Influenza at Sea.
There is no point more essential to a correct theory of influenza than to find out in what circumstances it has occurred among the crews of ships on the high seas. If it be true that a ship may sail into an atmosphere of influenza, just as she may sail into a fog, or an oceanic current, or the track of a cyclone, then the possible hypotheses touching the nature, source, and mode of diffusion of influenza become narrowed down within definite limits.
One of the first observations was made in the case of a Scotch vessel in the influenza of 1732-33[781]. The epidemic was earlier in Scotland than in England; it began suddenly in Edinburgh on 17 December, 1732, the horses having been attacked with running of the nose towards the end of October. About the time when the disease began among mankind, in December, a vessel, the ‘Anne and Agnes’ sailed from Leith for Holland. One sailor was sick on this voyage. She sailed on the return voyage to Leith, with the other ten of her crew in perfect health. Just as she made the English coast at Flamborough Head on the 15th of January, 1733, six of the sailors fell ill together, two more the next day, and one more on the day after that, so that when the vessel anchored in Leith Roads there was only one man well, and he fell ill on the day following the arrival. The symptoms were the common ones of the reigning epidemic. The dates are not given more precisely or fully than as above. Influenza was prevalent in Germany and Holland somewhat earlier than in Scotland or England; the men may, of course, have imbibed the infection when they were in the Dutch port, just as it is almost certain that the crews of Drake’s fleet in 1587 had received during a ten days’ stay upon the island of St Jago, of the Cape de Verde group, the miasmatic infection of which they suddenly fell sick in large numbers together in mid-Atlantic some six days after sailing to the westward.
This early case of the ‘Anne and Agnes’ in 1733 may pass as an ambiguous one. The next occasion when influenza on board ship attracted much notice was the epidemic of 1782.
On the 6th of May, Admiral Kempenfelt sailed from Spithead with seven ships of the line and a frigate, on a cruize to the westward; on the 18th May, he came into Torbay, and sailed again soon after; on the 30th May he came again into Torbay with eight sail of the line and three frigates, and on 1 June sailed again to the westward. Sometime before his squadron put into Torbay for the second time, influenza had appeared among them at sea, it is said in the ‘Goliath’ on the 29th of May[782]. A letter from Plymouth, of the 2nd June, after referring to the violence of influenza in that town, at the Dock, and on board the men-of-war lying there, says that the ‘Fortitude’ of 74 guns, and ‘Latona’ frigate came in that afternoon with 250 sick men from the fleet under Admiral Kempenfelt, mostly with fevers. Another Plymouth letter two days later (4 June) says: “Kempenfelt is returning to Torbay: he could keep the sea no longer, on account of the sickness that rages on board his fleet. More than 400 men have been brought to the hospital this morning. Our men drop down with it by scores at a time. The ‘Latona’ frigate, that sailed the other day is returned, the officers being the only hands that could work the ship[783].”
This outbreak on board ships in the Channel was fully as early as the great development of influenza in 1782 on shore, whether in London or Plymouth; but there were almost certainly cases of it at the latter port before the ‘Latona’ sailed to join Kempenfelt’s squadron. Robertson, however, who was surgeon on the ‘Romney’ in the Channel service at that time, says that “hundreds in different ships, towns, and counties, which had no communication with one another, were seized nearly as suddenly and so nigh the same instant as if they had been electrified.... The companies of many of the ships were very well at bed-time, and in the morning there were hardly enough able to do the common business of the ship[784].” This is confirmed by McNair, surgeon of the ‘Fortitude,’ who told Trotter that two hundred of her men, as she lay in Torbay, were seized in one night and were unable to come on deck in the morning[785].
There was another English fleet in the North Sea at the same time, under Lord Howe, watching the Dutch fleet or seeking to intercept the Dutch East Indiamen.
Howe sailed from St Helen’s on the 9th May, with twelve ships of the line. Towards the end of that month he had his fleet in the Texel; the men were in excellent health, “when a cutter arrived from the Admiralty, and the signal was given for an officer from each ship [to come on board the admiral]. An officer was accordingly sent with a boat’s crew from every vessel, and returned with orders, carrying with them also, however, the influenza”—which soon prostrated the crews to the same extraordinary extent as in the ships under Kempenfelt at the other end of the Channel. This was the oral account given to Professor Gregory of Edinburgh, by a lieutenant on board a sixty-four gun ship[786]. Another account says that the disorder first appeared in Howe’s fleet on the Dutch coast about the end of May, on board the ‘Ripon,’ and in two days after in the ‘Princess Amelia’; other ships of the same fleet were affected with it at different periods, some indeed, not until their return to Portsmouth about the second week of June. “This fleet, also, had no communication with the shore until their return to the Downs, on their way back to Portsmouth, towards the 3d and 4th of June[787].”
