Well written account of the pandemic and a warning to us all of how easily it can spread.

I read this during the recent pandemic

The the flu of a hundred years ago was spread by travel and human contacted and put huge strain put on doctors, nurses ,families and ended in millions of deaths across the world. It's scary to see the similarities between what is going on in our world today and what happened over 100 years ago.

I enjoyed this book, although at times the narration seemed a little stiff. Instead of tracing the course of the illness as a historical narrative, the chapters each follow an individual and how they fell ill. These are told as if you are there with the person who has gotten ill; I am assuming the stories of the people who survived came from interviews or diary entries and ones that died came from interviews with family or friends, perhaps from medical reports. In any case, these personal accounts make the terrible effects of the "Spanish" influenza more intimate. The chapters also follow the progress of the virus around the world, rather than just concentrating on the US or Europe.

I had this book to review on my pile for a while and the coronavirus outbreak did both put me off reading it, and also intrigued me to a degree as I often wondered how the Spanish Flu came to fruition and how the managed to control the outbreak over 100 years ago with them having nowhere near the scientific breakthroughs, medication and information we have now.

The book is well laid out and I liked the way that the book was written. Some of the chapters for me were really addictive, especially at the outset as I was craving more from the first few pages and the author managed to answer a lot of the questions I had straight away.

The sections on Alaska and how fast the virus spread there and the aftermath were shocking and to see towns decimated in that way must have been horrific, I was also appalled at the response regarding what they said needed to happen with the orphaned children too, it really was a different time back then but some of the inhabitants of the towns survived and they could easily have all been wiped out.

I also was intrigued by the author’s links between the pandemic and the rise of Hitler out of the ashes of the Germany economy that had been pretty much ruined after the Great War – another thing that has left me wondering and what the author has put forward, for me is entirely plausible too – it does make you think about how one action and the absence of Woodrow Wilson could have ultimately changed the world.

It is 4 stars from me for this one – definitely a book that has given me food for thought especially in the current coronavirus pandemic we are all going through - they do say history repeats itself

The author has assembled a substantial collection of personal anecdotes from across the globe which he utilizes as a lens to examine the impact of Spanish Influenza on history. This focus on personal recollections of the virus makes this book quite engaging for the general reader. However, the author's attempt to draw broad conclusions based on this assemblage of personal stories is not always convincing. For example, the author writes cryptically: "The British took the opportunity to wage mental welfare on the stricken German troops and thousands of propaganda leaflets were dropped by air over German lines suggesting that if their own troops could not relieve them, the British would." Without any further commentary, this assertion gives the impression that the flu epidemic sparked the first use of propaganda by the British during the conduct of the war. Certainly this was not the case, as both sides used propaganda from the outset of World War I in 1914. [See for example, Eberhard Demm, Censorship and Propaganda in World War I: A Comprehensive History (2019); World War I and Propaganda, edited by Troy R. E. Paddock (2014)]. For the reader who is aware that propaganda played a role in the war's conduct from the outset, this brief reference fails to answer the question: How was this usage of propaganda different from earlier usages? In other words, how exactly did the British mobilize the pandemic to their advantage? Since the author provides no citation, the reader has no idea where to look for further information.

Unfortunately, the above example is not the only place where the author makes broad claims without providing adequate evidence or explanation. For example in discussing influenza in the Austro-Hungarian Empire, the author notes: "With the peak of the death toll in the two weeks before the Armistice, it has been suggested flu caused social unrest which contributed to the collapse of the Austro-Hungarian Empire, and the end of the war." However, the reader does not tell us, who has suggested this? What historian? In what scholarly work? Again, in the absence of any citation, the reader has no options for follow-up.

These missing citations are made more visible by the fact that the text does include some notes as well as references some scholarly works within the body of the text. For example, the author discusses relevant scholarly works by multiple historians, including Richard Bessel, professor of twentieth century German history at York University and Geoff Rice, professor emeritus at Canterbury University, Christ Church.

These occasional notes and discussions of relevant historiography also contrast sharply with explanations of viral infections that seemed designed for children: "To put it another way, imagine influenza is a shop that sells only jumpers. Inside the shop, there are three main styles of jumpers; V-neck, sweater, or cardigan -- these are the three main subtypes....you select the size and decide on the color -- this is the strain." And on and on the "jumper/virus" analogy goes. It is difficult to imagine that the same reader who requires such explanations would also be interested in discussions of historiography.

For these reasons, I cannot recommend this book.

I would like to thank the publisher, the author, and NetGalley for an advance copy of this book in exchange for a fair and honest review.

