Pandemic influenza: An analysis of the spread of influenza in Kitchener, October 1918 (Ontario)

Influenza remains one of the major killers in modern society. In addition to the mortality it causes, it exacts a huge medical, social and economic toll. Due to its propensity to undergo change, through antigenic drift and shift, this disease continues to torment humankind. These changes are the driving force that enables influenza to periodically become epidemic and pandemic. The study of past pandemics thus may provide useful insight to comb-it the disease now and in the future. The 1918-19 pandemic is one of the three worst outbreaks of disease in recorded history, with only the Justinian plagues and the Black Death claiming more victims. This pandemic has largely disappeared from our collective memory. In this study the pandemic is examined at various scales: global, continental, national and local. Examination of the origins and spread of the disease, the mortality, particularly variations in that mortality with respect to age, sex and socio-economic conditions are made. Particular attention is paid to the experience of Kitchener, Ontario where the spatial aspects of the disease, along with other factors, are scrutinised. Using primary source data for the Kitchener experience of this pandemic is examined and the passage of the disease is mapped. This study establishes that Kitchener indeed suffered greatly from the 1918 influenza pandemic, with the crude death rate rising almost sevenfold for the month of October. The pattern of mortality, especially age-sex mortality, was very similar to that found elsewhere in North America. Socio-economic factors appear to have had some influence upon mortality arising from the disease. The influenza pandemic of 1918 displayed both hierarchical and contagious components to its diffusion. The disease relocated through the national urban hierarchy and then exhibited contagious diffusion at the local level