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Journal of the Chinese Medical Association 79 (2016) 166
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Letter to the Editor
1918 influenza pandemic origin in Chinese laborers/soldiers:
Medical historical analysis
To the Editor, References
The recent article on “1918 influenza pandemic origin in 1. Shanks GD. No evidence of 1918 influenza pandemic origin in Chinese
Chinese laborers/soldiers” is an interesting publication.1 This laborers/soldiers in France. J Chin Med Assoc 2016;79:46e8.
2. Cohen S, Alper CM, Doyle WJ, Treanor JJ, Turner RB. Positive emotional
is an exact medical historical analysis, which is a type of style predicts resistance to illness after experimental exposure to rhinovirus
research rarely seen in medical literature. Shanks1 mentioned or influenza avirus. Psychosom Med 2006;68:809e15.
that there was “no evidence of 1918 influenza pandemic origin 3. Combadiere B, Siberil S, Duffy D. Keeping the memory of influenza
in Chinese laborers/soldiers in France” and noted that “this viruses. Pathol Biol 2010;58:e79e86.
finding does not support a Southeast Asian importation of
lethal influenza to Europe in 1918.”. Most certainly, when Viroj Wiwanitkit*
working with the various tools associated with historical Tropical Medicine Unit, Hainan Medical University, Haikou,
research, it is very hard to control the reliability of the avail- China
able records. For example, if there is an indication of “no Department of Biological Science, Faculty of Medicine, Uni-
record”, that does not necessarily mean there has been no case. versity of Nis, Nis, Serbia
In the present day, the problem of underreporting remains Joseph Ayobabalola University, Ikeji-Arakeji, Nigeria
commonplace.2 Nevertheless, if we consider the natural his- Department of Community Medicine, Patil Medical University,
tory of influenza and relate it to the situation as it existed in Pune, India
1918, we might find some areas of concern. In 1918, the Public Health Curriculum, Surin Rajabhat University, Surin,
overall transportation system was poor, and it took many Thailand
weeks to travel from China or Southeast Asia to Europe.
Based on the fact that influenza has a short incubation period *Corresponding author. Dr. Viroj Wiwanitkit, Wiwanitkit
(less than 1 week),3 it is unlikely that the illness first appeared House, Bangkhae,
in Europe. In the past, the occurrence of worldwide pandemic Bangkok 10160, Thailand.
infection seemed to involve more barriers to transmission and E-mail address: [email protected].
thus was more difficult to spread than in the present day.
Conflicts of interest: The author declares that he has no conflicts of interest
related to the subject matter or materials discussed in this article.
http://dx.doi.org/10.1016/j.jcma.2015.12.005
1726-4901/Copyright © 2016, the Chinese Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