Though this was written before the current pandemic it's unbelievably similar to what's going on right now.
Detailing the Spanish Flu Epidemic right from the start with the first person infected,how it was spread from country to country and the numbers of those infected. It lasted for years as well with no vaccine. Masks were required back then and in some areas people got arrested for not wearing them. Human nature doesn't change though and some fought against wearing it just like today.
Just like today the numbers were incredibly high with those infected and deaths reported of course not all deaths were reported and all cases were not know for the cause of death.
Very informative and interesting . We should all give a thank you to our health care workers who go above and beyond at the cost of not seeing their families for periods of time and at the risk of their own health. Thank you health care professionals!!!!

Pub Date: 30 Oct 2020
I was given a complimentary copy of this book. Thank you.
All opinions expressed are my own.

This book has a lot going for it, and I would recommend it for use in the classroom. I have already recommended it to friends who teach at the college level, and am considering using a portion in one of my courses. Something inferred, but not often directly discussed, is the role of imperialism in the experience and aftermath of the flu. There's a great assignment there that I havent fully formed yet.

I'd also recommend it to armchair historians or people newly interested because of COVID.

Breitnauer covers a lot of space in not a lot of pages, including not only the US and Europe, but also China, Japan, Samoa, New Zealand, Australia, South Africa, Alaska, and more. Each chapter starts with a vignette of a specific person. Although citations are light, the material is accurate. There are also references to source material such as in this person's memoir, that person's letter, etc. There is some conjecture, but most of it is realistic and grounded. We may not have record of someone feeling weak or wiping sweat from their brow, but we know the symptoms of this flu or that the person was standing in a sun in a wool suit in summer.

That said, the last section makes a lot of claims about the far reaching effects of the Spanish Flu without much support offered. They arent ground breaking claims, but still a stretch to chalk up to just the flu epidemic. Also, the bias for modern and western medicine is a problem. But overall, these dont take away from the overall utility of the work.

Note - this was written *before* COVID

Thank you to Jaime Breitnauer, Pen and Sword, and Netgalley for a free ebook in exchange for my honest opinion

It feels very apt to have read this book at a time when we are experiencing the largest pandemic in our lifetime. It is a great read, meticulously researched, and somehow feels doubly relevant in today's climate. I thoroughly enjoyed this book, and would heartily recommend it.

My thanks to the publishers for a review copy of this book, written before the current pandemic, which charts the course of the last worldwide epidemic to kill millions. It’s the story of a pandemic overshadowed by a world war, told with the stories, imaginatively presented, of many individuals caught up in it. The parallels with the course of the coronavirus pandemic are the more chilling because the book was written before its outbreak, although perhaps there is a perverse consolation in our having collectively forgotten the horrors of this history, as I expect we will forget today’s story too.

This is an interesting book, dealing with a huge panoply of policy responses and historical impacts. Inevitably there is some over simplification in the historical summaries and some more contentious interpretations of history are presented too. Gandhi was no man of the people in my estimation for example. Nonetheless this is an important and relevant work which is very readable.

We begin with Gitchell, patient zero, the first recorded case, a mess cook in the gigantic military camp at Funston, Kansas, which prepared US soldiers before they were sent to France to join the war in Europe. He was the first of over 100 men admitted to the hospital wing on the first morning of an outbreak where later a total of 1,100 fell ill. 48 died. He survived. Many went to the war in Europe still sneezing and coughing.

Influenza first arose as a term in 1504, when an unusual alignment of stars was thought to influence an epidemic. Miasma or ‘bad air’ was another theory governing the spread of epidemic disease at that time. Epidemics of fever and respiratory disease which inflated mortality rates were not new but were overshadowed by smallpox as the most feared killer epidemic up until the 18th century and then cholera in the 19th. People only started to use virus as a term and think of organisms smaller than bacteria causing disease around the turn of 20th century but at that time flu was still thought to be caused by bacteria.

In 1910 a plague disease in Harbin travelled along the eastern Chinese railway Dr Wu conducted the first authorised autopsy in China and also got dispensation to cremate victims. But in 1918, when he tried a similar approach against a winter sickness, his remedies were rejected. The winter sickness symptoms were noticed but downplayed in the Chinese Labour Corps men shipped to Europe in 1917 to 1918.

Other recorded outbreaks in rural settings, notably in Etaples in France, thought to be purulent bronchitis or secondary infection pneumonia make it impossible to know where this flu really started in an age where viral disease and immunity were not understood and the role of birds as incubators and animals as carriers of lethal mutated virus unknown. These mechanisms remain obscure today.

It was only possible to see viruses and the analyse the proteins on their surfaces with the invention of the electron microscope in the late 1930s.

