A Hurricane Across the Green Fields of Life: How the 1918 Flu Affected the Caribbean

by Larry Smith

“So vast was the catastrophe...that our minds, surfeited with the horrors of war, refused to realise it. It came and went, a hurricane across the green fields of life, sweeping away our youth in the hundreds of thousands and leaving a toll of sickness and infirmity which will not be reckoned in this
generation.” -- Article in the Times of London on the 1918 influenza pandemic.

The Purple Death (or Spanish Flu) was born in March 1918 in the American midwest. A second, more deadly, wave of infection began in August of that year - probably in France - and continued into 1919.

This outbreak rapidly engulfed the world, killing more than 50 million people in a few months at the end of the Great War. And it is now known that the Purple Death (so named because it turned patients blue as they died) was a bird flu, similar to the one threatening us today.

The big difference is that the 1918 virus had mutated so that it could pass easily among people. The current strain of bird flu affecting people (called H5N1) has not achieved this yet.

So far there have been only 117 confirmed human cases in Asia (half of whom died). But experts say it is just a matter of time before someone with ordinary flu catches bird flu, and H5N1 merges with the human virus or mutates by itself into something far more dangerous.

And experts say it it will take four- to-six months from the time a pandemic flu strain emerges to develop and make a vaccine.

In the 1919 pandemic, the young and the fit were most at risk – those in the prime of their working and reproductive lives. And death rates were much higher than seasonal flu rates.

To learn what we could be up against if a similar pandemic got underway today, it is helpful to look at how the 1919 flu affected this region.

Strangely, this terrible event in the world’s recent past kept a very low profile until recently. Parents and grandparents never mentioned it. University of London history professor, Dr David Killingray, noted that: “despite the fearsome impact, there seems to have been a collective amnesia...the full impact of the epidemic appears to have been cloaked by the pre-occupations of a horrendous war.”

In the early years of the 20th century public health systems were limited, and contemporary observers were often vague in recording causes of death, particularly in outlying colonies. Dr Killingray has estimated there were about 100,000 flu deaths in the Caribbean, with nearly 30,000 in British territories:

“Its spread and effects on certain islands and areas seemed to be arbitrarily selective, and there are no clear answers why one place suffered high morbidity and mortality rates, another widespread infection but low mortality, while other places remained virtually untouched by the disease.

“Such variations may have been due to prompt quarantine by the authorities, for example, in the Bahamas, which although in close proximity to the United States, must have been helped by a dearth of wartime shipping.”

However, a 1919 Colonial Office report did note that “many” of the 2,500 plus Bahamian migrant workers in the Carolinas became infected and died during the pandemic.

Bahamian emigration to the United States peaked during this period, and the population of the islands actually fell for the first time. The total population recorded in1921 was marginally lower than that in 1901 – about 53,000.

As a non-notifiable disease, influenza was not covered by international quarantine regulations in 1918. And when the virus mutated in August of that year it spread rapidly and with unprecedented virulence, helped by wartime disruption and troop movements.

The Purple Death arrived in Jamaica aboard banana boats from the US in October, 1918. Among British territories, Jamaica, Guyana and Belize were the most severely affected in the region.

“The virus raged through the plantations and slum housing of the low-lying coastal towns.” Dr Killingray wrote in the 2003 edition of the Caribbean Quarterly. “East Indian labour was hard hit, but not as severely as Native Americans.

“By early October the influenza pandemic was well-established in Central America and from there it reached Belize on the eleventh of the month. Ten days before a banana boat brought the infection from North America to two ports in Jamaica, and a little later that month it appeared in the Bahamas”

But according to Dr Killingray, the Bahamas “operated an efficient quarantine system which seems to have preserved the islands from infection. Barbados was similarly fortunate.”

In Jamaica the authorities restricted rail travel, fumigated money and suspended mail service. Schools and shops closed and social functions were suspended, but by early November the disease had affected the entire island, with the Gleaner reporting that “coolie labour on the estates has been reduced almost to vanishing point.”

Medical facilities were overwhelmed across the region. In Belize infection rates were as high as 80 per cent in some areas and crops went unharvested. In Guyana there were serious strains on burial society funds as plantation labourers were decimated. And some Indian tribes were said to have been wiped out by disease.

“This epidemic has been the most severe visitation of disease within the memory of any colonist,” Guyana’s acting surgeon general concluded at the time. “The almost universal prevalence and high mortality rate have caused untold suffering.”

And of course, in the Caribbean, rum was considered one of the most potent treatments for the flu. Other popular remedies included white pine cough syrup, coryza tablets, formalin tablets, Horlicks, fly sprays, Palmolive soap and tobacco.

In the Bahamas there were no official reports of deaths from the flu, but recent estimates say as many as 60 people may have died during the epidemic. In Guyana, with a population of 310,000 there were some 12,000 deaths. And perhaps 10,000 in Jamaica, out of a population of 850,000.

“These figures take account of unrecorded deaths, those reported as dying of other causes such as fevers and pneumonia – often complications of influenza - (and) long-term influenza infections such as encephalitis lethargica,” Dr Killingray explained.

“The pandemic of 1918-19 came suddenly and moved with deadly speed. The largely laissez-faire systems of government were caught ill-prepared, while the medical and scientific professions were unable to provide effective treatment or cure.

“Despite great advances in virology since 1919, influenza remains an unpredictable disease,” he concluded.