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The epidemic of Spanish influenza of 1918 in Geneva, Switzerland
C.E. Ammon
Therapeutic Division of Teaching for Chronic Patients, University Cantonal hospital of Geneva, Dpt of Internal medicine, Geneva, Switzerland
A Geneva (Swiss), the epidemic of Spanish influenza of 1918 touched more than 50% of the population. The highest mortality was in the group of the 20-49 years and at the men. The socio-economic impact was very important, the low register disfonctionnements epidemic involving, including in the medical services. This major epidemic illustrates the socio-economic impact which the influenza can have and underlines the need for preparing with very possible pandemia.
Introduction
a study on the epidemic of Spanish influenza of 1918 in Geneva (Swiss) was carried out starting from various documents of the years 1918 and 1919. It was based on publications in the Swiss and foreign medical reviews, Genevese daily newspapers, cantonal and federal files. Supplemented by testimonys, it is directed mainly towards the town of Geneva, but certain data related to all Switzerland.
The epidemic
the epidemic of Spanish influenza touched Switzerland in several waves: the first in July 1918, the second, more severe, in October-November 1918, to be completed in FebruaryMarch 1919. Figure 1 presents the number of cases of influenza on the basis of obligatory declaration in Switzerland, from July 1918 to February 1919. In a context of world war, the first cases were indexed in 1918, at the borders of the country and in the camps of the foreign soldiers, then in the villages of the interior (Castle-D' Oex) (1,2). The epidemic was then spread very quickly with the civil population. It is estimated that more than 50% of the population was touched by the influenza in 1918, 58% for the two years of this pandemia (3).
Mortality was particularly important during the wave of OctoberNovember, with a severe influenza, characterized by a asphyxic form with cyanosite of the face and the ends, resulting in death in the 24 hours. The rates of morbidity and mortality were highest between 20 and 49 years, with a surmortality at the men (figure 2). This one could be explained by the living conditions within the army, frequent promiscuity and displacements facilitating the transmission of the influenza among the already weakened soldiers. The gravity of the influenza in the teenagers and the young adults was allotted to overwork, with the lack of care and promiscuity in military medium (4). Finally the oldest groups of age would have been relatively saved, because already exposed to the influenza at the time of the epidemic of 1889-91.
The socio-economic impact
the disturbances were numerous in the sectors private and public. The schools closed intermittently. In certain companies, more than 80% of the employees were reached influenza (5). The administration was also touched by the epidemic: certain post offices were closed or functioned with the idle, the telephones and telegraphs were submerged. A reduced service was founded (6). Public transport was irregular, with a number of passages limited, what facilitated the transmission of the virus in the crammed vehicles.
The medical sector was obviously very disturbed. The overflowed doctors imposed restrictions in the schedules of reception of the calls (7,8). Many was them-also reached by the influenza, or had succumbed to the disease. The taxis are transfered constrained to refuse to transport the patients to the hospital because of the risks of contagion and only one company was elected to move the patients. This one was to disinfect the vehicles after each race (9).
Hospitals overflowed
With the peak of the epidemic, in OctoberNovember 1918, the hospitals refused patients. Public places were requisitioned to be used as emergency hospital, also quickly overloaded. Advertisements were published in the press to ask for the contribution of voluntary in the overflowed hospitals. A Genevese doctor was condemned by the federal medical authorities to have omitted to declare cases of influenza, an obligatory declaration having been founded at the federal level at the beginning of the epidemic (10-14).
The hospital statistics were daily detailed in the press: numbers of admissions, refused patients, death, exits of the people reached of the influenza. The list of the deaths lengthened, the funeral advertisements covered two to three pages in the daily newspapers. The medical professions and scientists contradicted themselves in connection with the origin of the influenza, modes of transmission and treatments. For example, some recommended the alcohol consumption, whereas others rejected it severely. These divergences were included in the press general practitioner, as in the medical reviews. Each measure recommended by the medical authorities caused polemic amplified by the media (15,16).
It reigned in all the country a climate of panic. False information was published in the daily newspapers as in the scientific press. Articles and letters of readers explained in an erroneous way the origin of the disease, methods of prevention, modes of transmission and treatments possible. The recommendations of hygiene multiple and were varied, energy of the cleaning of the dry grounds to the obligation to sprinkle the streets of disinfecting. It was thought for example that the virus was transmitted by the dirty linen of the troops, washed by the civil volunteers of the Red Cross, or that it spread via the mail which the contaminated soldiers addressed to their family (17,18). Publicities for miracles treatments mixed with the funeral advertisements. They were going from the recommendation to in the open air eat onions with the exercises of breathing.
Measurements taken and prohibitions were severe: no activity of leisures gathering several people was authorized. In certain cantons, the coffees and the restaurants were seen imposing a reduction of the opening hours. Theatres, cinemas, the dance halls and the ballrooms were temporarily closed, cancelled spectacles. Even the churches were closed. In Lausanne, certain religious services were proposed in the public parks, but these gatherings were quickly prohibited thereafter. In Geneva, two priests accepted fines to have preached in spite of the prohibition of gathering (19,20). The funerary processions were limited to five people. The employees of the cemeteries pained to prepare the tombs and to bury deaths quickly.
