Before the flu season is completely over, we thought you might like to know more about some of the material we hold in the RCP library on this most virulent of seasonal pests. ‘Coughs and sneezes cause diseases’ as the maxim goes – and throughout history the diseases caused by unguarded coughs and sneezes have led to, in some cases, epidemic outbreaks of infectious illnesses with major repercussions and large-scale fatalities.
Most of us today would not expect to die from a bout of the flu, however unpleasant and confining it might be. It is a nebulous word that is used to describe a variety of common cold-like illnesses that may or may not be influenza proper. However, in the early 20th century a virulent strain of Spanish flu tragically afflicted an already war-torn Europe. It caused up to 50 million deaths worldwide, killing almost 3% of the world’s population.
In his book A history of the great influenza pandemics, Mark Honigsbaum explores the state of panic caused by 19th century outbreaks of the Russian flu, compared to stoical attitudes toward the later Spanish flu. Fuelled by evolving mass media channels, the Russian flu became a sensation. News of it was relayed in real time and spread via the telegraph. In comparison, wartime propaganda about the Spanish flu was strictly controlled by the virulently anti-German Northcliffe Press, encompassing the Daily Mail, Evening News and Times.
The 1918 wartime outbreak was unique in its pattern of infection. According to Honigsbaum:
Young adults between the ages of 25 and 40 accounted for nearly half the deaths, a departure from the pattern of previous pandemics and epidemics where the brunt of the mortality was borne by infants and the elderly.
Furthermore, the nature of the infection was particularly distressing; with the virus triggering ‘a peculiar autoimmune reaction that caused the lungs of young adults to fill with choking fluids.’ Gina Kolata describes it in even more gruesome detail in the book Flu: the story of the great influenza pandemic of 1918 and the search for the virus that caused it:
It may take a few days, it may take a few hours, but there is nothing that can stop the disease’s progress. Doctors and nurses have learned to spot the signs. Your face turns a dark brownish purple. You start to cough up blood. Your feet turn black. Finally, as the end nears, you frantically gasp for breath. A blood-tinged saliva bubbles out of your mouth. You die – by drowning, actually – as your lungs fill with a reddish fluid
Just over 90 years later another pandemic scare swept across the world. The RCP issued guidance to hospitals to cover the possibility of a major outbreak and suggested a blue and yellow card system to help identify patients who may or may not need to be seen urgently. Dame Deirdre Hine led the Cabinet Office review of the response to the H1N1 influenza, or ‘swine flu’ pandemic of 2009 and concluded that the stockpiling of antiviral drugs was not wasteful (as claimed in the press), and the response overall was ‘proportionate and effective’.
The RCP library collects material on infectious diseases such as influenza as well as public health, health policy and many other specialties. Check out our collections and discover some material you might not expect.
Claire Sexton, collections development librarian.
Books mentioned:
- Honigsbaum M. A history of the great influenza pandemics. London: I.B. Taurus, 2014
- Kolata G. Flu: the story of the great influenza pandemic of 1918 and the search for the virus that caused it. London: Macmillan, 1999
- Royal College of Physicians. Preparations for pandemic influenza: guidance for hospital medical specialties on adaptions needed for a pandemic influenza outbreak. RCP, 2009
- Hine D. The 2009 influenza pandemic: an independent review of the UK response to the 2009 influenza pandemic. London: Cabinet Office, 2010.
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