After his 2 am return from Paris-Plage, Greg was probably glad not to have an early start. In fact, he didn’t have much of a start at all as his aircraft’s engine had an oil leak, and he didn’t fly. The big event of the day was a visit by General Birdwood, commander of the Fifth Army.
Diary
Friday July 12th 1918. Found that the oil filter on my engine was leaking, so engine was taken out of E27.
Weather pretty dud, heavy rain in morning, afternoon fine but very windy.
General Birdwood came round in the morning (commanding 5th Army) and spoke to us all. Seemed a nice chap.
Watch the Birdy
General Sir William Birdwood visited 42 Squadron at Rely, not many miles from his headquarters at Upen d’Aval, just west of Thérouanne. Michael Seymour looks at the the man and the reasons for his visit, and finds a resonance with Greg’s characterisation of him as “a nice chap”:
In other news, the day’s Daily Orders from Major Hunter report that Greg is no longer on probation but has been confirmed in rank as a (temporary) 2nd Lieutenant:
The Daily Orders are written in their customarily elegant way. Rob (Parsons) thinks that it would almost certainly have been the Orderly Room Clerk who was the scribe. There would have been a Sergeant in charge, responsible for all the written records, disciplinary procedures etc. And then there would have been a Squadron Adjutant, possibly as a secondary duty.
To give a flavour of administrative operation of the squadron that day, here is a complete copy of the the day’s Daily Orders. Note the incorrect date on the top right of the first page. It was definitely 12 July that the orders relate to. But the clerk’s mind seems to have wandered back to May!
A day off! And a trip to the seaside at Paris-Plage that didn’t go entirely to plan…
Diary
Thursday July 11th 1918. The first of a series of tenders to the seaside went down to Paris-Plage.
I was picked out.
Tender left mess at 1.30 & owing to driver not knowing the way arrived at Paris-Plage at 5 pm.
Raining most of the way, but fine at Paris-Plage – which is quite a nice little place on the coast near Etaples. Had a walk around, dined at the Continental Hotel, & left at 9.30.
Arrived in camp at 2 am. Got lost on way home.
Paris-Plage
About a 45 mile (72 km) journey by road from Rely, and near Étaples, the town is today formally known as Le Touquet-Paris-Plage, often shortened to Le Touquet. The early years of the 20th century witnessed its development, and it became a fashionable resort for Parisians – hence the name.
It took Greg 3½ hours to get there and 4½ hours to get back. Not a great rate of net progress in either direction! Presumably driving was more difficult on the return journey because of a general lack of illumination in the dark. Étaples was still liable to German air raids, much as Greg had experienced when he was first posted to France – less than six weeks earlier, but an age ago:
After yesterday‘s crash on take-off from Rely, Marsh and McDonald both died in hospital. Greg did not fly – his final day off flying after the flu.
Monday June 24th. Marsh & Macdonald [sic, should be McDonald] both died in hospital. Marsh buried in afternoon. Did not fly.
So neither of them made it. 2nd Lt. Marsh, who had had such a lucky escape earlier in the month, had celebrated his 24th birthday just two days earlier, on 22 June 1918. Lt. McDonald was 19, the same age as Greg. A reminder, if one was needed, of how dangerous flying was even before anyone wished you harm.
Greg’s first day out of bed (just) after the flu was a bad day for the squadron, with a crash at Rely aerodrome.
Diary
Sunday 23rd. Got up, & walked round a bit feeling groggy. Macdonald [sic, should be McDonald] & Marsh spun into the ground & caught fire, both rescued & taken to hospital.
McDonald & Marsh Crash at Rely
Lt Hugh McDonald (as his name was spelt in the official report) was the pilot.
And 2nd Lt Cuthbert Alban Marsh was the observer, and was also Greg’s observer on his near-disastrous first day on the Front, when they crashed in crops at Trézennes. On that occasion, Marsh was thrown clear:
There were two hospital facilities at Aire-sur-la-Lys at the time. User mhifle of The Great War Forum says that the 54th Casualty Clearing Station came to Aire on 16 April 1918. This CCS was also known as the ‘1/2nd London CCS’. He gives its previous locations with the BEF in France as:
Hazebrouck 1 April 1915 to 31 July 1915
Merville 1 Aug 1915 to 28 March 1918
Haverskerque 29 March 1918 to 15 April 1918
At Aire, the 54th CCS joined No 39 Stationary Hospital, which was there from May 1917 to July 1918 according to The Long, Long Trail. So McDonald and Marsh may have been taken to one of these hospital facilities.
