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The recent outbreak of swine flu has evoked memories of earlier deadly epidemics, notably the global pandemic known as the Spanish flu that killed more than 21 million people worldwide in 1918-1919.

That epidemic began in the spring of 1918 in Spain, thus its name, and although it affected eight million Spaniards not a huge number died. Then it seemed to fade away, only to resurface a few months later in several places around the world. It appeared in eastern Canada in the summer, brought from Europe aboard troop ships by soldiers returning from the war. The first large civilian outbreak occurred in early September at a college in Victoriaville, Quebec, where four hundred students fell ill. Trains carrying veterans westward to their homes helped to spread the disease across the country like a runaway grass fire. It struck suddenly, with devastating consequences. A victim who was perfectly healthy in the afternoon might be dead by the next morning. By mid-October, fifty people a day were dying in Toronto, two hundred a day in Montreal.

The first cases appeared in Vancouver and Victoria in early October. The disease was characterized at the onset by cold-like symptoms: sore throat, a cough, stuffy nose, a mild fever. For the lucky ones, this was as far as it progressed. For others the fever worsened and was accompanied by general achiness, extreme lassitude, head pains, perhaps even delerium. In the worst cases pneumonia set in, leaving the patient with only a fifty-fifty chance of recovery.

The medical community was powerless. There was no drug, no pill or vaccine. Antibiotics had not yet been invented. Isolation was considered the best prevention. Public health officials urged people to avoid contact, not to kiss anyone or shake hands, to keep indoors and away from crowds. Schools closed; churches, pool halls and theatres emptied; shops shut early and authorities imposed a ban on all public meetings and sporting events. Vancouver was declared a “closed town”, which meant, according to a public notice: “Every place of assembly closed, every meeting stopped, all public amusement curtailed.”

The infection spread to the Interior along rail lines and up the coast on steamships. It thrived in logging and mining camps and was especially virulent in First Nations communities. In British Columbia, for example, the death rate from the flu in the general population was 6.21 per 1,000 people; among Aboriginals the rate was a whopping 46 per 1,000 people. (Paris and London, at the height of the epidemic, had death rates of 55.5 per 1,000!)

A total of two million Canadians came down with the flu, out of a population of about eight million. Of those afflicted, about 50,000 died. In BC the death toll was about 4,000 by the time the epidemic ran its course early in 1919. In Vancouver about 900 people died.

A recent book about the epidemic in Vancouver is Dr. Fred and the Spanish Lady: fighting the killer flu, by Betty O'Keefe and Ian Macdonald (Heritage House).

Labels: PUBLIC HEALTH

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