At the start of 1918, a strange flu epidemic spread throughout the world. Initially, it didn't especially worry the European populations. Though very virulent, it did not result in many deaths. Moreover, the major German offensives in the spring were much more of a concern.
The alarm bells suddenly started to ring at the end of the summer, given the growing number of patients and the worsening of their condition. In many communities, civilians were affected en masse. In the armies, general staffs began to see the numbers in their ranks plummet, at a time when the very outcome of the war was being decided. Newspapers refer less and less to the war, and more and more to the sick and dying. What was this illness that was so reminiscent of the great flu of 1889-1890, only much worse? Was there any protection against it? And where did it originate?
The newspapers on the Iberian Peninsula are the first to sound the alarm, while their European counterparts are entirely devoted to the conflict: the flu will therefore incorrectly be referred to as "Spanish". Contrary to any plausibility, certain conspiracy theorists even imagine that it was deliberately spread by the Germans via Spain, using contaminated food preserves.
At the end of the three normally distinguished waves (spring-summer then autumn of 1918, winter of 1919), the final count is catastrophic. The number of victims is so high that even today, its number cannot be quantified accurately. It is often said that, worldwide, the epidemic killed more people than the war, though it is problematic to compare two events of such differing natures. Since the 1990s, reference is generally made to a range of 30 to 40 million deaths. Some researchers, however, consider this number to be exaggerated, while others view it as too low and do not hesitate to posit more than 50 million… or more!
Nevertheless, one thing is certain: no epidemic has ever killed so many men and women in such a short time. What about in Belgium?
No epidemic has ever killed so many men and women in such a short time.
The "Spanish" flu attacks where it is least expected
The "Spanish" flu is surprising in many ways. In particular, it attacks people who are generally spared by "classical" epidemics. The populations are accustomed to seeing illnesses most strongly affect young children and the elderly, but the 1918-1919 pandemic primarily kills young adults, between 20 and 40 years of age. Incomprehensible at the time, this reality leaves observers dumbstruck. Indeed, the victims are brought down with the help of their own immune systems: vigourous resistance serves only to propagate the infection more rapidly. The flu itself didn't kill, or very seldom: the victims were finished off by other infections such as pneumonia, that took advantage of their weakness.
Since young people in their prime are most specifically affected, the epidemic takes a heavy toll on soldiers. With regard to the effects of the flu, the Belgian army has not been able to provide reliable medical statistics. The figures from Lieutenant General Dr. Mélis, who refers to 720 deaths per 12,000 military patients (i.e. only 6%), are unrealistic. In the absence of a definitive study, it is worth consulting the impressive memoirs of medical physicians, such as that of Dr. Colard, who refers to a "frightening mortality rate, comparable with the great pandemics of the Middle Ages, which at the peak of its development represented 30 to 40% deaths per day". In addition, in particular, we also have the accounts provided by combatants.
While the first wave of the flu is less fatal than the second, it is no less debilitating for the Belgian army, and traumatizing for its soldiers. They begin to fall prey to the illness in April-May 1918. Infected soldiers are soon systematically sent to the Cabour hospital in Adinkerke, in an effort to avoid contagion spreading through other care facilities, insofar as possible. Belgian accounts describe an illness that strikes the patients suddenly, leaving them without strength and resulting in a very high fever for two or three days (which justifies the name of "three day fever" quickly given to this first wave in the British army). Most patients – but not all! – survive this initial very high fever, and recover in two weeks or so.
This is the case of artillery man Edouard Froidure, who is struck by the flu on Sunday 2 June, in the midst of a mass celebrated by a military chaplain in Nieuwpoort. He loses consciousness and is carried off by stretcher bearers. He is quickly placed apart from the other patients, in the "outgoing" barracks, i.e. the people with little chance of surviving: "I stayed that way for three days, between life and death, with a 40° fever. The most dangerous thing, the really fatal blow for the most resistant (since curiously, the lads considered to be the weakest, or not as strong, anyway, lived through it), was to drop from a temperature of 39 or 40°, to another of 35° fever. That kind of thing took you to the cemetery… So for two or three days, I was raving, drained or agitated depending on the moment". By 15 June, Froidure is back on his feet. He was one of the lucky ones. Other patients recover more quickly, such as Gustave Tiberghien who, after three days of high fever at the end of June, went back on duty – with difficulty – after a single day of rest. The second wave in the autumn gave its victims fewer chances.