“British Casualty Clearing Station”
The Greg’s War collection includes the following aerial photograph captioned “British Casualty Clearing Station”, which is otherwise unidentified.
It is possible that this was the 54th CCS at Aire (maybe with No 39 Stationary Hospital also in shot). The landscape looks similar to that just west of Aire, upstream along the Lys valley, near the village of Mametz – Mametz (Pas de Calais) that is, not Mametz (Somme).
But I’m not entirely sure that this is the same place. In this instance, it’s hard to tell how much the landscape has changed over the years. Without any hard evidence of where the photo was taken, and without even knowing just where in or around Aire the 54th CCS was located, I can only identify it provisionally.
Another day in bed as Greg’s Spanish Flu, aka Merville Fever, continued. Still no flying for him. But what was the origin of Spanish Flu?
Diary
Saturday June 22nd. Stayed in bed all day.
Origin of Spanish Flu
After yesterday’s excursion into epidemiology, here’s a bit of a voyage into virology. (We’ll return to aviation soon enough.)
Let’s get one thing out of the way first: the origin of Spanish flu is probably not Spain. It is generally thought that the name came about because Spain’s neutrality in the First World War merely permitted more extensive reporting of the pandemic. See Trilla et al.Clinical Infectious Diseases47(5) 668–673 (2008) (https://doi.org/10.1086/590567) for more.
We now know – but in 1918 they didn’t – that the causative agent of flu is a virus. At the time, it was thought to be caused by a bacterium, Haemophilus influenzae, which is now known to be the cause of various other conditions, including some cases of bacterial meningitis.
Viruses
Like all viruses, influenza virus isn’t really a living entity. It’s a package of genetic material (in this case RNA rather than DNA) wrapped up in a protein-studded lipid (fatty) coat. It can’t reproduce on its own. It can only replicate by infecting a host cell and hijacking the cell’s replication machinery. The infected host then churns out vast quantities of progeny virus, and the cycle begins again.
Today we know what the virus looks like. Here is an electron micrograph of a recreated form of the 1918 Spanish Flu virus:
Surface Proteins and Subtypes
Among the proteins studding the lipid coat of the virus particles (which are in the order of 100 nm in diameter), two that are important for the way that the virus infects its host cells are haemagglutinin (abbreviated HA or H) and neuraminidase (NA or N). Haemagglutinin is involved in the virus binding to the host cell, and neuraminidase assists in viral trafficking. Here’s a schematic picture of a flu virus particle:
Although there are three kinds of influenza virus, A, B and C, it is only influenza A that poses a serious threat to public health. The 1918 so-called Spanish Flu was an example of influenza A. We now know (see below) that it was a subtype known as H1N1, so called because it contains haemagglutinin of subtype 1 (of 16 known subtypes) and neuraminidase of subtype 1 (of 9). Formally, the Spanish Flu virus is therefore known as 1918 A(H1N1) influenza.
Reassortment
When a flu pandemic arises, it is often because of genetic reassortment of the virus. This arises when two different viruses infect the same individual (human or another susceptible species such as pigs or birds). Because the RNA in the nucleus is in different segments, these segments can reassort to give a new genetic combination. In this way, an H1N1 virus might reassort with an H5N3 virus to give an H5N1 virus, say (not a random example, but that is another story). And the human immune system might not have ‘seen’ this reassortment before – at least in the recent past – and therefore have no effective immunity against it.
And the Origin of Spanish Flu is…
…actually not clear. It seems that the reassortment mechanism just discussed did not give rise to the Spanish Flu virus in 1918. Taubenberger and colleagues, working in the mid-1990s with archival influenza autopsy materials collected in the autumn of 1918, sequenced the RNA of the virus and determined it to be an H1N1 subtype and similar to a bird flu virus from an unknown source. (For a review, see Taubenberger & Morens “1918 Influenza: the Mother of All Pandemics” Emerg Infect Dis. 2006;12(1):15-22 (https://dx.doi.org/10.3201/eid1201.050979)). Similar to a bird flu virus, that is, but not exactly the same: it had a mutation, or mutations, that enabled it to infect humans – and pigs. So this proposed bird flu-like virus seems to have been new – immunologically speaking – both to us and to pigs.
