Paths of infection: The first world war and the origins of the 1918 influenza pandemic

War in History

Volumn 21, Issue 1, 2014, Pages 55-81

  Humphries, Mark Osborne ^a  

^a MEMORIAL UNIVERSITY OF NEWFOUNDLAND   (Canada)

Author keywords

1918 Influenza pandemic; China; Epidemiology; First World War; Origins of influenza pandemics; Spanish flu

Indexed keywords

EID: 84892764591     PISSN: 09683445     EISSN: None     Source Type: Journal    
DOI: 10.1177/0968344513504525     Document Type: Article

References (175)

1. William H. McNeill, Plagues and Peoples, rev. edn (Toronto: Anchor, 1998), p. 137.
2. Philip Ziegler, The Black Death (New York: Penguin, 1998), pp. 13-17.
3. See also McNeill, Plagues and Peoples, pp. 173-9.
4. Alfred W. Crosby, 'Conquistador y Pestilencia: The First New World Pandemic and the Fall of the Great Indian Empires', Hispanic American Historical Review XLVII (1967), pp. 321-37.
5. For a more recent synthetic treatment see Jared Diamond, Guns, Germs, and Steel: The Fates of Human Societies (New York: W.W. Norton, 1999).
6. R. Pollitzer, Cholera (Geneva: World Health Organization, 1959), pp. 19-21.
7. See also Roderick McGrew, Russia and the Cholera, 1823-1932 (Madison: University of Wisconsin Press, 1965), pp. 17-25.
8. Colonel Guy Carleton Jones, 'The Importance of the Balkan Wars to the Medical Profession of Canada', Canadian Medical Association Journal IV (1914), pp. 801-2.
9. On Jones's role in the Canadian Army Medical Corps during the Great War, see J. George Adami, War Story of the Canadian Army Medical Corps (Ottawa: Canadian War Records Office, 1918).
10. The best overview of the pandemic remains Alfred W. Crosby, America's Forgotten Pandemic: The Influenza of 1918 (Cambridge: Cambridge University Press, 1989).
11. See the following on the flu's virology: Jeffery K. Taubenberger, Ann H. Reid et al., 'Characterization of the 1918 Influenza Virus Hemagglutinin and Neuraminidase Genes', International Congress Series MCCXIX (2001), pp. 545-9;
12. Ann H. Reid, Thomas G. Fanning, Johan V. Hultin and Jeffery K. Taubenberger, 'Origins and Evolution of the 1918 "Spanish" Influenza Virus Hemagglutinin Gene', Proceedings of the National Academy of Science of the United States of America XCVI (1999), pp. 1651-6;
13. Ann H. Reid et al., '1918 Influenza Pandemic Caused by Highly Conserved Viruses with Two Receptor-Binding Variants', Emerging Infectious Diseases IX (2003), pp. 1249-53.
14. The literature on the pandemic is large and growing. Historiographical overviews are provided in Guy Beiner, 'Out in the Cold and Back: New-Found Interest in the Great Flu', Cultural and Social History III (2006), pp. 496-505
15. Howard Phillips, 'The Re-appearing Shadow of 1918: Trends in the Historiography of the 1918-19 Influenza Pandemic', Canadian Bulletin of Medical History XXI (2004), pp. 121-34.
16. See also Howard Phillips and David Killingray, The Spanish Influenza Pandemic of 1918-1919: New Perspectives (London: Routledge, 2003).
17. Carol Byerly, Fever of War: The Influenza Epidemic in the U.S. Army during World War I (New York: New York University Press, 2005).
18. See also Mark Osborne Humphries, 'The Horror at Home: The Canadian Military and the Great Influenza Pandemic of 1918', Journal of the Canadian Historical Association XVI (2005), pp. 235-60
19. The Last Plague: Spanish Influenza and the Politics of Public Health in Canada (University of Toronto Press, 2013);
20. Eckard Michels, 'Die "Spanische Grippe" 1918/19: Verlauf, Folgen, und Deutungen in Deutschland im Kontext des Ersten Weltkriegs', Vierteljahrshefte für Zeitgeschichte I (2010), pp. 1-33;
