The Last Irish Plague: The Great Flu Epidemic in Ireland 1918–19 (review)

A few years ago I drew a blank looking for any research on the impact of the influenza pandemic of 1918–19 in Ireland. Then in the space of a few months three Ph.D. dissertations appeared on the subject. The first was Caitriona Foley’s (Cork), to be followed by Patricia Marsh’s “The Effects of the 1918–19 Influenza Pandemic in Ulster” (Queen’s, 2010), and Ida Milne’s thesis on the pandemic in Leinster (Trinity College, Dublin, 2011). In addition there have been other papers, journal and newspaper articles, and a documentary film on the pandemic screened on RTE and BBC Northern Ireland. The tide has turned and there is now abundant reason and evidence for not ignoring the pandemic, which in the space of eleven months killed well over twenty thousand men, women, and children, leaving in its wake a long trail of further deaths and much distress.

Foley’s study is the first published attempt to analyze the course and consequences of the flu pandemic. The reason for the earlier scholarly neglect of the topic is addressed in this significant study of disease and demography in Ireland. Foley has drawn on a good range of sources, including those in Irish, although these are not fully identified in the footnotes or bibliography. Her major sources are private papers, including the personal diaries of Dr. Kathleen Lynn, the Sinn Féin politician and medical practioner; the records of hospitals, prisons, and asylums; the particularly rewarding records from selected county workhouses; the official Registered Papers of the Chief Secretary’s Office; and the rich materials contained in the papers of the Bureau of Military History. Local records from the counties of Cork, Donegal, Galway, and Wicklow have also been drawn on with great profit.

The first two chapters of Foley’s book examine the geography and demography of the pandemic. Chapter 3 is concerned with the social and economic impact, apparent to contemporaries but at a distance difficult for the historian to quantify. Here, and elsewhere in the book, more might have been done on the statistical analysis of the pandemic in Ireland. Flu was ubiquitous but not feared as were earlier outbreaks of disease such as cholera and smallpox. Large numbers of people caught flu, but most recovered.

One of the strengths of Foley’s book is her discussion of the cultural aspects of flu and the comparative context of the pandemic. She looks at earlier outbreaks of disease in Ireland, including the flu pandemic of 1889–90, and, as befits any study of a pandemic, more widely across the world in 1918–19. Irish medical services already seriously stretched by the war were placed under further strain. Knowledge of the etiology of flu was absent, and many in the medical profession argued that the symptoms in the suffering patients they saw around them were not those of flu. The central Local Government Board displayed a low level of purpose in even attempting to control the outbreak, while the Rural and Urban District Councils adopted ineffective means to deal with both the disease and the resulting distress. This was not surprising given that little was known by the medical profession about what they were supposed to be combating. As a result care for sick families was patchy, much of the burden being assumed by the active concern of neighbors and by private charity. On these topics Foley’s focus on a close analysis of the flu in four counties is useful, and the examples used are often telling. However, this reviewer would liked to have seen more on reactions from protestant Ireland, particularly from the northeast counties in the discussion of popular recourse to religion in order to make sense of the sudden visitation of the deadly pandemic. Foley is also very good on flu and memory, and she is surely correct in stating that, unlike the famine of...