Pandemic 1918

by Catharine Arnold

  As a soldier, Colonel Soltau was well aware that the epidemic of spring 1918 had significant military implications. Entire units were put out of action; one army brigade of artillery had at one time two-thirds of its strength laid up, and was unable to go into action, though badly needed, for three weeks. In military terms, the killer flu proved to be a blessing in disguise for the Allies. As the German army suffered heavily, Allied Intelligence learned that, according to the colonel, ‘this was one of the factors which caused the postponement of a certain contemplated attack of very critical importance’.16

  Colonel Soltau was one of the first to suggest that troop movements and drafting were responsible for spreading the epidemic. The colonel cited Major Zinsser, of the American Medical Corps, who had argued that ‘a formation of troops may develop a certain immunity to its own organisms, but breaking up and re-distribution of such a formation may lead to epidemics, as such immunized men are brought into contact with other strains of organisms, or take to other formations strains which are new to the latter and therefore not guarded against’.17

  By May, influenza was widespread among French troops, and the military authorities were calling for all outbreaks of la grippe to be reported via telegraph. As the first wave of influenza seemed to be receding in the United States, it was making a spectacular entrance in Europe.

  On 9 May, the 26th Division of the American army suffered a heavy gas shell attack in the midst of an epidemic of ‘Three Day Fever’.18 In the middle of the month, the fever hit the 42nd Division, filling hospitals to the brim. While the majority of soldiers shrugged off the disease, some developed a secondary pneumonia of ‘a most virulent and deadly type’.19 The new influenza proved astonishingly contagious, with 90 per cent of the 168th Infantry Regiment and the sailors of the US Navy Seaplane Station at Dunkirk affected to a greater or lesser degree.20

  By May, influenza had crossed effortlessly over ‘No Man’s Land’ to hit the German army. Known to Germans as Blitzkatarrh, the disease affected 139,000 men during June and peaked in early July. Lasting for four to six days on average, it left troops debilitated and brought the German army to a state of near exhaustion.21 In late June, German commander Eric von Ludendorff noted that over 2,000 men in each division were suffering from influenza, that the supply system was breaking down, and that the troops were starving. As the German high command struggled to replace more than 900,000 casualties, influenza put ever-increasing numbers of German soldiers out of commission. By late July, Ludendorff was blaming influenza for halting the German attack.

  ‘Our army suffered. Influenza was rampant,’ von Ludendorff wrote in his memoirs. ‘It was a grievous business having to listen every morning to the chief of staff’s recital of the number of influenza cases, and their complaints about the weakness of their troops if the English attacked again.’22 Influenza had brought the all-conquering German army to its knees, while the Allies, stricken too, took advantage of their enemy’s weakness to regroup.

  By the end of June 1918, The Times of London reported a successful advance by British troops in the Forest of Nieppe, during which more than 300 prisoners were taken, providing

  confirmation of the tales which we have heard of the prevalence of influenza in the German Army. Reports have been current for some time past that the malady was sufficiently serious to have constituted one reason why the Germans have been so slow in pushing the offensive, divisions intended for the attack being so prostrated as to be unable to fight … They say that the disease is widespread in all departments of the Army.23

  The first wave of influenza also made a significant impact on the Royal Navy, with outbreaks in Scotland at the Navy’s Grand Fleet at Scapa Flow, in the Orkney Islands and at Rosyth in the Firth of Forth, in April.24 According to Surgeon Lieutenant Commander Dudley, influenza had first appeared at Scapa Flow, headquarters of the British fleet, during May to June 1918. The hospital ship Agadir recorded only a few mild cases at this stage among her own ship’s company, with the Grand Fleet reporting that an estimated 10 per cent of men had been struck. According to Surgeon Commander Raymond, the source of infection in May had been traced to the return to the ship of stokers who had been engaged on a light cruiser attending to an oil fuel course where cases of influenza had developed.25 As a result, by 1 July 1918, First Sea Lord Admiral Sir Rosslyn Wemyss was telling Cabinet Secretary Sir Maurice Hankey that ‘the influenza is rife in the Navy [with the result that] many destroyers have been unable to go to sea, so that the loss of several merchant ships is directly attributed to this issue’.26

