The article "Pandemic influenza in Korea with special references to its etiology," published in JAMA in April, 1919 by Dr. Frank William Schofield, is a valuable material reflecting the influenza pandemic situation in 1918 in Korea. It contains the case reports of influenza infected patients and the results of the bacteriological experiments. Dr. Schofield worked as a bacteriology professor in Severance Union Medical College in Seoul from 1916 to 1920. His academic activities are lesser-known than the role of contributor of Korean independent movement. However, he was a remarkable veterinarian and scientist. According to Dr. Schofield, the number of Influenza infected population in Korea in 1918 was supposed to be 4,000,000 to 8,000,000, which corresponds with other resources(6.7 per 1,000 in Gangwon province). Considering the cases which were not registered as influenza infection by misdiagnosis of pneumonia complication the sum should be higher. However, the estimated crude influenza death rate from the reports by the Japanese colonial government was only 2.38(per 1,000). Dr. Schofield and his colleague tried to culture "Pfeiffer Bacillus" from the sputum and blood specimens of patients showing typical influenza symptoms. The bacterium was mistakenly considered as the influenza agent till the virological nature of influenza was discovered in the 1930s. From the results of his study he seemed to agree that "filterable virus" was the influenza agent and the secondary infection of the bacillus caused respiratory symptoms. He also reported on the influenza vaccination during the epidemics. Dr. Schofield's article confirms that the damage caused by the influenza outbreak in Korea was as great as in other Asian countries or even worse. It also gives information about the researches and education on the etiology and vaccination of influenza based on the germ theory in the medical colleges in Korea, which adopted the western medical educational system in the early 20th century.
Disease Outbreaks/*history ; History, 20th Century ; Humans ; Influenza Vaccines/history ; Influenza, Human/epidemiology/*history/mortality ; Korea/epidemiology ; Vaccination/history

INTRODUCTIONSingapore was substantially affected by three 20th Century pandemics. This study describes the course of the pandemics, and the preventive measures adopted.

MATERIALS AND METHODSWe reviewed and researched a wide range of material including peer-reviewed journal articles, Ministry of Health reports, Straits Settlements reports and newspaper articles. Monthly mortality data were obtained from various official sources in Singapore.

RESULTSThe 1918 epidemic in Singapore occurred in 2 waves--June to July, and October to November--resulting in up to 3500 deaths. The 1957 epidemic occurred in May, and resulted in widespread morbidity, with 77,000 outpatient attendances in government clinics alone. The 1968 epidemic occurred in August and lasted a few weeks, with outpatient attendances increasing by more than 65%. The preventive measures instituted by the Singapore government during the pandemics included the closure of schools, promulgation of public health messages, setting up of influenza treatment centres, and screening at ports. Students, businessmen and healthcare workers were all severely affected by the pandemics.

CONCLUSIONSTropical cities should be prepared in case of a future pandemic. Some of the preventive measures used in previous pandemics may be applicable during the next pandemic.

Disease Outbreaks ; history ; statistics & numerical data ; History, 20th Century ; Humans ; Influenza, Human ; epidemiology ; history ; mortality ; Public Health ; history ; Singapore ; epidemiology

Animals ; Global Health ; History, 20th Century ; Humans ; Influenza A virus ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; mortality ; virology ; Orthomyxoviridae Infections ; epidemiology ; veterinary ; virology ; Swine ; Swine Diseases ; epidemiology ; virology

Global Health ; History, 20th Century ; Humans ; Influenza A Virus, H2N2 Subtype ; genetics ; isolation & purification ; Influenza A Virus, H3N2 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; mortality ; virology