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| Cholera squad, c1915 |
As the Great War was raging in Europe and about to reach its final few battles to "end all future wars." Life in Cebu seems far affected by the horrors of war and destruction yet there is a pandemic that has already spread to different parts of the world and about to wreak havoc on the populace.
Even before the Spanish Flu has reached our shores, cholera and influenza have already ravaged the island well before the first deaths were recorded. It was only a decade removed when the Filipino-American War caused a lot of death and destruction not only because of the fighting but also because the Americans have implemented "concentration camps" in order to separate the rebels away from the civilians. It also resulted in the rise of cholera epidemics.
The deadly influenza pandemic was caused by the H1N1 influenza A virus. Lasted from February 1918 to April 1920, it infected 500 million people or about a third of the world's population at the time in four successive waves. The death toll is estimated to have been somewhere between 20 million to 50 million, making it one of the deadliest pandemics in human history.
Where it all began
The pandemic was documented to have originated in Kansas in the United States in March 1918 and then eventually reached the frontlines in France and Germany. Since most of the belligerent nations of the time were censoring the press, it was only reported in neutral Spain as a result of King Alfonso XIII's illness thus the Spanish Flu came to be known.
As the first wave of the pandemic has ravaged the United States and the European battlefields, it soon spread to Africa, South America, and Asia as the shipping routes transported the virus. With the war winding down and many soldiers were redeployed elsewhere bringing the virus even further than before. By June 1918, it already reached the Philippines.
The Pandemic reaches the Philippines
Medical practitioner Francis Coutant has personally witnessed the pandemic in Manila during the first and second waves. The pandemic is said to have infected the longshoremen and other laborers working around Manila's ports. A report in the "Revista Filipina de Medicina y Farmacia" has mentioned Provincial Chief of the Sanitary Service Dr. Eugenio Hernando stating an incomplete total number of deaths at 70,513, with morbidity of 40% of the total population.
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| The darker colors showed the hardest-hit areas |
As the pandemic spread throughout the archipelago, it's the domestic shipping and rail service that has spread it further away from Manila. The Visayas was the hardest hit region with 28 to 55 deaths per 100,000 people. However, Pangasinan was the most disproportionally-hit province with 55 to 83 deaths per 100,000 people. The average annual death rate was 25 per 100,000 people from 1904 to 1917 but doubled in 1918 to 40.79 per 100,000 people.
Cebu, which was already ravaged by cholera a decade before, registered an average of 350 deaths caused by influenza annually from 1916 to 1917. The total deaths reached 4,105 in 1918 or 43.2 per 100,000 people as compared to Pangasinan with 7,886 or 83 per 100,000 people.
The pandemic reached its peak from November to December 1918 as it 41,000 death on average as compared to the prior nine months with 350 deaths on average. Two distinct age groups that recorded the most deaths: ages 2 to 9 years with 30,693 deaths and ages 20 to 39 years with 23,731 deaths.
Pandemic in the News
It was reported in the October 10, 1918 issue of "Nueva Fuerza" that the pandemic has already reached the province. In the succeeding issues, it was mentioned as "trancazo" or "dengue" because they haven't had an idea what the mysterious deadly killer was.
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| The whole of Cebu infested |
Once the pandemic claimed more lives, the newspaper has started providing updates on it as well as other places in the Visayas, especially Leyte and Samar where the death toll was high.
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| Funeraria "La Fama" providing services |
Interestingly, Funeria "La Fama" has been advertising every issue of the newspaper. Not sure if it's just a coincidence or perhaps, there was a great demand for their services. The casket cost as much as P200 and even the cheapest one for P5!
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| Imported goods were blocked from entering the country |
Dengue was a very deadly disease then and even until now, it still claims a lot of lives annually. They described it as such even a month after the disease already spread throughout the island.
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| The pandemic was referred to as "dengue" |
Although influenza deaths had existed prior to the pandemic, the total deaths in 1918 were not as severe as in the other port provinces. However, Cebu would continue to have relatively high mortality in 1919. The rates for 1919 would indicate the third wave of the pandemic as it wound down in many parts of the country.
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| Quacks have started to say they know what the pandemic is |
By December 1918, there was an article about a purported cure for the "trangkaso." The so-called expert even mentioned that it is called the "catarrh" but went on to name it "dengue." As the death toll has increased, it's not surprising that a lot of people are looking for "albularyos" and quack doctors for medical assistance. Some who are enterprising enough are advertising their services and cure-it-all in the newspaper.
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| An account on the high death toll in Culion island |
The Culion Leper Colony was thought to be the ideal quarantine location that would hold off the spread of the virus. However, officials came to realize that the pandemic has reached those places as well. Influenza entered the colony in October 1918 and killing 216 lepers. The pandemic also reached the Iwahig Penal Colony on November 22, 1918, and spread to all inhabitants of the colony, including the nurses and servants.
Later Years
By late 1919, the pandemic has died down even though there was still a new wave of infection that happened in different parts of the world.
The health authorities assessed the impact of the epidemic by releasing a report by providing the following conclusions:
- The epidemic that raged from May to July was the grippe, also so-called influenza or "trancazo."
- The disease had a preference for the age groups between 10 and 29 years.
- The epidemic of October 2018 was merely a recrudescence and a continuation of the May to June epidemic.
- The attack of influenza during the first period of the epidemic conferred immunity against another attack of the second.
- The epidemic was of autochthonous origin, but the importation of foreign strains increased the virulence of the native strains.
- Maritime and land quarantines, hospitalization, and the closing of schools and places of amusement failed to cut the diffusion of the epidemic short.
References:
"The Philippines in the World of the Influenza Pandemic of 1918-1919," by Francis Gealogo
"1918-1919 Influenza Pandemic Map of Death Rate in the Philippine Islands," by Berniemack Arellano
Nueva Fuerza. Cebuano Studies Center.
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