‘spanish Flu’: The British Red Cross’ Work In The Face Of A Global Pandemic
The 1918 influenza pandemic – commonly known as ‘Spanish flu’ – is the most significant health event ever recorded. The British Red Cross’s museum and archives curator Mehzebin Adam explains how we responded
The 1918 outbreak of influenza, the deadliest global pandemic in history, killed between 50 and 100 million people worldwide. Around 250,000 people died in Britain, and a large number were young and healthy adults.
The pandemic, which lasted from 1918 to 1920, killed more people than the First World War. It was first reported in Spain as the country was one of the few in Europe to remain neutral during the war, and therefore not subject to wartime censorship. Although the origins of the outbreak are uncertain, wartime conditions such as the mass movement of troops, and overcrowded trenches and hospitals, contributed to the rapid spread.
Just as the British Red Cross is providing vital relief to people affected by Covid-19 today, we played an essential role in caring for those affected by the influenza pandemic over 100 years ago.
A call for volunteers
A VAD recruitment poster from the early 20th century
Joyce Sapwell, a British Red Cross VAD nurse during the First World War, wrote about her experiences working in a hospital in Aldershot as the Spanish flu of 1918 took hold.
A tremendous sacrifice
The Influenza Pandemic Of 19181919
On September 19, 1918, 21-year-old Army private Roscoe Vaughan reported to sick call at Camp Jackson, South Carolina, feeling achy and feverish. He was promptly hospitalized along with eighty-two other soldiers that day. Influenza had reached the camp only the day before and would send 1,000 men to the hospital within a week. Medical officers at Camp Jackson implemented a special treatment program for respiratory diseases, holding sick call twice a day to examine the men for the flu and sending anyone with a temperature over 100 degrees to the hospital. Despite their efforts, influenza sickened more than 10,000 of the 38,000 men in the camp, killing 400, including five nurses who were caring for the soldiers. Private Vaughan was one of the unlucky ones who developed pneumonia he died on September 26, just weeks after he had left home to join the Army. Captain K. P. Hegeforth performed an autopsy on the young man, excising a piece of his sodden lung and preserving it in formaldehyde and wax. This he sent to Washington for analysis and cataloguing at the Army Medical Museum where scientists were trying to understand the nature of the killer.
Bristow, Nancy. American Pandemic: The Lost Worlds of the 1918 Influenza Pandemic. Oxford: Oxford University Press, 2012.
Byerly, Carol R. The Fever of War: The Influenza Epidemic in the U. S. During World War I. New York: New York University Press, 2005.
Beef Gravy Was Also Touted As A Potential Remedy
Beef gravy is not only tasty, but some used to claim that it could help you ward off ailments like the flu. The idea was that by improving your constitution, you would be better placed to fight off disease.
During the Spanish flu, Oxo even ran ads claiming that “cupful of Oxo two or three times a day will prove an immense service as a protective measure.
While we cannot make any claims that beef gravy will, or will not , keep you safe from future influenza outbreaks, we cannot recommend it enough as a beverage . That being said, beef gravy may have some health benefits aside from fighting rampaging viruses.
Time to put the kettle on.
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Bizarre Remedies Used To Treat The 1918 Spanish Flu
The Spanish flu was one of the most deadly pandemics of all time. Estimates vary, but somewhere in the region of 3 to 5% of the population of the world was wiped out by it.
That was estimated to be around 50 million people all told. Unlike some other global pandemics, the Spanish flu tended to be most deadly for those between the ages of 20 and 40. It was highly infectious and led to some very debilitating symptoms, including hemorrhages in the nose, stomach, and intestine, and both edema and hemorrhage in the lung.
With no real understanding of what they were up against, many people were desperate to try anything to help them survive. Here are some of the ways they tried.
News Of Cures Spread Far And Wide
In much of Australia just after WWI there were often no doctors close by. So many people were used to dosing themselves with homemade potions and remedies. They shared their prescriptions in the pages of local newspapers.
Between 1918 and 1920, Australian newspapers were flooded with Spanish flu cures of all kinds.
In October 1918, a journalist at Victorias Bendigo Independent lamented:
Cures? My goodness me, the vast amount of cures on the market are positively frightening, and everyone has a favorite cure. I pin my faith to one, you to another. Theres a certain influenza mixture that, taken in the early stages, is regarded as a certain cure by one large section Asperin is the cry of another batch of victims, and they tell you that that drug does the trick. Try whiskey and milk taken hot and taken often, is the advice of others who have had it. But one and all end in the same way: Go to bed and stay there till the thing leaves you.
Aspirin was very popular as a Spanish flu treatment worldwide. But people sometimes took it at dangerously high doses, which may have boosted the number of deathsattributed to the flu.
In the absence of many other treatments, government authorities promoted aspirin, along with quinine and phenacetin.
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The Spanish Flu In Labrador
The Spanish influenza was even more destructive in Labrador, which experienced a disproportionately high mortality rate the same virus that killed less than one per cent of Newfoundlands population killed 10 per cent of Labradors. Several factors contributed to this Labrador did not possess adequate medical resources and personnel to prevent the disease from spreading, frequent storms prevented doctors and nurses from travelling to Labradors remote communities, and inefficient modes of communication with the outside world made it difficult to request help from Newfoundland.
