09:45am Sunday 15 December 2019

Past is prologue: Pandemic influenza

ANN ARBOR, Mich. —Scholars, teachers and anyone fascinated by the social, cultural or scientific features of the 1918 influenza pandemic in the United States will be interested in the just-released special issue of Public Health Reports, the official journal of the U.S. Public Health Service. 

In this collection of original essays, public health historians and scientists use narrative, photographs, illustrations and charts to present a mosaic of what individuals and institutions understood about influenza in 1918, their strategies for coping with the ever-widening pandemic, and what we know in hindsight about the most devastating influenza pandemic of the modern era. 

“As a whole, the collection of essays allows us to step back and appreciate a more complete picture of these intricate events,” says Howard Markel, M.D., Ph.D., the George E. Wantz Distinguished Professor of the History of Medicine at the University of Michigan. 

The volume includes a forewordby Thomas R. Frieden, director of the Centers for Disease Control and Prevention (CDC), and other CDC leaders Stephen C. Redd, Anne Schuchat and Peter A. Briss, that frames the importance of studying the 1918 pandemic to improve current and future public health and medical responses. Alexandra Minna Stern and Howard Markel from the University of Michigan Center for the History of Medicine, and Martin S. Cetron from the CDC explore those lessons and challenges in greater detail in an accompanying editorial. 

“These essays are especially pertinent for public health practitioners responding to the current influenza pandemic, and to those planning for emerging infectious threats,” says Alexandra Minna Stern, Ph.D., the Zina Pitcher Collegiate Professor in the History of Medicine. 

The supplement begins with a photographic essay depicting people in different  places struggling to fight the 1918 pandemic. Following it is a section on the biology of influenza that details what scientists knew – or didn’t know – about influenza then, and the vaccines they developed, complemented by the most recent research on the 1918 and 2009 influenza genomes. The next sections describe public health in the early 20th century and how key social institutions such as the military, the American Red Cross and nursing organizations took action. The final essays focus on how individuals within the community responded, including African Americans and several immigrant groups. 

According to Martin S. Cetron, M.D., Director, Division of Global Migration and Quarantine at the CDC, the collection of essays should resonate with recent experience during the 2009 H1N1 pandemic, despite differences in the severity of the circulating virus between then and now. 

“Our broadening understanding of the 1918 pandemic has left a lasting mark on public health policy, planning and practice that was apparent during the recent pandemic and will inform our plans and public health decisions for future pandemics,” he says.

 The genesis for this supplement was a May 2009 workshop organized by Markel and  Stern at the University of Michigan where most of the essay contributors participated in discussions and debates on the historical implications of the 1918-1919 influenza pandemic on public health and American society. David Rosner, who is a PHR contributing editor, helped to coordinate the supplement. Support for this project came through an RWJF Investigator Award in Health Policy Research from the Robert Wood Johnson Foundation®, Princeton, New Jersey, and the Centers for Disease Control and Prevention.

 Public Health Reportsis a peer-reviewed journal of the U.S. Public Health Service and the U.S. Surgeon General. It is published in collaboration with the Association of Schools of Public Health. PHR is the oldest journal of public health in the U.S. and has published since 1878. Laurence D. Reed is the acting editor of PHR.

Written by Mary Beth Reilly

Media contact: Mary Beth Reilly
E-mail: reillymb@umich.edu
Phone: 734-764-2220

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