Influenza Pandemic of 1918

PERSPECTIVES in British India alone … Without fear of exag- Infl uenza Pandemic of 1918 geration, it can be stated then that in a few months infl uenza was responsible for six mil- Lessons in Tackling a Public Health lion deaths (including Native States) in India. Catastrophe In the end, few months of infl uenza resulted in more deaths than nearly 20 years of plague in many Indian provinces. The epidemic struck India at a time T V Sekher when the country was least prepared to cope with the calamity. The total failure As India battles hard to combat the hen the world and India are of the monsoon, scarcity of food supply, COVID-19 outbreak, it is important battling hard to combat the inadequate medical facilities and short- COVID to look back and examine how a W -19 outbreak, it is im- ages of health personnel, created a mis- portant to look back and examine how a erable situation in many parts of India. major pandemic that occured major pandemic that occurred nearly a White (1919: 5) pointed out: nearly 100 years ago—the century ago, the infl uenza pandemic of Infl uenza within the space of four or fi ve infl uenza pandemic of 1918 or 1918, or Spanish fl u, was tackled. This months was responsible for the death of 2% pandemic killed around 12 million people of the total population of British India, the “Spanish fl u”—was tackled by the in India alone, more than in any other percentage of persons falling victims vary- then colonial administration. country. The challenges encountered by ing between 5.7 in the Central Provinces and 0.4 in Bengal. As regards the incidence of The challenges encountered are the then administration in colonial India the disease in Native States but little infor- examined, drawing specifi cally are examined, drawing specifi cally from mation is, at present, available, with the sin- the experience of the state of Mysore, gle exception of Mysore. The total number from the experiences of the state of which was considered one of the better- of deaths ascribed to infl uenza in Mysore, in Mysore, considered as one of the administered “progressive” prin cely states 1918, was 1,27,651, which is equivalent to a death rate of 22.37 per thousand. well-administered, “progressive” in British India. Census data and archival princely states in British India. records, available both in India and Eng- Exact data on the prevalence of infl u- land, are used to make a historical anal- enza among the general population was ysis of the administrative challenges in not available for most provinces and handling the pandemic. only the mortality data were compiled. However, the statistics on incidence and Infl uenza Mortality in India mortality of jail inmates of some provinces The infl uenza pandemic of 1918 claimed were available (Table 2, p 33). Those up to 70 million lives around the world, provinces reported high infl uenza mor- until it unexpectedly disappeared in 1919. tality among the general population but The author is grateful to Wellcome Trust, United No other outbreak has appeared Table 1: Influenza Deaths in British India, 1918 Kingdom for funding the research. The facilities with such intensity and devasta- Province Population Total Estimated Influenza and cooperation extended by the archives of tion in large parts of the world (Census 1911) Influenza Death Rate per Deaths Thousand the British Library and Wellcome Trust Library within such a short time as the at London; Karnataka State Archives, Bengaluru; Central Provinces Divisional Archives, Mysuru; National Archives, infl uenza outbreak in 1918. In and Berar 1,39,16,308 7,90,820 56.8 New Delhi; and other libraries are acknowledged. India, the infl uenza pandemic Delhi 4,16,656 23,175 55.6 The author also thanks the anonymous cost at least 12 million lives, Bombay 1,95,87,383 9,00,000 45.9 reviewers for their helpful comments on an though the estimates vary con- Punjab 1,93,37,146 8,16,317 42.2 earlier version of this article. siderably.1 The sanitary com- North-West Frontier Province 20,41,077 82,000 40.0 This paper is an updated version of an earlier missioner of the Government of paper, “Public Health Administration in United Province 4,68,20,506 10,72,671 22.9 India, F Norman White (1919: 1), Princely Mysore: Tackling the Infl uenza Coorg 1,74,976 3,382 19.0 Pandemic of 1918,” Sekher, T V, published in noted in his preliminary report Madras 4,00,05,735 5,09,667 12.7 India’s Princely States: People, Princes and on the pandemic: Assam 60,51,507 69,113 11.4 Colonialism (2007, W Ernst and B Pati [eds], From the incomplete information, at Bihar and Orissa 3,44,89,846 3,59,482 10.3 London and New York: Routledge, pp 194–211). present available, it would appear Burma 98,55,853 60,000 6.0 that no country suffered as severely T V Sekher ([email protected]) is with the Bengal 4,53,29,247 2,13,098 4.7 as did India, during the last quarter International Institute for Population Sciences, British India 23,80,26,240 48,99,725 20.6 of 1918. Altogether infl uenza was Mumbai and co-author of the book Health and Source: “A Preliminary Report on the Influenza of 1918 in India by the responsible for a death-toll of ap- Medicine in the Indian Princely States: 1850–1950. Sanitary Commissioner with the Government of India,” Simla: Government proximately fi ve millions [Table 1], Monotype Press,1919 (London: Wellcome Library). 