While gunfire and bombs raged in Europe during WW1 - hoards of otherwise healthy young men reported ill in crowded military bases and in the war's front lines. Soon, they reported experiencing the typical symptoms of flu. Their medics soon realized that this is not the typical seasonal flu. Many of these young men will then suffer and die among millions of others as the "Spanish flu" spread exponentially and reach places far flung from Europe such as the Philippines.
Looking at the narratives of the Philippines' history in health care, it is interesting to note that if one gets to dig a bit deeper regarding the impact of the Spanish flu in the Philippines, the word "Spanish flu" isn't usually used, but is often referred to as the trancazo or influenza.
Now, one can't help but ask, "Why is that?" Records by Francis Coutant in "AN EPIDEMIC OF INFLUENZA AT MANILA, P. I."published on November 9, 1918 gives us some hints. This all started in 1918. The medical practitioner Francis Coutant who was in charge of St. Luke's hospital in Manila at that time observed the increase of individuals with unusual symptoms of flu. After determining their origins, he notes that cases were first and mostly seen among laborers along the waterfront near Manila’s ports. He then suggested that the Spanish flu has reached Manila as the cases he was handling suggests that it had been brought in from ships coming from the Americas thus connoting that there might be an outbreak in the there. The United States wasn't pleased to learn of this report. Being at the tipping point of World War 1, they wanted to keep cases of an outbreak a secret as they didn’t want to divulge any weakness which could potentially be capitalized on by Germany.
It is then here where the American Medical Journal was placed in a position to contest what Coutant had earlier observed. The American Medical Journal posited that the disease was of local origin and became severe only when mixed with the infection from outside the country and that therefore it couldn't be labeled as Spanish flu. This then would serve as the basis for succeeding reports regarding the Spanish flu in the Philippines. Hence, in later public reports it wasn’t referred to as the Spanish flu, but the trancazo or influenza. The word Trancazo then long became the reference word for the Spanish flu.
Written in Spanish, Nueva Fuerza reports of the Trancazo reaching Cebu in October 1918
Although we don't hear or read much about the details of what happened during the influenza pandemic in the Philippines, a report released by the Philippine Health service of 1920 via the Boston Medical and Surgical Journal gives us an idea about the severity of the flu outbreak in 1918 Philippines which claimed around 85,000 lives.
The Report:
The year was a particularly disastrous one from the standpoint of epidemiology: never in its history, excepting perhaps during the years of the cholera epidemics of 1902 and 1903, have the resources of the Health Services been taxed so heavily. For this reason, although all the usual activities of the work were carried on throughout the year, few permanent sanitary improvements could be effected. Influenza and smallpox proved to be the most serious of the epidemiological problems during the year. From influenza alone there occurred an estimated 85,000 deaths. The disease appeared first in a mild form, with low mortality but the second wave which swept over the archipelago from Aparri to Sulu from the latter part of September to the end of the year caused a mortality of about 1.8 percent. Most of the deaths were due to respiratory, cardiac, and renal complications.
References
Gealogo, F. A. (2009). The Philippines in the world of the influenza pandemic of 1918–1919. philippine studies, 57(2), 272-281. http://www.philippinestudies.net/files/journals/1/articles/2972/public/2972-3796-1-PB.pdf
History. (2018, May 22). https://www.history.com/news/why-was-the-1918-influenza-pandemic-called-the-spanish-flu
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