  In late May, reports had begun to arrive from Valencia, Spain, regarding ‘a disease of undetermined nature … characterised by high fever, to be of short duration, and to resemble grippe’.27 The spring epidemic of influenza had crossed the Alps into Italy and demonstrated its impartiality by appearing in neutral Spain. When ‘a strange form of disease of epidemic character’28 was reported in Madrid, the city responded by closing theatres and stopping trams. The price of lemons, a traditional remedy, spiralled, but the outbreak was not considered serious, with the Madrid daily El Liberal informing its readers on 30 May 1918 that there was no reason for alarm.29

  Even when King Alfonso XIII fell ill after attending Mass in the Palace chapel, and government ministers Miguel Villanueva, Santiago Alba and Eduardo Dato became sick, there was no immediate panic. Poet Juan Pérez Zúñiga scoffed at the outbreak, dismissing it as ‘the fashionable illness’:

  There is no more remedy, sirs

  Than to speak a little

  Of this illness, whose rigours

  Has all of Madrid crazy.30

  Journalist Mariano de Cavia was equally dismissive: ‘What’s the big deal with this silly trancazo that is content with three days’ bed rest and a medicine cabinet?’31

  King Alfonso recovered, and the mysterious new disease was immortalized as ‘Spanish flu’, depicted by cartoonists worldwide as the ghoulish ‘Spanish Lady’, a nightmare lady grinning skull dancing across headlines in a black flamenco dress.

  Thanks to the neutrality of Spain, the progress of the so-called ‘Spanish flu’ was freely reported by the warring nations and could be read about and discussed by doctors in medical journals. This excerpt from the British Medical Journal provides an insight into the questions doctors were asking themselves about the epidemic in Spain.

  The widespread epidemic of an acute catarrhal affection in Spain, which was stated in our last issue to be most probably influenza and attended by little or no mortality, is now reported to have caused 700 deaths in ten days, but if the number of cases has been as large as reported the case mortality must have been very low. The Times of 3rd June quoted Dr Pittaluga to the effect that the disease attacks the respiratory rather than the abdominal organs; that relapses frequently occur within a few days; and that, although the disease is clearly of the character of influenza, bacteriological examination has not resulted in the discovery of the influenza bacillus, but has revealed an organism described as the parameningococcus. It is well known that the Bacillus influenzae is quite commonly absent in cases clinically characteristic of influenza, and that Micrococcus catarrhalis, which has some superficial resemblance to the parameningococcus, is very commonly found. Although, as recent reports of the Medical Research Committee have shown, an epidemic of meningococcus carriers may reach a very high percentage amongst contacts, we are not cognizant of any previous outbreak of cerebro-spinal fever in any degree comparable in extent to the epidemic in Spain. Before coming to any conclusion it is obvious that further bacteriological information must be awaited.32

  Dr Gustavo Pittaluga, Chair of Parasitology and Tropical Pathology at the University of Madrid, was one of the first doctors to argue that the new disease was not influenza at all. ‘The epidemic we’re suffering from differs from grippe for the following fundamental reasons: (a) because the set of symptoms is much more uniform … (b) because of the near constant absence of bacterial forms identifiable with Pfeiffer’s b
acillus, the pathogen that causes influenza.’33 Pittaluga’s comments, and the responses of his ‘most vocal antagonist’, Gregorio Marañón, who was convinced that what they were dealing with was influenza, constituted the early salvos in a medical controversy which raged for longer than the epidemic itself.

  Initially, many Spanish journalists dismissed the impact of the influenza epidemic as negligible, while others were more guarded. The commentator Antonio Zozaya, writing in the same newspaper two days later, reminded his readers that life possessed greater threats than the influenza outbreak, on a daily basis. Citing the dangers of public highways, railways and even suicide, he nevertheless conceded that the epidemic was serious and urged his readers to take a stoic approach: ‘The epidemic has arrived. It’s an unpleasant contingency. We do not find ourselves more oppressed or helpless in this merciless valley because of it. Let us try to live prudently, to proceed as good people do and suffer with dignity.’34

  Meanwhile, grim scenes were being enacted in Spain that would become familiar across the world in the months to come:

  A funeral that was making its way along a central street saw, to the amazement of those who witnessed it, the coach driver fall from his seat to the ground dead, as if struck by lightning, and one of the mourners keeled over on the ground, having also died suddenly; panic gripped the others who were part of the procession and they scattered, leaving the coach abandoned. An ambulance had to come collect the dead and a municipal guard tied a cord to the horse’s bridle and walking ahead some twelve meters pulled the coach to the cemetery.35

  CHAPTER FIVE

  ONE DEADLY SUMMER

  THE ‘SPANISH LADY’ had already set foot at Scapa Flow in May 1918. Later that same month, she arrived in the Scottish dockyards, causing three deaths on ships moored in Glasgow harbour. The slums of Govan and the Gorbals in Glasgow swiftly succumbed to an eight-week influenza epidemic, with the Glasgow Herald reporting thirteen deaths from influenza and twenty-six from pneumonia on 17 July. A week later the toll was even higher: fourteen deaths from influenza and forty-nine from pneumonia.1

  As Spanish flu travelled south from Scotland, homecoming military personnel also brought the disease home with them. Influenza arrived in Portsmouth and other Channel ports, and was carried on to London, Birmingham and the northern cities of Leeds, Manchester and Liverpool, and west towards Bristol and Cardiff. In July 1918, nearly 1,000 of 3,000 German prisoners of war interned at Bramley Camp, Hampshire, were reported to be ill,2 and had to be taken to nearby civilian hospitals.

  One famous victim of the Spanish Lady’s arrival in Britain was Mrs Rose Selfridge (1860–1918), Chicago-born wife of Harry Gordon Selfridge, founder of the eponymous department store in London’s Oxford Street. When the family moved to Highcliffe Castle, Dorset, in 1916, this energetic, active woman joined the Red Cross along with her two oldest daughters. Following a stint nursing at nearby Christchurch Hospital, Rose had opened a convalescent hospital for American soldiers at Highcliffe Castle after the United States joined the war. According to Hayden Church, an American reporter who visited Rose at Highcliffe, she was very enthusiastic about her hospital. ‘The Christmas gift of this American business man to his wife was a perfectly equipped convalescent camp,’3 wrote Church.

  The former cricket pavilion with thatched roof that must be over a century in age has been transformed into an office for the commandant and into a kitchen and cheerful dining room, in which the convalescent ‘Sammies’ take their meals. The huts in which they live number 12, with quarters for two men in each, and each of these huts whose open side is protected against the elements by a thick rubber curtain, which is mounted on an axis in such a way so that it may always face the sun. Then there is a recreation hut provided with a gramophone, games, books, maps, writing material and other things to make the men who use it comfortable. Lastly, there is another building known as the ‘Medical Ward,’ which provides quarters for the permanent American non-commissioned officer who is responsible for the discipline of the camp and which also houses the linen room and the men’s bathroom.4

  Tragically, Rose developed influenza herself, as a result of her nursing duties, and contracted pneumonia. Rose Selfridge died on 12 May 1918 and was buried in the churchyard of St Mark’s church at Highcliffe, near the castle.5 Rose’s widower, Harry Selfridge, continued the work at the convalescent camp, in her honour.

  * * *

  WHILE SPANISH FLU had insinuated itself into Britain by a number of points of entry, the North was initially hit hardest, particularly the northern industrial cities.6 The silent menace travelled undetected through shops, businesses, public transport and person to person, before gradually spreading out into rural communities. In Newcastle, labour was becoming scarcer by the hour as up to 70 per cent of employed men fell sick, while Durham also suffered an outbreak. At a time of coal shortages, when Britons were being exhorted to burn as little fuel as possible to conserve stocks for the war effort, mineworkers appeared susceptible to developing secondary respiratory infections. According to The Times, coal-miners were particularly prone to attack by influenza, while the Nottinghamshire press reported that ‘in Northumberland and Durham the rapid spread of the disease is seriously affecting the collieries, in some cases 70 per cent of employees being off work’.7 In Nottinghamshire itself, ‘a number of employees from the Digby Collieries … had to be taken to their homes suffering from the malady’.8 Nottinghamshire collieries were struggling, 250 men succumbing to the infection at the Mansfield pit in one day.

