Yorkshire's last pandemic: How the Spanish flu killed thousands in 1918

The Spanish flu outbreak became a worldwide pandemic after the end of World War One, when movements of large numbers of people following the end of the fighting allowed it to spread with ease.

It's thought to have killed up to 100 million people across the globe, with around 228,000 victims in Britain. A third of the entire world population caught it, and some historians have claimed it was more destructive than the Black Death. David Lloyd George, Groucho Marx, Walt Disney, Amelia Earhart and Mahatma Gandhi all recovered from it.

Yorkshire was hit as hard as anywhere else in 1918-20. In 1918, there were 1,401 deaths in Leeds attributed to the strain, and the city's children's hospital had to be entirely given over to treating cases of the disease. There were another 623 deaths in 1919.

It was most virulent in the winter months, when families spent more time indoors and bodies often lay in houses for several days to allow relatives to pay their last respects.

York reported 59 deaths in 1919, including five children and a teacher.

University of Huddersfield professor of health history Barry Doyle has researched the pandemic's effects in Yorkshire, and concluded that Sheffield was the city worst affected.

He claims that central government failed to take adequate action to halt the spread of Spanish flu, despite the country having one of the most advanced public health systems of the day.

“The government didn’t want people to panic, so they tried to keep it quiet.

“The only thing the authorities could do was publish advice and it varied from quite useful to completely odd. For example, there was a suggestion that permanganate of potash, salt and water could either be gargled or snuffed up the nostrils two or three times a day!

“Most of the advice was don’t go to crowded places, wrap up warmly, stay indoors, go to bed and wait till the flu passes. But the problem was that adults had work to go to, plus commitments to children and at the beginning of the pandemic there was still a war on, so there was a lot of pressure on people to get to work, especially in industrial areas.

"Sheffield had one of the highest mortality rates because it was a munitions town."

In Sheffield, during the autumn 1918 wave, there were 1,332 deaths, and another 450 before the end of the year. By 1920, five extra wards had been opened at Moor Lodge Hospital, but cases petered out by the end of the summer. There were even suspensions of tram services and backlogs of burials at Burngreave Cemetery.

Stocks of 'remedies' such as Bovril sold out in shops.

Professor Doyle believes that younger, healthier adults of working age were disproportionately affected because in the days before paid sick leave, they could not afford to avoid work or crowded places. Jobs in armaments production were also essential to the war effort, and some of these roles were held by conscripted labour.

Vulnerable elderly people were able to stay indoors and rest, but those in essential jobs often tried to 'shake it off' which resulted in them developing the complication that killed most Spanish flu victims - septic pneumonia.

Medical staff were badly hit themselves, while many doctors and nurses were still serving at the Front in field hospitals. There were even shortages of gravediggers and undertakers because of the fighting.

With no NHS at the time, the health system was localised, and the government had limited powers.

Professor Doyle also scotches the rumour that the strain originated in Spain - it is actually thought to have begun in a remote part of Kansas in the USA. Spain did not participate in World War One, so the nickname was given because the country publicised the pandemic more than the British, French and American press, which were trying to suppress panic in already demoralised populations and still had censorship in place. This lack of accurate information led many to mistakenly believe that the outbreak had been traced to Spain.

A 2009 BBC factual drama about the flu, The Forgotten Fallen, was filmed in Yorkshire at locations including Dewsbury Town Hall, although it was set in Manchester.

Although significant progress had been made by 1918 in understanding the spread of infectious diseases, there were still factors which made the population more susceptible to serious illness now than they would be today. Many of those returning from war had weakened immune systems caused by years of living in primitive conditions in close proximity to others.

Even among those who had stayed at home, industrial disease was prevalent, and many people suffered from long-term respiratory conditions associated with poverty and poor living standards. For the poor, housing was often overcrowded and badly ventilated. There had been food shortages during the war years and general nutrition standards were not high.

Public health and disease control is also centralised thanks to the formation of the NHS in the 1940s, so a response can be more easily co-ordinated across the country.

The Yorkshire aristocrat whose death from Spanish flu contributed to modern research

In 2008, samples from the body of a Spanish flu victim were extracted and preserved in Atlanta to help scientists isolate future strains of flu.

The body was that of Sir Mark Sykes, a diplomat and aristocrat who lived at Sledmere House, the stately home near Driffield which is still in the Sykes family today and open as a visitor attraction.

Sir Mark became an expert on Middle Eastern affairs and negotiated agreements which protected western interests in the region in the early 20th century.

In 1919, he was invited to attend the Paris peace conference in a diplomatic capacity. He fell ill with the flu, and died in his hotel room at the age of 39. He was buried at St Mary's Church near the Sledmere estate.

He had two sons at the time of his death, and his eldest grandson Sir Tatton Sykes is the current baronet of Sledmere.

The Sykes family gave virologist John Oxford permission to exhume the body in 2008 - his remains were in a lead-lined coffin, which led to Oxford believing that the virus could be extracted intact. There are only five other examples of the Spanish flu virus in existence.