Britain and the 1918-19 Influenza Pandemic: A Dark Epilogue (review)

Having long been ignored by historians, the "Spanish" influenza pandemic of 1918–19 has, in the last fifteen years, attracted more attention from them than in the preceding seventy years. The reasons for this range from the historiographical—the growth of the social history of medicine as a subdiscipline and a renewed interest in the history of epidemics, largely prompted by HIV/AIDS—to the very topical: for example, the imminent threat of a lethal new influenza pandemic, most recently seen in the worldwide panic about a new strain of avian flu that, to date, has claimed 172 human lives on three continents.

The book under review falls squarely into this surge in historical literature on the 1918–19 pandemic. The author, Niall Johnson, is no newcomer to the field, having written two academic theses and several articles on the topic; in fact, the core of this book stems from his 2001 Cambridge doctoral thesis, "Aspects of the historical geography of the 1918–1919 influenza pandemic in Britain." Certainly his training as a geographer shows in the book, the most innovative feature of which is a spatially informed analysis of the spread of the deadly second wave of the pandemic in England and Wales and the geographical distribution of the deaths it caused.

But Johnson's focus is much wider than this, for he aims, he says, to produce a "total history" of the pandemic in Britain by examining how the "environmental, geographical, political, cultural, biological and medical aspects inextricably bind together to constitute and epidemic" (p. xi). Accordingly, his eight chapters look at the pandemic through a variety of disciplinary lenses, the only way (I would suggest) that the multisided nature of such a phenomenon can be effectively comprehended.

However, the problem with pursuing such a determinedly "in-the-round" approach in this case is that the British sources he has tapped are relatively thin on many of these dimensions, as a result, he suggests, of the country's preoccupation with the climax of World War I, which was occurring at the very same time. "For an outbreak that had such a massive impact [nearly 250 thousand deaths in a population of 40 million]," laments Johnson, "there is a decided paucity of material relating to the pandemic" (p. 163).

To fill this gap, Johnson draws on the extensive literature on the pandemic elsewhere in the world, especially in Australia, New Zealand, and South Africa, using this to put Britain's experience into comparative perspective. The result, however, is that all too often Britain's experience is swamped by that of other parts of the world, almost pushing it to the margins in some chapters. For instance, only about one third of chapters 6 and 7 ("Cultural dimensions" and "Repercussions," respectively) focus on Britain, leading to the paradox that the book delivers both less than the title promises in respect to Britain but far more in the case of the rest of the world. To succeed, comparative history must surely draw comparisons and not just pile up an array of different examples.

Looking at Johnson's chief sources for Britain—one national newspaper, The Times, and the records of central government departments like the Registrar General's Office, the Local Government Board, the Medical Research Committee, and the Ministry of Health—I wondered if approaching the topic using sources generated from below, as it were, like local newspapers, municipal records, and military camp records, may not have been more fruitful, as it was at this pit-face level that the attempts to counter the pandemic were concentrated. Johnson's comment that ". . . the British reaction was a devolved or decentralised one" (p. 133) certainly points in the direction of such sources. In short, though this book reveals much that is novel about the 1918–19 pandemic in England, Scotland, and...