The second wave of the 1918 flu, which started in September 1918, was more virulent than the initial outbreaks and attacked mainly those aged 15 to 44. Those who had been exposed to the spring wave appeared to fare better if they caught flu again in the autumn. The role of acquired immunity for those who lived through the Russian flu of 1889 to 1891 and background immunity for young children are not easy to explain. Lack of immunity especially of indigenous people around the world proved catastrophic.

The second wave also targeted the young and healthy, triggering cytokine storms and inflammation in their actIve immune systems leading to blue faced asphyxia. We are seeing that again too. This flu, however, also proved more fatal to pregnant women.

Fake news and conspiracy theories abounded, although it is possible that the chemical agents in mustard gas assisted viral mutation and made it even more difficult for soldiers with damaged lungs to survive the ravages caused by the virus.

Governments also ignored scientific warnings about the scale of the second wave to be expected. Hospitals were slow to realise the benefits of ventilation. Towns were much worse affected than country areas.

The individual stories in this book range from the early childhood trauma of Anthony Burgess, author of ‘A Clockwork Orange’ to Maria in Spain, aged 6, who lost her mother, unborn sibling, bother and father to the ‘Naples soldier’, a colloquial name for the flu which had probably come from France upon the return of migrant Spanish workers from there by rail. Spain was not active in the world war so it had workers to supply. Over 160,000 Spaniards died in the 3 waves of flu. Despite the king being a high profile patient, it seems unlikely that ‘Spanish flu’ originated in Spain.

We meet too Egon Schiele, the talented Austrian expressionist artist, painter of The Family, his own, which was never to be as his pregnant wife and he succumbed within days of each other.

The third wave of the flu was instigated by demobilisation, and, while not as devastating as the second wave, it still killed people in their prime.

The effect of the travelling war machine created a pandemic which killed more people in 6 months than the Black Death did in 4 years and dwarfed the casualties of both world wars in the 20th century. In England, Wales and Scotland, the death toll for the official 46 weeks of the epidemic was recorded as 170,000 and likely to have been in fact around 220,000.

In Russia it spurred the development of national health care under Lenin, something which didn’t happen fully here until the end of another world war. Changes to the National Insurance Act of 1911 meant that half the UK adult population had affordable access to modern hospitals by 1936 and there was a growth in GP subscription services and free access to philanthropically funded hospitals.

National health insurance in France started in 1928 and in 1919 the Paris initiated International Office of Public Hygiene moved to Vienna. It eventually became the WHO together with the League of Nations and its US equivalent.

Sweden lost 40,000 out of a population of 5 million during the course of the epidemic, which lasted there until 1920.

25,000 died in neutral Switzerland, which took in PoW from both sides. The situation fuelled an acrimonious general strike which eventually resulted in demands for a 48 hour week, social insurance and a system of collective bargaining being accepted.

200,000 died in Germany in a populace already weakened by hunger. Arguably the flu halted a promising German advance on the western front and changed the course of the war. It may have led to the end of the war too, by contributing to the social unrest which assisted the collapse of the Austro-Hungarian empire.1.5 million German soldiers died of flu.

700,000 Americans died with different cities handling the epidemic in very different ways. Washington shut down, New York tried to balance military, commercial and health priorities, Philadelphia went into denial before being overwhelmed with 200,000 cases and 300 deaths in just 24 hours on 6th October.

Flu spread from east to west across Canada, affecting isolated communities drastically and resulting in around 50,000 deaths.

Disastrous lack of preparedness and denial in Brazil ultimately generated the Sanitation Movement in the 1920s, although it seems some features of history do repeat.

60,000 of the 190,000 working were hospitalised by flu in a 6 week period from the start of October in South African gold mines and more than 1,100 died. 2,500 died in Kimberley diamond mines.

Flu travelled on troop ships. Cape Town was badly affected but the trains carrying workers to their native villages infected indigenous people causing huge casualties, perhaps half a million out of 6 million died with the shortage of fit people causing crop failures and famine to follow. On the African continent as a whole, 50 million deaths occurred over 10 months leaving 12 million orphans.

Around 21% or 2.5 million people died in Iran.

In India there were nearly 7 million excess deaths from fever between 1916 and 1920 according to provincial sanitation records. Other estimates based on public health data reckon the toll at 18 million. By contrast, 1.4 million men of the British Indian Army fought in the war. The malign neglect and carelessness of the British rulers, along with wartime extension of repressive laws in India and the outrageous Jallianwala Bagh massacre did all contribute to agitation for independence, although not really quite as described here.

Armistice celebrations aggravated the spread of the flu as did the suppression of news which went with war.

