Hong Kong flu in France (1969-1970)

Third largest influenza pandemic of the 20th century, it struck France in the winter of 1969-1970 and would have killed more than 30,000 people. How did the French experience this crisis? How does this translate into a society that is still sorely lacking in resources to raise awareness in the face of the health crisis?

Ten years after the Asian flu, another “pandemic” is hitting the world and the result of a virus once again underestimated by the authorities. It is the H3N2 virus, called “Hong Kong flu”, and against which the population finds itself completely devoid of immunity as it is unknown. There is no mention of the term “pandemic“ in the scattered articles that cover the subject at the time.

France is living at the time of the first major social and cultural transformations suggested by the revolution of May-1968. It is still difficult to have sufficient means to characterize, at the time, “a health crisis”.

Hong Kong flu does not seem to go unnoticed in the press. On the contrary, if it does not make any headlines, the press is a perfect illustration of the “general disorganization” engendered by the epidemic.

Spread and symptoms of the pandemic

The virus appears in China in the summer of 1968 it spread to Hong Kong, quickly toured Southeast Asia, reached Taiwan, Singapore and Vietnam, then reached India, Australia, Iran before reaching the United States, where he traveled in particular with the military returning from Vietnam. He continues his world tour in Europe which he crosses from East to West, touching Great Britain and reaching France through Spain where the flu begins by hitting the South West during the winter of 1969. Hong Kong flu wraps around the world in a year and a half, helped by the increase in the means of transport then more accessible.

In The world December 3, 1969, it says that “the affection it causes translates into _a high fever_, inflammation of the nasopharyngeal areas with abundant flows, respiratory problems often accompanied by cough and of headache“.

Any pandemic can generate unexpected complications, but in 1969-1970, this flu from Hong Kong did not seem to have aroused so much concern. France Evening reported on December 14 that “in a minority of cases, the case has taken a more worrying turn, with fatal cases among flu patients suffering from vascular disorders. Doctors have found quite a few cases of _pulmonary congestion_, otitis, conjunctivitis, resulting from secondary infection“.

A “health crisis” that does not say its name

It is the precipitation of the French population to go to the doctor and to the pharmacy to find the means to cure and to guard against the plague which soon reveals the contradictions of the means of the medical world:

• When France Evening reveals a France hit by the virus

As the days pass, the daily communicates a certain number of figures which give an account of the ravages that the “epidemic” causes in France. This is what can be read on December 10, 1969: “At SNCF, 15% of Parisian employees are affected. Parisian schools affected one by one. In Toulouse, 25% of the population is seized, in Lyon it is a quarter of the Lyon population which is affected“.

Other articles mention the extent of the flu which causes, throughout France, absences and closings of factories and schools where they are, in the Paris region, up to 20% of teachers and students who are sick. At RATP, the bottom of the curve was reached on December 20 when 5,000 employees out of 30,000 were bedridden. The former administration of Posts, Telegrams and Telephones is also particularly affected; social Security was overwhelmed by an unexpected spike in compensation in January 1970.

To the point that initial estimates are given thanks to the FIFG and relayed, on January 23, 1970, by France Evening :

36% of French adults have been affected.

It turns out that 12 million French people have been affected by the virus.

When on March 14, 1970, the National Institute for Demographic Studies (INED), he counts 40% more deaths than the average in December due to the Hong Kong flu. This equates to an additional 20,000 deaths on average!

Of course, the appreciation of statisticians of the time must be greeted with caution because we have to wait for the research carried out by epidemiologists Antoine Flahault and Alain-Jacques Valleron, in the early 2000s, via INSERM, to have access to a reliable assessment of this flu. They specify that it would be 31,226 dead in total, in France and in two months.

• “Vaccine race” and saturation of health professionals

December 11, 1969, in The world, Doctor Escoffier-Lambiotte reports that “the Institut Pasteur sees its vaccine production double and can no longer meet demand“. The pharmacies are robbed by the French, many of whom are clearly aware of the ravages of the scourge without even having been made aware of it by any organized prevention system.

December 5, France evening reports that a real “vaccine race” is taking place! In reporting the testimony of a pharmacist: “People rushed to pharmacies to buy flu shots, stocks were plundered. I sold 20 vaccines per hour, the needs exceeded the possibility of manufacturing the vaccines“.

We can vaccinate thousands of people, not several million.