The virus first appeared at Cartwright after the mail boat SS Sagona docked there on October 20 with four infected crewmembers. Two days later, most of the communitys residents were sick and the disease was spreading throughout Sandwich Bay. By early 1919, the influenza had killed 69 of the areas 300 residents.
Spanish Flu In Canada
The virulent Spanish flu, a devastating and previously unknown form of influenza, struck Canada hard between 1918 and 1920. This international pandemic killed approximately 50,000 people in Canada, most of whom were young adults between the ages of 20 and 40. These deaths compounded the impact of the more than 60,000 Canadians killed in service during the First World War . Inadequate quarantine measures, powerlessness against the illness, and a lack of national coordination between military, political, public health authorities hindered the efforts of countless doctors, nurses, volunteers, and members of charitable organizations who were risking their lives to ensure that a large number of the ill and their families survived. The Spanish flu was a significant event in the evolution of public health in Canada. It led to the creation of the federal Department of Health in 1919, which established a partnership between the various levels of government and made public health a shared responsibility.
Criticized for failing to provide resources and coordination to public health authorities across the country, the federal government responded to the crisis by founding the Department of Health in 1919.
Backgrounder last update: 2018-12-18
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Laxatives Are The Way To Go So To Speak
Another bizarre remedy for the Spanish flu was the use of laxatives. In fact, some newspapers, like the Oshkosh Daily Northwestern, even recommended people get an early night, take a laxative, eat “nourishing” food, and keep their strength.
“Nature is the ‘cure’!”
The idea was to keep your body flushing out any and all toxins. Of course, as we know today, this kind of treatment runs the very possible risk of dehydration. Some early laxatives even contained toxic, potentially carcinogenic ingredients too.
Both Caused Global Pandemics Here’s How They Compare In Terms Of Symptoms Treatment And Death Toll
Since the early days of the COVID-19 pandemic, comparisons have been drawn with previous pandemics, most often the H1N1 influenza pandemic of 1918 .
Like COVID-19, the 1918 virus was “novel,” meaning it was a new virus that hadn’t been seen before. Also like COVID-19, nobody had immunity to it and it was highly infectious, spreading through respiratory droplets. Here’s the lowdown on Spanish flu, including how it compares to COVID-19, if it was eradicated, and how long people wore masks to protect themselves from it.
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The Spanish Flu : The Global Impact Of The Largest Influenza Pandemic In History
In the last 150 years the world has seen an unprecedented improvement in health. The visualization shows that in many countries life expectancy, which measures the average age of death, doubled from around 40 years or less to more than 80 years. This was not just an achievement across these countries life expectancy has doubled in all regions of the world.
What also stands out is how abrupt and damning negative health events can be. Most striking is the large, sudden decline of life expectancy in 1918, caused by an unusually deadly influenza pandemic that became known as the Spanish flu.
To make sense of the fact life expectancy declined so abruptly, one has to understand what it measures. Period life expectancy, which is the precise name for this measure, only looks at the mortality pattern in one particular year and then captures this snapshot of population health as the average age of death of a hypothetical cohort of people for which that years mortality pattern would remain constant throughout their entire lifetimes. Period life expectancy is a measure of the populations health in one year.
This influenza outbreak wasnt restricted to Spain and it didnt even originate there suggests that the epidemic originated in New York due to evidence of a pre-pandemic wave of the virus in that city).1
Even in a much less-connected world the virus eventually reached extremely remote places such as the Alaskan wilderness and Samoa in the middle of the Pacific islands.3
Spanish Flu Pandemic Ends
Almost 90 years later, in 2008, researchers announced theyd discovered what made the 1918 flu so deadly: A group of three genes enabled the virus to weaken a victims bronchial tubes and lungs and clear the way for bacterial pneumonia.
Since 1918, there have been several other influenza pandemics, although none as deadly. A flu pandemic from 1957 to 1958 killed around 2 million people worldwide, including some 70,000 people in the United States, and a pandemic from 1968 to 1969 killed approximately 1 million people, including some 34,000 Americans.
More than 12,000 Americans perished during the H1N1 pandemic that occurred from 2009 to 2010. The novel coronavirus pandemic of 2020 is spreading around the world as countries race to find a cure for COVID-19 and citizens shelter in place in an attempt to avoid spreading the disease. .
Each of these modern day pandemics brings renewed interest in and attention to the Spanish Flu, or forgotten pandemic, so-named because its spread was overshadowed by the deadliness of WWI and covered up by news blackouts and poor record-keeping.
