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Journal of the History of Medicine and Allied Sciences Advance Access originally published online on October 11, 2006
Journal of the History of Medicine and Allied Sciences 2007 62(1):56-89; doi:10.1093/jhmas/jrl042
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© The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Toronto’s Health Department in Action: Influenza in 1918 and SARS in 2003

Heather MacDougall*

* Heather MacDougall, Department of History, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1 Canada. E-mail: hmacdoug{at}uwaterloo.ca.


  Abstract

This article compares the Toronto Health Department’s role in controlling the 1918 influenza epidemic with its activities during the SARS outbreak in 2003 and concludes that local health departments are the foundation for successful disease containment, provided that there is effective coordination, communication, and capacity. In 1918, Toronto’s MOH Charles Hastings was the acknowledged leader of efforts to contain the disease, care for the sick, and develop an effective vaccine, because neither a federal health department nor an international body like WHO existed. During the SARS outbreak, Hastings’s successor, Sheela Basrur, discovered that nearly a decade of underfunding and new policy foci such as health promotion had left the department vulnerable when faced with a potential epidemic. Lack of cooperation by provincial and federal authorities added further difficulties to the challenge of organizing contact tracing, quarantine, and isolation for suspected and probable cases and providing information and reassurance to the multi-ethnic population. With growing concern about a flu pandemic, the lessons of the past provide a foundation for future communicable disease control activities.

Key Words: Influenza • SARS • Toronto • epidemic • public health • disease control • pandemic


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