Trump Virus or Kung Flu? Naming Pandemics in History

Last year, Chinese officials and many others accused Donald Trump of racism because he referred to Covid-19, or coronavirus, the "Chinese virus." At his Tulsa rally, he called it "Kung Flu."  "Trump Virus" may be the most accurate name, because he has done more than anyone on the planet to spread it. His rhetoric has also contributed to an upsurge on attacks on Asian Americans. 

Racist or not, and it often is, naming pandemic diseases after their alleged place of origin is an old practice. In 1957 and 1968, two deadly flu pandemics were named the "Asian Flu" and the "Hong Kong Flu." A pandemic flu first reported in St. Petersburg in 1889 was denoted the "Russian Flu." It was later called "Asiatic Flu," although St. Petersburg is a long way from Asia.

When pandemic cholera first made its way from India to the UK in the early 19th century, people called it the "Indian Cholera," as in the broadsheet below from 1831. One reason for adding the adjective "Indian" was to distinguish this new, mysterious disease from an old, familiar one: "cholera infantum," a type of childhood diarrhea. but the name led to Indians being blamed for the disease.

In the cartoon below, also from 1832, the cholera is dressed in Indian garb, trying to enter England, but caught by stout John Bull. The reality was far different for England and the world. A series of cholera pandemics during the 19th and early 20th century killed millions in Asia, Africa, Europe and North America, more than 30 million in India alone.

Later in the 19th century, cholera was often referred to as "Asiatic Cholera."

In 1918-1919, a virulent form of influenza became pandemic, and ultimately killed 50-100 million people worldwide. It quickly became known as the "Spanish Flu," although it probably originated in the USA. But the USA was engaged in World War I and sending thousands of troops to Europe. The press was instructed not to report about the epidemic, lest it lead to demands to stop troop shipments -- the overcrowded ships were excellent incubators for such a disease. 

Most European countries involved in the war similarly kept quiet at first, to avoid hurting morale. Spain, however, was neutral, and its press reported on the outbreak. Spain's reward was to have one of the worst pandemics in history named after it. 

It was also called "Flanders Grippe" in Britain, "Bolshevik Disease" in Poland, "Too much inside sickness" in Hong Kong.

Today, it is usually called the "Great Influenza." Perhaps it should be called the "American Flu."

Interestingly, the greatest and most famous pandemic in world history was not named for a place or nation. That was the pandemic of plague that ravaged Eurasia during the 1340s, killing between 75 and 200 million, It wiped out perhaps as much as 60 percent of the European population. It probably originated in Central or East Asia and traveled west along the Silk Road to the Middle East, Europe, and North Africa. 

The 14th century pandemic is best known today as the Black Death, but that name was not applied to it at the time. Other names for it include, Plague, Great Plague, Black Plague, and Pestilence (La Peste). Before the pandemic, plague and pestilence simply meant a deadly epidemic disease. (Below: The Dance of Death, or Danse Macabre, late medieval, Nuremberg Chronicles).

Syphilis, which struck Europe in pandemic form after 1500, was generally named after other, often disliked, countries. The English called it the French Disease. The French called it the Italian Disease. The Italians returned the compliment. The Dutch called it the Spanish Disease. Russians called it the Polish Disease. Turks called it the Christian Disease. The Japanese called it the Portuguese Disease because Portuguese traders brought it from Europe.  

An Unwelcome Immigrant: Cholera Comes to Britain

At the beginning of the 1830s, Britain was in ferment. As with Brexit today, the country was badly divided over several issues: reform of Parliament and extension of the suffrage, abolition of slavery, poor law reform. In the midst of rising unrest, an unwelcome immigrant was approaching Britain. 

Doctors called it Indian or Asiatic Cholera after its alleged place of origin. It had long been known in the Indian subcontinent, much of which was now under British control. An outbreak in 1817 killed 10,000 British soldiers and hundreds of thousands of Indians.

In the following years cholera spread inexorably into Southeast Asia, the Middle East, Africa, Russia, and continental Europe. By 1830 it had reached Western Europe and was poised to cross the English Channel. 

Local authorities in Britain vowed to keep it out. The cartoon below imagines John Bull seizing the cholera, imagined as an Indian, trying to sneak through an equally imaginary protecting fence into England. The reality was far different.

Efforts to prevent cholera reaching Britain proved in vain, as no one then knew how cholera spread or what caused it. Indeed, within a few months after making landfall in Britain it had reached the Americas and become a truly global pandemic. 

In November 1831, cholera broke out in the northern English port city of Sunderland. The main effect of cholera is violent diarrhea, which produces severe dehydration and often death, within hours or a day or two. The victims' skin often turned blue, giving it the name "Blue Disease." The image below shows a woman who died at Sunderland. 

Within weeks, cholera was breaking out in many parts of the kingdom. In London and elsewhere, authorities tried to locate the source of the disease, with no success. See Looking for the Elusive Mr. Cholera on this blog.

Boards of health informed the inhabitants of cholera's symptoms and listed remedies, most of which would have had no impact on the course of the disease. Medical and health boards often emphasized temperance in eating and drinking. They advised agaist drinking cold water when the body was heated and consuming "ardent spirits." 

The connection with water was correct. The main medium through which cholera spreads is water contaminated by the intestinal evacuations of the infected. But avoiding water only when one was "heated" would have had little effect. Ardent spirits caused many health problems, but cholera was not one of them. Some doctors prescribed ardent spirits.

Medical professionals tended to favor standard remedies for most dangerous diseases: bleeding, purging, mercury, and opium. Removing fluids from a body that was already becoming dehydrated seems perverse, and did make things worse. 

A couple of physicians argued for rehydrating with saline solution and got better results. Most medical men scorned such an unorthodox therapy until the late 19th century or later. Today rehydrating is a standard procedure, often combined with antibiotics.

Critics ridiculed the advice and efforts of boards of health and doctors in the 1830s, as seen in these contemporary cartoons. 

The cartoon below shows the Central Board of Health congratluating iself with a sumptuous dinner despite the mounting death toll from cholera. At bottom right a paper has the words "while doctors differ and deny, the country bleeds and patients die."

The 1832 epidemic killed about 55,000 people in the UK. It was the first of several outbreaks to strike the country during the nineteenth century. Other diseases killed far more people during that time, but they were mostly familiar and aroused far less terror than cholera. 

In the 1850s, following a couple more severe outbreaks in Britain, London surgeon John Snow demonstrated that contaminated water was the main source of cholera infection. See London's Great Stinks, Cholera, and John Snow on this blog. 

Snow had no idea what the contaminant was. He theorized that it might be a microscopic organism. In the early 1880s, German physician Robert Koch isolated the microbe responsible: the cholera vibrio. 

The solution became obvious: avoid drinking contaminated water and you could prevent cholera. Some authorities, accepting Snow's theory, had begun to advise that precaution even before Koch's discovery, as this poster from 1866 shows. 

The first cholera vaccine came into use in the 1880s and improved versions followed. (Below: Inoculation in Calcutta 1894) 

Today, cholera is preventible and curable. But thousands of people continue to die of this dreadful disease each year from a lack of safe water and adequate medical care in Africa, Asia, and Latin America. The civil war in Yemen has unleashed an ongoing major epidemic, with hundreds of thousands of infections. (Below: cholera patients in India)