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Influenza At The Camp Brooks Open
When the influenza virus pandemic took hold in the United States in 1918, emergency hospitals were started in schools, halls, and large private houses, and open-air hospitals were being thrown up all over the country.1 In the harbor of East Boston, 1200 out of 5100 merchant sailors onboard training ships had contracted influenza. The seriously ill were too numerous for local hospitals to accommodate. The Massachusetts State Guard responded by building the Camp Brooks Open Air Hospital at Corey Hill in Brookline, near Boston.37,38 The hospital comprised 13 tents, 12 of which were occupied by one or two patients each and the other by the head nurse. The State Guard took seven hours to erect the tents, make sure the site was properly drained, and provide running water, latrines, and sewerage. Portable buildings were then set up for the medical staff and nurses. From the time the camp opened on September 9, 1918, until its closure a month later on October 12, a total of 351 victims of the pandemic were admitted, one third of whom were diagnosed with pneumonia. In total, 36 of the 351 sailors received at the hospital died.37
Fighting The Spanish Flu
When the 1918 flu hit, doctors and scientists were unsure what caused it or how to treat it. Unlike today, there were no effective vaccines or antivirals, drugs that treat the flu.
Complicating matters was the fact that World War I had left parts of America with a shortage of physicians and other health workers. And of the available medical personnel in the U.S., many came down with the flu themselves.
Additionally, hospitals in some areas were so overloaded with flu patients that schools, private homes and other buildings had to be converted into makeshift hospitals, some of which were staffed by medical students.
Officials in some communities imposed quarantines, ordered citizens to wear masks and shut down public places, including schools, churches and theaters. People were advised to avoid shaking hands and to stay indoors, libraries put a halt on lending books and regulations were passed banning spitting.
According to The New York Times, during the pandemic, Boy Scouts in New York City approached people theyd seen spitting on the street and gave them cards that read: You are in violation of the Sanitary Code.
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Severe Acute Respiratory Syndrome And Influenza
Influenza pandemics have been described throughout history and typically occur several times each century. The influenza pandemic of 1918 was one of the major plagues to have affected humankind. It is estimated that this Spanish flu infected as many as 500 million people worldwide and led to the deaths of as many as 50100 million people in just 25 weeks. The Spanish flu was caused by an H1N1 strain of influenza virus that continues to cause human influenza pandemics. The 1957 and 1968 pandemics did not approach the catastrophic level of the 1918 pandemic.
H1N1 influenza continues to impact society to this day, and CDC estimates for the 2009 pandemic of influenza A in the United States from April 2009 to January 2010 was 57 million cases, 257,000 hospitalizations, and 11,700 deaths. In seasonal influenza the greatest mortality is among the very young and the very old. In contrast the 1918 and 2009 epidemics affected children and younger adults.
Signs and Symptoms
Cedric Mims, in, 2000
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After von Behrings antitoxin was distributed worldwide to treat diphtheria in 1895, doctors experimented with the same passive immunity technique for curing measles, mumps, polio and influenza.
During the pandemic influenza outbreak of 1918 known as the Spanish flu, fatality rates were cut in half for patients who were treated with blood plasma compared to those who werent. The method seemed particularly effective when patients received the antibodies in the early days of their infection, before their own immune systems had a chance to overreact and damage vital organs. In the 1930s, doctors like Gallagher used convalescent plasma effectively against measles.
READ MORE: Why the Second Wave of the 1918 Spanish Flu Was So Deadly
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Background On The Research
What research does the Science article describe? Why is it important?
Read more on how an expert group of researchers and virus hunters located the lost 1918 virus, sequenced its genome, and reconstructed the virus in a highly safe and regulated laboratory setting at CDC to study its secrets and better prepare for future pandemics.
This report describes the successful reconstruction of the influenza A virus responsible for the 1918 Spanish flu pandemic and provides new information about the properties that contributed to its exceptional virulence. This information is critical to evaluating the effectiveness of current and future public health interventions, which could be used in the event that a 1918-like virus reemerges. The knowledge from this work may also shed light on the pathogenesis of contemporary human influenza viruses with pandemic potential. The natural emergence of another pandemic virus is considered highly likely by many experts, and therefore insights into pathogenic mechanisms can and are contributing to the development of prophylactic and therapeutic interventions needed to prepare for future pandemic viruses.
What are the reasons for doing these experiments?
Who funded the work described in this article?
When did CDC begin research on the 1918 virus?
Could a 1918-like H1N1 virus re-emerge and cause a pandemic again?
Are current antivirals and vaccines effective against the 1918 H1N1 virus?
The Mother Of All Pandemics: 19181919
The influenza pandemic of 19181919 killed more people than the Great War, known today as World War I, at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in the four years of the Black Death Bubonic Plague from 1347 to 1351. Known as Spanish Flu or La Grippe, the influenza of 19181919 was a global disaster.
Molly Billings, 2005The Influenza Pandemic of 1918
The 1918 influenza pandemic, caused by an H1N1 influenza subtype came on suddenly in March of 1918 and spread rapidly throughout the world. In the United States the first reports came from public health officials in Haskell County, Kansas, who reported 18 cases of influenza of a severe type. By June the virus had spread from the United States to Europe, where it quickly moved from the military to the civilian population. From there, the disease circled the globeto Asia, Africa, South America, and, back again, to North America.
The effect of the influenza epidemic was so severe that the average lifespan in the United States was depressed by 10 years . The Spanish influenza of 1918 is estimated to have hit nearly a third of the worlds population. Conditions at the end of World War I likely contributed to the mortality .
Influenza Ward During the 19181919 Epidemic
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