The worst flu pandemic in history

The Spanish Flu pandemic of 1918 was one of the deadliest disease outbreaks in human history; in recognition of its Centenary and as the northern hemisphere heads into this year’s new flu season, we’re putting the influenza virus under the microscope. The 1918 pandemic coincided with the end of World War 1, which is thought to have catalysed the pace with which the disease took hold. To guide us through what happened that year Georgia Mills was joined by Anglia Ruskin University historian Sean Lang. But why was it called Spanish flu?

肖恩-它’s terribly unfair because it didn’t start in Spain at all; in fact, Spain was no more affected than anywhere else. But because the war was on when it started, for example, among American troops and when it’s underway in Germany of course, they didn’t want the other side to know of a weakness so they didn’t report it. Spain was neutral in the war so there was no particular reason to hold back, and so the first major reports came out of Spain and everyone assumed it started there, which it didn’t.

Georgia - So they were being honest and got all of the blame?

Sean - Absolutely! They did try to blame it on the Portuguese incidentally, but that didn’t stick.

Georgia - How many people did it affect? How far around the world did it spread?

肖恩-它spread absolutely all round the world; every continent. There were major outbreaks, for example, in Western Samoa where the population was absolutely decimated. Alaska, North America, all across Europe. Asia were very very badly affected.

In terms of the number of people who died, there’s a lot of argument about the figures because it’s not easy to get accurate death figures because not everyone kept them. Nevertheless, we reckon it’s about 50 million upwards. The highest estimates were about 100 million - probably 50 to 70 million something like that. Now to put that into context the total number of deaths in the First World War is about 17 million. And, of course, these 50 plus million who die all within the space of a year. In other words, it’s very concentrated compared with the First World War which, of course, is spread over 1914 to 1918. So it’s absolutely devastating and there’s no part of the world really which is immune.

Georgia - So people have just sort of made it through one of the biggest wars in the history of the world and then this hits us?

Sean - Absolutely, yes! You’ve got a lot of the soldiers coming home at the end of the war in November 1918 or thereafter. And so you get people who’ve come home, as you say who survived the war and expecting now to enjoy peace, and of course their families are expecting to have them home after the war, and then the death comes, so it’s absolutely tragic. Of course you do have plenty of people who catch it and survive but, of course, they’re debilitated as well. So it is an absolutely global tragedy - no question.

Georgia - And it’s been mentioned, as pandemics go, is the sort of big hitter, was this linked with the war?

Sean - Yes and no. Clearly there are areas like, for example, the Midwest of America or indeed China where you can’t really blame the effect of war. For example, you haven’t got population weakened by naval blockade or you haven’t got the direct influence of the war. On the other hand, where you do have that, where you have the population in Germany, for example, which is very badly hit and you’ve got a population which is very very badly weakened because of the naval blockade which cut off food supplies, then it clearly seems to have lowered people’s natural resistance to it. So yes, it’s linked with the war but it doesn’t seem to have been caused by the war.

Georgia - Who was affected the worst by the flu?

Sean - Ah, now this caught people out because the medical authorities tend to assume that the obvious candidates would be children or old people. So quite often, for example in Cambridge you have schools shut down or children excluded from places of public entertainment. But actually, and this really caught them out, it was young people apparently in the prime of health who were the most vulnerable, so young men, young, women in their 20s. So it really did catch them out and of course, it meant that the measures they were taking weren't very effective because they were aimed at the wrong people. So yeah, I’m afraid it’s sort of healthy young men and women in their 20s.

Georgia - Uh oh.

Sean - I don’t want to worry you.

Georgia - I’m a little bit worried. Was there any treatment or medicine around at the time?

Sean - Well, because they didn’t really know what was causing it there’s no sort of one effective measure that is taken. There was a sort of vaccination that was used, or at least it was a preparation, and it does seem to have had some success against the cases that were linked with pneumonia, but it didn’t actually affect against the flu. But they tried everything: in Cambridge there was a wonderful thing - I can’t remember the doctor’s name, but his ‘pink pills.’ Take pink pills and you’ll be fine.

A lot of the advice was simply go to bed; quarantine or keep away from other people; keep away from crowded areas; keep the windows open, and my favourite one which I discovered advertised was Bovril. And Bovril actually advertised itself as rendering you influenza proof.

Georgia - How did they get that idea? do we know? Was it just...

Sean - Very good marketing? I suppose it’s the idea that because people tend to think of flu as being like a bad cold. Very often people have got a bad cold and they say they’ve got the flu, which they haven’t. But they got that sort of link in people’s minds. So the idea is that you go to bed with a nice hot drink - it’ll see you through, so I think that’s what’s really going on there.