One of them is grenadier Gustave Groleau. Seriously wounded at the start of 1918, he must cool his heels in the rear instead of taking part in the final offensive. Far from the gunfire and shells, he is suddenly confronted with a completely different kind of death. On 1 October, his diary describes the surprise and tension resulting from the epidemic:
"At around 9 AM, I heard some bad news: a comrade, Sergeant Gustave Van Erp, from the Borinage region, has just died of bronchial pneumonia. What's going on in camp! The number of invalids grows each day, and everyone is worried. Even the doctors would like to know. We just don't know what's going on. Others of my friends have also been affected by this sinister illness: first Sergeant Majors Beckaert and Vincke, Sergeant Major Moetaert and quartermaster Bernier, all stout lads. What is this illness that doesn't forgive, and has already carried off Lieutenant Touret [?] It's frightening".
Vincke dies the next day: "Death is cutting a swath through the NCOs, and my table has been hit hard. There are eight of us at each table. At ours, five of the lads are ill, four very severely; amongst the latter, two have died". Moetart finally dies a week later. Just amongst the non-commissioned officers whom he knows personally, G. Groleau mentions the deaths of four other Sergeants before 10 October. But after that date, the flu disappears from his journal as quickly as it had appeared at the end of September. Gustave Groleau has survived the second wave of the epidemic.
Many others will not be so lucky. Amongst them, poet Louis Boumal, well-known in the small world of Belgian authors on the Yser. On the front since the start of the war, this lieutenant in the 5th Regiment of the Line earned the admiration of his comrades, both for his bravery and for his writing talent. At the start of 1918, L. Boumal writes a one-act play, "Quand ils auront passé de l’Ombre à la Lumière" (When They Will Have Moved from the Shadow to the Light). In it, he imagines seeing his wife again, who is barely disguised by a name change: the lieutenant is renamed Philippe, and his wife Marie-Thérèse becomes simply Thérèse. But Louis Boumal will never see his wife again, nor ever see the face of their child, who was born after his departure. Sent to the hospital at Bruges on 25 October, the illness carries him off five days later, two weeks before the Armistice.
Was he more or less fortunate than the ones who, like infantry sub-lieutenant Octave Amand, succumbed to the epidemic under the eyes of their families after returning home to them at the end of the hostilities? Still others must live with survivor's guilt: this is the case of Firmin Bonhomme, who sees his older brother Léon for the last time while on leave in Paris in late October 1918. Without knowing it, both are infected by the virus, which strikes Firmin upon his return to the front. He must be hospitalised and cannot return to his unit until 14 November, after the Armistice. He learns that his brother, infected at the same time as he, died more than a week before. The physician treating Léon said to Firmin : "my friend, all of those patients suffering from the flu were dropping like flies!".
What's going on in camp! The number of invalids grows each day, and everyone is worried. Even the doctors would like to know. We just don't know what's going on.
It spreads everywhere, like a fine powder
The illness is extremely contagious. It is enough to be briefly in the presence of a patient in order to catch the flu as well. But even more impressive is the very short incubation period. In a few hours, a healthy person begins to develop the initial symptoms. If death occurs, it sometimes only takes a few hours, at most a few days. When certain victims finally decide to go to the hospital (a decision that was not so obvious at the time), it's often too late.
It is generally estimated that 1/5 of the population of the belligerent countries catches the virus. But the "Spanish" flu is in no way a consequence of the conflict, and strikes all nations indiscriminately. America is perhaps even more affected than Europe. Within Europe, as we have seen, it's neutral Spain that gives its name to this illness. Spared by the war, Switzerland isn't missed by the illness: the Belgian engraver Frans Masereel, a refugee in Geneva, falls ill at the start of October.
While the war therefore plays no particular role in the illness' propagation, it nevertheless partially influences the mortality risks. Indeed, it creates a limited but vulnerable group of victims: soldiers who have been gassed. Because of the condition of their lungs, they are at greater risk of succumbing to the pneumonia that often accompanies the flu. Léon Barthélemy is one of them. Gassed with yperite (mustard gas), this soldier from the 1st Regiment of Grenadier's nevertheless manages to return home to Rochechaut (Belgian Ardennes), after the Armistice. The third wave of the epidemic catches up with him and kills him, in April 1919.
