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Kraut’s Examination of Influenza Pandemic of 1918–19 Relevant Today

Alan Kraut

In the spring of 2009 Alan Kraut was busy working on an article on the influenza pandemic of 1918–1919 when a not-so-funny thing happened: another broke out.

While the swine flu, or H1N1 outbreak, was terrifying to many and deadly to some, it paled in comparison to the Spanish flu pandemic that nearly a century ago killed an estimated 550,000 Americans and 20 million people worldwide.

“In the mini-crisis we had two springs ago, the cases were milder, but the fear was the virus would alter and become more virulent,” said Kraut, an AU history professor. “In 1918 and 1919, people were dying quickly after they contracted the disease. Sometimes within days. They were trying to separate the sick from the well. They were trying to close down places in society where people came together. Circuses that came to town were told you can’t open to the public. Churches cancelled their services. Everybody understood that it was spreading so fast and it was so virulent.”

Kraut was asked to examine the pandemic as it related to immigrants by his friend Howard Markel of the University of Michigan’s Center for the History of Medicine, who received a grant to study the subject from the U.S. Centers for Disease Control.

The project, originally envisioned as a book, took on a much more immediate importance with the new outbreak, so it was released earlier this year as a special edition of the journal Public Health Reports.

Kraut’s article is entitled “Immigration, Ethnicity, and the Pandemic.” Surprisingly, he wrote, immigrants were not widely blamed for the outbreak.

“By and large, the kind of stigma that occurred with other diseases was much less true in 1918–1919 because it was so hard to identify the entry into the community of a particular group that coincided with the disease,” Kraut said. “Part of the reason is that the disease was spreading virulently within the American army. We were in the middle of World War I, and soldiers in our armies and other armies were contracting the disease. If big strong guys of different backgrounds were getting the disease and dying of it, then it’s clearly not any one group’s fault.”

Individual ethnic groups took it upon themselves to spread the word among their people on how best to fight the flu.

“Every immigrant group and its leadership tried to influence its own population in its own language to practice good habits of health and hygiene, which is all you could really do,” Kraut said. “They encouraged people to obey the edicts of public health officials. These were new Americans; they were nervous; they were scared; they didn’t know who to believe. Southern Italians, for example, didn’t believe in modern medicine. They relied on prayer and more broadly on superstition. Their inclination in a crisis was to turn to those things. Italian leaders wanted them to practice the modern standards of health and hygiene.”

Pandemics affect virtually every area of society, and some groups used the 1918–19 event for their own political purposes.

“One of the [newspapers] I quote extensively is a New York Yiddish socialist paper which blamed capitalism,” Kraut said. “They cited the corruption of public officials and the bad living conditions of industrial workers. They argue that illness of poor people has a socioeconomic cause.”

By the end of 1919 the pandemic simply had burned out. But its lessons endure.

Today, we still do the things we did then—we just do them better, Kraut said.

“We need to envision how we would arrange our policies in the face of epidemic disease. We keep the disease under surveillance; watch it progressing; see who it’s affecting. We test to see what pathogens are involved. We need to understand the intersection of health, disease, and fear. We need to understand it on the personal level and on a public level too if we’re going to create public health policies and social control policies within society.”