Research Notes – The Great War (9) Patient Zero: The Spanish Flu

I’m researching The Great War for my current work in progress: a historical novel set partially during that time. To write the period accurately, I’ve been reading and studying the war and the surrounding events. Some of the older material I’m reposting in order to better organize it. This post from 2016, is especially important as the Spanish Flu will play a central role in the historical timeline. I hope you find it interesting and don’t mind me recycling! ~ Meg

The mysterious virus that emerged in 1917-1918 and reached pandemic proportions has a murky origin story. Smaller outbreaks had been occurring in the years leading up to 1918 but the flu wasn’t as severe in nature or as long in duration. People were getting over it within a few days to a week at most. The earliest and most authoritative report of the Spanish Flu comes from Haskell County, Kansas, USA. So why on earth was it called “Spanish” flu? More about that in a bit.

Fort Riley in Haskell County had been set up fifty years earlier to be a cavalry barracks during the Indian Wars. The fort was surrounded by rich farmland and sat near the confluence of two rivers. In the spring of 1917, when the USA decided to declare war on Germany, Fort Riley was hastily converted to a training facility. A large army encampment –Camp Funston–was constructed within the sprawling military reserve lands, to hold and prepare some 56,000 troops to go ‘over there.’

On March 4, 1918, Camp Funston’s cook, Albert Gitchell reported sick with a sore throat, fever and headache. He would have been up before dawn to prepare breakfast but after a restless night without sleep, he felt so unwell by morning that he reported to the camp’s infirmary. Gitchell is thought to be the great flu epidemic’s patient zero.

One after the other, men began reporting with similar symptoms. They were placed in isolation wards and the medic in charge informed his boss, chief medical officer, Colonel Edward Schreiner. By noon, 107 cases had reported and the fear of epidemic became real. By the end of the week, 522 cases had reported and by month’s end 1100 men had become incapacitated. Colonel Shreiner requisitioned a hangar to house the overflow from the overcrowded base hospital.

It soon became apparent that this was no ordinary flu. While most did recover, 48 men had died. The symptoms were alarming. The violent cough, projectile nose bleeds and the deathly blue discoloration of the face were not symptoms of the classic seasonal flu outbreaks. The medical staff realized they had something more deadly on their hands.

So why the “Spanish Flu” you might ask, when the origin was likely from the other side of the ocean? The flu was in fact, erupting all over Europe during the spring of 1918. However, the nations involved in the turmoil were reluctant to give publicity to the flu outbreak so as not to panic or further demoralize the already battered and war weary civilian population.

The sobriquet “Spanish” Flu became popular when the outbreak hit Madrid, Spain. Theaters, schools and tram service was curtailed to stop the spread of the disease. Most notably though was the contraction of the flu by King Alfonso XIII and members of his government. The Prime Minister and Finance Minister were both afflicted along with a third of the population of Spain. As a noncombatant country, the Spanish had no concerns about a ‘civilian scare’ and thus both foreign and domestic correspondents reported freely on the pandemic in that nation. Thus the virulent flu became known as “Spanish.”

Source material: Living With Enza – The Forgotten Story of Britain and the Great Flu Pandemic of 1918, by Mark Honigsbaum

Edvard Munch and The Spanish Flu

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Self Portrait, Spanish Influenza
Mr. Cake (cakeordeathsite) has graciously agreed to share another of his wonderful art posts with me. In reading about the flu epidemic, I learned that the artist, Edvard Munch, was a victim. This was once again a nugget of information perfectly suited to his expertise. 

At beginning of 1919, the Norwegian artist Edvard Munch (see Madonna) who painted one of the most famous paintings of all time, 1893’s The Scream, became seriously ill with the Spanish Influenza that had already claimed the lives of millions across the world.

Munch painted hundreds of self-portraits throughout his career, most notable are Self-Portrait with Burning Cigarette from 1895

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Self Portrait With a Burning Cigarette
and 1903’s startling Self-Portrait in Hell.

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Self Portrait In Hell
Munch’s art which encompassed Symbolism and paved the way for Expressionism, brought a new and unprecedented focus on subjectivity and psychological states, naturally found raw material in the unflinching and dramatic presentation of the diseased and tormented self.

Self-Portrait, Spanish Influenza, featured at the top, though of a later period, is no exception in its neurotic intensity. The jarring colours are suggestive of sickness and trauma and Munch’s sallow mask-like face seems to be staring straight at death.