21. Manfred Vasold, Die Spanische Grippe: Die Seuche und der Erste Weltkrieg (Darmstadt: Primus, 2009).
22. For an overview of the literature, see Beiner, 'Out in the Cold', and Phillips, 'Re-appearing Shadow'. Examples include Niall Johnson, Britain and the 1918-19 Influenza Pandemic: A Dark Epilogue (London: Praeger, 2005);
23. Esyllt Jones, Influenza, 1918: Disease, Death, and Struggle in Winnipeg (Toronto: University of Toronto Press, 2007);
24. Eileen Pettigrew, Silent Enemy: Canada and the Deadly Flu of 1918 (Regina: Western Producer Prairie, 1983);
25. Dorothy A. Pettit and Janice Bailie, A Cruel Wind: Pandemic Flu in America, 1918-1920 (Murfreesboro, TN: Timberlane, 2008);
26. Howard Phillips, 'Black October': The Impact of the Spanish Influenza Epidemic of 1918 on South Africa (Pretoria: Government Printer, 1990);
27. Geoffrey W. Rice, Black November: The 1918 Influenza Pandemic in New Zealand, 2nd edn (Christchurch: Canterbury University Press, 2005).
28. Kirsty Duncan, Hunting the 1918 Flu: One Scientist's Search for a Killer Virus (Toronto: University of Toronto Press, 2003);
29. Gina Kolata, Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It (New York: Farrar, Straus and Giroux, 1999);
30. Heather MacDougall, 'Toronto's Health Department in Action: Influenza in 1918 and SARS in 2003', Journal of the History of Medicine and Allied Sciences LXII (2007), pp. 56-89;
31. Howard Markel et al., 'Non-Pharmaceutical Interventions Implemented by US Cities during the 1918-1919 Influenza Pandemic', Journal of the American Medical Association CCXCVIII (2007), pp. 644-54;
32. S. Zhang, P. Yan, B. Winchester, and J. Wang, 'Transmissibility of the 1918 Pandemic Influenza in Montreal and Winnipeg of Canada', Influenza and Other Respiratory Viruses IV (2010), pp. 27-31.
33. For a brief scientific overview, see World Health Organization, 'Fact Sheet: Influenza', www.who.int/mediacentre/factsheets/2003/fs211/en/[accessed 25 September 2011], and Center for Disease Control (CDC).
34. Seasonal Influenza: Flu Basics', www.cdc.gov/flu/about/disease/[accessed 23 September 2011].
35. Pettit and Bailie, Cruel Wind, provides a good overview of the science behind pandemics in ch. 1, pp. 1-37.
36. W. Graeme Laver, Norbert Bischofberger and Robert G. Webster, 'The Origin and Control of Pandemic Influenza', Perspectives in Biology and Medicine XLIII (2000), pp. 173-91.
37. Pettit and Bailie, Cruel Wind, pp. 22-37.
38. Kerri Smith, 'Concern as Revived 1918 Flu Virus Kills Monkeys', Nature CDXXXXV, 237 (2007), www.nature.com/nature/journal/v445/n7125/full/445237a.html [accessed 25 September 2011]
39. Darwyn Kobasa et al., 'Aberrant Innate Immune Response in Lethal Infection of Macaques with the 1918 Influenza Virus', Nature CDXXXXV, 319-23 (18 January 2007), www. nature.com/nature/journal/v445/n7125/abs/nature05495.html [accessed 10 September 2011].
40. On the search for the virus, see Kolata, Flu.
41. Edwin Oakes Jordan, Epidemic Influenza: A Survey (New York: American Medical Association, 1927), p. 60.
42. J.S. Oxford et al., 'Early Herald Wave Outbreaks of Influenza in 1916 prior to the Pandemic of 1918', International Congress Series MCCXIX (2001), pp. 155-61;
43. J.S. Oxford, 'The So-Called Great Spanish Influenza Pandemic of 1918 May Have Originated in France in 1916', Philosophical Transactions of the Royal Society B CCCLVI, 1416 (29 December 2001), pp. 1857-9;
44. J.S. Oxford et al., 'World War I May Have Allowed the Emergence of "Spanish" Influenza', Lancet: Infectious Diseases II, 2 (2002), pp. 111-14;
45. J.S. Oxford et al., 'A Hypothesis: The Conjunction of Soldiers, Gas, Pigs, Ducks, Geese, and Horses in Northern France during the Great War Provided the Conditions for the Emergence of the "Spanish" Influenza Pandemic of 1918-1919'