It kills quickly and in large numbers.
The figures often mentioned with regard to the epidemic can be misleading. They are only truly meaningful when considered against the backdrop of their time. The vast majority of the epidemic's victims die within the space of a few months, even only a few weeks. In the occupied territory, the first cases are often detected at the beginning of July. In Brussels, L. Picon indicates its presence as of the first day of the month, and writes 10 days later: "It's the Spanish flu, since this illness spread through Spain before appearing here. It isn't dangerous.". At that point, in fact, the epidemic does not seem so threatening, despite its virulence. Indeed, the same L. Picon notes on 24 July that the illness is inspiring performances: "It's being played as a review at the Alcazar theatre (as though everything finishes with songs and reviews)". A week later, however, he must nevertheless admit that there are "quite a number of fatal cases". But it's the second wave in October-November 1918 that is the most murderous in Belgium, as is generally the case elsewhere.
In many Belgian communities, the rhythm of the deaths – German soldiers or Allied prisoners, French refugees or Belgian civilians – is too fast even to allow for the celebration of masses. The parish priest in Willebroek (Antwerp Province), for example, mentions 63 flu victims in the village in November, 35 of whom die in only 10 days. In the big cities, dozens die every day. In Mons, the honorary notary Adolphe Hambye mentions more than 200 deaths in under a week, between 25 and 31 October. Given that wood is lacking after the German requisitions, caskets sometimes become impossible to find. The bodies are then rolled in sheets, placed in carts and taken to open pits filled with lime.
The excess mortality related to the flu can be approached in several manners: The archives from morgues are one of the potential leads. In Brussels, the morgue at the Saint-Jean hospital receives 269 deaths in October-November: twice as many as the number of victims for the same period in 1917 (107), almost 4 times the 1920 figure (72). Of the 135 deaths in October 1918, 108 occur in the second half of the month, at the start of the second wave. The age of the victims is also an indication. Of the 269 deaths in October-November, more than half (136) were born between 1876 and 1901: men and women between 17 and 42 years of age, normally not very vulnerable to illnesses, but the preferred targets of this epidemic. The rare violent deaths in Brussels during these days in November cannot explain such an influx, in what is in fact only one morgue amongst others within the capital.
The documents publish by hospitals are also useful. Between 19 October and 18 November 1918, the civilian La Louvière hospital received 28 epidemic patients. Three of them arrive late by their own means, and die. Of the 25 other patients, generally French refugees quickly brought in by order of the German military authorities, 5 die, i.e. 1/5. The age of the patients is revealing: 18 patients out of 28 are between 21 and 40 years old, which is the most affected range.
But the most useful archives are often retained by the communities. Everywhere, the civil status indicates an impressive mortality rate in 1918. In Huy, the number of deaths almost doubles relative to 1914-1916, with many diagnoses related to the "Spanish" flu. In Bruges, Mouscron and Wavre, we find the same proportions. But only a detailed analysis makes it possible to truly grasp the event. At La Louvière, the number of deaths per year between 1911 and 1921 is between 300 and 400 deaths. In 1918, the figure is above 500. This increase, however, primarily occurs in the months of October and November and, to a lesser degree, in December, if we compare them.
It comes back, again and again.
But it does not stop there. The third wave, that strikes Belgium at the end of the winter and start of the spring of 1919, is less known than the previous one, since it is generally less fatal. It nevertheless carried off a certain number of Belgians and put their families into mourning, in this Belgium that is only recently liberated and still under the shock of the war and its destruction.
