European studies blog

Exploring Europe at the British Library

23 March 2015

The Serbian Typhus Epidemic - 100 years on

The devastation caused by the influenza pandemic at the end of World War One is well known; what is less well known is that many parts of Europe were badly affected by diseases throughout the war. One of the first of these was an epidemic of typhus and relapsing fever which started in Serbia at the end of 1914 and killed upwards of 150,000 people in a population of around four and a half million.  Both diseases shared similar symptoms – a high temperature, rashes and constant itching - and were spread by the same means – lice. They were also highly infectious and often occurred together. While the exact start date of the epidemic was disputed, sources agreed that it ended in June 1915. Even in this short time the epidemic was still devastating in a small country where the diseases spread rapidly.

Rockefeller                                                   New York, 1915.  British Library 08248.h.19.

The documents listed below are the key contemporaneous accounts of this epidemic. The differences in emphasis are dramatic, ranging from the appeal for assistance from the Rockefeller Foundation to Minkine’s more clinical account of the epidemic, and from the self-promotion of the Hunter and Strong reports to the critical soul-searching analysis by Serbian doctors in 1925, edited by Stanojević.  

Minkine                                                      Paris, 1915. British Library F7/3088

In contrast to the first of these accounts to be published (that of the Rockefeller Foundation) where the Serbs were portrayed as helpless victims, by the time of the Stanojević analysis there was an active desire not just to understand the causes of the epidemic, but to prevent any future recurrences. The Hunter and Strong reports, published immediately after the war, emphasised the actions taken by their respective groups to relieve the epidemic, but without clear advice about what ‘weather-proofing’ was needed for Serbia to remain disease-free.

Hunter                                                    London, 1920. British Library Wf1/4919

The fact that the epidemic took place during a war, which made ascertaining the facts especially difficult, explained some of the differences between the accounts. These sources reveal why typhus was such a feared disease even after it was found to be preventable; in 1909 it was discovered that the disease was caused by body lice, although the cure was not known until after the war.  

Strong                                              Cambridge USA, 1920. British Library X8/2016

In a parallel with the recent Ebola crisis, the international community was scared that the disease would spread. They realised that an epidemic was not just the concern of one country, but had global implications. A number of countries, particularly in Europe, implemented new and stricter quarantine laws in 1915, specifically citing the risk posed by Serbia.

Stanojevic                                               Belgrade, 1925. British Library YF.2011.a.22007

Despite the dramatic and tragic losses, the typhus and relapsing fever epidemic taught some useful lessons. The epidemic was ended very quickly by the standards of the time. It was a good example of the international community coming together in a common cause, and it demonstrated a key principle in terms of epidemic management, namely that prevention was cheaper than relying on a cure that had not been invented.  

Tara Finn, the First World War Centenary Commemorations Team of Foreign and Commonwealth Office


William Hunter, The Serbian epidemics of typhus and relapsing fever in 1915 (London, 1920).  Wf1/4919 [available online from PubMed]

M. Jeanneret-Minkine, Le typhus exanthematique (Paris, 1915).  F7/3088    

The Rockefeller Foundation, The relief of suffering non-combatants in Europe: Destitution and disease in Serbia (New York, 1915).  08248.h.19.

Vladimir Stanojević, ed., Istorija srpskog vojnog saniteta (Beograd, 1925).  YF.2011.a.22007

Richard P. Strong, ed., Typhus fever with a particular reference to the Serbian epidemic (Cambridge, Mass., 1920). X8/2016 [available online (copy from Harvard University) at]


Thanks for this. Did you know that a Scottish lady doctor, Dr Elisabeth Macbean Ross died in this epidemic, after volunteering there? I first got to know about her because she also worked in the Zagros Mountains in Persia with the Bakhtiari tribe (see my article
and my soas site and a blog posting : but I also know that she is commemorated - I think annually in Serbia:
In Persia, she is reported to be one of the few Edwardian ladies to have had her corsets removed by brigands - because they wanted the whalebones!
Please dont hesitate to contact me if you want to know more. I dont know what you have in BL about her - my source were elsewhere. Maybe you have her book?
Best wishes
Carolline Mawer
[email protected]

Thank you very much for your lovely comment and the information about Dr Elisabeth Macbean Ross. Your interest and comment are appreciated very much.

I am pleased to confirm that the Library holds two copies of Dr Ross’s book. Elisabeth Macbean Ross, A Lady Doctor in Bakhtiari Land ... Edited by Janet N. MacBean Ross. London : Leonard Parsons, 1921. BL shelmarks, and ORW.1986.a.1448 [Another copy].

Thank you for your post on this tragic event in history. It is an epic story that is all but forgotten.

I am trying to write a comprehensive account, but my ability to access serbian documents is limited. Is the serbian account above translated into english anywhere to your knowledge?

Are there any photos inside?

Thank you for your comment. Unfortunately “Istorija srpskog vojnog saniteta : Naše ratno sanitetsko iskustvo” (1925) is not translated into English. This book includes charts, tables and statistical data but not photographs. However Strong (1920) includes some very good contemporary photographs.
Best wishes, Milan Grba

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