46. Vaccine XXIII (2005), pp. 940-5.
47. Oxford et al., 'Early Herald Wave Outbreaks', pp. 156-7.
48. For the original articles, see J.A.R. Hammond et al., 'Purulent Bronchitis: A Study of Cases Occurring amongst the British Troops at a Base in France', Lancet II (1917), pp. 41-5
49. A. Abrahams et al., 'Purulent Bronchitis: Its Influenza and Pneumococcal Bacteriology', Lancet II (1917), pp. 377-80.
50. Oxford et al., 'Hypothesis', pp. 940-5.
51. See R.B. Belshe, 'The Origins of Pandemic Influenza: Lessons from the 1918 Virus', New England Journal of Medicine CCCLIII, 21 (24 November 2005), p. 2209
52. Ann H. Reid et al., 'The 1918 Spanish Influenza: Integrating History and Biology', Microbes and Infection III (2001), p. 86.
53. Belshe, 'The Origins of Pandemic Influenza', p. 2209;
54. Reid et al., '1918 Spanish Influenza', p. 86.
55. James E. Edmonds, History of the Great War Based on Official Documents: Military Operations, France and Belgium, 1918, vol. 5: 26th September-11 November 1918: The Advance to Victory (London: HMSO, 1947), p. 615.
56. Holger H. Herwig, The First World War: Germany and Austria-Hungary, 1914-1918 (New York: St. Martin's, 1997), pp. 446-7.
57. Stephen Graubard, 'Military Demobilization in Great Britain Following the First World War', Journal of Modern History XIX (1947), p. 301.
58. The majority of Canadian troops did not return home until late in the winter of 1919.
59. G.W.L. Nicholson, Canadian Expeditionary Force, 1918-19 (Ottawa: Department of National Defence, 1962), pp. 530-3.
60. See E. Jay Howenstine, Jr, 'Demobilization after the First World War', Quarterly Journal of Economics LVIII (1943), pp. 95-105, but especially p. 103.
61. Margaret MacMillan, Paris 1919: Six Months That Changed the World (New York: Random House, 2001), p. 471.
62. Jordan, Epidemic Influenza, pp. 62-76.
63. John M. Barry, The Great Influenza: The Epic Story of the Deadliest Plague in History (New York: Penguin, 2005), pp. 92-6.
64. See also John M. Barry, 'The Site of Origin of the 1918 Influenza Pandemic and Its Public Health Implications', Journal of Translational Medicine II (2004), www.translational-medicine.com/content/2/1/3 [accessed 13 September 2013].
65. Anon., 'Influenza: Haskell, Kansas', Public Health Reports XXXIII (1918), p. 502.
66. Barry, 'Site of Origin'.
67. Maj. Gen. M.W. Ireland, The Medical Department of the United States Army in the World War, vol. 9: Communicable and Other Diseases (Washington: U.S. Government Printing Office, 1928), p. 78.
68. These statistics include admissions for influenza, bronchitis, and pneumonia.
69. See also George A. Soper, 'Health of the Troops in the United States during 1918', Military Surgeon (October 1919), pp. 11-12.
70. This source simply refers to outbreaks of flu throughout the winter and spring but cites many early outbreaks at military camps in March 1918.
71. Ireland, Medical Department, p. 78.
72. See, for example, Robert G. Webster, 'Wet Markets: A Continuing Source of Severe Acute Respiratory Syndrome and Influenza', Lancet CCCLXIII (17 January 2004), pp. 234-6.
73. See Christopher Langford, 'Did the 1918-19 Influenza Pandemic Originate in China?', Population and Demographic Review XXXI (2005), pp. 473-505.
74. Langford, 'Did the 1918-19 Influenza Pandemic', pp. 492-3.
75. Plague Raging in Shansi', North China Herald, 29 December 1917, p. 768.
76. On the history of pneumonic plague in China, see Mark Gamsa, 'The Epidemic of Pneumonic Plague in Manchuria, 1910-1911', Past & Present CXC (2006), pp. 147-83.
