reporting around the globe

The full extent of the epidemic in the UK was censored in the press. The international impact, particularly on the enemy, was used as propaganda. While Germany reported that London had become one big infirmary, the Times was quick to report the illness raging in Germany and other “enemy countries” highlighting the effect on enemy production as factory and mine workers fell ill.

Anyone reading these reports would have known that officials in the UK were fighting an epidemic of the same proportions. Preventative measures included closing churches, schools, theatres and cancelling public meetings. Quarantining the sick was also put in place in most communities.

Lasting impact on tackling Public Health

In the wake of the WWI the League of Nations was created and one of its founding purposes was to help fight pandemic diseases such as the Influenza and later the typhus which was widespread in Europe after the war. Public Health measures were introduced or strengthened in many countries in the wake of the Spanish Flu.

Global systems have since been implemented to identify, track and develop vaccines against new viruses that could become pandemics. The World Health Organisation and other bodies operate surveillance systems to detect epidemics. This includes lab networks to identify diseases and staff to track and contain outbreaks. They also develop emergency systems to coordinate a national or global responses. All of these networks monitor diseases that appear around the world and measures are improved and lessons learned from more recent outbreaks such as Swine Flu, HIV and Cholera, Ebola, SARS, and Zika virus