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News - Miscellaneous - 17 Sep 2008

News Item 1339 of 1425 

Miscellaneous: 17 Sep 2008
Amid the Great War, the pandemic that history forgot

Crouded sleeping area extemporized on the Drill Hall floor of the Main Barracks, with sneeze screens erected as a precaution against the spread of influenza. Photographed during World War I, probably in the latter part of 1918.
Credit: U.S. Naval Historical Center

The Allied Forces were gaining hard-earned ground in the late summer of 1918, carving a path that would shortly lead to an armistice for the First World War.

As those armies battled over the blood-soaked fields of Europe 90 years ago, another enemy was on the move. This adversary didn't choose sides. It didn't restrict itself to Europe. It didn't spare civilians.

By the time it was through rampaging around the globe, this assailant - the Spanish flu - had killed between 50 million and 100 million people, several times more than had lost their lives in the soon-to-be-concluded war.

Yet despite the scope of the death and illness, the fear and social disruption, amazingly - inexplicably - the history books made little mention of what is now viewed as the deadliest outbreak of infectious disease in recorded history.

"If I hadn't researched and written a book myself, I'd want to go look it up in the Encyclopedia Britannica to find out whether it really happened or not," historian Alfred Crosby said in a recent interview from his home on Nantucket Island, Mass.

Mr. Crosby's 1976 account of the event - America's Forgotten Pandemic: The Influenza of 1918 - sank the first spade in what has turned into a historical and scientific excavation of the Spanish flu.

"For me, that's the most mysterious thing about it," Mr. Crosby says. "The vagaries of the virus, we'll understand them eventually. And we'll understand how flu epidemics work.

"But we're never going to understand: How the hell did we have something that killed millions and millions of people and then we said, 'Oh, well,' and went on to the World Series or something?

"It's impossible. And yet it's true."

Most Canadians would have had a relative - an aunt, a grandfather, a great-grandmother - who was sick with the Spanish flu. If we'd asked or if they'd offered, they could have told stories of a taxing time, when gymnasiums morphed into crowded makeshift hospitals, when undertakers ran out of coffins, when the Stanley Cup playoffs were shelved - the only time that happened until the National Hockey League lockout of 2004 to 2005.

In fact, there are still some among us who can recall those dreadful months in the fall of 1918 and the spring of 1919. Rev. Francis Stevens of Coquitlam, B.C., is one.

Now nearly 102, and a retired United Church minister, Father Stevens remembers vividly that it felt like the world was spinning out of control when the Spanish flu coursed through his Vancouver neighbourhood.

His entire family was sick. Father Stevens, then 12, caught the flu first and recovered, only to find school closed and chums either bedridden or forbidden by frightened parents from playing with others who might infect them.

"You were kept in. Kept in at home, kept out at school," he recalls. "Your school and your home were your two places of security. And both were collapsing."

Recounting the details now, the story seems like bad science fiction - 50 million to 100 million dead globally, 30,000 to 50,000 dead in Canada. If a similarly virulent outbreak occurred now, between 186 million and 372 million people around the world would die, and between 112,000 and 186,000 Canadians would succumb.

Today such a catastrophe would be non-stop news. Consider the SARS outbreak of 2003: The disease infected just over 8,000 people and killed fewer than 800, but rivalled the start of the war in Iraq for top-of-the-news status.

Not so in 1918. Accounts of the war in Europe crowded news about the flu bug out of the front pages of newspapers. "Usually it was on page 12," Mr. Crosby notes.

Heather MacDougall, a historian at the University of Waterloo, has studied Canadian newspaper coverage of the time.

"The press was heavily self-censored because the war was still on. And when you look at the news stories, the rhetoric of the stories is that this is just another battle that we have to fight. Except it's against disease, not against the Germans.

"And given that we are now finally winning the war against the Germans, we will win this war against disease."

It has been suggested the curious under-reporting of the event in countries that were combatants in the First World War contributed to the evolution of the outbreak's moniker, which implies the virus arose in Spain. (Influenza viruses are named after the place where they are first found.) The thinking is that because Spain was a non-combatant, its newspapers were more openly reporting on the alarming new twist on an old illness.

Influenza viruses circulate all the time, sending victims to their beds with bone-aching fatigue. The viruses can even kill. In Canada, between 4,000 and 8,000 people a year - often elderly - die from influenza or the pneumonia that can follow. But occasionally a new influenza virus for which humans have little or no immunity will emerge from nature, causing a global outbreak of disease known as a pandemic.

There appears to be no cycle or pattern involved. Nine years separated two pandemics in the mid-1800s, but it's now been 40 years since the most recent pandemic, the 1968 to 1969 Hong Kong flu.

American historian John Barry, author of the 2004 book The Great Influenza, believes the virus responsible for the 1918 pandemic emerged in the spring in the U.S. heartland, probably Kansas. Unusually virulent outbreaks of influenza were reported in some military camps there. Later, Mr. Barry and others believe, troop ships took the virus to the battlefields of Europe, where massive numbers of soldiers on both sides fell ill.

The virus went quiet in the northern hemisphere's summer, but reports started to crop up of renewed sickness in Europe in late August. In September, the illness erupted at Camp Devens, a military base near Boston.

In Canada, the first report of an outbreak among civilians occurred at Victoriaville College in Quebec on Sept. 8. School officials elected to send home students who were well enough to travel, undoubtedly sending flu along with some of them.

It was during this second wave of the pandemic that the new influenza virus turned preternaturally deadly.

It's thought that roughly 2.5 per cent of people who caught the flu died from it - an extraordinarily high rate for influenza. But the toll was substantially worse among certain groups - pregnant women, aboriginals and young, previously healthy, adults.

Today, scientists are still trying to figure out why the virus was so deadly. Back then, doctors were trying and failing to cope with a flu bug that caused regular influenza in some people and a rapidly progressing and devastating disease in others.

"There was terror," says Mr. Barry, who notes that doctors, who felt medicine was on the verge of conquering infectious diseases because of scientific advances, were helpless in the face of the onslaught.

"It kicked them right in the face and destroyed their confidence," he notes. "And of course society itself was just overwhelmed."

The virus swept round the world like a firestorm in the fall of 1918. After a brief respite, a third wave hit in the spring of 1919; in some places the third wave occurred in 1920.

And then the virus seems to have weakened, and flu seasons resumed their normal pattern.


HELEN BRANSWELL, The Canadian Press

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