8. Spanish Flu

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  • Spanish Flu
    • What was Spanish Flu?
      • A virus
        • Flu endemic, normally responsible for 1-3% of deaths
        • Not identifiable at the time, not visible under normal microscope
        • Death resulted from uncontrolled immune response or from pneumonia or secondary infections
        • Subtype of same virus that caused 2009 swine flu pandemic
      • Three "waves"
        • Spring 1918: before end of WWI, around time of crucial military campaigns leading to end of war in Europe.
        • Autumn/winter 1918: around end of WWI.
        • Winter 1919: after WWI.
      • Who did it affect?
        • Affected the young, people 20-40 years old.
          • Required healthy immune system.
        • Affected women, working class and poorer countries more seriously.
      • Deadly
        • Big rise in mortality and massive dip in life expectancy.
        • Killed around 50m in 2 years.
        • WWI killed 17m in 4 years.
        • Global deaths, almost everywhere in world.
    • Global public health
      • Public health before Spanish Flu
        • Big strides in public health in 19th c.
        • Emergence of international health - quarantine regulations, research networks, conferences etc.
      • Germ Theory
        • Discovery that bacteria causes disease.
        • Developed from 1860s by figures like Pasteur and Koch.
        • Gradually gained acceptance among professionals.
      • Public Health and Spanish Flu
        • Germ Theory irrelevant and viruses poorly understood.
        • Unclear that Spanish Flu was flu.
        • Uncertainty about nature of epidemic, or how symptoms or waves were linked.
        • Uncertainty about origins.
        • Limited international coordination and information sharing.
        • Reliance on traditional measures of public health.
    • World War I
      • Flu exacerbated by war
        • Huge movement of people - troops and civilians
        • Poor living conditions and overcrowding
        • Young healthy adults - soldiers
        • Spike coinciding with Armistice celebrations
      • National Security
        • Warlike rhetoric of fight against flu and heroes fighting it.
        • Treated as national security issue - quarantine etc.
        • Reflected history of international public health and national or imperial security. Seen as threatening non-European disease - Asiatic disease.
      • Spanish Flu differed from war
        • Flu was more 'global' than war.
        • Impact of flu more severe and arbitrary.
          • Indiscriminate: even king of Spain and Woodrow Wilson caught virus.
    • Remembering Spanish Flu
      • In contrast to WWI
        • WWI at heart of national memorial culture but this established through official efforts.
        • No victory over Spanish Flu unlike WWI.
        • Pandemic overshadowed by WWI.
      • History of public health only relevant when new emergencies arise?
      • Limited impact on public culture at the time.


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