The SPANISH FLU or 'GREAT FLU' of 1918 was one of the greatest pandemics of all time. It killed between 50 and 100 million people - approximately 35% of the population. Despite its name, the outbreak affected virtually every country in the world.
To mark this centenary RCSI Library worked with Research Summer School students Kate Moran and Vikneswaran Raj Nagarajan to investigate the historical impact of the out outbreak under the following questions:
- What features of this strain of influenza led to it being such a severe outbreak?
- What was the impact of the pandemic, socially, medically politically?
- What was the response to the breakout in Ireland?
- What did the Irish public health sector do in response?
- How can we use the pandemic as a model for future pandemics?
Over the 8 weeks, Kate and Vik, investigated and analysed primary and secondary sources available to them in RCSI Heritage Collections including medical journals, pamphlets, archives and newspapers. They also got the opportunity to use science-focused search engines such as PubMed to identify published studies and articles on the topic of pandemics, epidemiology and public health. In addition, both students were offered to opportunity to visit external library and research facilities largely associated with historical research, including the Dublin City Library & Archive, the National Library and the archives of the Royal College of Physicians in Ireland. In doing so, they were able to identify, select and analyse material that would help them answer their research questions.
As the weeks progressed, both students were able to delve into the topic and were successful in garnering results to their questions. They learned the spread of the 1918 influenza was largely facilitated by the mass movement of people due to World War I and, later, the end of the war. Contrary to expectations, the transmissibility of the virus was quite low, with its reproductive rate (R0) being between 2 and 3 - only slightly higher that that of normal influenza. Meanwhile, its mortality rate was 10-20%, in sharp contrast to the usual seasonal influenza rate of 0.1%. Even more notably, the group at highest risk of death was young, healthy adults - those aged between 20 and 30. This was due to the effect that the virus had on the immune system - it caused a 'cytokine storm', wherein the immune system would mount a huge inflammatory response to the virus. Those with the strongest immune system (i.e. the aforementioned group) were hence the highest risk of death.
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| Normal Flu virus |
In terms of the long-term impact of the pandemic, the effect of those who were in utero during the outbreak was broad and severe. The likelihood of someone from this cohort completing high school was 9% lower than average, and disability rates of those born in 1919 were 6.5% higher than the surrounding years. Later in life, this group had higher rates of kidney disease, respiratory disease and cardiac disease - possibly due to organ damage caused by a cytokine storm.
The impact of the pandemic on the field of public health was also considerable. Influenza became a disease worthy of more recognition- it became a reportable disease during the pandemic, and was isolated in 1933, with a vaccine being developed in the 1940's. An international bureau was established in Vienna with the aim of fighting epidemics - this may be seen as a precursor to the World Health Organisation and Centers for Disease Control.
At the end of the programme, both students presented their work at a 'Spanish Flu' Library Seminar held in the Albert Theatre. Alongside the students, two notable speakers - Spanish Flu historian Dr Ida Milne, talked about the impact the pandemic had on Irish life and society and Dr Karen Burns, Consultant Clinical Microbiologist in Beaumont Hospital, gave a wonderful and thought-provoking talk on the flu as we know it today and Irish public health response to it.
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| Susan Leyden (Archivist), Vik Raj Nagarajan, Dr Ide Milne, Kate Moran, Dr Karen Burns |
If you are interested in taking part in next years Research Summer School program with the Library you can do so now over in Moodle by clicking on this link: https://vle.rcsi.ie/course/view.php?id=3275
We have an exciting project lined up for next year which involves the history of Medicine, the city of Dublin and walking! The project will be of interest to any students who love history, medicine, the humanities and much more! Take a look and see what exciting possibilities it can offer you.