While the causes of the disease remained unknown until the 1930s, some suspected that it might have been transmitted through the post. The timing of the outbreak coincided with the Christmas period, a peak time for mail deliveries.
In several instances, postal workers were among the first to be infected with the disease. And the early appearance of the flu in post offices across the country focused attention on the mail as a vector of transmission. In Cheltenham, Newport and Cardiff, postal workers were among the first to be infected with the virus.
In Market Deeping, a small and isolated village in the Cambridgeshire fens, the flu first infected a postal clerk who had travelled to the General Post Office in London. Particularly worrying were cases where people were thought to have contracted the disease after receiving letters through the post.
The suspicion that mail was one of the main ways the illness spread appeared to be confirmed by the very high rate of infection among employees at the General Post Office in London compared with other postal workers.
A report on the first wave of the epidemic by the Local Government Board’s medical advisor, Dr Franklin Parsons, recorded that over a third of all telegraph operators had contracted the illness, though the figure was lower for workers elsewhere in the central headquarters and in other London post offices.
Elsewhere, doctors pointed out that those who actually delivered the mail were less likely to contract the disease than other postal workers, blaming the spread not on contact with the mail but on contagion from those who had already had been infected. Long hours of work in overcrowded offices rather than letters were blamed for the spread of the infection among postal workers.
The high rate of infection among telegraphists was blamed on the very cramped conditions in which they worked and the intensity of the tasks they had to perform. Listening intently for hours to the constant clicking of a telegraph machine was thought to exhaust the nerves and increase susceptibility to the disease.
The long-term effects of the flu epidemic are difficult to assess. At the height of the first wave, it was estimated that 400,000 Londoners were affected – about 10% of the population. The death rate more than doubled as a result.
It also had a longer-term effect on the population. Measures of the height of young adults in Scotland in the early 1900s show a dip for those who had been born during the years of the Russian flu, suggesting that the effect of the disease could be transmitted to babies in the womb.
The rapid global spread of disease, the debate about mechanisms of transmission, the lack of diagnostic certainty, doubts about treatment and potential long-term effects are all too familiar as we now struggle to contain a virus that has also spread westwards along global lines of transportation. The age of pandemics brought about as a result of an increasingly interconnected world, which began with the Russian flu in 1889, looks set to continue for many years to come.