title: "Spanish flu, or whatever it is...": The paradox of public health in a time of crisis.
abstract: Without the modern tools of surveillance, or the ability to develop a national vaccination campaign, local health departments were often on their own in preparing and combating the spread of the disease during the influenza epidemic of 1918. This article reviews the state of public health before the epidemic, seeking to place the reaction to the disease in the context of the evolution of public health. The epidemic struck at a critical time in the history of the nation and of public health, and we must explore not only the tools and technologies that were available to practitioners at the time, but also the authority provided by local and state public health practitioners to apply these tools. Much of public health was rooted in the experiences and practices developed over the previous century in responding to often dramatic outbreaks of cholera, yellow fever, typhoid, and a host of other infectious diseases.
authors.affiliation: Center for the History & Ethics of Public Health, Mailman School of Public Health, Dept. of Sociomedical Sciences, 722 W. 168th St., Ste. 929, New York, NY 10032, USA. dr289@columbia.edu
authors.forename: David
authors.initials: D
authors.lastname: Rosner
mesh_terms: D004196:Disease Outbreaks / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000266:history*; D015980:Public Health Practice / Q000266:history*; D012498:Sanitary Engineering / Q000266:history; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000266:history