Tag Archives: Influenza

Spanish Flu: H1N1 has an older brother

Reconstructed_Spanish_Flu_Virus

The reconstructed flu virus of 1918. (Author: Unknown; Source: here)

‘This is the event we’re all scared might happen at any time, … We’d be faced with an event worse than the 1918 Spanish flu pandemic.’ Neil Ferguson

Spanish Flu: H1N1 has an older brother.

‘World War I’ or ‘The Great War’ of 1914-18 was, understandably if a little mistakenly, called, ‘The war to end all wars’. An unprecedented number of people, both soldiers and civilian, died in the fighting during those fifty months from late July 1914, the usual estimate being about sixteen million. On average, that meant just over 10 000 deaths for each day of the conflict, or one every eight seconds. Such numbers may be almost meaningless as they distract us from the significance of the horror itself but they do in some ways offer some idea of the scale of that conflict which was so central to the development of the century itself. Everyone knows something of the war, its causes, its impact on those who fought and its significance but far fewer people are aware of the way that further tragedy reached out from the trenches as the conflict ended. Just as many were celebrating the return of victorious troops and others were seeking revenge and retribution in the light of defeat, an event was beginning to unfold which would take the pain and suffering from the Western front straight into villages and homes around the world. From New York to New Zealand, from Stockholm to Samoa, the suffering would continue and millions more would indirectly become victims of the war which had begun following those assassinations in Sarajevo in June 1914. The cause of all the trouble was ‘influenza’ and the outbreak goes by the name ‘Spanish flu’ – and it was bad.

   SpanishFluPosterAlberta

One of the many posters announcing the danger of ‘Spanish flu’ after the Great War. (Author: Unknown; Source: here)

 Today, there are a few specialists who are studying ‘Spanish flu’ and the tragic events of the post-war period. Their research has taken on some urgency in recent years as the world prepares itself for what most scientists predict is both inevitable and overdue, namely, the next world wide outbreak of flu, the full-blown successor of one of the worst epidemics in recorded history. No one really knows the true numbers involved but it is estimated that ‘Spanish flu’ killed at least 50 million people around the world between March, 1918, and June, 1920; some estimates put the deaths at 100 million. It should be remembered that this happened at a time when the total population of the world was about 1.8 billion, so the lower figure of 50 million casualties would give an equivalent number today of 190 million, about the same as the population of Brazil. That lower figure would mean that over 3% of the world population died, not on the scale of ‘Black Death’ in 1347-50, when between a third and a half of all Europeans died, but still a pretty astonishing number. There were at least three times as many deaths as in the Great War and they happened in about half the time, giving a death rate six times greater than that in the war; in other words, at least one person died every second because of the epidemic.

Unlike ‘Black Death’ which for most people is not a relevant threat today, despite a few deaths in places like Vietnam, Madagascar and Russia, flu most certainly is a concern. It doesn’t excite people, and especially students, in quite the way that the gory horrors of bubonic plague do, but flu has the potential to unleash nature’s full force upon humanity. It is for this reason that scientists and medical experts are on almost constant stand-by as they monitor developments in outbreaks of flu, most of all for those that start in animals and birds, looking for how they can be transmitted to humans. They give the outbreaks that have raised concerns such dull, technical names as H1N1 or H5N1, but they are reported as ‘Bird flu’ or ‘Swine flu’, cousins of ‘Spanish flu’. The world usually experiences such an outbreak of flu, a pandemic, once every 50-80 years or so; there has been no such outbreak since 1920, so many people predict such an event has to be on the horizon. Many people get concerned about the super-volcano at Yellowstone National Park but, to be honest, they should probably be less concerned about that going up than the flu virus mutating. Sorry.

But, anyway, what happened in the last flu pandemic – and why was it called ‘Spanish flu’? The name of flu epidemics is normally based on the place where the first significant outbreaks were recorded, and in 1918, this meant Spain. The outbreak had actually killed people in France before it got to Spain but it received more attention in the newspapers when the deaths there were reported. That is more than a bit harsh on Spain, though, as research has shown that the outbreak should certainly not be called ‘Spanish flu’ nor, in fact, ‘French flu’ because it really takes us back to the war itself; it should really have been called something like ‘Western Front flu’ or ‘Trench flu’.

CampFunstonKS-InfluenzaHospital

Victims of ‘Spanish flu’ were often treated in improvised hospitals and in over-crowded conditions like this in Kansas, USA. (Author: Unknown US Army Photographer; Source: here)

The research done over the years provides the evidence which shows that there was an initial outbreak of this flu in the trenches of the Great War in 1916 or so, after which things went quiet for some time. This was a classic example of how the flu virus exists or operates, if you like, with a relatively small outbreak followed by a quiet period when the virus seems to have disappeared but is actually still around but mutating. Some months later, the virus re-emerges and in the case of ‘Spanish flu’, this happened right at the end of the war; the timing could hardly have been worse. As the fighting came to an end in November, 1918, soldiers were keen to get home and politicians were keen to send them there, and so off they went, moving from Europe to countries around the world: Australia and New Zealand, India and China, the USA and Canada, many parts of Africa and most of Europe.

The end of ‘The war to end all wars’ was perfect for the flu virus and it was unleashed on every continent, carried home by the troops as they celebrated victory or survival, spreading easily amongst them as they were living so close to each other on ships and trains. Many of them lived in crowded housing at home, passing the virus on to their families and so the disease spread with devastating speed and frightening consequences. Without realising it, they were taking a far greater danger home than the one they had survived. As many as 60% of people in some countries caught the disease and, as mentioned, over 3% of the world’s population died. The death rates were huge: in Britain, 250 00 died, in France it was 400 000, in the USA at least 500 000. In India, unconfirmed statistics suggest as many as 17 million people died, as many as the total deaths in the Great War. In some communities which had no immunity to flu, the death rates were far higher, reaching over 20% in islands like Samoa in the Pacific Ocean, some 10 000 miles away from the trenches.

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Burials of flu victims on Labrador, Canada, in 1918. (Author: Unknown; Source: here)

Thanks to some astonishing scientific work, we actually know just what the flu virus of 1918-20 was like as it has been found in the remains of people buried in the icy wastelands of Alaska and other places inside the Arctic Circle. On Spitsbergen, for example, which is to the north of Norway, seven coal-miners died of ‘Spanish flu’ and like many others, they were buried in shallow graves on the island. Their bodies were perfectly preserved in the frozen ground, allowing them to be removed so that scientists could study the virus and learn from the way it mutated. The story of what happened in the outbreak is understood very well – and it carries serious warnings from history. Hopefully medical science will be able to offer better protection than that available after the Great War but despite the extraordinary developments seen in medicine and technology since 1920, the next flu pandemic will come and there will be casualties; keep your fingers crossed.

 

Find out more

Books: ‘The Great Influenza’ by John M. Barry (Penguin, 2009); ‘Living with Enza’ by Mark Honigsbaum (Palgrave MacMillan, 2008); ‘Flu – A Social History of Influenza’ by Tom Quinn (New Holland Publishers Ltd, 2008)