Percy Smythe, Australian soldier whose unit is billeted in Marcinelle, is therefore awoken by crying in the night of 17 to 18 February: his host, "Mr. Paul", has just died in the next room. According to P. Smythe, flu-related deaths are daily at the time in Marcinelle, but it was only Belgians having to be buried, "Australian soldiers seem to be almost totally spared". In fact, this is hardly the case, as recently demonstrated by historian Bernard Lejeune. For example, the 20th Casualty Clearing Station of the British army, based in Charleroi, records 140 deaths in the early days of 1919, amongst the Empire's troops (along with a few German prisoners). Of these, 107 men (76%) die as a result of the "Spanish" flu. The Allied occupation troops will therefore also pay their dues to the epidemic. Many English-speaking and French soldiers die in Belgium in this early part of 1919. They include the young carpenter from Tasmania, Henry James Hall, who joins up in June 1918 and dies at the age of 20 years from the "Spanish" flu in our country, without ever having had the time to fight…
No one is safe
The flu surprises the Belgians from that time not only because it attacks people in good health, but because of its "democratic" nature. Where other epidemics tend to rage in more disadvantaged neighbourhoods, this one seems to ignore living conditions and social status. The diary of Adolphe Hambye is a testament to this. As an honorary notary, he has sufficient means to correctly provide for his family. Until October 1918, the war has by and large spared him: his six children are still alive. That's when everything changes: this 25-year-old daughter, Denise, falls ill from the flu on 21 October. On the 23rd, he writes: "In the midst of our anxiety, the events of the war had taken second place, despite being so distressing". Denise dies two days later, and his wife is also affected: "We haven't the heart to pay attention to news about the war, our more or less upcoming deliverance, nor the rumours running through the region. We're told that, in the city, there has been an upsurge of the Spanish flu and the death rate". His wife finally dies after a relapse, the day after the Armistice. The two victims had devoted themselves to taking care of sick French evacuees, and they paid for it with their lives. For the Hambye family, the "Spanish" flu proved to be more murderous in three weeks than the Great War in fifty-two months.
And unfortunately, it doesn't just kill. While a number of victims die from a heart attack, most of them suffered terribly before dying. They are suffocated by the fluids in their own body, that invade their lungs. A pink froth comes out of the mouth and nose. Shortly before or quickly after death, the patient's body turns blue. The suffering of the dying and the appearance of their cadaver cause terror, along with many rumours. These relate equally to the very nature of the illness (some refuse to believe that it's a "simple" flu and claim, for example, that it's cholera), and to means for protecting yourself from it (the manufacturers of "miracle" remedies make a fortune while taking advantage of the fear amongst the population). Physicians have trouble advising their patients: even they don't know which way to turn.
Medicine is impotent
The progress of western medicine in the years before 1914 led to a surprising result: despite all expectations, and despite the terrible sanitary conditions at the front, the Great War is the first conflict in which soldiers die (much) less from illnesses than from combat. Faced with the "Spanish" flu, however, physicians can offer no efficient remedy. Hospitals spread the virus more than they save lives. The only theoretical solution would be to quarantine any home in which the epidemic is found. This solution is envisaged in Australia, but impractical in Belgium in wartime. Locally, the authorities attempt insofar as possible to prevent the illness from taking advantage of large assemblies by prohibiting any performance, cinema showings or conferences, such as in Huy in the summer of 1918. But the efficiency of these commonsense measures is probably very limited.
Faced with the "Spanish" flu, physicians can offer no efficient remedy. Hospitals spread the virus more than they save lives.
A disturbing memory
In Europe, the "Spanish" flu will not become part of the collective memory, just the individual memories of families. In fact, people only remember things that make sense. People can come to terms with a war, even a conflict as terrible as the 1914-1918 war. Participants and their loved ones can understand their place – or not – in the stories told by society: in the stone monuments erected in towns, in the mountains of paper produced by newspapers and editors. In time, even the disputes surrounding these stories will find their place in the collective memory. But death as a result of an illness is devoid of meaning – at least in 20th century Europe. What sense can be made of an epidemic against which nothing can be done? It isn't commemorated, it is suffered in silence and then forgotten.
For that reason, the episode of the "Spanish" fever has long remained in the shadow of the Great War. However, the "avian" flu at the start of the 2000s sparked a new interest in this pandemic. On paper and on screens, the flu makes its way into fiction, whether in the very popular Twilight saga (Edward Cullen turns into a vampire just before dying from the epidemic) or in the fourth season of the Walking Dead series (the "Spanish" flu contributes to the transformation of the bulk of humanity into zombies). Fascinating and threatening at the same time, the pandemic remains quietly present in our imagination, far away but nevertheless disturbing.