'In California the prognosis is good' : understandings of contagion in Southern California during the 1918-1919 influenza pandemic

This thesis examines Southern Californian medical and civilian reactions to the 1918-1919 influenza pandemic, exploring how these reactions were shaped by understandings and experiences of contagion in the region. In an October 1918 ‘Medical Meeting on Influenza’, a member of Los Angeles’ medical profession confidently stated that despite the flu’s severity, ‘in California the prognosis is good’. The pandemic was responsible for over 20,000 deaths in the State, with an estimated 100,000 infections in Los Angeles alone, yet throughout its 5-month visitation in Southern California, a belief in the region’s natural resistance to influenza persisted in both the medical and lay press. This thesis investigates how legacies of the region’s late-19th century ‘health rush’; pre-pandemic experiences of tuberculosis; and the continued prevalence of pre-germ theory understandings of contagion, shaped Southern Californian understandings of disease and created an atmosphere in which such a belief was upheld. Germ theory, though gaining in popularity by the early-20th-century, was not universally accepted in the period as representing the sole contagion narrative that could inform health decisions. Through an analysis of public health literature; newspaper articles and advertisements; and personal ephemera, this thesis reveals the fluidity with which individuals in Southern California interpreted and interacted with germ theory during the pandemic, and how understandings of disease were shaped by their engagement with a number of different, and often conflicting, theories of contagion. It explores the impact of prior disease experiences on understandings and behaviours in flu-time, charting the significance of tuberculosis as a bacterial and cultural entity in the region, and offering new insights into the impact of influenza-tuberculosis comorbidity on tuberculosis sanatorium patient experiences. This thesis contributes to existing debates on contagion knowledge in the United States and offers a new perspective on Southern California’s 1918-1919 influenza pandemic experiences.