‘Although we have had 30 years to prepare for what should be done in the event of an influenza pandemic, I think we have all been rushing around trying to improvise investigations with insufficient time to do it properly.' 1/n

This was a comment from J Corbett McDonald of Public Health Laboratory Service to Ian Watson, Director of the College of General Practitioners' Epidemic Observation Unit in the autumn of 1957, referring to that year’s Asian Flu epidemic. 2/n

First noticed in Hong Kong in April 1957. Despite WHO advice supposed unlikely to arrive before winter. Letter to BMJ from a GP in June 1957: 3/n

‘The public seems under the impression that nothing can be done to prevent the calamity ... threatened by the advance of influenza in the Far East. On the contrary ... great deal that the Government can do; by acting at once they may save hundreds and thousands of lives.’ 4/n

First cases in UK late June. Serious outbreak in general population in August and spread through country. Peaked in October. Limited return in winter. 5/n

GP ‘we were amazed at the extraordinary infectivity of the disease, overawed by the suddenness of its outset and surprised at the protean nature of its symptomatology.’6/n

By early 1958 estimated that ‘not less than 9 million people in Great Britain had … Asian influenza during the 1957 epidemic. Of these, more than 5.5 million were attended by their doctors. About 14 000 people died of the immediate effects of their attack.’ 7/n

£10, 000, 000 spent on sickness benefit. With factories, offices and mines closed economy was hit. 8/n

Main sufferers aged 5–39 years with 49% between 5–14 years. In London, 110,000 children off school suspected of having influenza. With adults usually a connection to children; for example, parents, teachers, doctors, or a closed group such as armed forces and football teams. 9/n

Largely dealt with by GPs with no uniform treatment. Hospital wards closed as nurses and doctors fell ill. No national epidemic plan implemented. Local plans often inconsistent. Some areas school closures were ordered. Elsewhere only assemblies and physical training banned. 10/n

There were complaints about inadequate warning and poor advice to public. Another letter to BMJ urged the BMA to take ‘urgent steps to counteract the … exaggerated publicity in the press:’ 8/n

‘There have been no cases in this neighbourhood; patients have already started sending urgently on most inadequate grounds. One woman in the best of health had obeyed instructions given her in a woman's magazine’. 12/n

All this from
Claire Jackson.,’History Lessons; the Asian Flu Pandemic’, British Journal of General Practice, 2009 Aug 1; 59(565): 622–623. End