Coughs and sneezes spread diseases

The 1918 influenza pandemic was devastating in its impact. A Culture volunteer working on the Poole History Centre First World project has looked at the history of the pandemic and its effect on Poole and its inhabitants.

Although many places have been put forward no-one knows where the 1918 pandemic started; there are suggestions it may have been present in a less serious form in 1917. The death toll from the pandemic has been estimated upwards of thirty million but the actual figure will never be known. There a few facts which are certain:
– It was global. North and South America, Europe, Africa, Asia, Australasia and the Pacific Islands were affected.
– The death toll was high. For example, around 250,000 died in England and Wales, in France 400,000, and over 14 million in India. More American soldiers died from influenza than died in battle during the war.
– It was different. Previous influenza viruses affected the very young and the elderly but this virus was most serious for adults aged 20 to 40. It was most virulent during the summer and autumn of 1918 in Europe whereas normally influenza occurs during winter.
– It was spread by travel. Millions of soldiers moved from country to country, continent to continent as did those displaced by the fighting. Over-crowded troopships, troop trains, hospitals and military camps were ideal for spreading the virus. A seriously ill soldier would be transported to hospital spreading the virus – in normal life they would have stayed at home.

There are believed to have been two phases: the first less serious, the second highly virulent with the second appearing around August 1918. Reported deaths peaked in October and then began to drop significantly and the virus disappeared as rapidly as it had appeared. It was followed by an epidemic of encephalitis lethargica (an inflammation of the brain) and a further influenza epidemic in 1920.

What was the impact on Poole? An advertisement from the Borough of Poole Health Department appeared in the local newspaper in 1919. Its aim was to suggest ways of reducing the impact of influenza and recommendations included:
– Keep fit, eat healthily and regularly. Get plenty of rest, keep warm, and avoid alcoholism.
– Be in well-ventilated rooms and avoid crowds.
– Wear a face-mask if nursing someone who is ill.
– Hold a handkerchief in front of the mouth if coughing or sneezing as it was spread by ‘discharge from mouth and nose’. The handkerchief was to be boil-washed and a paper handkerchief burnt. [It is now believed that around half million particles are released every time someone coughs or sneezes]

The local newspaper had various adverts for medications which allegedly ‘cured’ and ‘prevented’ influenza. Other medications started to include influenza in their list of illnesses that benefitted from whatever they were selling. The advice from William Gosse, the Poole Medical Officer at the time, however, was clear – ‘do not waste money on drugs in the false hope of preventing infection’.

Poole elementary schools and the Schools for Mothers closed in late 1918 because of ’the prevalence of sickness’. The local newspaper reported that some local councillors believed that if schools were closed then so should theatres and cinemas. The Health Authority planned on disinfecting cinemas while the Medical Officer said that children should be stopped from visiting them. A newspaper report recommended glass as the safest and most hygienic container for food and hoped that workers in the glass industry would be demobbed quickly.

The Reports of the Medical Officer of Health for Poole make fascinating reading about the general health of the town’s residents. The History Centre has several volumes from which the following data has been extracted and shows a noticeable increase in influenza deaths in 1918 and 1919. The table includes data on diphtheria to put the influenza figures into context. The population of Poole is estimated to have been between 39,000 and 41,000 from 1916 to 1920.

graph

The primary concern for health professionals was not influenza itself but the complications which were extremely serious. The Medical Officer believed the true figure for influenza deaths in 1919 was much greater because it often turned into bronchitis and pneumonia from which there had been 66 deaths.

The raw data does not tell the tragic impact it had on people’s lives. Private Sidney Dolman, whose father lived on Market Street, died of pneumonia in Alexandria on November 7th. His death was especially difficult as he had recently written saying how he was looking forward to coming home. Able Seaman Reginald Vincent had survived the Zeebrugge raid and the First World War but contracted influenza while on home leave and died of pneumonia. The local newspaper also reported on the deaths of people in Poole from influenza – sadly some were couples. Mr and Mrs Charles Worth of Branksome were in their thirties when they died within a week of each other to leave a 5 year old daughter.

The 1918 influenza pandemic has sometimes been referred to as the ‘forgotten pandemic’ because of the reaction to it. It is thought that with so much reporting on the loss of life from the war the distinction between deaths from military action or influenza became blurred. Another possible reason is that there were so many diseases at the time that it was just one amongst many. There were 969 cases of infectious diseases reported in the Borough of Poole in 1918. This included 654 cases of measles or Rubella, 146 of tuberculosis, 49 of diphtheria, 51 of scarlet fever, and 27 of chicken pox.

For more information on health during the First World War go to our earlier blog ‘The Mutual Enemy of WW1’.

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