…and in Flew Enza!

in flew enza
A Children’s Skipping Game during the Great Flu Epidemic

As we now reach the 100th anniversary of the Great War’s end we should not overlook another equally devastating, natural disaster which was about to cut down those who had survived the worst years of the fighting – influenza.

At the AGM, Tony Foster from Darwen Heritage Centre provided an excellent introduction to the topic, especially as it related to the area of Lancashire where probably the majority of Entwistles then lived. It inspired me to read more widely about this tragedy, especially a recently published account by Laura Spinney[1].

This is a topic that has emerged from our collective memory of World War I over the last 20 years or so. With a death toll of between 50 and 100 million people across the world, the flu pandemic of 1918 was one of the greatest human disasters of all recorded history. Scientists have studied tissue samples from 1918 victims, including the frozen corpse of an Inuit woman buried in Alaskan permafrost and have managed to sequence its entire genome. Their findings suggest it may have originated in birds and a mutation may have allowed it to spread to humans. It killed far more people than both the 1st and 2nd World Wars, yet it is only relatively recently that it has been much talked about, written about and analysed. Both my own parents were alive then, but I don’t recall them ever talking of it.

The beginnings

When first noticed in early 1918, the symptoms were relatively mild, little worse than a common cold. Soldiers in the trenches complained of sore throats, headaches and lack of appetite.  It was highly infectious in the cramped conditions in the trenches but seemed to clear up within a few days and military doctors were not worried. There had been similar outbreaks in 1916 and 1917, especially in the crowded encampments at Étaples in France, possibly caused by contact with wild birds flying over the Somme estuary, or the pigs and poultry farms that had developed in the neighbourhood to feed the troops. Étaples also had several hospitals where soldiers were evacuated for treatment after being gassed on the battlefields. Other theories point to the outbreak originating in Fort Riley, Kansas, USA, where there were 100 victims in one morning, then being spread to Europe via the soldiers of the American Expeditionary Force.

The earliest mention in UK newspapers seems to have been in the Times edition of 24 May 1918 where there was a brief report of US airmen arriving in Europe and another brief report of a new disease that had appeared in Madrid. This was initially very mild, influenza with some gastric disturbance but the virus quickly mutated. Just three days later the outbreak was reported as being very serious with Alfonso XIII, the King of Spain critically ill. Thus, it became known as ‘Spanish’ flu, probably because Spain was a neutral nation in the War and newspapers there were able to report the outbreaks.

In the UK the first cases seem to have appeared in Glasgow in May 1918, spreading south by June when there were reports of outbreaks in Belfast, South Wales, Rochdale, Bury and Manchester. The authorities tried to claim this was scaremongering, just a bad cold, not flu. Not like the ‘Russian Flu’ of 1889/90. In this first outbreak the number of deaths due to the ‘three-day fever’ was low and the Blackburn Telegraph reported “While there are many cases in Blackburn the town is not suffering apparently so severely as some other centres.” Nevertheless, on 30th June seven members of the borough’s police force reported sick (next day the number rose to sixteen) and the wife of a local J.P. was struck down; taken ill on a Friday, by Sunday Mrs Peel was dead. [2]By 6 July the Blackburn Telegraph was recommending its readers to avoid crowds and have good ventilation. The newspapers carried daily reports of the outbreak, but it wasn’t until mid-July that the local area was badly hit. The Hoddlesden pipe works was forced to close and mill owners in Darwen reported hundreds of workers sick; supplies of medicines began to run out at chemists and suddenly the death notices in the newspapers were of young people as, unusually, most of its victims were aged 25-40.

Things worsen

In September the British Prime Minister, Lloyd George, visited Manchester to be presented with the keys of the city and to celebrate recent Allied successes. On the evening of his arrival he developed a sore throat and fever and collapsed. For the next ten days he remained in Manchester Town Hall, attached to a respirator and too ill to move. Newspapers played down the severity of his illness to maintain morale, but it seems to have been very serious. Traffic was stopped in the area around the Town Hall and Lloyd George was eventually returned to London by taxi, attached to a respirator. He survived. Many others did not.

There were three waves of the epidemic. Even during the first wave it was reported that children were collapsing at their desks. This first wave broke over an exhausted, beleaguered populace and then it withdrew. Most of those who fell ill in the spring of 1918 suffered little more than the symptoms of ordinary flu – sore throat, headache, fever, but then recovered. Just as the survivors were beginning to pick themselves up, it returned in even greater strength, becoming more sinister, killing more quickly and more violently. The flu itself was worse and was more likely to be complicated by pneumonia. It was, in fact, bacterial pneumonia that seems to have caused most of the deaths with people drowning ever more swiftly in their own blood as their lungs were laid waste. Their complexions turned purple then black. Delirium was common.

news article Darwen flu deaths
Spanish flu in Darwen

In my home town, Darwen, by November 1918 there was the highest number of victims of any medium sized town in England and Wales. All Darwen schools were closed from September to December 1918, factory workers were advised against ‘kissing the shuttle’ (the process by which weavers used their mouths to pull thread through the eye of the shuttle when the weft rod was replaced). The Library was closed, and its books fumigated. Theatres and cinemas were told to close, but their owners refused. Political meetings were cancelled. Spring Bank School was converted into a hospital to deal with the flu cases.

Who was worst affected?

Cruelly, for a nation that had seen the flower of British male youth mown down by German guns, the majority of flu victims were adults aged 20 to 40. Particularly sad are the newspaper death notices for so many soldiers who had survived the war only to succumb to influenza within weeks of its end. The mortality was the inverse of most flu seasons, when deaths fall most heavily on the elderly and the under-fives.  One suggestion is that the elderly enjoyed greater immunity because, as children, they had been exposed to a pandemic virus with a similar genetic makeup to the H1N1 Spanish flu. Conversely, those aged 28 and over had an immunological blind spot because their first exposure had been to the 1890 ‘Russian flu’, an H3 virus with a completely different configuration of genes.

Combatting it and, the after effects

Many types of treatment were promoted. Fumigators were sold, as were inhalers and various patent medicines. Powders were given to make the patients sweat. Bed rest was advised with plenty of fluids. Some victims died within hours of their first symptoms. Others lasted five or six days; before finally dying of the other symptoms, usually pneumonia. The death notices in local papers began to feature the phrase “from pneumonia, following influenza”.

The last stages of the Great War helped spread the flu worldwide, infecting at least 500 million people and killing up to 100 million. With inconsistent and poor record-keeping, we’ll never know with certainty how many died in that Great Influenza Pandemic, but it is estimated that almost a quarter million died in the UK alone.

Even many of those who recovered from the initial flu-like symptoms went on to suffer long-term neurological or psychiatric conditions, including visual and auditory difficulties and lingering states of lassitude and despair. But it’s difficult to disentangle the effects of the flu from the effects of the bereavement and social upheaval caused by the war.

??? Do any of our readers know of members of their own families (especially Entwistles) who died in 1918/19 of the Spanish Flu?

[Eileen Cowen, Editor]

[1] Laura Spinney, ‘Pale rider – The Spanish Flu of 1918 and How it Changed the World.’ (2018 Penguin Vintage ISBN 978-1-78470-240-3)

[2] www.cottontown.org

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