But, apart from the story of the Admiralty despatch-boat carrying the influenza to Howe’s squadron, it appears that both Kempenfelt and Howe were joined from time to time by additional ships, which might have carried an atmosphere of influenza with them[788]. Still, it was an influenza atmosphere that they had carried, and not merely so many sick persons. The doctrine of contagion from person to person would have to be so widened as to become meaningless, if all those experiences of the fleet in 1782 were to be brought within it. In the history both of sweating sickness and of influenza, there are instances of the disease breaking out suddenly in a place after someone’s arrival; but the new arrival may not have had the disease, it was enough that he came from a place where the disease was[789]. That was, perhaps, the reason why Beddoes, in his inquiry of 1803, framed one of his questions so as to elicit information about the dispersal of influenza by fomites.
It is not easy to prove that a ship may meet with an atmosphere of influenza on the high seas; but many have believed that ships have done so. Webster says: “The disease invades seamen on the ocean in the same [western] hemisphere, when a hundred leagues from land, at the same time that it invades people on shore. Of this I have certain evidence from the testimony of American captains of vessels, who have been on their passage from the continent to the West India Islands during the prevalence of this disease[790].” There are several instances of this, authenticated with times, places, and other data of credibility.
The best known of these is the voyage of the East Indiaman ‘Asia’ in September, 1780, through the China Sea from Malacca to Canton: “When the ship left Malacca, there was no epidemic disease in the place; when it arrived at Canton it was found that at the very time when they had the Influenza on board the Atlas (sic) in the China seas, it had raged at Canton with as much violence as it did in London in June, 1782, and with the very same symptoms[791].”
In the present century, the cases nearly all come from the medical reports of the navies of Great Britain, France, Germany and the Netherlands, and they relate to ships on foreign service—in the East Indies, the Pacific, Africa, or other foreign stations. In some of the instances influenza went through a ship’s company in port or in a roadstead, others are examples of outbreaks at sea:
1837: “The ship’s company of the ‘Raleigh,’ were attacked by epidemic catarrh—influenza—first in March, while at sea between Singapore and Manilla, and again, although less severely, in June and July while on the coast of China.... Influenza also made its appearance amongst the crew of the ‘Zebra’ in April while she lay at Penang; it was supposed to have been contracted by infection from the people on shore, as they were then suffering from it. No death occurred under this head[792].”
1838: In the ‘Rattlesnake,’ at Diamond Harbour, in the Hooghly River, a large proportion of the men were suffering from epidemic catarrh. Intermittent fever made its appearance; “the change from the catarrhal to the febrile form was sudden and complete, the one entirely superseding the other[793].”
1842: In the ‘Agincourt’ on a voyage from the Cape of Good Hope to Hongkong in August and September, the greater part of 102 cases of catarrh occurred; many of these were accompanied with inflammation of tonsils and fauces, and in some there was deafness with discharge from the ear. This is not claimed as an instance of epidemic influenza, but as an aggregate of common colds, due to cold weather in the Southern Ocean and to wet decks[794].
1857: “Influenza broke out in the ‘Monarch’ while at sea, on the passage from Payta [extreme north of Peru] to Valparaiso. She left the former place on the 23d August, and arrived at the latter on the last day of September. About the 12th of the month [twenty days out], the wind suddenly changed to the south-west, when nearly every person in the ship began to complain of cold, although the thermometer did not show any marked change in the temperature. On the 12th and 13th seven patients were placed on the sick list with catarrhal symptoms; and during the following ten days, upwards of eighty more were added, but by the end of the month the attacks ceased. [She carried 690 men, and had 191 cases of “influenza and catarrh,” in the year 1857.] Some of the cases were severe, ending either in slight bronchitis or pneumonia, accompanied with great prostration of the vital powers. On the arrival of the ship at Valparaiso, the surgeon observes: ‘We found the place healthy, but in the course of a few days some cases of influenza made their appearance, and very soon afterwards the disease extended over the whole town. It was generally believed that we imported it, and the authorities took the trouble to send on board a medical officer to investigate the matter.’ He further observes that the whole coast, from Vancouver’s Island southward to Valparaiso was visited by the epidemic.” It made its appearance on board the ‘Satellite’ at Vancouver’s Island in September, and among the residents ashore, both on the island and mainland, at the same time[795].
1857: Catarrh “assumed the form of influenza in the ‘Arachne’ [149 men, 114 cases] while the vessel was cruizing off the coast of Cuba, with which, however, she had no communication. There was nothing in the state of the atmosphere to attract special attention. A question therefore arises whether it might not have been caused by infection wafted from the shore.” It was prevalent at the time at Havana[796].