In New Zealand Maoris were 7 times more likely to die than European settlers. 22% Samoans died in Western Samoa, fuelling political unrest which led ultimately to independence.

Australia imposed quarantine at ports but then states went their own way, resulting in hundreds of people getting stranded in country before a unified approach was again agreed. But only 12,000 died in Australia out of a population of 5 million. - less than 1%. A relative success story.

In China remote villages were afflicted far worse than provinces where industrialisation and foreign trade had developed. Southern and north western regions of China were worse hit. There is controversy as to whether the Shansi plague in 1917 was the original flu outbreak or whether the flu came from the trenches in France to China, conveyed by the Chinese Labour corps returnees.

In Japan there were 21 million cases and 260,000 deaths, a very low death rate, perhaps because a mild epidemic preceded the second wave, but also because of good general cleanliness, the advice to patients to stay in bed until the fever had gone and mask wearing.

The book points to the illness with flu of some key protagonists at the Versailles treaty talks and at the talks to settle the Middle East questions with lasting adverse repercussions.

Many cases with unusual neurological symptoms were diagnosed after the flu epidemic subsided as well as some cases of a type of encephalitis known as sleeping sickness. An interesting parallel with the ‘long COVID’ cases being noticed now.

As well as triggering cytokine storms, the flu virus eventually studied from the frozen remains of Eskimo people killed by it was able to block the production of interferons.

All in all this book is a fascinating read. I thoroughly recommend it!

Attention History Lovers! This fascinating book is well titled. The author has written not a grisly death-fest founded on shocking data but rather a nuanced examination, continent by continent, second and third flu surges taken into account, of the impact the Spanish Flu epidemic had on human beings, our history and cultures. Because of the great attention paid to human interest stories--to the people whose lives were indelibly touched (and frankly, they all were)--many moments written of will stick in my head. That is an accomplishment.

For instance, I do not think I will ever forget that the sound of a baby babbling happily was what greeted Joseph Wilson as he returned home on leave from the Army Pay Corp, where he saw to the salaries of those fighting the Kaiser. So along the street of Manchester, England, trudges a man wanting to see his wife Elizabeth, his 8-year old daughter Muriel and the 18-month old John. I wasn't prepared for how this story would turn out based on the names, but once Joseph got inside his home and found his wife and daughter dead on the bed, and the small boy hungry but smiling in his cot, the hairs on the back of my neck rose--especially reading that this small child would feel resentment from his father for surviving and would go on to be world famous as Anthony Burgess, author of A Clockwork Orange. Gracious, that story is not even in Wikipedia!

The Spanish Flu Epidemic and its Influence on History is full of such gripping human interest details, showing how people we know for whatever reason were forever affected by a virus that showed no discrimination.
The author traces the probable causes of the spread of the Spanish flu to various parts of the world. It is not less heartbreaking in Africa's mines than it is in the Ganges river, where corpses were allowed to swell and rot because poor families in India could not afford a funeral pyre. India's story pivots around the life of the famous poet Nirala, who married a woman from Uttar Pradesh, a "genteel and culturally rich" area . Although arranged, it was a love match and they had a baby swiftly. Nirala loved sitting atop the King Dal Dev fort in the area and would have probably had the most romantic of associations with Uttar Pradesh if not for the Spanish flu arriving.

Other than these wonderful human interest stories, the reader will get a real sense of deja vu. San Francisco's mask protesters while all kinds of conspiracy theories evolved spontaneously to explain where the flu had come from--usually the laboratory of the enemy (although why the Germans would want to kill themselves off is a good question). A wonderful and timely book!

#TheSpanishFluEpidemicanditsInfluenceonHistory #NetGalley
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A great overview of the 1918-1920 H1N1 pandemic and its effects.

The author begins each chapter with a personal story of someone who was deeply affected by H1N1. She explores the likely antecedents of the pandemic in France in 1916 and parts of China in 1917 and then fully focuses on the spread of the virus throughout America and then to Europe in a spring and fall wave in 1918 thanks to significant troop movements in World War I, and then how the virus continued to spread throughout Africa, the Middle East, Asia, Oceania, and the Americas. She describes areas terribly affected and others not as affected and the reasons why: previous exposure, better quarantine standards, better public health awareness, etc.

