The pneumonic influenza in Portugal: risk and public health management in Portugal during the First Republic
The pneumonic influenza in Portugal: risk and public health management in Portugal during the First Republic
The influenza - or "Spanish influenza" - of 1918-19 was the greatest demographic disaster of the 20th century and, for some, the greatest in all human history. In spite of the data that exists regarding the number of deaths not being entirely reliable, we know that the Spanish influenza accounted for far more fatalities than the other major cause of deaths at the time - the First World War. In fact, estimates of the number of mortal victims point towards between 21 and 60 million.
The pneumonic influenza, as the influenza epidemic of 1918-1919 became known to us, arrived in Portugal at the end of May 1918. From July onwards it reached Lisbon and Porto, subsequently spreading throughout the entire national territory. The estimated mortalities attributed to the influenza in Portugal also vary, from more than 50 000 to more than 100 000 people, in line with the fatalities registered at a worldwide level. There is, nevertheless, consensus as to the demographic consequences of this epidemic: in fact, in Portugal, the pneumonic influenza was the single factor that caused the most deaths in the 20th century, exceeding by far the number of deaths in the colonial war and in the first world war.
In spite of its enormous relevance, the studies on this worldwide catastrophe are very few. In fact, following a first and almost contemporaneous phase of the outbreaks, in which many accounts of the epidemic were published, only at the end of the 70's was some systematic research begun. However, only in the 90's, and in particular with the conference held in Cape Town in 1998 to mark the 80 years of the epidemic, was there a renewed interest on this topic.
Similar trends were also observed in Portugal. There were a number of accounts and analyses of the pneumonic influenza at the time of its occurrence, among which the works of Ricardo Jorge (1919) and some PhD theses in medicine that elected the pandemic as a topic are noteworthy, followed by a long period of almost absolute silence. The interest in the phenomenon was reborn in some academic works, such as those of Cúcio Frada, Trindade and Girão.
However, the research produced on this occurrence is far from having exploited all of its virtues. The purpose of this work, based on the existing research, is to contribute towards the comprehensive study of the pandemic, namely with respect to public health management strategies. With this work we seek to not only understand, in multidimensional terms, a marked event in the history of Portuguese society, which involved the political and scientific fields, as well as several agencies related with public health. We also seek to use this case-study to reflect, based on what happened at the time, on the various dimensions - economic, social, cultural, political and scientific - of the problems of epidemics and on the pandemic risks which we face in the globalised universe of today, which continue to be a main concern of national and international public health agencies.
In fact, this pandemic presents many of the characteristics that some authors emphasize as typical of the society in which we currently live, a global "risk society". It was a global threat in the actual sense of the term, in that the influenza virus, like many current dangers, was not bound by countries, continents or species. It was a type of threat that challenged the health structures of the time that were not prepared to respond to this type of problem and that continues to elicit concern from the scientific community, which fears the possibility of a resurgence (idem). And it was probably a threat that, like current threats, was the object of contrasting interpretations, based upon the interactions between various social agents and different political forces.
The characteristics of the pandemic of 1918-1919 are therefore ideal to be studied in light of the current debates on new risks. A study in which the ideas, representations and controversies raised by the epidemic shall be analysed and compared with those surrounding similar current phenomena. The present situation, of a world that is far more unified than in the past, namely due to the migrations of the last few decades and the massification of air transport, keeps alive the fears of a resurgence of the pandemic.
In this sense, the objective of this project on the pneumonic influenza is to simultaneously analyse the phenomenon in its specific context and contribute towards a more extensive reflection on current pandemics and their public health consequences.
Risk, Health Policies, Social Representations
The influenza - or "Spanish influenza" - of 1918-19 was the greatest demographic disaster of the 20th century and, for some, the greatest in all human history. In spite of the data that exists regarding the number of deaths not being entirely reliable, we know that the Spanish influenza accounted for far more fatalities than the other major cause of deaths at the time - the First World War. In fact, estimates of the number of mortal victims point towards between 21 and 60 million.
The pneumonic influenza, as the influenza epidemic of 1918-1919 became known to us, arrived in Portugal at the end of May 1918. From July onwards it reached Lisbon and Porto, subsequently spreading throughout the entire national territory. The estimated mortalities attributed to the influenza in Portugal also vary, from more than 50 000 to more than 100 000 people, in line with the fatalities registered at a worldwide level. There is, nevertheless, consensus as to the demographic consequences of this epidemic: in fact, in Portugal, the pneumonic influenza was the single factor that caused the most deaths in the 20th century, exceeding by far the number of deaths in the colonial war and in the first world war.
In spite of its enormous relevance, the studies on this worldwide catastrophe are very few. In fact, following a first and almost contemporaneous phase of the outbreaks, in which many accounts of the epidemic were published, only at the end of the 70's was some systematic research begun. However, only in the 90's, and in particular with the conference held in Cape Town in 1998 to mark the 80 years of the epidemic, was there a renewed interest on this topic.
Similar trends were also observed in Portugal. There were a number of accounts and analyses of the pneumonic influenza at the time of its occurrence, among which the works of Ricardo Jorge (1919) and some PhD theses in medicine that elected the pandemic as a topic are noteworthy, followed by a long period of almost absolute silence. The interest in the phenomenon was reborn in some academic works, such as those of Cúcio Frada, Trindade and Girão.
However, the research produced on this occurrence is far from having exploited all of its virtues. The purpose of this work, based on the existing research, is to contribute towards the comprehensive study of the pandemic, namely with respect to public health management strategies. With this work we seek to not only understand, in multidimensional terms, a marked event in the history of Portuguese society, which involved the political and scientific fields, as well as several agencies related with public health. We also seek to use this case-study to reflect, based on what happened at the time, on the various dimensions - economic, social, cultural, political and scientific - of the problems of epidemics and on the pandemic risks which we face in the globalised universe of today, which continue to be a main concern of national and international public health agencies.
In fact, this pandemic presents many of the characteristics that some authors emphasize as typical of the society in which we currently live, a global "risk society". It was a global threat in the actual sense of the term, in that the influenza virus, like many current dangers, was not bound by countries, continents or species. It was a type of threat that challenged the health structures of the time that were not prepared to respond to this type of problem and that continues to elicit concern from the scientific community, which fears the possibility of a resurgence (idem). And it was probably a threat that, like current threats, was the object of contrasting interpretations, based upon the interactions between various social agents and different political forces.
The characteristics of the pandemic of 1918-1919 are therefore ideal to be studied in light of the current debates on new risks. A study in which the ideas, representations and controversies raised by the epidemic shall be analysed and compared with those surrounding similar current phenomena. The present situation, of a world that is far more unified than in the past, namely due to the migrations of the last few decades and the massification of air transport, keeps alive the fears of a resurgence of the pandemic.
In this sense, the objective of this project on the pneumonic influenza is to simultaneously analyse the phenomenon in its specific context and contribute towards a more extensive reflection on current pandemics and their public health consequences.