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Thursday Review: “‘Spanish Flu’: When Infectious Disease Names Blur Origins and Stigmatize Those Infected”

As important as any given fact is, it may be more important to notice what we’re being asked to do with the information.

In the American Journal of Public Health, Trevor Hoppe uses the simple fact that there is nothing inherently Spanish about the “Spanish flu” to talk about the rhetoric of naming diseases.

It was only in 2015 that the World Health Organization deprecated the use of specific places, names, occupations, etc., to name infectious diseases.1 The history of naming often makes use of some exotic or marginal place, at least relative to the Euro-American world. One effect Hoppe writes, of these naming practices is, whether intentional or not, to communicate to the broader public a causal relationship in how the disease is transmitted.2

The examples Hoppe lists go beyond “Spanish flu”, which apparently was first reported from Madrid to news media.3 The H1N1 outbreak in 2009 was often called some variant of “Mexican swine flu”. Ebola is named after a river in the Democratic Republic of the Congo. Though not named for a place, fourteenth-century English writers stated that the Black Death is supposed to have originated variously in the Gobi desert, in Manchuria, or … in the depths of Asia.4 Maybe most amazingly, Hoppe’s previous work reveals that AIDS was first called “gay-related immune deficiency”.5 Contrasted with a name or an origin from some undesirable Other, Hoppe pointedly remarks that the fact there is no epidemic colloquially known as American flu or European flu in recorded history is perhaps telling.

The most interesting point in the article, and where naming diseases bleeds into storytelling, is that these naming practices have two completely opposite outcomes. What’s more, these opposite effects usually immediately follow each other in public discourse.

The first narrative puts foreign names in the context of an alarm bell. The story goes something like this:

  1. A disease is threatening our lives.
  2. It’s named after (or is from) a developing economy.
  3. We should fear it.

The later narrative shifts to the foreign disease being remote and, well, foreign. That story is told like this:

  1. A disease has appeared in our population.
  2. It’s named after (or is from) a developing economy.
  3. It’s easy to contain.

It’s the same information, but the story around it has shifted completely. In Hoppe’s words,

Health communication scholars have observed that media coverage of an emerging infectious disease will quickly shift from the strategy of promoting fear to the strategy of emphasizing safety. Early coverage typically emphasizes the threat of contagion, whereas subsequent reporting aims to reassure the public that the threat will be contained.6 One strategy for reassuring readers of an epidemic’s containment is to associate the epidemic with foreigners or a foreign country.


The article reviewed: Hoppe, Trevor. 2018. “‘Spanish Flu’: When Infectious Disease Names Blur Origins And Stigmatize Those Infected”. American Journal Of Public Health 108 (11): 1462–1464.

1 World Health Organization. Investing to overcome the global impact of neglected tropical diseases: third WHO report on neglected tropical diseases 2015. Vol. 3. World Health Organization, 2015.

2 Hoppe, Trevor. Punishing Disease: HIV and the Criminalization of Sickness. University of California Press, 2017.

3 Trilla, Antoni, Guillem Trilla, and Carolyn Daer. “The 1918 ‘Spanish flu’ in Spain.” Clinical Infectious Diseases 47, no. 5 (2008): 668–673.

4 Aaronovitch, David. “Fever pitch: Once it was the chicken virus, then Ebola, now it’s Sars. We worry too much.” The Observer (2003).

5 Hoppe, Trevor. Punishing Disease: HIV and the Criminalization of Sickness. University of California Press, 2017.

6 Ungar, Sheldon. “Hot Crises and Media Reassurance: A Comparison of Emerging Diseases and Ebola Zaire.” British Journal of Sociology (1998): 36&ndash56.

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