It’s the same phenomenon among doctors who see a real epidemic: “They vaccinate non-stop, visit the flu day and night” and “it’s a blackened agenda of appointments who waits for them at the end of each day for the next day “notes France evening respectively on December 10 and 12, 1969.

This anxiety phenomenon comes directly into question vaccine production capacities and testify to lack of means of the time in terms of public health. Which translates a lower health and medicinal ethics which could in no way respond to this crisis.

Towards a very fragile first prevention system

We must admit that this is just the start of the flu vaccination practice in France. No one could have predicted that millions more doses of vaccine would have been required and, most importantly, that the vaccine would be ineffective:

• Laborious vaccination

December 30, 1969, France Evening reports the testimony of a doctor who fell ill and targets the inaction of the vaccine: “Vaccination is clearly questioned by some, despised by others, because it should not belong to the 30% in which it fails“.

It would be wrong to think that the health authorities have not attempted to set up a prevention system capable of combating the epidemic because the sources attest that the Pasteur Institute was aware, from the end of 1968 of the potential arrival of the flu from Hong Kong in France. Besides, on December 11, 1968, The world reports that “The Institut Pasteur de Paris was, in September 1968, in possession of the strain of influenza virus from Hong Kong, which it took measures to ensure the manufacture of vaccines from this strain in order to incorporate it into the vaccine existing flu“.

On the other hand, what can be questioned is that vaccine efficacy and composition, at the same time as the underestimation of its evolution a year later in France. This is what the testimony of Professor Geneviève Cateigne, from the Institut Pasteur, reveals on December 28, 1968:

It is very likely that the viral strain A2 to which the professor alludes, and which is used for the preparation of the vaccine against the flu of Hong Kong, is in fact that of the Asian flu of 1957-1958 and not that of Hong Kong. The two strains are considered sisters at the time when it is absolutely nothing. These are two flu viruses that are completely foreign to each other. This is confirmed by Patrice Bourdelais in an article by Release :

By not taking into account the modification of the virus, the effectiveness of the vaccine was greatly reduced.

A error in judgment is also committed when it claims that a certain immunity will take place thanks to the liabilities of the Asian flu. As another doctor rightly reports in France Evening January 3, 1970:

The worst part is that influenza A2 virus does not immunize you from another family’s virus

In truth, there are many subtypes of the influenza virus, the strains vary enormously from year to year. Even if the strain of the Hong Kong virus had been taken into account, research may have missed an unexpected strain that had not been included in the vaccine. The percentage of people in whom the vaccine would have been probably ineffective could therefore rise well above the 30% suggested at the start and could thus come to explain the terrible balance sheet that we know.

• Health can’t afford to doubt itself yet

The mentality was almost equivalent to that of the French faced with the Asian flu at the end of the 1950s when the lack of means implied a certain fatality. The effects of a simple seasonal flu and an “epidemic flu” were naturally brought closer, as if they were similar.

This is why we can read in The world of November 11, 1968 that “this flu seems mild, it does not seem that it should take on a character of any seriousness“. And on December 10, 1969, the World Health Organization, clarified that:”for the time being, the disease is relatively mild everywhere“.

It is only when the flu translates its catastrophic effects on the population, that the medical community becomes aware of its own contradictions and handicaps in being able to set up an effective prevention system to curb the epidemic, without being alarmed. December 11, in The world, Doctor Escoffier-Lambiotte considers, after the fact, that it was in October and not in December that this preventive effort should have been considered “.

The only political statement existing during this “flu pandemic” is the interview that Robert Boulin, Minister of Public Health and Social Security, gives in France Evening. The newspaper dedicates a complete dossier, January 7, 1970, which goes around the flu problem in France and the solutions to bring. It could not be more explicit and revealing of what is then happening in France:

It is impossible to set up a prevention system in time for all French people.

“A flu epidemic, he continues, like the one we know is very difficult to predict and prevent“. In addition to the lack of sufficient medical means, in the Minister’s words, the lack of awareness of the chaotic situation in which France finds herself. Especially when he emphasizes”that panic is never justified“.

It is thanks to the awareness of the inadequacy of the means to stem this “pandemic”, that French medical research leads to a better understanding of the mechanisms of variation of infectious diseases, at the same time as a strengthening of the systems of surveillance and stimulation of the larger production of vaccines, accompanied by greater health efficiency from the 1970s.

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