Spanish Flu (1918 – 1920)
There is something inherently tragic about someone who had survived the carnage of the killing fields of any of the theatres of the First World succumbing to what was known as Spanish flu, possibly the deadliest pandemic of all time. It is estimated that up to 500 million people world-wide caught the disease and between 50 to 100 million – between 3 and 5% of the then world population – died as a result. Unusually for influenza most at risk were the previously healthy and young adults rather than the traditional constituency of the disease, the elderly, very young or already enfeebled. The other unusual feature about it is that it struck in the summer and autumn (in the Western hemisphere) whereas “traditional” influenza is normally rife in the winter.
The pandemic earned its moniker not because it originated in the Iberian peninsula but because Spain was neutral and not subject to the level of press censorship that prevailed in other Western countries such as England, France and Germany and so contemporary newspaper reports focused on the impact there rather than on their own populations, in a rather ill-fated attempt to maintain morale. In Spain, though, it was known as the Naples Soldier.
It is thought, although it has by no means been conclusively proven, that the troop staging post and hospital camp in the northern French town of Etaples was the epicentre of the disease and that the original strain of the virus originated in birds and then mutated to pigs which were kept near the Western front.
The symptoms were unusual and so what is now known to have been a strain of influenza was often misdiagnosed as something more exotic such as dengue fever, cholera or typhoid. Often the patient sustained haemorrhaging in the nose, stomach and intestine and bleeding from the ears and from red or purple spots on the skin known as petechia. Some people succumbed to the virus itself, particularly if it caused haemorrhaging in the lung, but most died as a result of bacterial pneumonia, a secondary infection caused by the virus.
If you contracted the disease, you had a 20% chance of dying. No part of the world escaped its ravages. 17 million are thought to have died from it in India alone and there were significant outbreaks in countries as far apart as Japan, the United States, Indonesia, Ethiopia as well as Western Europe with around 250,000 dying in Britain and 400,000 in France. By the time the flu had run its course only an island on Brazil’s Amazon delta, Marajo, could claim not to have had at least one victim.
As we have seen with other pandemics a second wave struck which was much deadlier than the first. It is thought that the movement of troops with the virus from the trenches to civvy street by train and other forms of mass transportation and the general dispersal of troops following the Armistice contributed to its spread. If you had survived the first outbreak you were immune from the second, pointing to the fact that they were the same strain.
Almost as quickly as the virus struck it died out, probably because the virus mutated into a less lethal strain, a feature common with influenza viruses because the hosts of the more dangerous strains tend to die out.
It is possible that one of the consequences of the virus was that it tipped the balance of power in the dog days of the War in the favour of the Allies, the virus striking the Central Powers earlier and mortality rates amongst the Germans and Austrians being higher. It was also a forgotten pandemic because the slaughter on the battle fields made the population immune to the impact of the disease and it did not receive the level of prominence and publicity that it would have had in more normal circumstances.