77. CDC, 'Facts about Pneumonic Plague', www.bt.cdc.gov/agent/plague/ factsheet.asp [accessed 14 July 2008].
78. The biological identity of the Black Death has been disputed by a number of scholars over the years.
79. See David Herlihy, The Black Death and the Transformation of the West (Cambridge: Harvard University Press, 2007);
80. Samuel K. Cohn, 'The Black Death: End of a Paradigm', American Historical Review CVII (2002), pp. 703-38;
81. Samuel K. Cohn, The Black Death Transformed: Disease and Culture in Early Renaissance Europe (London: Edward Arnold, 2002).
82. Recent investigations of DNA from plague victims in London suggest that the bacterium Yersinia pestis did indeed cause the Black Death, although it may have been a very different strain of the bacteria from what is commonly found today.
83. See Verna J. Schuenemann et al., 'Targeted Enrichment of Ancient Pathogens Yielding the pPCP1 Plasmid of Yersinia Pestis from Victims of the Black Death', Proceedings of the National Academy of Sciences of the United States of America CVIII (2011), www.pnas.org/content/108/38/E746 [accessed 13 September 2013].
84. CDC, 'Facts about Pneumonic Plague'.
85. Peking Legation Memorandum', 1 January 1918, FO 228/3115, The National Archives (hereafter cited as TNA), Kew.
86. Peking Legation Memorandum', 4 January 1918
87. Telegram, British Consul at Nanking to John Jordan', 19 March 1918', FO 228/3115, TNA.
88. See also North China Herald, 26 January 1918, p. 185.
89. North China Herald, 5 January 1918.
90. See also Wu Lien-Teh, Plague Fighter: The Autobiography of a Modern Chinese Physician (n.p.: W. Heffer, 1959).
91. Carsten Flohr, The Plague Fighter: Wu Lien-Teh and the Beginning of the Chinese Public Health System (London: Taylor & Francis, 1996).
92. North China Herald, 12 January 1918, pp. 49-50;
93. North China Herald, 11 January 1919, p. 59.
94. The papers reported: 'People are dying on the roads and in the inns. Six cases occurred on January 5 at Sopingfu, 600 li North of Taiyuanfu, which city is by now probably affected. This means that the Kinhan Railway, Hankow and the Yangtze are menaced.' 'The Plague in Shansi', Peking and Tientsin Times, 12 January 1918, extra issue, p. 1.
95. This means that the Kinhan Railway, Hankow and the Yangtze are menaced.
96. 'The Plague in Shansi', Peking and Tientsin Times, 12 January 1918, extra issue, p. 1
97. Report on "Plague"', 14-21 January 1918, FO 228/3115, TNA; North China Herald, 12 January 1918, pp. 54 and 65.
98. North China Herald, 12 January 1918, p. 57.
99. Report of the Shansi Plague Prevention Bureau, 1918', FO 228/3115, TNA, pp. 2, 31.
100. Gamsa, 'Epidemic of Pneumonic Plague', p. 147.
101. Report on "Plague"', 14-21 January 1918.
102. British doctors also concluded that the 'mortality is not very great on the whole'.
103. See Telegram 67, 9 February 1918, FO 228/3115, TNA;
104. North China Herald, 12 January 1918, p. 57;
105. By 18 March, three months into the investigation, the most certain pronouncement that the team could make was to say that an outbreak in Nanking was 'now practically established to be pneumonic plague' See Telegram, British Consul in Nanking to John Jordan, 19 March 1918, FO 228/3115, TNA.
106. Note from the Plague Service of the Board of the Interior, 29 March 1918, FO 228/3115, TNA.
107. Wai Chiao Pu to H.M. Minister, 14 November 1918, FO 228/3115, TNA.
108. [Signature illegible], 'Spanish Influenza in Sinkiang: Heavy Death Toll', 7 December 1918, FO 228/3115, TNA.
109. His evidence is detailed in charts and several appendices.
110. See especially the table on p. 478.
111. Wataru Iijima, 'Spanish Influenza in China, 1918-20: A Preliminary Probe', in Howard Phillips and David Killingray, eds, The Spanish Influenza Pandemic of 1918-19: New Perspectives (New York: Routledge, 2003), pp. 101-9;
112. Mark Osborne Humphries, 'The Duty of the Nation: Public Health and the Spanish Influenza in Canada, 1918-19', unpublished PhD dissertation, University of Western Ontario, 2008, ch. 2.
