Aden Field Force. Indian troops who died of influenza being carried to the burning ghats.
© IWM (Q 13074)
Aden Field Force. Indian troops who died of influenza being carried to the burning ghats. A frequent scene at Sheikh Othman during the influenza epidemic of Oct-Nov, 1918.

In the final year of the First World War, a far more deadly killer was sweeping around the globe.

The Spanish influenza pandemic of 1918-19 was one of the most deadly pandemics in human history. In a little over a year, it infected up to a third of the world’s population, and killed up to 100 million people.

The Spanish flu was not named ‘Spanish’ because it began in Spain, but because Spain was neutral during the First World War, and did not censor bad news like the belligerent countries.

It could cause dramatic symptoms. One of the most striking was heliotrope cyanosis. As a victim’s lungs clogged with fluids, their bodies became starved of oxygen. As a result, cyanosis - a blueish-purple tinge - started to spread from their extremities, including their fingers, toes, nose, ears, and mouth. This was often a sign of impending death. After death, some bodies turned completely black.

Ruth Dingley was a doctor with University College Hospital in London in 1918-1919 and described how the illness affected people.

'You almost knew they were going to die'

Ruth Dingley: “It was essentially an acute chest infection, more like a very acute pneumonia, extreme breathlessness and violet colour. Extreme cyanosis it was called then. High fever, and people died. I suppose some recovered but I think you died in a few days you almost knew they were going to die.”

Social and medical services were overwhelmed during the peaks of the virus. Doctors and nurses were scarce due to the war and to the scale of the pandemic.

Walter Cook served with the 27th Field Ambulance RAMC and while on home on leave, he was asked to assist in the treatment of a family friend.

'I stayed there the rest of my leave'

Walter Cook: “My aunt who lived in Knightsbridge phoned up, said she'd heard I was home from one of the boys, that her boy was seriously ill, the flu epidemic in 1918. Could I come and have a look at him? So, I went, and I stayed there the rest of my leave and nursed this boy. He died in the hospital just on the corner, Knightsbridge there. He died the day before I went back. He was 14 years old.”

With so many people dying, the bodies of those who had passed away were sometimes stacked on top of one another, in coffins or wrapped in cloth. Wood for coffins ran out, and gravediggers and undertakers could not keep up with demand. The dead were taken to the cemeteries by the lorry load. In some places, mass graves had to be used in order to bury the dead quickly enough.

Arthur Baxter, a private in the Machine Gun Corps, returned home in winter 1918. His brother had been killed by the flu and he described the impact of the  disease, recalling ‘the towns were full of dead’.

The war was instrumental in helping to spread the virus, as crowded troopships helped convey the pandemic around the world.

Leonard Holt, a boy telegraphist on board HMS Donegal, recalled how the flu became ‘rampant’ on troop ships his vessel escorted while on convoy duty.

'The deaths became more frequent'

Leonard Holt: “The Spanish flu had broken out and the, with all these American troop ships that we had, it was rampant amongst these troop ships, and we started off as deaths at sea occur, you see, giving them the full treatment of all the ships stopping and lowering the flags and the body being thrown overboard. And it was costing a lot of time and eventually the deaths became more frequent, and we just had to dispense of that and any ship with a death just had to haul out of the land, dispose of the poor chappy and regain its station.”

In some countries, including the United Kingdom and New Zealand, the peak of the mortality was in November 1918, in the midst of peace celebrations. Mass jubilation and cheering crowds also helped to spread the virus, and death tolls peaked in the days following the celebrations as the virus worked its course.

Margaret Warren, a nurse with the Red Cross Voluntary Aid Detachment at Brooklands Hospital in Weybridge, recalled getting ill as the war ended.

'The most dreadful flu I've ever experienced in my life'

Margaret Warren: “Then we had that awful flu, that's what they called Spanish flu at the time of the Armistice. That was the most dreadful flu I've ever experienced in my life. I got it on Armistice Day, Armistice night, I'd had the day in peace, but we lost three men and one nurse all died of it in the hospital because really, it was a terrible thing.”

The Spanish flu virus was unusual. Unlike normal seasonal flu, which affects mostly the very young and old, the Spanish flu hit young adults hardest - those between 20 and 40 years of age. This was exactly the age range already hit hardest by the war – soldiers, nurses, and young families at home. Some soldiers and nurses survived the war, but perished from influenza before they could return home. Nurses were especially susceptible to catching it from their patients, and as such were on the front line of the battle with pandemic influenza. Nurse Rosamond Curtis  - described as a loving, cheerful friend who had faithfully cared for the sick and wounded - died three days after Armistice. 

Nursing Sister Dorothea Crewdson was stationed at Etaples camp on the Western Front. She recorded in her diary; ‘My ward is now an influenza department and I have thirteen 'fluers' filling the atmosphere with germs. I am wondering if I can escape by any means myself. I felt sure the complaint was attacking me this afternoon, but now I feel better again and there is still hope.’

Dorothea subsequently died in March 1919.

Soldiers and nurses that survived the war and returned home sometimes found that the virus had decimated their families while they were away. What should have been a time of celebration and relief for soldiers, nurses, and their families at having survived the war, was marred by the horror of this mysterious and deadly disease.

Hannah Mawdsley began an AHRC Collaborative Doctoral Partnership, entitled ‘Politics of Commemoration and the ‘Forgotten’ Pandemic’, in September 2015. Find out more about her research

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