Munch would survive the Spanish Influenza, dying in 1944 at the age of 80. His paintings and prints retain an evocative urgency in their depiction of the universal states of anguish, illness, sexual anxiety and dissolution of the body.

 

The Spanish Flu of 1918- Research Discoveries

I’ve been researching for my story Here Lies a Soldier by reading as much as I reasonably can about the time period. Honestly, too much and I’d be ready to jump off a bridge… One part of the story involves The Spanish Flu Epidemic –albeit ever so peripherally– and I wanted to educate myself on the plague that killed some 50 million people worldwide in 1918, more than 10 times the number killed by The Great War.

Rather than ‘reinvent the wheel,’ pulling tidbits and random facts from all over the place, I am in the process of reading a book about the flu:  Living With Enza -The Forgotten Story Of Britain and the Great Flu Pandemic Of 1918.  IMG_3464

Thusly, the information I am going to share with you has been taken from this work. The author —Mark Honigsbaum— has compiled and sifted through a huge amount of data to write this book. Here are some of the things I found interesting and frankly, horrifying.

Some facts about influenza:

The term influenza most likely derives from the Italian phrase ‘influenzi coeli’ meaning ‘influence of the heavens.’ By the mid 18th century it was more common to hear the term, ‘influenzi di freddo’ or influence of the cold. It was in this sense that the term entered the English language in 1743.

Influenza viruses spread aerially, usually in small droplets expelled when someone coughs or sneezes, and tend to be more stable in cool dry conditions. Researchers have also discovered that at around 5 degrees C (41 degrees Fahrenheit) the virus transmits for about 2 days longer than at 20 degrees. A popular (and morbid) children’s rhyme of the time may actually be spot on. It goes like this:

I had a little bird
Its name was Enza
I opened the window
And in-flu-enza

The Spanish Flu in particular:

The Spanish Flu was so virulent because of its genetic makeup. There are 3 types of influenza viruses: A, B, and C. The B type produces classic winter flu while the C type rarely causes disease in humans. The A type, however, is the one responsible for the great pandemics of history. Because viruses are not cells, they do not have DNA to organize their replication. Rather, they use 8 delicate strands of RNA which codes for proteins and enzymes on the surface of the virus. Trouble arises during replication because the RNA cannot copy perfectly. Errors called ‘antigenic drift’ occur when the avian or swine strain of the virus is exchanging genes with the human host.  The result is a new subtype of the virus. Then once inside the new host, the 8 strands of RNA randomly shuffle, generating an entirely new virus for which the human immune system has no antibodies. With no defense, the virus can spread like a wild-fire.

The rate of mortality fell disproportionally on young adults, usually the least vulnerable of a population. The 1918 flu struck suddenly and without warning. One moment a person was up and about, the next day they would be lying incapacitated, coughing up greenish-yellow sputum. The final stage came when their lungs filled with fluid, prompting the heart to leach oxygen from the head and feet, resulting in a dark purple staining across the lips and cheeks of the victim.

Possible contributing factors:

The effects of gas attacks during the war.  Gasses like phosgene and chlorine were not only capable of disabling and killing on contact, they also acted as soil contaminants denying valuable ground to the enemy. In all, it is estimated that some 150,000 tons of poison gasses – the equivalent of a modern day supertanker – were dumped on the killing fields of Flanders and Northern France during the last 2 years of the war, saturating the soil to the point where it became impossible for attacking troops to hold territory without large numbers of men having to retreat to field hospitals with suppurating blisters, damaged lungs, and eyes.

The most mutagenic of all gasses – mustard gas – 12,000 tons of which was dumped on the Western Front in 1917, accounted for 400,000 casualties. According to John Oxford, Professor of virology at Queen Mary’s Medical School of London and military historian Douglas Gill: these agents may have prompted ‘stepwise mutational changes’ in the influenza virus. And in combination with the bitterly cold conditions that prevailed at the Western Front in the winter of 1917, and the stresses and strains of war, it is possible such contaminants would have lowered men’s resistance to the flu.

That is a lot of information and I’m only part way into this fascinating book. If this subject interests you at all, I recommend reading it. As I continue my research, I’ll share some more of what I learn along the way. Or if you think this is terribly boring, let me know in the comments!