The influenza pandemic of 1918–19 caused a huge and dramatic epidemiological catastrophe during the years following the end of the Great War. There is evidence that the Spanish flu caused a total death toll of between 40 million and 100 million people, mostly youngsters, in three waves between the spring and autumn 1918 and spring 1919. Moreover, it represents a turning point in the epidemic manifestation of infectious diseases with a deep impact on twentieth-century epidemiology. It was the starting point of the emergence of viruses as new contagious agents at a time when ‘it was widely believed that laboratory trials would finally result in the isolation of the pathogenic agent of influenza’. However, previous hypotheses failed and no conclusive evidence was universally accepted until more than a decade after, when P. Laidlaw in 1933 isolated a flu virus from humans.
Over the past decade historiography has paid attention to its social, scientific and public health dimension, highlighting its relevance for the development of international public health and national health care systems. The World Health Organisation described the Spanish influenza pandemic as ‘the single most devastating infectious disease outbreak ever recorded’. The essays in this volume aim to complement previous historiography, contributing new perspectives and elucidating specific aspects of the pandemic that have received minimal attention, including social control, gender, class, religion, national identity, and military medicine’s reactions to the pandemic and relationship with civilian medicine.
The group of study cases that make up the chapters of the book have a dual aim: on the one hand. they discuss the role played by the Iberian peninsula in the spread of the pandemic to the Americas; on the other, they target three major gaps in previous Spanish flu scholarship. First, the book deals with geographic areas that do not appear in previous English-language publications about the pandemic: Brazil, Portugal, Argentina and Spain. Various contributors provide updated research on the pandemic in these regions: Catherine Belling, Josep Bernabeu-Mestre, Liane Maria Bertucci, Ryan A. Davis, Esteban Domingo, Magda Fahrni, Hernán Feldman, Pilar León-Sanz, Maria Luísa Lima, Maria de Fátima Nunes, Mercedes Pascual Artiaga, María-Isabel Porras-Gallo, Anny Jackeline Torres Silveira, José Manuel Sobral, Paulo Silveira e Sousa and Christiane Maria Cruz de Souza.
Indeed, the Great War increased the traffic of the virus and impaired the health condition of many populations already affected by famine and poor living conditions. Soldiers and refugees in Spain and Portugal served as vectors for introducing the virus in the Iberian peninsula. From there authorities believed that the pandemic was spread to Latin America. L.M. Bertucci explains in her ‘Spanish Flu in Brazil: Searching for Causes during the Epidemic Horror’ how the Oswaldo Cruz Institute and the Butanta Institute, with their excellent international connections, played an important role in the identification of the germ. Hernán Feldman shows in his ‘The Spanish Flu in Argentina: An Alarming Hostage’ how the epidemics revealed the inefficiencies in the Argentinian health care system, the lack of verifiable statistics and the need to undertake major reforms. Although the Spanish flu did not originate in Spain, it is striking that Spain, boasting rich primary sources, has hitherto received little attention in English-language historiography.
In addition, the book fills a gap in the expanding theoretical and critical frameworks shaped around the 1918–19 pandemic. Several chapters discuss sociocultural dynamics such as social control and class (Souza, Bernabeu-Mestre and Pascual Artiaga), gender (Fahrni), religion (Sobral, Lima, and Silveira, Sousa, and Souza), national identities (Davis), urban development (Silveira) and military medicine strategies in relation to civil medicine (Porras-Gallo). Other participants contribute original perspectives on more common issues such as biographies of relevant figures. M.F. Nunes on Ricardo Jorge shows how health policies depended upon prominent figures. Pilar León-Sanz analyses the role played by the sociedades de socorros mutuos (mutual benefit societies). In several cases, the authors contribute to our understanding of social and medical dynamics by expanding the reach of previous historiography.
Another perspective relates to the bacteriological debate, the scientific controversies and the lack of medical consensus. The failure of bacteriology to provide a definitive diagnosis at a time of huge trust on the germ paradigm provoked mistrust and discomfort.
The book is divided into three parts. The first, ‘Scientific Discourse: Now and Then’, is devoted to the flu germ and the scientific attempts to identify it. It starts with an exploration by Esteban Domingo of the evolutionary potential of the human influenza virus. The second part, ‘Social Responses: Human and Institutional Actors’, focuses on the social context, institutional reactions and public health policies to cope with the pandemic. All the chapters in this part deal with Spain, Portugal and Brazil. Finally the essays contained in the third part, ‘Interpreting the Epidemic: Sociocultural Dynamics and Perspectives’, explore the sociocultural resonances of the political reactions as well as general aspects of the pandemic. It shifts the focus from a preoccupation with social questions to an emphasis on cultural issues.
In sum, The Spanish Influenza Pandemic of 1918–1919: Perspectives from the Iberian Peninsula and the Americas elucidates aspects that received little attention in previous historiography, emphasising the importance of the Iberian peninsula as key point of connection between Europe and the Americas. It is an original and valuable contribution to the historiography of the Spanish flu and contemporary medicine.
