The Infamous Spanish Influenza

The following blog post was contributed by Andrew Belyea, who is the Museum of Health Care’s 2017 Margaret Angus Research Fellow. Andrew has a degree in Life Science from Queen’s University and will start at the Queen’s School of Medicine in the Fall.

Over the coming summer months, I have the pleasure of developing a manuscript for the Museum of Health Care discussing the Spanish Influenza’s impact on Kingston. With biweekly blogs, I hope to share some of the insights, stories, and images that I come across as I explore this fascinating topic.

What was the Spanish Flu?

The Spanish Flu was a particularly devastating flu epidemic that swept across the world starting in the fall of 1918 and persisting until early 1920. There are many theories as to how the particular strain, now identified as an H1N1 variant, first developed. It is believed that around 50 million people worldwide were killed by the flu, roughly 3% of the globe’s population at that time.

The 1918 Flu epidemic had several factors that contributed to its devastation: a high morbidity rate, high mortality rate, the end of the First World War and, most significantly, the propensity to develop into pneumonia. The Flu’s morbidity rate (the frequency at which a disease appears in the population) was particularly high for this epidemic. It has been estimated that half the globe’s population was infected with this strain of influenza. This astounding worldwide coverage is due in large part to the end of WWI, which saw millions of soldiers returning home and taking the Flu with them. Unlike the majority of annual influenza strains, the 1918 H1N1 strain affected healthy young adults disproportionately more than juvenile, elderly, or immunocompromised individuals. This was because the virus elicited a cytokine storm, an overreaction of the body’s immune system that can fatally shock the body. Additionally, the strain lead to an unusually high incidence of pneumonia, which was the main reason the mortality rate was so high.

Where did the Flu come from?

The most commonly believed theory is that the Flu developed at a pig farm in the American Midwest, moving from there to Fort Riley, Kansas, where the first confirmed case occurred, that of mess cook Private Albert Gitchell. From here, it travelled with American troops overseas and, with increased globalization and travel around the world, rapidly spread to all corners of the globe. In fact, it is believed that only a single population of humans escaped the virus – those living on the small island of Tristan da Cunha in the south Atlantic.

Why ‘Spanish’ Flu?

The Spanish Flu actually has little to do with Spain. The epidemic’s name is given to Spain because of wartime censorship occurring in the United States, Britain, France, and Germany, all of which were deeply impacted by the Flu. To control the spread of news and panic during the war, countries fighting in the war censored the media to downplay the Flu’s impact. In turn, this created a false sense that the epidemic was bypassing those regions. Since Spain was impartial during the war, there was no media censorship and the development of the Flu soon became associated with Spain since they could broadcast unfiltered messages. It is also likely that the Allied forces’ animosity towards the Spanish encouraged them to place blame on Spain for the epidemic.

Spanish Flu ad Oct 11 1918
The Spanish Flu in Kingston

Kingston, like most cities around the world, was deeply affected by the Spanish Flu. For a number of reasons, Kingston is recorded as having the highest influenza mortality rate in Ontario. According to a Canadian Medical Association Journal article in 1919 by the Provincial Medical Health Officer Dr. J.W.S. McCullough, Kingston’s death rate due to influenza was 644 per 100,000 people while Ottawa had the second highest rate at 548 per 100,000 people, Toronto was 327 per 100,000 people, and Port Arthur was 131 per 100,000 people.

At the end of the war, many soldiers returned to Kingston hoping to reacquaint themselves with their former lives. With this, a myriad of factors contributed to Kingston’s unexpectedly aggressive local epidemic. One factor is that Kingston was a military hub and thus many returning soldiers were either stationed or filtered through the city. When the Flu hit, the soldiers who had expected to be sent home were now forced to have an extended stay. Additionally, Kingston boasted two hospitals that were able to support many ill patients: Kingston General Hospital and Hotel Dieu Hospital. When it became clear that the ill would outnumber the available beds, an additional emergency hospital was set up at the Great War Veterans Association. Grant Hall, which was a military hospital to serve the wounded, also took a number of influenza patients. The most significant factor that contributed to the high death rate was that treatment in hospital was free. Unlike most hospitals in the province, Kingston had a unique relationship between Queen’s Medical School and the hospitals: to best teach the medical students, it was determined that the hospital should have free admission so that sick individuals could be investigated by the students. This enabled hands-on learning for the students while encouraging people to seek help at the hospital rather than staying home.

Free hospital service, along with the increased bed space allocated via the Great War Veterans Association hospital and Grant Hall, meant deaths in Kingston were tracked more thoroughly than in other cities. It is therefore likely that Kingston was not particularly devastated by the epidemic, but rather proportionally more deaths occurred in hospital than at home, which falsely inflated the mortality rate.

When news of the epidemic began to spread, business owners were quick to advertise any and all products that might be useful to citizens. Although many ads were for pharmaceutical concoctions, my favourite so far is for a phonograph (seen above)!

Stay tuned for more blog posts from Andrew, including a more in-depth look at the impact of the Spanish Flu in Kingston.

Advertisement Source: British Daily Whig. 11 October 1918.

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