2 Burnet, Sir Macfarlane and White, David O., Natural History of Infectious Disease (4th ed., Cambridge, 1972), 202Google Scholar; Jordan, Edwin O., Epidemic Influenza: A Survey (Chicago, 1927), 229Google Scholar; Crosby, Alfred W., Epidemic and Peace, 1918 (Westport, Conn., 1976), 207, 311.Google Scholar For the epidemiology of the disease, see Beveridge, W. I. B., Influenza: The Last Great Plague: An Unfinished Story of Discovery (New York, 1977)Google Scholar; and Palese, Peter and Young, James F., ‘Variation of influenza A, B, and C viruses’, Science, ccxv (19 Mar. 1982), 1468–1474.CrossRefGoogle Scholar

3 Crosby, , Epidemic and Peace, 207.Google Scholar

4 Crookshank, F. G., Influenza (London, 1922)Google Scholar; Great Britain, Ministry of Health, Report on the Pandemic of Influenza, 1918–1919 (London, 1920)Google Scholar; Vaughan, Warren T., Influenza: An Epidemiological Study (Baltimore, 1921).Google Scholar There are a few anecdotes on Africa scattered in Collier, Richard, The Plague of the Spanish Lady: The Influenza Pandemic of 1918–1919 (New York, 1974).Google Scholar

5 Patterson, K. David, ‘Disease and medicine in African history: A bibliographical essay’, History in Africa: A Journal of Method, I (1974), 141–148.CrossRefGoogle Scholar Exceptions include Phimster, I. R., ‘The “Spanish” influenza pandemic of 1918 and its impact on the Southern Rhodesian mining industry’, Central African Journal of Medicine, XIX (1973), 143–148Google Scholar; a popularly-written chapter in Burman, Jose, Disaster Struck South Africa (Cape Town, 1971), 83–106Google Scholar; Pankhurst, Richard, ‘The “Hedar Basita” of 1918’ J. Ethiopian Studies, XIII (1975), 103–131Google Scholar; and Ohadike, D. C., ‘The Influenza Pandemic of 1918–1919 and the Spread of Cassava Cultivation on the Lower Niger: A Study in Historical Linkages’, J. of Afr. Hist, XXII (1981), 379–391.CrossRefGoogle Scholar See also Patterson, K. David, ‘The demographic impact of the 1918–1919 influenza pandemic in sub-Saharan Africa: A tentative assessment’, in Christopher, Fyfe and David, McMaster (eds.), African Historical Demography, II (Edinburgh, 1981), 401–431Google Scholar; and Patterson, K. David and Pyle, Gerald F., ‘The spread of influenza in sub-Saharan Africa 1918–19: A geographical analysis’, to appear in Social Science and Medicine, 1983.Google Scholar

6 Gold Coast Medical and Sanitary Report for 1919 (henceforth M.S.R.), 6. For a general overview of the health situation and the medical services, see Patterson, K. David, Health in Colonial Ghana: Disease, Medicine, and Socio-Economic Change, 1900–1955 (Waltham, Mass., 1981).Google Scholar

7 Scott, David, Epidemic Disease in Ghana 1901–1960 (London, 1965), 187.Google Scholar In 1918 the Principal Medical Officer suggested that the 1891 outbreak might have been pneumonic plague (M.S.R., 1918, 14), but this seems highly unlikely (Scott, , Epidemic Disease, 188).Google Scholar

8 See, for example, Collier, , Spanish Lady, 35–36, 104–108.Google Scholar

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10 M.S.R., 1918, 10.Google Scholar

11 W. Tefler, Medical Officer (henceforth M.O.) Native Hospital, Accra, to Principal Medical Officer (henceforth Prin. M.O.), 3 September 1918, NAG Acc. No. 2753/58; Tefler to Medical Officer of Health, Accra, 3 September 1918, Ibid.

