Friday, 31 December 2010

Leek and the 1918 flu pandemic

The last hundred years has seen 4 major flu pandemics, the 2009 outbreak follows pandemics in 1968, 1957 and 1918.The present swine flu outbreak has dominated the news media with increasingly hysterical reports of the potential impact of the disease. There are dreadful forecasts of the potential death rates from the disease. Local have responded to the crisis as well and are full of information on what to do if you are feeling unwell and where to collect the tamiflu drug should you or your family require it. Conjecture and rumour are flying. I heard a woman on Macclesfield railway station confidently assert when reports of the intial Mexican outbreak began circulating in April that it would not affect her as it was only poor people who were susceptible to the illness. As I walked through Leek yesterday I saw a poster outside a health food store in town advertising an herbal preparation which it assured readers could combat the virus.
As a consequence of this interest I thought I would carry out a little historical research into the major flu epidemic of 1918 - the Spanish Flu outbreak which proved so devastating to communities all around the world to see if there were any lessons to be learned. The pandemic of 90 years ago was caused by a deadly virus H1N1. Unusually most of its victims were healthy young adults; usually flu affects the very young or the elderly. It lasted from March 1918 to the summer of 1920 although the outbreak in the context of Leek was at its severest between October 1918 to January 1919. It was truly global killing people in remote communities in the Arctic and remote Pacific islands. It is thought anywhere between 50 to 100 million died and that a third of the worlds population- around 500 million- became infected. It was described as the "greatest medical holocaust in history" and may have killed more people than the medieval Black Death. In the UK it killed 300,000 people and in the US 750,000.
The illness was especially devastating in Africa and India where 17 million died. Entire villages were wiped out in Greenland and Alaska and 1 in 4 of the populations of South Pacific islands perished.
It was called "Spanish flu" because it was thought to have originated from that country. The disease is actually thought to have started in China, mutated in the US and arrived in Europe via the French ports. The main spreaders were Allied troops who were engaged in the last battles of the First World War. It is within that conflict that the virulence of the pandemic can perhaps be explained. Massive troop movements and close proximity and poor hygiene helped to increase transmission, this coupled with the privations of 4 years of war suffered by soldiers and civilians fatally weakened immune systems. Some historians have argued that the flu helped to tip the balance in favour of the Allied Armies as the illness hit the German and Austrian Armies first and the death rates in Germany were higher than in Britain and France.
Another factor that increased the occurrence of the illness was travel. Shipping made it easier for travellers to spread the illness to even the most remote communities and this, of course, is before the advent of global air travel. Those countries that escaped the worst of the pandemic were those such as Japan which put in place the most strict quarantine laws.
There are some similarities with the present Swine flu outbreak in that the first outbreak during the spring of 1918 was a mild "herald" form of the disease. The deadly second wave began in August in the United States and France and at this stage the virus mutated and spread helped on by very sick soldiers being sent on crowded trains to field hospitals. The scene was set by the autumn of 1918 for the H1N1 virus to begin its deadly work.
The space in the Leek Times for October 1918 are largely taken up with reports of the coming victory in the Great War but what is noticeable is that the reports of soldiers dying in the war increasingly mention influenza and not German bullets or shells.
Gunner Brunt of Upper Hulme dies of the illness, the report of his death tells rather tragically that he had served on the Western Front for 4 years and at the end of the war he had hoped to resume life as a farm labourer. Privates Ralph Vernon of 39 Broad St and Percy Osbourne of 10 Fountain St succumbed to the virus as does Sergeant Vigrass.
As the autumn progressed the Chief Medical Officer Dr McClew informed a local council meeting that more people had died of flu in the last month than the previous three months combined and that the illness had killed over 20 people in Leek. It is noted that Norton and Brown Edge are particularly badly hit. As a precaution all local schools are closed and remained closed for several weeks.
 By November the Leek Times offers its readers helpful advice in a 6 point plan
  • Go to bed on first appearance of the symptoms
  • Stop in bed until all aches are gone and if attacked don’t be alarmed.
  • Keep cheerful and don’t worry
  • Take best food you can
  • Ventilate room well
  • Avoid all excesses.
