Epidemic Encounters: Influenza, Society and Culture in Canada, 1918–20 ed. by Magda Fahrni and Esyllt W. Jones (review)

Epidemic Encounters is an important and thought-provoking examination of the influenza pandemic in Canada at the close of the First World War. Though several localized historical studies have been made on the flu in Canada, this collection of essays is unique in the breadth of its inquiry, sources, and methodological or theoretical approaches. Epidemic Encounters presents nine studies that encompass the Canadian experience, from Quebec to Manitoba and British Columbia. Organized in four sections by theme/approach, the chapters address the response to the epidemic by the military, nurses, and citizens; the spread of the disease and the factors affecting its path; the cultural experience and memory of the disease and the dead; and a comparison of the public health response to the flu and the sars outbreak of 2003. Each multidisciplinary study contributes to the social and cultural examination of the causal factors, experience, and consequences of the epidemic. As a whole, the collection emphasizes how gender, race, and class had an impact on one’s experience, persuasively critiquing suggestions that the flu was democratic in its grasp.

Despite the diversity of material, this is a cohesive and complementary collection. Each chapter reinforces another, simultaneously deepening understanding of the complexity of the historical moment and providing an alternative perspective that leads the reader to ask new questions of the whole. For example, the racialized experience of the pandemic is reiterated and explored across several chapters. Karen Slonim compares the spread and impact of the flu on two Aboriginal communities in Manitoba, using a syndemic analysis. In reaction to the still-too-common tendency to paint all Aboriginal communities with the same brush, Slonim demonstrates the quite different experiences in Norway House and Fisher River, and posits a number of organizational, economic, and social factors that shaped this experience. Mary-Ellen Kelm’s cultural study of how the flu was understood and remembered as an un-modern and foreign entity includes an analysis of First Nations’ oral and written accounts of the epidemic. These stories, though interpreted for their commentary on modernity, also reinforce Slonim’s argument that disease morbidity and mortality were influenced by factors such as kin group living arrangements, access to nursing, and colonial institutions.

The syndemic approach to epidemiological study, first advanced in the 1990s, is a valuable analytical lens through which Slonim, Herring and Korol, and DuBois, Thouez, and Goulet conduct their studies of community morbidity and mortality rates. Instead of studying a disease in isolation, syndemic studies analyze the synergistic relationships between diseases (such as influenza and tuberculosis) and the interaction of diseases with social conditions. As such, they provide a complex and nuanced picture. Though Slonim is most explicit in her use of the approach, Herring and Korol demonstrate that poverty and population density had an impact on mortality rates in Hamilton, while the more traditional statistical epidemiological analysis of DuBois, Thouez, and Goulet indicates the differential mortality rates between urban and rural Quebec milieus. Although these studies focus on different geographies and use varied sources, including newspapers, journals, death records, and gis mapping, they reinforce the fundamental argument that influenza did not touch all areas of Canadian society equally.

In addition, the collection enriches the field by seeing the 1918–20 period in the context of a “total epidemic,” a term introduced by Magda Fahrni (87). Though studies by Mark Humphries, Linda Quiney, and Heather MacDougall illustrate how institutional policy, organization, and decisions influenced the spread and treatment of the flu, Magda Fahrni, Mary-Ellen Kelm, and Esyllt Jones highlight conversely how citizens experienced, recounted, and coped with the traumatic events of the pandemic. Read together, they create a holistic picture that privileges neither top-down nor bottom-up interpretations and effectively proves that much can be learned from balanced, integrated, “total” perspectives.

Consistently underpinning these articles is the public health response to prevent and manage the outbreak. Given the...