12 Senior Sanitary Officer to Prin. M.O., 3 September 1918, Ibid.

13 M.S.R., 1918, chart opposite p. 7.Google Scholar

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15 Tefler to Prin. M.O., 16 September 1918, Ibid.

16 Prin. M.O. to Colonial Secretary, Accra, 17 September 1918, Ibid.

17 The Gold Coast Independent, 21 September 1918, 2.Google Scholar

18 Legislative Council Debates, session of 28 October, 1918, 22, NAG ADM 14/2/5.Google Scholar

19 M.S.R., 1918, chart opposite p. 7.Google Scholar As was true elsewhere, many fatalities were due to secondary pneumonia infections. See Ibid. 12–13 and case histories, 16–19.

20 Legislative Council Debates, 22–23.Google Scholar

21 M.S.R., 1918, 11.Google Scholar Mortality in Accra, including data on specific population groups, will be discussed below.

22 Ibid. 10; Provincial Commissioner, Central Province, to Colonial Secretary, 20 September 1918, NAG Acc. No. 2753/58.

23 Gold Coast Leader, 21 September 1918, 2Google Scholar; 28 September, I; 5–12 October, I; 19 October, 1–2; 26 October, I; 2–9 November, 1. The African press gave surprisingly little space to the epidemic; local political and social news and events in war-torn Europe were much more extensively covered. Influenza items were rarely more than a few sentences long. Influenza reporting in the American press followed a similar pattern (Crosby, , Epidemic and Peace, 314.)Google Scholar

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25 Ibid. 9.

26 Ibid. 10.

27 Ibid. 8.

28 W. W. Claridge, Senior M.O., Lomé, to Prin. M.O., Accra, 12 October 1918, NAG Acc. No. 2753/58.

29 Senior M.O., Lomé, to Prin. M.O., Accra, 22 October 1918, Ibid.

30 Governor of the Gold Coast to Governors, British West African Colonies, Belgian Congo, French Colonies, British Consul at Monrovia, 30 September 1918, Ibid.

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35 Provincial M.O., Kumasi, to Prin. M.O., Accra, 7 November 1918, Ibid.

36 C.C.A. to Colonial Secretary, 26 October 1918, Ibid. Further reports and scattered casualty figures were submitted on 2, 9, and 16 November, Ibid.

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38 Chief Commissioner, Northern Territories, (henceforth C.C.N.T.) to Colonial Secretary, 23 October 1918, NAG Acc. No. 2753/58; Ibid., 5 November.

39 Ibid., 1 November.

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45 District Commissioner (henceforth D.C.) Bawku to C.C.N.T., 18 November 1918, Ibid.

46 Tumu District Diary, 16 and 19 November 1918, NAG ADM 66/5/6.

47 Ibid., 4 December and passim; D.C. Tumu to Provincial Commissioner, North-Western Province (henceforth P.C.N.W.P.) 7 January 1919, NAG ADM 56/1/223.

48 Zuarungu District Diary, 27 November 1918, NAG ADM 68/5/1; Acting D.C. Zuarungu to Acting P.C.N.E.P., 27 November 1918, NAG ADM 56/1/223.

49 Zuarungu Diary, passim; M.O. Zuarungu to Acting P.C.N.E.P., 9 December 1918, NAG ADM 56/1/223; D.C. Zuarungu to P.C.N.E.P., 25 January 1919, Ibid.

50 D. C. Bawku to P.C.N.E.P., 18 January 1919, Ibid.; P.C.N.E.P. to Provincial M.O., 6 December 1918, Ibid.

51 D.C. Navarro-Zuarungu to P.C.N.E.P., 14 April 1919, Ibid.

52 Lorha Diary, 2 December 1918.

53 P.C.N.W.P. to C.C.N.T., 4 March 1919, NAG ADM 56/1/223.

54 Zuarungu Diary, 20 December 1918.

55 M.O. Zuarungu to Acting P.C.N.E.P., 9 December 1918.

56 Scott, , Epidemic Disease, 191.Google Scholar

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58 Colonial Secretary to C.C.A., 27 September, and Colonial Secretary to Provincial M.O., 25 September 1918, Ibid.