1857: “Australian Station:—An eruption of epidemic catarrh occurred in the ‘Juno’ [200 men, 131 cases], but long after she left the station[797].”
Whilst the influenza was on the American Pacific coast in September, 1857, it was on the coast of China three months earlier—on board the ‘Inflexible’ at Hongkong on the 18th of May, and in the ‘Amethyst’ and ‘Niger’ in a creek near Hongkong early in June[798]. But it had been on the Pacific coast of South America the year before, according to the following:
“1856: Epidemic catarrh broke out in the ‘President’ when lying off the island of San Lorenzo in the bay of Callao, first on the 20th October, and the last cases were placed on the sick list on 1st November,—the usual period which influenza takes to pass through a frigate ship’s company. About sixty required to be placed on the sick list.” It had occurred on board English ships of war at Rio de Janeiro, on the other side of the continent, some two months before, in August, 1856[799].
1863: The following, in the experience of the French navy, has been elaborately recorded[800]: The frigate ‘Duguay-Trouin’ left Gorée, Senegambia, for Brest, in February. There were no cases of influenza in Gorée when she left; but four days out, an epidemic of influenza began on board, the weather being fine and the temperature genial at the time. Another French frigate, which had left Gorée, on the same voyage to Brest, two days earlier, did not have a single case.
The following instance, here published for the first time, belongs to the most recent pandemics of influenza, 1890-93. It relates to only a single case of influenza, in the captain of a merchantship; it would have been a more satisfactory piece of evidence, if there had been several cases in the ship; but among the comparatively small crew of a merchantman, the same groups of cases are not to be looked for that we find on board crowded men of war; and in this particular case the only other occupants of the quarter-deck were the first mate and the steward.
The ship ‘Wellington,’ sailed from the Thames, for Lyttelton, New Zealand, on the 19th December, 1891. The epidemic of influenza in London in that year had been in May, June and July; the mate of the ‘Wellington’ had had an attack of it ashore, on that occasion, but not the captain nor the steward. On the 2nd of March, 1892, when seventy-four days out and in latitude 42° S., longitude 63 E., near Kerguelen’s Land, the captain began to have lumbago and bilious headaches, for which he took several doses of mercurial purgative followed by saline draughts. The treatment at length brought on continual purging, which, together with three days’ starving from the 22nd to the 24th of March, caused him a loss of weight of eight pounds. The navigation had meanwhile been somewhat difficult and anxious, owing to a long spell of easterly head winds. Quite suddenly, on the 26th March, when the ship was in latitude 44 S., longitude 145 E., or about two hundred miles to the south of Tasmania, he had an aguish shake followed by prolonged febrile heat, which sent him to his berth. The symptoms were acute from the 26th to the 30th March,—intense pain through and through the head, as if it were being screwed tight in an iron casing, pain behind the eyeballs, a perception of yellow colour in the eyes when shut, a feeling of soreness all over the body, which he set down at the time to his uneasy berth while the ship was ploughing through the seas at about twelve knots, and a pulse of 110. The head pains were by far the worst symptom, and were so unbearable as to make the patient desperate. This acute state lasted for four days, and suddenly disappeared leaving great prostration behind. The captain, who had long experience with crews and passengers, and a considerable amateur knowledge of medicine, summed up his illness as a bilious attack, passing into “ague” with “neuralgia of the head.” While the acute attack lasted the ship had covered the distance from Tasmania to the southern end of New Zealand, and on the 31st of March the captain by an effort came on deck to navigate the vessel in stormy weather up the coast to Lyttelton, which was reached on the 2nd of April. The pilot coming on board found the captain ill in his berth, and on being told the symptoms, at once said, “It is the influenza: I have just had it myself.” The doctor who was sent for found the captain “talking foolishly,” as he afterwards told him, and had him removed to the convalescent home at Christchurch, where he remained a fortnight slowly regaining strength. The doctor[801] could find no other name for the illness but influenza, although he had not supposed such a thing possible in mid-ocean. They had just passed through an epidemic of it in New Zealand, and it is reported about the same time in New South Wales, afterwards in the Tonga group, and still later in the summer in Peru. The symptoms of this case are sufficiently distinctive: the intense constricting pain of the head is exactly the “fierro chuto” or “iron cap” of South American epidemics; the pain in the eyeballs, the soreness of the limbs and body, and the unparalleled depression and despair, are the marks of influenza without catarrh. The patient was of abstemious habits, and had made the same voyage year after year for a long period without any illness that he could recall. He had reduced himself by purging and starving, on account of a bilious attack during a fortnight of foul winds from the eastward, and had doubtless become peculiarly susceptible of the influenza miasm before the ship came into the longitude of Tasmania on the 26th March.