  On 22 June 1918, The Times reported that influenza similar to that being experienced in Spain had appeared in Birmingham, resulting in critical labour shortages in the munitions factories and ironworks. ‘Birmingham was the first provincial city to experience a sudden and sustained rise in influenza mortality with deaths also occurring in neighbouring Wolverhampton and Coventry at about the same time.’9 Two weeks later, influenza appeared in South Wales: The Times reported that there were hundreds of influenza cases in the Monmouthshire collieries.10

  In Lancashire, one textile house employing 400 workers was reduced to making do with just 100, as three-quarters of the workforce was laid up.11 In Sheffield, the Yorkshire Telegraph reported that 15 per cent of employees were off at one factory, and there was a run on quinine. As the body count rose, Sheffield’s deputy town clerk appealed for gravediggers. ‘People are lying dead in their houses seven days, and sometimes nine. The position is very serious indeed.’12 Fearing that the disease was caused by soldiers home on leave, Sheffield’s council banned military personnel from cinemas and other places of entertainment.

  Influenza hit the East Midlands at the end of June, wreaking havoc on factories and coal mines. The local press reported that the infection was prevalent in Derby and affecting work and education, although it was thought to be only a mild form of the disease. At the beginning of July, the Leicester Mercury stated that there were already ‘a considerable number of cases of the new influenza’ in the town and even one fatality, a nineteen-year-old woman.13 The following day the same newspaper announced that ‘The influenza epidemic has reached North Nottinghamshire where there are many hundreds of cases.’14 The Loughborough Herald carried a similar story but also indicated that there did not seem to be cause for great anxiety: ‘There are further reports of the spread of influenza in many parts of the Kingdom, and in the large towns especially … Some fatal cases have occurred, but it is the opinion of the medical Officers of Health … that the epidemic, though so widely prevalent, is for the most part of mild type.’15

  But by 11 July the Herald’s mood had darkened, with reports of several deaths from influenza in the village of Barrow upon Soar, three deaths occurring in one family.16 Thirty miles north, in Nottingham, the Nottingham Journal stated: ‘As far as this country is concerned the epidemic continues to be more severe in the Midlands and the North than elsewhere … Although it cannot be said that the malady is present in Nottingham in grave epidemic form, there are
nevertheless quite a number of cases.’17

  As reporting continued on the progress of the influenza pandemic across the county throughout July, it was clear that the situation was much worse than had originally been thought; reports of deaths and disruption began to fill the newspapers. Under the front page headline ‘The “Flu” Scourge: Extension of its Ravages Locally’, the Nottingham Journal and Express declared it to be spreading across Nottinghamshire and Derbyshire and spoke of deaths in Derby and Lincoln, the closure of schools, delays in carrying out important work and victims collapsing in the street.18 In the Leicester press, the report of the death of a woman showed how quickly the disease could overtake a victim: ‘A doctor was stopped in the street by a woman who said she was suffering from influenza and while he was talking with her she collapsed and died almost immediately.’19

  The Spanish Lady arrived in Salford, Greater Manchester, in late June. The Salford Reporter, 25 June 1918, announced that ‘the epidemic of influenza has reached Salford and if it is not of the old “sneezing variety”, it is very prostrating. Hundreds of cases have occurred in the borough during the week, and doctors are extraordinarily busy.’20 The paper instructed its readers to go to bed as soon as they started to experience the symptoms and included an interview with a doctor who commented: ‘If you get about and try to shake it off it becomes much worse.’21

  Over in Manchester, resourceful Chief Medical Officer of Health Dr James Niven tackled the influenza epidemic with a formidable mixture of clinical experience and public information. Niven had experienced epidemic influenza before. In 1890, Niven had been working in Oldham when the city was hit by an outbreak of ‘Russian flu’. Niven’s prompt response, ordering isolation for the sick and cleansing of infected premises, undoubtedly saved lives, and when ‘Russian flu’ returned to Oldham in 1891 and 1892 the city fared better than its neighbours. In June 1918, Niven responded with the same tactics, having 35,000 handbills printed and distributed to local factories and businesses, with information and instructions in clear plain English. Niven also recommended that any infected individuals should quarantine themselves for three weeks before returning to work, to prevent the further spread of influenza. On 18 July 1918, Manchester’s education committee agreed to close all the schools on Niven’s recommendation after the shocking news that children had died at their desks, ‘like a plant whose roots have poisoned, the attack being quite sudden, and drowsiness a prominent symptom’.22