However by the middle of the month all reports of the progress of the epidemic are swept aside by news of victory as the German Army agrees to a laying down of weapons. The news is ecstatically received in Leek. Churches put on special services to thank God for deliverance and for the final victory. An editorial in the Leek Times opined on the conclusion of the war to end all wars.
"Right has vanquished might, civilisation has conquered barbarism and outraged humanity may now hope to see the day dawn when man shall no longer hate his brother man"
But there is always room for more prosaic considerations a correspondent from South Portland Street complains that reduced street lighting has lead to gloomy streets in the town.
More deaths are later reported in the paper such as Sergeant Oultram of Broad St sometime superintendent of Leek Public Baths.
The newspaper also carries adverts for various cures for the disease such as Blades Pine Cure at a shilling a bottle. It advisers purchasers to avoid the flu by inhaling the concoction from a hand kerchief. Those who wish to avoid the illness are advised to take Peps Preventative medicine- it seems to cure everything.
The early years of the 20th century also see a growing appreciation of the role of women and the Leek Times reflects this trend with its own women’s page. It is written by Margaret Osbourne who clearly finds the pandemic trying.
" It is rather hard luck that the influence epidemic should have broken out just now and that we have a torrent of good advice from doctors on how to avoid influenza and at the same time very little opportunity to take that advice".
She cites the problems that the modern woman of 1918 has in following such advice
"rationed food, rationed fuel and trains and omnibuses full to bursting, we may as well ask for the moon".
But still deaths are reported that edition reports that the epidemic has killed a well respected employee of Brough, Hall and Nicholson George Howarth of 75 Shirburn Rd who leaves a wife and family. Mr Howarth was 38.Howarth’s death is typical of the age that many citizens of the town were dying. The ages of the dead were often in the 20s and 30s.
 Modern day research carried out on the bodies of the 1918 epidemic preserved in the permafrost of the Arctic have concluded that the H1N1 virus killed as a consequence of an over reaction of the body’s immune system which explains its virulence and the predominance of young adult victims. The strong immune systems of people in their 20s ravage the body, whereas the weaker immune systems of babies and older people cause fewer deaths. Another theory is that older people may have had some immunity developed from surviving an earlier influenza pandemic of 1889- the Russian flu outbreak.
December 1918 saw another 24 deaths in the town caused by the virus but at this stage the aggressiveness of the plague seemed to be running its course. One explanation for the reduction in the death rate is that doctors got better at treating the illness while another view is that the virus changed again into a less lethal strain.
  Other news in the town was equally grim; a warehouseman named Bratt who lived in Picton Street ran amok and attacked his wife and children with a hammer before cutting his throat with a razor.
On a lighter note town magistrates heard a case of disorderly conduct involving 6 youths in Derby Street who were arrested for signing "Auld Lang Syne" and forcing pedestrians into the road. Rev Parker who at on the bench aid that 5 of the youths belonged to the Boy Scouts Movement and he asked his colleagues on the bench to leave punishment to him as their Scoutmaster.
What lessons can we draw from the modern outbreak and the one 90 years ago? Well certainly today we have many advantages. In modern Britain we have an NHS, information systems such as the Internet, better diet and up to date drugs to fight the present H1N1 virus.
In 1918 however Britain had been at war for 4 years, civilians were used to putting up with hardships such as rationing, the experience of being surrounded by death and also to obeying orders. This meant that when doctors said stay at home, patients listened and were not likely to panic. People in 1918, and this is born out by the low key reporting in the Leek Times of the influenza epidemic, displayed a understated stoicism. They gritted their teeth and got on with it. Is this true of today when government help lines are besieged by the "worried well" and websites crash overwhelmed by queries? And when there is a fear of loosing your job how many people will ignore the advice to "isolate" themselves to reduce the risk of spreading the disease if they feel that an absence might result in an individual making themselves a likely candidate for redundancy?
As happened in 2000 over the petrol shortage panic is as infectious as any virus and how will people react if the pandemic does result in shortages? How will the "I want it now" generation "respond to rationing and restrictions? Perhaps the old fashioned virtues of stoicism and community spirit need to rediscovered, but whether we have time is of course another matter.