59 Prin. M.O. to Senior Sanitary Inspector, 11 October 1918, Ibid.

60 P.C.N.E.P. to C.C.N.T., 20 November 1918, NAG ADM 56/1/223.

61 Resident de Leo a D.C. Lorha, 12 November 1918.

62 Tumu Diary, 21 November and 4 December 1918.

63 P.C.N.W.P. to D.C. Lorha, 20 November 1918, NAG ADM 56/1/223; C.C.N.T. to P.C.N.E.P., 27 November 1918, Ibid.

64 Senior M.O., Lome, to Prin. M.O., Accra, 12 October 1918, NAG Acc. No. 2753/58 and Officer Commanding British Forces, Lome, to Colonial Secretary, 1 November 1918, Ibid..

65 Senior M.O. to Prin. M.O., 12 October 1918.

66 Ibid., 22 October 1918.

67 Ibid., minute of Prin. M.O., 22 October and minute of Governor, 25 October.

68 Prin. M.O. to M.O.s in Colony and Ashanti, 21 September 1918, Ibid.; P.C. Central Province to Colonial Secretary, 20 September 1918, Ibid.; Annual Report, Western Province, 1918, 12Google Scholar, NAG ADM 5/1/95.

69 M.S.R., 1918, 7.Google Scholar

70 Tumu Diary, 1 and 19 November 1918; D.C. Lorha to P.C.N.W.P., 15 November 1918, NAG ADM 56/1/223; Lorha Diary, 15 and 30 November.

71 Colonial Secretary to Editors of the Colony's Newspapers, 27 September 1918, NAG Acc. No. 2753/58. The statement was buried, justifiably, at the bottom of page 2 of the Gold Coast Leader, 5–12 October 1918.Google Scholar

72 Legislative Council Debates, 25, statement of Nana Ofori Atta.

73 M.S.R., 1918, 40.Google Scholar

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76 Prin. M.O. to Colonial Secretary, 20 October 1918 and enclosures, NAG Acc. No. 2753/58. The doctors included B. W. Quartey-Papafio and C. Reindorf.

77 Minute of October 28 on Ibid.

78 Kimble, David, A Political History of Ghana 1850–1928 (Oxford, 1963), 97–100Google Scholar; Dumett, Raymond E., ‘The campaign against malaria and the expansion of scientific medical and sanitary services in British West Africa, 1890–1910’, African Historical Studies, 1 (1968), 191–5CrossRefGoogle Scholar; Gale, Thomas S., ‘Sir Gordon Guggisberg and his African critics’, Transactions of the Historical Society of Ghana, XIV (1973), 271–5.Google Scholar

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80 Legislative Council Debates, 19–22.Google Scholar Statement of the Prin. M.O. He tentatively accepted the common, but erroneous view that Phieffer's bacillus caused influenza. For the frantic and unsuccessful world-wide search for the causative agent and an effective vaccine, see Crosby, , Epidemic and Peace, 264–290.Google Scholar

81 M.O. Zuarungu to Acting P.C.N.E.P., 13 December 1918.

82 Tumu Diary, 29 November 1918.Google Scholar

83 Gold Coast Independent, 21 September 1918, 2.Google Scholar

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85 Ibid., 30 November 1918, 1.

86 Ibid., 19 October 1918, 1. Traditional medicine is described in Field, Margaret J., Religion and Medicine of the Ga People (New York, 1937)Google Scholar and Twumasi, P. A., Medical Systems in Ghana (Accra, 1975)Google Scholar, but neither work mentions influenza. Local healers and remedies were doubtlessly used by most victims. I was told in 1975 in northern Ghana that during the 1957 epidemic the most widely used medicine was hard liquor, which was considered effective even by many devout Moslems.