32 may 22, 2021 vol lVi no 21 EPW Economic & Political Weekly PERSPECTIVES also showed high mortality among jail the state. According to government re- of Mysore, Sri Krishnaraja Wodeyer (1921). inmates, though the jail population can- cords, the total number of incidents was On 22 October 1918, at the prize distri- not be a representative of overall popu- 8,83,491 and the death toll amounted to bution function of the dasara industrial lation for various reasons, including the 1,66,391 (Table 3; GoM 1919a: 3). The and agricultural exhibition, he said: huge differences in sex and age structure 1921 Census for Mysore revealed that the Ladies and Gentlemen, once our Annual Dasara and higher chances of infection in a crow- number of deaths per 1,000 in 1918 was Exhibition has turned its course and it is my ded environment. According to available about 30 (though the Mysore Gazetteers pleasant duty to distribute the principal prizes to successful Exhibitors. I wish that we could evidence, the prevalence of infl uenza later provide much higher fi gure as shown have met under happier circumstances and was fairly constant across the provinces, in Table 4), whereas in the previous year that the complete success which this Exhibi- but the mortality varied considerably. it had been 10 and for the year 1919 it tion deserves had not been somewhat marred was only eight, a good indication of the by the adverse season and the sickness which Situation in Mysore State severity of the epidemic.3 is prevailing everywhere and which has nat- urally kept away many visitors, besides de- The fact that Mysore was the only Table 4: Death Rates in Mysore State, 1913–1925 priving the Committee of the services of their princely state that could provide timely Year Death Rate per Year Death Rate per Secretary and a number of their working staff. Mille of Population Mille of information on infl uenza mortality is an Population indication of its administrative effi ciency, 1913 18.07 1919 16.44 Administrative Measures even during crisis situations. This may 1914 18.66 1920 14.99 In fact, the chief secretary to government, have been partly due to 50 years of 1915 15.53 1921 14.22 C S Balasundaram Iyer, issued an order direct British rule from 1831 to 1881, 1916 16.63 1922 14.52 directing the temporary structure for when the administrative machinery in 1917 19.54 1923 16.09 the exhibition to be placed at the dispos- 1918 60.28 (Year of Influenza) 1924 21.18 the state was modernised, thereby con- al of the president of the Mysore city mu- 1925 17.44 tributing to Mysore’s subsequent reputa- Source: C Hayavadana Rao (1927–30): Mysore Gazetteers, nicipal council, for opening a provisional tion as a “progressive princely state.”2 compiled for Government, Bangalore,1927–30. dispensary for the treatment of infl uenza Infl uenza made its fi rst appearance in Apart from increased mortality, infl u- patients.4 The chief secretary issued strict a mild form in Bangalore city in July 1918, enza also affected the spirit of celebra- instructions to the deputy commissioners but disappeared soon without causing tions at the most important annual of the districts and the presidents of any signifi cant loss of life. It reappeared events of Mysore, that is, the dasara fes- the two municipalities, Bangalore and in the middle of September 1918 and tival celebrations and exhibition. This is Mysore, regarding the monitoring and co- spread with lightning speed throughout evident from the speech of the maharaja ordination of relief work.5 The district Table 2: Influenza Mortality Rates, Incidence Rates and Case Mortality Rates: Selected Provinces medical offi cer, the sanitary offi cer, the and Jail Populations, British India, 1918 (rate per 1,000) amildars (revenue offi cers), and the Sl Province Province Influenza Jail Influenza Jail Influenza Jail Influenza No Mortality Rate Mortality Rate Incidence Rate Case Mortality deputy amildars were to tour the taluks 1 Central provinces 67.6 34.8 457.5 76.1 and ensure that the government instruc- 2 Bombay presidency 54.3 36.0 348.0 103.4 tions were implemented effi ciently.

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