113. F. Norman White, The Prevalence of Epidemic Disease and Port Health Organization and Procedure in the Far East (Geneva: Health Committee of the League of Nations, 1923), p. 78.
114. White, Prevalence of Epidemic Disease, pp. 79, 83.
115. The remaining statistics are derived from Langford, 'Did the 1918-19 Influenza Pandemic', and White, Prevalence of Epidemic Disease.
116. Langford presents a good overview of the questions which must be answered to make this case.
117. Pamela Atwell, British Mandarins and Chinese Reformers: The British Administration of Weihaiwei (1898-1930) and the Territory's Return to Chinese Rule (New York: Oxford University Press, 1985), pp. 1-31.
118. Telegram No. 280, 'China, Military', Sir J. Jordan to Foreign Office, 26 September 1918, WO 106/33, TNA.
119. Telegram No. 131, 'China, Military', Sir J. Jordan to Foreign Office, 30 September 1918, WO 32/11345, TNA.
120. Telegram No. 76, 'China, Military', Mr. Alston to Foreign Office, 19 February 1917, WO 106/33, TNA.
121. Telegram No. 77, 'China, Military', Mr. Alston to Foreign Office, 19 February 1917, WO 106/33, TNA.
122. Telegram No. 553, SNO Hong Kong to Admiralty, 8 February 1917, MT 23/818, TNA.
123. Telegram No. 510, Admiralty to Commodore Hong Kong, 24 February 1917, MT 23/818, TNA; Telegram No. 627, Admiralty to Commodore Hong Kong, 3 March 1917, MT 23/818, TNA; Pettit and Bailie, Cruel Wind, pp. 66-7.
124. Colonial Office Memorandum, T22497, 10 March 1917, MT 23/818, TNA.
125. See Patricia E. Roy, A White Man's Province: British Columbia Politicians and Chinese and Japanese Immigrants, 1858-1914 (Vancouver: UBC Press, 1989);
126. The Oriental Question: Consolidating a White Man's Province, 1914-1941 (Vancouver: UBC Press, 2003);
127. British Columbia's Fear of Asians', Histoire Sociale/Social History XIII (1980), pp. 161-72.
128. See also Peter S. Li, The Chinese in Canada (Toronto: Oxford University Press, 1988).
129. E.P., 'Chinese Coolies: Great War', 30 April 1940, GAQ 8-36, vol. 1833, RG 24, Library and Archives Canada (hereafter LAC), Ottawa.
130. See various documents in the files of the Chief Press Censor, file 331, vol. 620, RG 6, LAC.
131. See also Elizabeth A. Tancock, 'Secret Trains Across Canada, 1917-1918', Beaver (October-November 1991), pp. 39-43.
132. Epidemic of Pneumonia in Chinese Province', Globe, 5 January 1918, p. 7.
133. WO 32/11345, TNA;
134. R.F.J., Office of the Adjutant General to T.J. Bourne, War Office Recruiter, 14 January 1918, FO 228/3115, TNA.
135. Telegram P9151-SR1, Unnamed sender to Director of Transports and Shipping, 1 March 1918, MT 25/13, TNA.
136. Statement Showing Movement of Vessels Conveying Chinese Workers to France and Numbers Reported on Each Vessel', WO 32/11345, TNA.
137. Telegram, Canadian General Staff to London, 25 March 1918, file c2276, vol. 2554, RG 24, LAC.
138. The cause of death was provided to me by Gregory James, Hong Kong University of Science and Technology, on the basis of his detailed research for Foch's Reserves: The Chinese Labour Corps, 1917-1921 (Hong Kong: Proverse, 2013).
139. Internal Memorandum for Naval Secretary, Interdepartmental Committee, 30 March 1918, file c2276, vol. 2554, RG 24, LAC.
140. Surgeon General Jones to GOC MD 11, 2 April 1918, file c2276, vol. 2554, RG 24, LAC.
141. Personal communication with Gregory James, based on his research for Foch's Reserves.
142. See MT 25/13, TNA.
143. The Military Secretary for the Interdepartmental Committee to the Naval Secretary, Interdepartmental Committee, 9 May 1918, file 48-45-2 part 12, vol. 3738, RG 24, LAC.
