Spanish Flu outbreak 1918

SPANISH FLU 1918-1919 - the greatest pandemic in History:

Estimated death total worldwide = 50 to 150 million

The last major global pandemic occurred 100 years ago in the summer of 1918. Spanish flu was first reported in the early summer of  1918 by newspapers in Spain, unaffected by wartime censorship. By then, the US, French, British and German armies were already troubled by it.

In Ireland 20,057 people were reported as having died of influenza in 1918 and 1919 (the average annual rate for the preceding years of the war had stood at 1,179). In addition, an increase in deaths caused by related illnesses, most notably pneumonia (from which over 3,300 died above what would usually have been expected), can be attributed to the epidemic.Sir William Thompson, the registrar-general, admitted that the official influenza mortality rate was a conservative estimate, and there are reasonable grounds to assume that additional influenza deaths in Ireland were uncertified, attributed to other illnesses, for example pneumonia and often simply not recorded at all.

There were three outbreaks, and perhaps a fourth. The first wave peaked was in early summer 1918, and peak of the second wave in late October 1918 and the third in the spring of 1919.  But even though there were peaks, it was really continuous for about 15 months from June 1918.

The first wave, which hit Ireland in the early summer of 1918, was the least destructive, although severe enough for schools and businesses to close. After the first (and mildest) wave in the early summer, people questioned what all the panic had been about. The earliest verifiable record of its arrival in Ireland can be found in US naval archives, which document an outbreak on the USS Dixie, docking outside Queenstown (Cobh), in May 1918. On 12 June the Belfast News-Letter reported that Belfast 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. Nevertheless, by mid-July the first wave had abated.

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. The almost equally severe third wave, which lasted from mid-February to mid-April 1919, affected Dublin again, as well as the western part of the island (in particular Mayo and Donegal). As influenza moved through towns and communities, schools, libraries and other public buildings were closed, and court sittings were postponed. Businesses closed sporadically on account of staff illnesses. Medical officers of health, mainstays of the Poor Law medical system, worked around the clock to treat their patients, paying 100,000 more home visits during the epidemic than in the previous year. Hospitals and workhouse infirmaries struggled to cope with the numbers of patients, pharmacists worked long hours to dispense medicines, and mortuaries, undertakers and cemeteries had to queue the dead for burial.

Some areas suffered severely during all three waves, notably Dublin, where troops returning from the war may have been a major factor. Dublin county and borough had in 1918 a death rate of 3.7 per thousand living (1,767 flu deaths) and of 2.3 per thousand living (1,099 deaths) in 1919. At 3.85 per thousand, Belfast had one of the highest death rates in 1918, but in 1919 it had one of the lowest—0.79 per thousand. Some counties almost escaped the epidemic. Clare, for example, had the lowest death rate from influenza of any county in 1918, at 0.46 per thousand. Kildare had the highest influenza death rate in 1918—3.95 per thousand (263 deaths). Water and power shortages in Naas during the height of the second wave contributed to a particularly severe local outbreak in the county.

A global peculiarity of the 1918–19 pandemic was its targeting of normally healthy young adults. In 1918, 22.7% of all deaths from influenza in Ireland were of people aged between 25 and 35; in 1919 the figure for this age group was 18.95%. The registrar-general estimated that there were more male than female deaths from influenza in Ireland, which contrasted with the rest of the United Kingdom, where slightly more female than male deaths were recorded. Ulster followed the British pattern, as the female influenza mortality was slightly higher than the male, especially in the more industrial areas of the province. There were high proportions of women textile-workers in Belfast, Derry, Lurgan and Lisburn, and the overcrowded, hot, damp conditions of linen workshops encouraged the spread of influenza. In Belfast females between 25 and 35 had a higher influenza mortality rate than any other age or gender group in the city.

Individuals employed in occupations involving close contact with the general public were more likely to contract influenza. Doctors and nurses were particularly exposed. The high number of Dublin teachers suffering from influenza in October 1918 led to the closure of schools in the city. Absence owing to influenza depleted police forces throughout Ireland. Public transport employees were also vulnerable, and in Belfast 100 tramway employees were absent with influenza during July 1918, and 120 in November. Priests and clergymen were also in the front line, and a lot of them died. Staff illness forced the closure of shops, with many shopkeepers and assistants dying.

In Ireland, there are 20,000 deaths directly attributed to the influenza, also an A H1N1 variant. Another 3,000 people died from pneumonia following influenza. These figures would suggest in excess of 800,000 cases here, given a death rate of 2.5 per cent.  During one week at the end of October, hundreds were reported ill in Naas, Dundalk, New Ross, Wexford, Gorey, Kilkenny, Bray, and thousands in Dublin.

Applying to official mortality figures an estimate that only 2.5% of those who caught influenza actually died suggests that there were over 800,000 influenza cases in Ireland, 20% of the population. Between June 1918 and April 1919 the epidemic, which further taxed a health service already struggling with war-related shortages of medical personnel and hospital beds, temporarily incapacitated urban and rural communities across the island.

Summing up the local effects of the epidemic in its immediate aftermath, Sir William Thompson noted that ‘Since the period of the Great Famine with its awful attendant horrors of fever and cholera, no disease of an epidemic nature created so much havoc in any one year in Ireland as influenza in 1918’.

But, surprisingly, it has not featured in Irish historiography. The ground-breaking documentary Aicíd, screened on TG4 in November 2008, was the first programme to introduce the topic to public debate in Ireland.