She does quite well at showing the long-term historical effects of H1N1: how Sykes of the Sykes-Picot treaty was having second doubts, but died before any changes were made, leading to all kinds of "what if" questions about the Middle East over the past century; and Wilson's debilitation in the wake of H1N1 and the "what if" questions about how the Treaty of Versailles would have looked had Wilson been more engaged at the end, and what that would have meant for Europe over the next two decades. Above all she speaks of how the H1N1 pandemic did not seem to leave much trace in the historical record even though the effects on individuals and families must have been enormous: physical trauma was manifest in children born during the pandemic throughout their lives; the mental and emotional trauma of survival while losing parents and other loved ones must have been immense; and few talked about it in the wake of the calamity of World War I. And yet she also speaks of how the H1N1 pandemic led many countries to better prioritize public health and led to the creation of many impressive healthcare systems which work to the benefit of many to this day.

Such also explains why the documentation of the 1918-1920 H1N1 pandemic seems so sparse: because it is sparse.

Barry's magnum opus on 1918-1920 H1N1 goes into much greater depth in terms of the science and the scientists grappling with pandemic in America, but this book does much better at telling stories of those actually affected by H1N1 and provides more global testimony to the pandemic. Do not think that just because you've read Barry you've got the whole picture; I recommend reading this work as well. On the whole, this work is much better at keeping focused on the 1918-1920 H1N1 pandemic and telling its important story for the modern age.

Spanish Flu killed about 12,000 Australians - less than one per cent compared with over six per cent of the global population, The Director General of the Commonwealth Quarantine Service Dr. John Cumpston read the reports from Europe in 1918 about an outbreak of a vicious new disease causing countless deaths, mostly about young people. He took speedy action, and the States agreed to thirteen resolutions to ensure that they acted consistently.

Unfortunately, in January, there was a new outbreak in Melbourne and Cumpston didn't push Victoria to declare it. Soon it spread to NSW and faith in the new Federal government broke down. The agreement was broken. Now the States decided to act alone but we 'still stayed the hand of the disease long enough to allow its virulence to weaken', and Cumpston was appointed the first director general of health in March 1921. Hopefully, we will handle this virus well, too.

This part of the book was probably the happiest story- it certainly gave me hope, although 12,000 people is not exactly minor. It's mostly a harrowing and miserable, but fascinating, tale about a deadly disease which ripped through the world's population, and had long and lasting effects. Some of the stories will even bring tears to your eyes.

The Spanish Flu even had great political effects. The terrible effect on the Germans may have caused them to lose the First World War, for example. Also, President Wilson's bout of Spanish Flu may have contributed to the Versailles Treaty, and his premature retirement from a stroke (probably cause by the flu) meant that he was unable to persuade the US to join the League of Nations or ratify the Treaty of Versailles.

This is a timely and comprehensively researched book which all politicians, and health directors, should read. Although harrowing, it is a compelling tale.

I received this free ebook from NetGalley in return for an honest review.

As a pharmacist working through this pandemic, this book brought about lots of feelings for me. Both from a reader standpoint and a science standpoint. Oh how we wish we learn from the past! We know what works and what doesn’t. But in this day and age how can we not have learned. All the information must be shared and shared honestly with everyone, especially doctors and scientists. Let’s read this book and relearn what happened during the flu pandemic. Why would any country want to go through it.


I voluntarily reviewed a copy of this book provided by NetGalley.

This fascinating book could not be more timely...parallels between the 1918-1920 Spanish Flu and present Covid-19 epidemic are uncanny from the fear of the unknown sinister killer to societal reactions to quarantine. The last sentence before the epilogue is chilling as this book was written before the current pandemic.

In March of 1918 a man with a cold became person zero as the first known/recorded carrier of what rapidly grew to pandemic proportions. The author of this book takes us into real lives of those who witnessed it or contracted it around the globe. She then writes about its effects on politics, health and societies. Some regions suffered unimaginable losses of up to 20+% of the population. Seeing the horror through their eyes is gut wrenching.

Symptoms were often sudden with quick deaths just hours later as dead bodies were found on buses, trains and park benches. Yet others suffered longer. Those hardest affected were in the ages 10-40 category. Healthy strong bodies literally attacked themselves which meant soldiers and others serving in the war. It is said approximately 5% of the world's population died. The effects on many countries were devastating, including higher prices and starvation and entire families wiped out.

So much to learn from this book from scientific studies including DNA to naming flus to antigenic drift to how different cultures reacted to what happened to the dead bodies.

Finally people realized isolation and masks made a huge difference. Some regions fined people for not wearing them. The Spanish Flu disappeared after it had come in several waves and caused incomprehensible sorrow and economic ruin.

Do read this if at all interested in comparing and contrasting the Spanish Flu to our current pandemic and if you wish to learn about science behind flus. Not only that but put yourself into the places and minds of others who have...and are...suffering. I highly recommend this compelling and well-researched read.

My sincere thank you to Pen & Sword and NetGalley for providing me with an ARC of this enthralling book in exchange for an honest review. Much appreciated.