HOW THE SPANISH FLU TOOK A DEADLY GRIP ON THE WORLD

THE GLOBAL Spanish Flu outbreak of 1918 killed 50 million people worldwide, more lives than were lost in the First World War.

More people died of influenza between 1918 and 1919 than in four-years of the Black Death Bubonic Plague from 1347 to 1351.

The Spanish Flu pandemic was widely held to have started in Kansas, in the USA, when an army cook reported sick with a volatile form of influenza on March 4, 1918. The outbreak went on to kill 48 soldiers at the base within a short period of time before spreading its deadly tentacles further afield and with alarming speed and ferocity.

It killed primarily healthy young adults, frequently within 24 hours of the first symptoms developing.

Yet more than 100 years on, its origins are still opaque. The truth is that no one really knows how it started, just as the cause of the current Coronavirus outbreak is still opaque.

In Ireland, Spanish Flu claimed 23,000 lives and infected some 800,000 people before it ran its course, many of the victims soldiers who had fought on World War One battlefields and people they infected on their return from war.

Spanish Flu was so named because unlike the warring countries which censored the Press, Spain was neutral and more free to report about the killer outbreak.

The US and European Press simply did not acknowledge or carry accurate and contemporary reports about the number of casualties among their military and civilian populations.

While its origins may be disputed, there is no doubt that British and Irish troops brought the Spanish Flu home with them when they returned from the war although how it reached the blood-soaked trenches is not clear

The earliest verifiable record of its arrival in Ireland can be found in US naval archives, which document an outbreak on the docking USS Dixie, outside then Queenstown (Cobh), in May 1918.

On June 12, 1918, History Ireland says the Belfast Newsletter reported that the city had been struck by a mystery illness resembling influenza. By the end of June there were reports that it had reached Ballinasloe, Tipperary, Dublin, Derry and Cork.

By mid-July the first wave had abated only to be followed by an even more lethal outbreak.

The second wave, from mid-October to December, was the most virulent of the three; and, as in the first wave, Leinster and Ulster were worst affected

In his study ‘Ireland and the great flu epidemic of 1918’ John Dorney says the symptoms of the first, or milder flu, were lack of energy, aching pains, rising temperature, unstable pulse, sore throat, headaches, loss of appetite, gastro-intestinal pains, immobilising a person suffering from the disease.

The symptoms of the second type were similar to the first ,but a patient quickly developed pulmonary complications, their lungs became infected and bronchial pneumonia, or blood poisoning, set in.

At times the patient turned purple, or even black – leading to the disease being widely nicknamed, ‘the black flu’.

On June 20, 1918, the Irish Independent reported that ‘a mysterious scourge was spreading, the Freeman’s Journal described it as the ‘the advance guard of an invasion of disease.’ A shortage of gravediggers in Dublin meant coffins being stacked 18-high in the Union Hospital mortuary.

The top scientists of the day considered the disease was carried by bacteria and was no more deadly than the Russian Flu of 1889-92. Consequently the authorities did not make it ‘notifiable’ until the third outbreak in spring 1919.

Only in 1933 was it identified as the avian flu H1N1A.

In 1918 in Dublin, 9,008 births and 9,397 deaths were recorded. There were 1,506 deaths from influenza and 1,140 deaths from flu-related pneumonia.

The influenza epidemic in Ireland as elsewhere in the world killed too many of its hosts too quickly for it to reproduce itself effectively and by the summer of 1919 it had burned itself out, leaving no more trace since its coming than tens of thousands of freshly-filled graves.

There was no cure, although there were plenty of ‘remedies’ ranging from lozenges made from formaldehyde (embalming fluid) and lactose, snuff, towels soaked in vinegar, soda and sugar in a glass of hot milk, a strong dose of whiskey and ginger and even disinfectant.

The medical profession were at a loss to how to deal with what had quickly become a pandemic.

In Ireland, there were some forward thinkers, but nothing could hold back the spread of the virus,

Medical professionals such as Kathleen Lynn, a doctor and a member of socialist republican group the Irish Citizen Army, called for returning soldiers to be quarantined, their uniforms disinfected.

Lynn had joined the Irish Citizen’s Army during the 1916 Rising and was appointed as Captain and Chief Medical Officer and spent time in Kilmainham Jail for her revolutionary activities, but was released following the intervention of Dublin’s Lord Mayor to help fight the Spanish Flu epidemic.

While Ireland suffered 23,000 deaths, the numbers of fatalities here was relatively small when compared to other parts of the world caught up in the outbreak.

The US-bases Centres for Disease Control (CDC) describes the 1918 pandemic as the most severe pandemic in recent history.

‘It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated.. it is estimated that about 500 million people or one-third of the world’s population became infected with this virus.

‘The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.’

Our closest neighbour, the United Kingdom, suffered 228,000 deaths, with a quarter of the population being affected.

More than 250,000 people died from the flu in Spain, the disease probably transmitted there as a result the heavy transport in migrant workers from France and Portugal.

However, the numbers of those killed by the flu in Europe and the USA is dwarfed when compared to the 18 million Indians who died from it.

The CDC says that with no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly.

A report by Stanford University says the epidemic was so severe that the average life span in the US was depressed by 10 years.

‘The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years.

One physician writes that patients with seemingly ordinary influenza would rapidly ‘develop the most viscous type of pneumonia that has ever been seen’ and later when cyanosis appeared, ‘it is simply a struggle for air until they suffocate.’

Another recalls that the influenza patients ‘died struggling to clear their airways of a bloodtinged froth that sometimes gushed from their nose and mouth.

Historians have suggested that the Spanish influenza mutated and became most deadly in spring 1918, spreading from Europe to ports as far apart as Boston and Freetown, Sierra Leone, and as far as the Arctic and the Pacific.

For the last decade, experts such as Jeffery Taubenberger, of the National Institute of Allergy and Infectious Diseases, have sought burial samples across continents, seeking to find preserved samples of the virus in victims of the outbreak in a bid to better determine its origins, but to this day Spanish Flu is still a deadly enigma.

* First published in Ireland’s Own magazine