Influenza pandemic warning signals: Philadelphia in 1918 and 1977-1978

ABSTRACT

Global public health has struggled to provide timely warning of influenza pandemics. In this study, we review the signal pattern of local media reporting associated with the 1918 type A/H1N1 influenza pandemic and subsequent return of the A/H1N1 virus in 1977 and 1978 in Philadelphia. Open source local media reports are a critical source of warning intelligence for influenza pandemics. Documentation and analysis of pandemic influenza signal patterns is essential to capture lessons in effective warning intelligence for health security.

Acknowledgements

The authors gratefully acknowledge the manuscript reviewers for their comments.

Disclosure statement

Dr. Wilson is employed by M2 Medical Intelligence.

Notes

1. Johnson and Mueller, “Updating the Accounts,” 105–15.

2. DeBruyne, American War.

3. Barry, Great Influenza.

4. Crosby, America’s Forgotten Pandemic, 31.

5. Anonymous, “Fear New Epidemic,” July 22.

6. Anonymous, “Theaters, Saloons”, October 4.

7. Newman, Reports on Public Health, 288–89.

8. Crosby, America’s Forgotten Pandemic, 3–32.

9. Ibid.

10. Jester et al., “Historical and Clinical,” 32–37.

11. Morris, Cleary, and Clarke, “Secondary Bacterial Infections,” 1041.

12. Crosby, America’s Forgotten Pandemic.

13. Cox and Subbarao, “Global Epidemiology of Influenza,” 407–21.

14. Schmeck, “U.S. Experts Meet,” December 23.

15. Whitney, “Hundreds of Thousands,” December 30.

16. Associated Press, “From Russia,” January 27.

17. Barron, “Early victim,” February 12.

18. Centers for Disease Control, Influenza Surveillance Summary.

19. See note 17 above.

20. See note 18 above.

21. Associated Press, “Hong Kong, Soviets”, December 17; and Associated Press, “From Russia,” January 27.

22. Shurkin, “Flu sweeps Pennsylvania,” February 11.

23. Zakstelskaja et al., “Influenza in the USSR,” 919–22.

24. Rozo and Gronvall, “The Reemergent 1977 H1N1,” e01013-15.

25. Wilson, “Signal Recognition”; and Wilson, Iannarone, and Wang, “Media Reporting,” S148-53.

26. Newspapers.com.

27. Anonymous, “Austrians Still Strong,” July 3; and Anonymous, “Editorial Comment,” July 6.

28. Anonymous, “All Highest, Kaiser,” July 11.

29. Anonymous, “Spanish influenza,” July 14.

30. Anonymous, “Fear New Epidemic May Reach Here,” July 22.

31. Draper, “Crown Prince’s Position,” July 27.

32. Anonymous, “It’s a Trying Malady,” August 11.

33. Anonymous, “Editorial Comment,” August 23.

34. Anonymous, “Influenza Grips Boston,” September 11.

35. Anonymous, “Dr. Leen, Carney Hospital,” September 17.

36. Anonymous, “Protect Camp Dix Men Against Influenza,” September 17.

37. Anonymous, “Spanish Influenza Sends,” September 19.

38. Anonymous, “1500 Cases Influenza Develops at Camp Dix,” September 19.

39. Anonymous, “Krusen not Alarmed,” September 19.

40. Anonymous, “U-Boats Freed Germs,” September 19.

41. Anonymous, “Philadelphia Navy Yard,” September 20.

42. Anonymous, “Spanish Influenza German,” September 21.

43. Anonymous, “Spanish Influenza Epidemic Waning,” September 23.

44. Anonymous, “Camp Dix Quarantined,” September 24.

45. Anonymous, “Camp Dix Appeals,” September 26.

46. Anonymous, “Influenza Outbreak,” September 26; and Anonymous, “Spanish Influenza Invades Shipyards,” September 27.

47. Anonymous, “Influenza Halts Call,” September 17.

48. Anonymous, “Theaters, Saloons,” October 4.

49. Treasury Department, The Liberty Loan Legislation.

50. Anonymous, “Telephone Service Faces,” October 4.

51. Anonymous, “Spanish Influenza,” October 5.

52. Anonymous, “More Nurses Needed,” October 5.

53. Anonymous, “Fewer Influenza Cases Reported,” October 11.

54. Anonymous, “Say Convalescents,” October 14.

55. Anonymous, “Siege of Influenza,” October 16.

56. Anonymous, “May Place Scranton,” October 20.

57. Anonymous, “Denounce Stopping,” October 23; and Anonymous, “Return of sanity to Philadelphia,” October 29.

58. See note 7 above.

59. Anonymous, Annual Report of the Surgeon General, 175.

60. See note 7 above.

