Tuesday, 5 May 2009

Nigel Jones: When the World Sneezed.....

by Nigel Jones

The current outbreak of Swine 'flu has unsettling parallels with the devastating global pandemic of Spanish 'flu that, even before the age of inter-continental air travel, at its peak swept around the world in just three catastrophic months from October 1918 to January 1919 - and killed more than 21 million people - twice as many as had just died in the First World War, which ended in the week when mortality from the 'flu was at its height.

The Spanish 'flu was the third greatest pandemic in recorded history, bearing comparison only with the Plague of Justinian, which scoured the eastern Roman Empire around Byzantium for half-a-century from A.D. 542, killing a reported 100 million people; and the 'Black Death' - a pestilence, believed to be bubonic plague, - which raged from 1347-1350, and killed more than 60 million - 25 million of them in Europe; around a third of the continent's total population.

The origins of the Spanish 'flu are still steeped in mystery. It came in two waves. The first, deceptively mild in character, apparently began in March 1918 in Spain - from where the outbreak acquired its name. The epidemic was remarkable for the number of victims struck down, some eight million Spaniards were affected, from humble peasants to King Alfonso XIII himself. But in the vast majority of cases the illness passed within three days, and most victims made a full recovery after taking to their beds suffering the familiar gamut of 'flu symptoms : coughs and sneezes; high temperatures; aching limbs; headaches and sore throats.

The first wave apparently receded. It now seems, however, that this outbreak was merely an overture, and that a more deadly variety of the same type A 'flu virus, of the sub-strain H1N1 - worryingly, the same virus that is causing the current outbreak of Swine 'flu - was already incubating. Throughout the spring and summer of 1918, outbreaks of a flu-like illness were reported all over the world - from China to Sierra Leone, from Peru to Kansas, and from Scandinavia to the crowded trenches of the western front. Some epidemologists believe that the virus may have originated with pigs kept in close proximity to British troops at the great Etaples training camp near Boulogne, which then - like the Mexican outbreak - 'jumped species' and hit humans.

In the autumn of 1918, the Great War, which had ravaged Europe for four years, was nearing its conclusion.
A starving and blockaded Germany, having fruitlessly spent its remaining reserves of men and material in its five unsuccessful Spring offensives, was being driven remorselessly back towards its own frontiers by the Anglo-French armies. The Allies were boosted by great draughts of new blood in the shape of hundreds of thousands of American 'doughboys' - strapping young US recruits pouring into France aboard every trans-Atlantic troopship. With savage irony, and as with today's Swine flu, it was these fit young people who appeared most susceptible to the 'flu virus - in the crowded troopships and training camps they fell ill and died like flies.

One terrifying aspect of the lethal virus was the speed of its onset. In Cape Town, a doctor boarded a tram for a routine three mile journey to his parents' home. First the conductor literally dropped dead on his platform. Then a passenger succumbed. Then another passenger. Finally, the driver died. The doctor completed his journey on foot.

The 'flu was no respecter of rank : the tough commander of the US Expeditionary Force, General 'Black Jack' Pershing went down - but survived. In October, while 50,000 Americans died in battle, 70,000 of them were hospitalised with 'flu, of whom 32 percent died.

The 'flu affected the course of the war. The Allied offensives almost ground to a halt because so many soldiers were sick. Had the high command but known it, however, the malnourished Germans were in an even worse state. The negotiations to end the conflict were held up for 48 hours when Prince Max of Baden, the Kaiser's last Chancellor, fell sick with 'flu, overdosed on palliative drugs, and went into a coma.

Other fatally afflicted victims included; the great sociologist Max Weber, who died in June 1920 when the pandemic was long past its peak; Lenin's lieutenant Jakov Sverdlov; and the Austrian erotic artist Egon Schiele, who had to watch the
funeral cortege of his bride Edith, pregnant with their first child pass by before returning to his sickbed to die.

Two days after Schiele's death, the Armistice was signed on November 11th. The same week, 'flu deaths in Europe reached their height with more than 2,500 people dying in Paris and London respectively : a death rate of 55.5 % per 1,000 that was comparable with mortality in the great London Plague of 1666. Two of the world leaders who gathered in the French capital to hammer out the Treaty of Versailles, British premier Lloyd George and US president Woodrow Wilson, both caught the 'flu - and lived. But the young British diplomat, Sir Mark Sykes - whose controversial Sykes-Picot plan to carve the Middle East into British and French spheres of influence - did not.

Strangely, Sykes had a posthumous role to play in a search for a vaccine to prevent a repetition of the pandemic. He was buried in a lead casket at his family mausoleum at Sledmore, near Driffield in east Yorkshire. It was thought that the lead might have preserved Sykes's corpse, and that the virus might still be lurking in his DNA. Sadly, when his tomb was opened in September 2008, the coffin had split and the body was too decomposed to yield a clue to the deadly organism that had wreaked so much havoc in a world already devastated by war.

Without a vaccine, public health authorities - just as today - were essentially helpless as the pandemic swung its sword and killed millions. The only way of attempting to avoid infection - then as now - were the ubiqutous facemasks and staying away from crowds. Once infected, however, retiring to bed and eating bland but nourishing food such as soup offered the best hope of recovery. One moribund patient, however, got better after an exhausted nurse fell asleep on his oxygen pump, blowing his body up like a balloon, but apparently saving his life. The great scientist J. B. S. Haldane swore by this 'oxygen cure' ever after. The pandemic also spared Joseph Pilates, German founder of the eponymous exercises, who, interned in the Isle of Man, claimed that all those who had adopted his yoga-like routines in his prison beat off the 'flu.

We must all hope that today's world, already menaced by economic breakdown, can avoid the fate prophesised by Albert Camus in his 1947 novel The Plague:

"He knew...that the plague bacillus never dies or disappears for good; that it can lie dormant for years and years in furniture and linen chests; that it bides its time in bedrooms, cellars, trunks and bookshelves; and that perhaps the day would come when, for the bane and enlightenment of mankind, it would rouse up its rats again and send them forth to die in a happy city".

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