144. See Anon., 'The Necessity of a Recognition and Isolation of Trachomatous Patients in Canada', Canadian Practitioner and Review XXVI (1901), pp. 508-9.
145. H.D. Livingstone, 'Chinese Labour Corps' Medical Officer's Journal, 5th Contingent.' The handwritten original is in the possession of Mr David Livingstone of Waterloo, Ontario, who kindly allowed me to quote from his father's papers.
146. Livingstone Memoir', pp. 14-15.
147. This is a typed memoir, a copy of which is in possession of the author while the original remains with Mr David Livingstone of Waterloo, Ontario.
148. I would like to thank Mr Livingstone for allowing me to consult the memoir and photograph it in the summer of 2008.
149. According to Pettit and Bailie, sore throats were rampant in the camps: see Cruel Wind, pp. 65-7.
150. See E.P., 'Chinese Coolies: Great War', and Surgeon General Jones to GOC MD 11, 2 April 1918, file c2276, vol. 2554, RG 24, LAC.
151. Compiled from daily orders in 'Military District 11-No. 43-Railway Service Guard', vol., series II-F-9, RG 9, LAC.
152. Livingstone Memoir', pp. 22-3.
153. See various entries in War Diary, Number 3 Native Labour General Hospital, WO 95/4115, TNA 14 January 1918
154. On the diagnosis of swine diseases before the identification of influenza, see W.W. Dimock, 'Differential Diagnosis of Diseases of Swine', Journal of the American Veterinary Medical Association LIV (1919), pp. 321-30
155. J.S. Koen, 'A Practical Method for Field Diagnosis of Swine Disease', American Journal of Veterinarian Medicine XIV (1919), pp. 468-70.
156. Barry, Great Influenza, pp. 91-2.
157. War Diary, Number 9 Canadian General Hospital, Shorncliffe, 13 April 1918, file 858, vol., series III-D-3, RG 9, LAC.
158. Livingstone Memoir', p. 22.
159. War Diary, Number 9 Canadian General Hospital, Shorncliffe, 25 April 1918, file 858, vol., series III-D-3, RG 9, LAC.
160. Status of Infectious Diseases', War Diary, Assistant Director of Medical Services, Shorncliffe, 17, 30 April 1918
161. See various entries in War Diary, Number 3 Native Labour General Hospital, February-August 1918, WO 95/4115, TNA.
162. Crosby, America's Forgotten Pandemic, pp. 37-40.
163. See the log of Coolie Transportation in WO 32/11345, TNA, various correspondence in MT 23/818, TNA, and the log of Plymouth Harbour in ADM 53/48308, TNA.
164. Devonport General Order 653', 26 July 1918, ADM 130/27, TNA.
165. Ship's Log, HMS Mantua, 31 July 1918, ADM 53/48308, TNA.
166. Sandra M. Tomkins, 'Colonial Administration in British Africa during the Influenza Epidemic of 1918-19', Canadian Journal of African Studies XXVIII (1994), pp. 68-70.
167. Phillips, Black October, p. 8.
168. Rice, Black November, p. 58.
169. Ship's Log, HMS Mantua, ADM 53/67788, TNA. This is a significant finding, in part because previous historians have argued that there were no deaths from influenza on board the ship and thus the illness that it was carrying must have been of the earlier, more mild type, rather than the fatal autumn strain.
170. See Crosby, America's Forgotten Pandemic, p. 37.
171. See the log of Plymouth Harbour for July and August 1918, ADM 53/48308, TNA.
172. Influenza Is Now Spreading', Marion Daily Star (Ohio), 14 September 1918, p. 9.
173. 2000 Cases of Influenza Found among Soldiers', Syracuse Herald (New York), 15 September 1918, p. 11.
174. John Barry told NPR in an interview published online on 20 February 2006: 'Ultimately, I don't think it matters where it began . The most important thing is that it can begin anywhere.'
175. Vikki Valentine, 'Origins of the 1918 Pandemic: The Case for France', www.npr.org/templates/story/story.php?storyId=5222069 [accessed 28 February 2012].