61. See note 10 above.

62. See note 4 above.

63. Quarantelli, What is a Disaster?.

64. Beckett, The Great War.

65. Federal Reserve Bank of Philadelphia. Business Conditions, 2 December 1918.

66. Federal Reserve Bank of Philadelphia. Business Conditions, 2 January 1919.

67. Yarnall, Emergency Service, 4.

68. Ibid., 5.

69. Ibid., 35.

70. Ibid., 35.

71. Ibid., 35.

72. Associated Press, “Hong Kong, Soviets”, December 17.

73. Lloyd, “Flu reduces classes,” December 21.

74. Inquirer Wire Services, “New a-Texas flu,” December 22.

75. Associated Press, “Now it’s Soviet flu,” December 23.

76. Lessler et al., “Transmissibility of Swine flu,” 755–62.

77. Sencer and Millar, “Reflections 1976 Swine,” 29–33.

78. Associated Press, “Brezhnev: Stop Neutron Bomb,” December 24.

79. Anonymous, “A State Laboratory,” December 27.

80. Anonymous, “First Wave,” December 31; and Associated Press, “All Counties,” January 4.

81. Anonymous, “Soviet and American,” January 17.

82. See note 16 above.

83. Anonymous, “Answers to Flu Questions,” February 9.

84. Hoppe, “If you get Swine Flu,” February 10.

85. See note 22 above.

86. Anonymous, “Another College Gets,” February 12.

87. Anonymous, “New Jersey Reports,” February 13.

88. Anonymous, “Five New Cases,” February 15.

89. Anonymous, “Two More Cases,” February 18.

90. Anonymous, “The Carter Administration,” February 24.

91. Schmeck, “Scientists Expect Mild,” October 6.

92. Schmeck, “U.S. Experts Meet,” December 23; and Whitney, “Hundreds of thousands,” December 30.

93. Colen, “U.S. fears,” December 23.

94. Schmeck, “Soviet Flu,” January 13.

95. Anonymous, “Death Toll From,” February 4; and Colen, “Texas-type Flu,” January 7.

96. Schmeck, “Major Flu Epidemics,” February 11.

97. Colen, “U.S. Influenza Epidemic,” February 11.

98. Associated Press, “Russian Flu Found Widespread,” March 10.

99. See note 18 above.

100. Centers for Disease Control and Prevention. “The Influenza Season”.

101. Wilson, “Signal Recognition”; and Wilson, Iannarone, and Wang, “Media Reporting,” S148-53.

102. Dausey, Aledort, and Lurie, “Tabletop Exercises”; Barry, Great Influenza.

103. Wilson et al., “Reanalysis Anthrax Epidemic,” e2686.

104. Wilson and Daniel, “Historical Reconstruction.”

105. Markel et al., “Nonpharmaceutical Interventions,” 644–54.

106. Olson et al., “Epidemiological Evidence,” 11059-63; and Crosby, America’s Forgotten Pandemic, 26.

107. See note 18 above.

108. World Health Organization, “Influenza,” 22.

109. See note 23 above.

110. Wilson, Iannarone, and Wang, “Media Reporting,” S148-53.

111. See note 24 above.

112. See note 18 above.

113. See note 105 above.

114. Wilson and Daniel, “Historical Reconstruction”; and Wilson et al., “Reanalysis Anthrax Epidemic,” e2686.

Additional information

Notes on contributors

James M. Wilson

James M. Wilson is the CEO of M2 Medical Intelligence, Inc. Dr. Wilson is a board-certified, practicing pediatrician who specializes in operational health security intelligence, with a focus on the anticipation, detection, and warning of infectious disease crises. Dr. Wilson led the private intelligence teams that provided tracking of H5N1 avian influenza as it spread from Asia to Europe and Africa, detection of vaccine drifted H3N2 influenza in 2007, warning of the 2009 H1N1 influenza pandemic, discovery of the United Nations as the source of the 2010 cholera disaster in Haiti, and several investigations of alleged and confirmed laboratory accidents and biological weapon deployments. Dr. Wilson is a strong advocate for effective and accountable global health security intelligence and the need for credible and balanced threat assessments.

Garrett M. Scalaro

Garrett M. Scalaro was a research analysts with the Nevada Medical Intelligence Center in the School of Community Health Sciences, University of Nevada-Reno.

Jodie A. Powell

Jodie A. Powell was a research analysts with the Nevada Medical Intelligence Center in the School of Community Health Sciences, University of Nevada-Reno.