The deadly wave of epidemics in Russia in 1918-1921

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

During the Civil War in Russia, more than 700 thousand people died from typhus alone. A deadly wave of epidemics swept across the country.

Epidemiological context: the collapse of health care

Even before the outbreak of World War II, 13 million infectious patients with varying degrees of severity of disease were registered in the Russian Empire (as of 1912). While the sanitary services and the Russian Red Cross Society retained large-scale organizational and material resources, the government managed to cope with foci of diseases and prevent new large-scale epidemics even during the war.

But when the state collapsed, so did healthcare. In 1918, in the conditions of the civil war, there was a expanse for infections: in the opposing armies, there was a permanent lack of doctors (the deficit in the Red Army reached 55%), vaccines and medicines, medical instruments, baths and disinfectants, hygiene products and linen. For these reasons, the armies were the first victims of the infection.

The severe sanitary condition of the Red and White troops immediately affected the civilian population and refugees with whom the military contacted: they were massively ill, primarily in cities overcrowded and dirty due to migration and the collapse of the urban economy. The weakened immunity of military and civilians (due to wounds, fatigue and malnutrition) also had tragic consequences.

Military ambulance train, early 20th century Source: forum-antikvariat.ru

Hospital early. XX century, Kurgan. Source: ural-meridian.ru

All-Russian misfortunes: typhus, dysentery and cholera

How many people have been ill, no one knows - we are talking about tens of millions of people. A smaller proportion of cases were registered. Only those who fell ill with typhus in 1918 - 1923. 7.5 million people were registered.

According to the Soviet immunologist and epidemiologist of that time L. A. Tarasevich, the real number of cases of typhus only in 1918 - 1920. amounted to 25 million people. In the most unfavorable areas, up to 6 thousand fell ill per 100 thousand inhabitants. According to incomplete data, more than 700 thousand people died from the "sypnyak".

[Note: typhus is a serious and "forgotten" (ie rare today) disease. The causative agent is Provachek's rickettsia, which is carried by common lice. Symptoms are weakness, loss of appetite, nausea, chills, high fever, dry and reddened skin, joint pain, headache, shortness of breath, shortness of breath, nasal congestion, restless sleep. Patients are often delusional. A rash appears a few days after the onset of the disease. If the body copes with the high temperature and complications, then after about 2 weeks it recovers. Relapsing fever is caused by bacteria - spirochetes and borrellia (which can also be carried by lice). This disease is characterized by severe febrile seizures, and pneumonia is not uncommon.]

1919 poster Source: Pikabu

The catastrophic spread of typhus and relapsing fever is associated with vectors - lice, which are practically impossible to exterminate in war, since in the field during battles no fighter can fully comply with sanitary standards. In addition, unvaccinated, sick servicemen of the Red and White armies constantly ran to the enemy and involuntarily became a "bacteriological weapon."

Especially often they infected red whites, in which the sanitary situation left much to be desired. Denikinites and Kolchakites were infected almost without exception. People's Commissar of Health N. A. Semashko spoke about it this way in 1920: "When our troops entered the Urals and Turkestan, a huge avalanche of epidemic diseases (…) moved on our army from the Kolchak and Dutov troops."

According to Semashko, 80% of the defectors were infected. Whites were rarely vaccinated.

In addition to typhus of various types, foci of cholera, smallpox, scarlet fever, malaria, consumption, dysentery, plague (yes, you shouldn't be surprised) and other diseases arose in Russia. There is no need to talk about various rhinoviruses, coronaviruses and flu.

Since more or less systematic accounting was carried out only in the Red Army, only data on it can be used to assess the scale of the problem: in 1918 - 1920. only 2 million 253 thousand infectious patients were registered (these sanitary losses exceeded combat losses). Of these, 283 thousand died. The share of relapsing fever was 969 thousand sick, typhus - 834 thousand Tens of thousands of Red Army soldiers caught dysentery, malaria, cholera, scurvy and smallpox.

Fatalities in Novo-Nikolaevsk, 1920 Source: aftershock.news

Mass epidemics of typhus and cholera in the white armies also resulted in thousands of victims: for example, in December 1919, Yudenich's troops retreating to Estonia did not receive enough food, firewood, hot water, medicine, soap and linen.

As a result, they became covered with lice. In Narva alone, the outbreak of typhoid fever claimed 7 thousand lives. People literally lay in heaps and died on the dirty floors of abandoned factory premises and in heating facilities, practically without any medical help (small and helpless without medication, doctors themselves were sick and dying). The bodies of the dead lay in piles at the entrances. This is how the Northwest Army perished.

According to rough data, about 2 million people died from infectious diseases during the Civil War in Russia. This figure, if not, is at least close to the number of those killed in battles (here estimates reach 2.5 million).

From the list of losses of the Red Army [51 thousand dead, ed. 1926]. Source: elib.shpl.ru

Fight disease

Only the Bolsheviks were able to achieve serious success on the "lousy front" of the Civil War, and only after victories over the Whites - the victories allowed them to devote attention and resources to medical problems and take emergency measures.

Although back in 1919, the Soviet government began to act quite energetically. V. I. Lenin at the next All-Russian Congress of Soviets said: “… Louse, typhus (…) mows down our troops. And here, comrades, it is impossible to imagine the horror that occurs in places affected by typhus, when the population is exhausted, weakened … "The leader of the Bolsheviks demanded the most serious attitude to epidemics:" Either lice will defeat socialism, or socialism will defeat lice!"

1920 poster Source: aftershock.news

To combat epidemics, plenipotentiary sanitary and military-sanitary commissions were created on the ground, the work of which was directed by the Council of People's Commissars of the RSFSR. In the Red Army, this was done by the Military Sanitary Department: he created a network of quarantines, isolation checkpoints and front-line hospitals for those infected with infections, and promoted cleanliness.

The Bolsheviks concentrated in their hands the old material base of health care, all the property of the Red Cross and the production of drugs - due to this, they received funds for a systematic approach to epidemics. They not only treated the sick, but also began to vaccinate a large number of healthy people.

Gradually, the entire personnel of the army and navy underwent mass vaccination. In 1918, there were only 140 "immunized" people per 1,000 people, in 1921 there were already 847, and in 1922 only a few remained unvaccinated. It was finally possible to solve the problem of epidemics by 1926 - the result of many years of quiet work to improve the sanitary situation in the Red Army and the country as a whole.

1920s poster. Source: Pikabu

[Note: Efforts to combat disease were also undertaken by whites, who were not effective enough due to general organizational and administrative problems and the huge mass of refugees. The trouble was compounded by the collapse of the economy and corruption. White-occupied cities lacked doctors, beds, linen, baths and steam laundries, disinfection chambers, and firewood; sanitary and epidemiological surveillance was not carried out everywhere. Often, foci of disease arose in prisons and train stations. As whites lost the war, they were less likely to complete medical tasks.]

Konstantin Kotelnikov