87 Indeed the government was so convinced of the futility of counter-measures that when the Prin. M.O. drafted a telegram to notify neighbouring governments of the appearance of the disease in the Northern Territories, it took four days of bureaucratic wrangling to get it sent. Some officials argued that the telegrams would just be a waste of money. Governor to Lt. Governors Dahomey and Bingerville, Governor-General Dakar, 19 November 1918, and attached minutes, NAG Acc. No. 2753/58.

88 Legislative Council Debates, 25.Google Scholar

89 Gold Coast Leader, 1 February 1919, 5.Google Scholar

90 Ibid., 19 October 1918, 3.

91 Ibid., 7 December 1918, 4–5, column by ‘Atu’, perhaps an African physician.

92 Legislative Council Debates, 12–13Google Scholar; 18–23.

93 Ibid. 14–15.

94 Legislative Council Minutes, 28 October 1918, 17, NAG ADM 14/1/16.Google Scholar

95 M.S.R., 1918, 8Google Scholar; P.C.N.W.P. to C.C.N.T., 4 March 1919.

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104 Annual Report, Western Province, 1918, 12.Google Scholar The seriousness of the situation in the Eastern and Western Provinces of the Colony is suggested by several short reports in the Gold Coast Leader; e.g. 7 December 1918, 5, for Kebbi; 14–21 December, 5, for Akwapim and Tarkwa; 11–18 January 1919, 5, for Beyin and Peki; 25 January, 2, for Essiama; 1 February, 5, for Keta; and 8 February, 2, for Mampong.

105 Annual Report for Ashanti, 1918, 19.Google Scholar

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113 D.C. Navarro-Zuarungu to P.C.N.E.P., 14 April 1919, Ibid.

114 D.C. Zuarungu to P.C.N.E.P., 25 January 1919.

115 Ibid.

116 D.C. Navarro-Zuarungu to P.C.N.E.P., 14 April 1919.

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119 M.S.R., 1918, 40.Google Scholar

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121 Gold Coast Leader, 23 November 1918, 2.Google Scholar

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125 P.C.N.W.P. to C.C.N.T., 26 January 1919, Ibid., data for the entire Wa District; D.C. Navarro-Zuarungu to P.C.N.E.P., 25 January 1919, death by sex figures available for 12 of 34 divisions of Zuarungu and 22 of 28 divisions of Navarro; D.C. Bawku to P.C.N.E.P., 18 January 1919, based on sex data for 1126 of 2354 reported deaths; D.C. Lorha to P.C.N.W.P., 8 January 1919 data for entire district.

126 D.C. Lorha to P.C.N.W.P., 8 January 1919.

127 General accounts of the epidemic in Africa are available in Great Britain, Ministry of Health, Report on the Pandemic of Influenza; Gouzien, P., ‘La Pandémie Grippale de 1918–19 dans les Colonies Françaises’, Bulletin Mensuel International d'Hygiène Publique, XII (1920), 686–724Google Scholar; Gouzien, P., ‘L'Epidêmie d'Influenza de 1918–19 dans les Colonies Françaises’, Annales de Médecine et de Pharmacie Coloniales, XIX (1921), 264–300Google Scholar; Dr Huot, ‘L'Epidémie d'Influenza de 1918–1919 dans les Colonies Françaises. II. Groupe de l'Afrique Equatoriale Française’, Ibid.., 443–478. For a summary, see Patterson, and Pyle, , ‘Spread of influenza in sub-Saharan Africa’.Google Scholar

128 Gouzien, , ‘L'Epidémie d'Influenza’, 270–271Google Scholar; Great Britain, Report, 363.Google Scholar

129 Jordan, Epidemic Influenza, 226–7, 229.Google Scholar The estimated population of Africa in 1920 was about 141 million. (United Nations Demographic Yearbook, 1962, 124.)Google Scholar

130 Great Britain, Report, 364.Google Scholar

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