Spanish Flu Reports
Plagues in Europe

[The Survey; September 28, 1918]

Probably no amount of information concerning vibrios will ever make the word "cholera" a pleasing sound to lay ears, and memories are still vivid of days before typhus and yellow fever were under control. Hence, rumors of outbreaks of such diseases in European countries arouse anxious questionings. To these questionings answers are perforce brief rather than informing, and reassurance rests less upon explicit detail than upon the recollection of progress in the control by scientific public health measures of these and other communicable diseases. Information which reaches this country from abroad is naturally more or less confidential in character, lest capital be made of the situation by enemy countries. However, the following facts are authentic:

To the public health authorities of this country the situation in Europe does not seem to be gravely serious and not at present a menace to this country, although extensive troop movements always are potential and demand vigilance. Cholera rages in parts of Russia, but danger of its importation to the United States seems remote on account of the commercial isolation of that country at present. Just how many of the scientific staff of able physicians who fought this disease three years ago still remain to control it at this time it is impossible to say. Cholera seems to be gaining a foothold in Sweden, but the quarantine officers of the United States Public Health Service are fully advised and on the alert for the detection of carriers on vessels from the Scandinavian peninsula.

Typhus at present is considered a rather negligible factor. Since, however, this disease usually reaches epidemic proportions in winter months, it may possibly increase in the immediate future. As to bubonic plague, it is the practice at quarantine stations to consider practically all the ports of Africa, Asia, and South America, and many ports of Europe, as plague infected, so that although vessels from any of these ports are not detained unless actual cases of plague are on board, nevertheless the ships themselves are without exception fumigated for the destruction of rats. Yellow fever in Mexico and Guatemala is, according to the federal health authorities, the chief object of concern at present and the strictest efforts, are being directed to guard all ports against travel from Mexico and Central America.

With a view to preventing the spread of infection from this source, the strictest quarantine procedures have been established at Guatemala City. The city itself, because of its altitude and its usual freedom from mosquitoes, is considered out of danger from infection. But all travelers passing from west to east will be detained at that place and cars passing from west to east will be fumigated for the destruction of mosquitoes. Since early August, Senior Surgeon J. H. White, of the United States Public Health Service, and Dr. Alvin H. Struse, of the Rockefeller Foundation, have been present in the yellow fever district and are exercising general supervision of preventive and eradicative measures.

Finally, it is no secret that a new outbreak of influenza has spread widely enough throughout the world to be technically termed pandemic. The name "Spanish influenza" is about as accurate and necessary as the term "Indian" would be, applied to plague. Said a physician lately who had been for some time in hospital work in Spain: "Conditions in Spain justify the expectation of almost any outbreak that could occur. In my own operating room the flies have been so thick as to crawl upon the face of the patient, approach the wound itself, despite the efforts of the nurse, and interfere with the vision, to say nothing of comfort, of the attendants as well as myself."

According to a special announcement just appearing from the United States Public Health Service, the "Spanish influenza" is apparently grippe resurrected after an interval of twenty-five years. It has been reported from several European countries and at various ports of entry in this country. Cases are reported from New Orleans, New London, Philadelphia and New York City in relatively smaller numbers. The outbreaks have been more serious in Massachusetts and Virginia. Since the disease in this acuter form is unfamiliar to many who have begun practice since the outbreak of 1892, a special bulletin for doctors on the symptoms, and treatment of influenza has been prepared by the Public Health Service and is available on request. For the lay public the moral is a familiar one: Avoid crowds when possible; cover the nose on sneezing (also when anyone else sneezes). One is tempted to add the wisdom of the Duchess: "speak severely to the boy and beat him when he sneezes"—if the hapless youth in public forgets the proper screening of his face on this occasion.

Fresh air and good condition, with rather more prompt attention than usual to any grippy symptoms, should, it is believed, go far to prevent a serious epidemic in this country.

© J. Fred MacDonald, 2013



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