Conclusion
In Switzerland, measurements taken to fight against the Spanish influenza into 1918 were founded, cancelled, then handing-over in force (in particular the closing of the schools), what still contributed to the climate of insecurity. The importance to diffuse consistent messages of information and quality to the population is to be underlined, because this was cruelly lacking. The analysis of this pandemia provides invaluable indications on the socio-economic impact of an epidemic of massive influenza and illustrates the need for preparing in an optimal way to a possible news pandemia.
http://www.flutrackers.com/forum/showthread.php?t=7007
The epidemic of Spanish influenza of 1918 in Geneva, Switzerland
C.E. Ammon
Therapeutic Division of Teaching for Chronic Patients, University Cantonal hospital of Geneva, Dpt of Internal medicine, Geneva, Switzerland
A Geneva (Swiss), the epidemic of Spanish influenza of 1918 touched more than 50% of the population. The highest mortality was in the group of the 20-49 years and at the men. The socio-economic impact was very important, the low register disfonctionnements epidemic involving, including in the medical services. This major epidemic illustrates the socio-economic impact which the influenza can have and underlines the need for preparing with very possible pandemia.
Introduction
a study on the epidemic of Spanish influenza of 1918 in Geneva (Swiss) was carried out starting from various documents of the years 1918 and 1919. It was based on publications in the Swiss and foreign medical reviews, Genevese daily newspapers, cantonal and federal files. Supplemented by testimonys, it is directed mainly towards the town of Geneva, but certain data related to all Switzerland.
The epidemic
the epidemic of Spanish influenza touched Switzerland in several waves: the first in July 1918, the second, more severe, in October-November 1918, to be completed in FebruaryMarch 1919. Figure 1 presents the number of cases of influenza on the basis of obligatory declaration in Switzerland, from July 1918 to February 1919. In a context of world war, the first cases were indexed in 1918, at the borders of the country and in the camps of the foreign soldiers, then in the villages of the interior (Castle-D' Oex) (1,2). The epidemic was then spread very quickly with the civil population. It is estimated that more than 50% of the population was touched by the influenza in 1918, 58% for the two years of this pandemia (3).
Mortality was particularly important during the wave of OctoberNovember, with a severe influenza, characterized by a asphyxic form with cyanosite of the face and the ends, resulting in death in the 24 hours. The rates of morbidity and mortality were highest between 20 and 49 years, with a surmortality at the men (figure 2). This one could be explained by the living conditions within the army, frequent promiscuity and displacements facilitating the transmission of the influenza among the already weakened soldiers. The gravity of the influenza in the teenagers and the young adults was allotted to overwork, with the lack of care and promiscuity in military medium (4). Finally the oldest groups of age would have been relatively saved, because already exposed to the influenza at the time of the epidemic of 1889-91.
The socio-economic impact
the disturbances were numerous in the sectors private and public. The schools closed intermittently. In certain companies, more than 80% of the employees were reached influenza (5). The administration was also touched by the epidemic: certain post offices were closed or functioned with the idle, the telephones and telegraphs were submerged. A reduced service was founded (6). Public transport was irregular, with a number of passages limited, what facilitated the transmission of the virus in the crammed vehicles.
The medical sector was obviously very disturbed. The overflowed doctors imposed restrictions in the schedules of reception of the calls (7,8). Many was them-also reached by the influenza, or had succumbed to the disease. The taxis are transfered constrained to refuse to transport the patients to the hospital because of the risks of contagion and only one company was elected to move the patients. This one was to disinfect the vehicles after each race (9).
Hospitals overflowed
With the peak of the epidemic, in OctoberNovember 1918, the hospitals refused patients. Public places were requisitioned to be used as emergency hospital, also quickly overloaded. Advertisements were published in the press to ask for the contribution of voluntary in the overflowed hospitals. A Genevese doctor was condemned by the federal medical authorities to have omitted to declare cases of influenza, an obligatory declaration having been founded at the federal level at the beginning of the epidemic (10-14).
The hospital statistics were daily detailed in the press: numbers of admissions, refused patients, death, exits of the people reached of the influenza. The list of the deaths lengthened, the funeral advertisements covered two to three pages in the daily newspapers. The medical professions and scientists contradicted themselves in connection with the origin of the influenza, modes of transmission and treatments. For example, some recommended the alcohol consumption, whereas others rejected it severely. These divergences were included in the press general practitioner, as in the medical reviews. Each measure recommended by the medical authorities caused polemic amplified by the media (15,16).
It reigned in all the country a climate of panic. False information was published in the daily newspapers as in the scientific press. Articles and letters of readers explained in an erroneous way the origin of the disease, methods of prevention, modes of transmission and treatments possible. The recommendations of hygiene multiple and were varied, energy of the cleaning of the dry grounds to the obligation to sprinkle the streets of disinfecting. It was thought for example that the virus was transmitted by the dirty linen of the troops, washed by the civil volunteers of the Red Cross, or that it spread via the mail which the contaminated soldiers addressed to their family (17,18). Publicities for miracles treatments mixed with the funeral advertisements. They were going from the recommendation to in the open air eat onions with the exercises of breathing.
Measurements taken and prohibitions were severe: no activity of leisures gathering several people was authorized. In certain cantons, the coffees and the restaurants were seen imposing a reduction of the opening hours. Theatres, cinemas, the dance halls and the ballrooms were temporarily closed, cancelled spectacles. Even the churches were closed. In Lausanne, certain religious services were proposed in the public parks, but these gatherings were quickly prohibited thereafter. In Geneva, two priests accepted fines to have preached in spite of the prohibition of gathering (19,20). The funerary processions were limited to five people. The employees of the cemeteries pained to prepare the tombs and to bury deaths quickly.
Conclusion
In Switzerland, measurements taken to fight against the Spanish influenza into 1918 were founded, cancelled, then handing-over in force (in particular the closing of the schools), what still contributed to the climate of insecurity. The importance to diffuse consistent messages of information and quality to the population is to be underlined, because this was cruelly lacking. The analysis of this pandemia provides invaluable indications on the socio-economic impact of an epidemic of massive influenza and illustrates the need for preparing in an optimal way to a possible news pandemia.