It has to be said that not everyone goes along with the Taubenberger bird virus origin theory. A lively debate in the pages of Nature testifies to that. And even Taubenberger says that it is not just a question of a single mutation arising in a pre-existing H1N1 bird flu. That theory is discounted by the large number of mutations found between the 1918 virus and known bird flu viruses. For the moment, the answer to the question “what is the origin of Spanish Flu?” is the unsatisfactory “we don’t really know”. But the bird flu theory is still a contender.
A Live Issue
Intriguingly, this is not merely a question of historical interest. The legacy of the 1918 Spanish Flu is still with us today. The reason that Taubenberger & Morens called the Spanish Flu pandemic in 1918 “the mother of all pandemics” in the title of their 2006 review article is that, in their words :
All influenza A pandemics since that time, and indeed almost all cases of influenza A worldwide…, have been caused by descendants of the 1918 virus.
Yet another long shadow cast from the years of the Great War.
Greg’s flu – ‘Merville Fever’ as he called it yesterday – continued. Today he said it was Spanish Flu. Unsurprisingly, he did not fly.
Diary
Friday June 21st. Stayed in bed all day. (Known in England as ‘Spanish Flu’.)
Spanish Flu
Greg equates what was evidently known within 42 Squadron as ‘Merville Fever’ with Spanish Flu. Possibly the words in brackets in his diary entry were added at a later date. But in any event, can he really have been talking about the same ‘Spanish Influenza’ that killed so many in 1918 and 1919? Especially if, as he said yesterday, it was merely “a sort of ‘flu lasting three or four days”?
Perhaps surprisingly, the answer was quite probably ‘yes’ – for a couple of reasons. (Nice bit of epidemiology coming up.)
The W-Curve
First, he was the right age not to be too badly affected. At 19 and in good health he would have had a fairly robust constitution. Furthermore, the 1918-19 influenza pandemic did not affect all age groups equally. Mortality was greatest among children under four and among the elderly – two immunocompromised groups – as one might expect. Also, there was also a curious minor peak of mortality among those aged 25-34, but Greg’s age put him only on the lower slopes of that peak.
Because of the minor peak among 25-34 year olds, a plot of mortality rate against age for the 1918-19 pandemic became known as the W-curve. This contrasts with the more expected U-curve that was seen in earlier years between pandemics:
The Three Waves
Secondly, as shown by the following plot of mortality rate against time (not age of patient, as in the above figure) there were three waves of the 1918-19 influenza pandemic, of unequal lethality. They were:
A first, mild wave in June/July 1918;
The second, most severe wave in Autumn 1918; and
A third, moderately severe wave in Spring 1919.
We see this three-wave pattern even more clearly from the UK data shown in Figure 1 of Taubenberger & Morens (2006), cited above:
Greg’s illness was in the first wave, which had the least rate of mortality of the three waves.
Not a Great Threat
So all in all, Spanish Flu – or Merville Fever – was by this stage not the great threat that it became, particularly for a young man of his age. At the time, it was quite plausibly regarded as “a sort of ‘flu lasting three or four days”. This is entirely in line with the observation by Taubenberger & Morens (2006) that:
Despite the extraordinary number of global deaths, most influenza cases in 1918 (>95% in most locales in industrialized nations) were mild and essentially indistinguishable from influenza cases today.
With Lt Roche having contracted flu yesterday, today it was Greg’s turn to be struck down by ‘Merville Fever’.
Diary
Thursday June 20th. Started with an attack of Merville Fever. A sort of ’flu lasting three or four days. Called P.U.O. (Placed Under Observation).
Had a letter from Kenneth & one from Alice.
So no flying for Greg. But two letters from the family in Holyhead must have cheered him up.
Kenneth Gregory and Alice Gregory
Kenneth was an elder brother, a mining engineer who worked with their father managing the quarry on Holyhead mountain. Alice was their sister, and a Queen Alexandra Nurse. She was also, in Oscar Wilde’s memorable phrase, excessively pretty.
In spite of declaring himself fit for war flying, the dud weather awarded Greg another day on the ground:
Diary
Monday June 10th 1918. Pretty dud day; did not fly.
“Dud” was always one of Greg’s favourite adjectives (and nouns) of disapprobation. It was a word that was rapidly rising in popularity during the First World War, as this Ngram graph from Google Books shows:
For an explanation of Ngrams, click here (opens in new tab). This Ngram was generated using the corpus of English books (British and American) between 1800 and 2008.