HISSTER Archives - Quetelet Center

The Spanish flu in Belgium

DETAILS

Used dataset:

LOKSTAT, HISSTER, S.O.S. ANTWERPEN

Date:

December 2021

The Spanish flu in Belgium

This article provides the first comprehensive overview of the severity and impact of the Spanish flu in Belgium (1918-1919) and thereby makes a long overdue connection with the extensive international literature on pandemics in general and Spanish flu in particular. Leveraging ego documents (diaries), municipal-level excess mortality, and individual-level cause-of-death registers, we present new evidence on the chronology and spatial distribution of Spanish flu mortality in Belgium in 1918 and 1919 as well as social and demographic characteristics of the Spanish flu deaths in the city of Antwerp and discuss the government measures taken in the difficult context of the German occupation. In Belgium, our analysis shows that the chronology and geography of the Spanish flu cannot be seen in isolation from the vagaries of the First World War, in terms of soldiers and evacuees both acting as likely vectors of influenza transmission as well as inflating crude death rates at the municipal level.

Article:

Devos, I., M. Bourguignon, et al. (2021), “The Spanish Flu in Belgium, 1918–1919. A State of the Art”, Historical Social Research Supplement 33: 251-283.

Belgium: the nineteenth-century anti-vaxxer?

BELGIUM: THE NINETEENTH-CENTURY ANTI-VAXXER?

DETAILS

Used database:

HISSTER

Date:

January 2021

Category:

Blogpost

Auteur: Isabelle Devos

At the end of December 2020, Belgium started the vaccination campaign against COVID-19. This is more than two centuries after the very first vaccine was administered. Back then, it concerned smallpox, the only disease for which a vaccine was developed and rolled out on a large scale in Europe as early as the nineteenth century. For other infectious diseases, this did not happen until the 1950s-60s.

Although Belgium was one of the pioneers of smallpox vaccination, it failed to introduce compulsory vaccination against the disease in the nineteenth century, unlike almost all other European countries. It became clear that the information campaign from the start was not enough to overcome the lack of political will and suspicion among the general public in the longer term.

Variola virus

Smallpox is a highly contagious disease that is spread by the variola virus and transmitted through the air or by direct contact. The disease is easily recognized by a purulent rash and pus-filled sores.

Until the early nineteenth century, the disease caused 5 to 15 per cent of all deaths, mainly among children. Those who survived the disease were marked for life by deep, pitted scars, but gained immunity.

Smallpox was eradicated in 1980, the only infectious human disease to have been eliminated worldwide. This is thanks to a large-scale vaccination campaign that had already started in Europe at the beginning of the nineteenth century.

From variolation to vaccination

The forerunner of vaccination, so-called variolation, was introduced to Europe early in the eighteenth century. This technique, which originated in China, consisted of deliberately infecting people by applying a small dose of smallpox (scabs or pus from the sores) through a cut in the arm.

Variolation became known in Europe through, among others, Lady Mary Montagu, wife of the British ambassador in Constantinople, who had learned about it there.

Once a victim of the disease herself, on her return to England she had her daughter inoculated in the presence of several prominent doctors. Many enlightened minds and monarchies, such as in Sweden and Russia, encouraged the use of this new medical technique.

The first variolations in our regions took place on 17 May 1768 in Brussels. The Gazette des Pays-Bas reported on it two days later. Doctors in other cities and rural municipalities soon followed.

Various ordinances were issued under Maria Theresa and Joseph II to prevent the spread of the disease by using variolation. As of September 1768, variolations were only allowed to be administered at a distance of least 200 toises (390 metres) from a built-up area. Violations were punished with a fine of a thousand guilders. In 1788, Joseph II extended the distance to 400 toises and introduced a higher fine.

Meanwhile, opposition to the variolations had grown all over Europe, especially from the clergy and doctors. On the one hand, it was considered interference with God’s work and, on the other, inoculating healthy people was thought to be dangerous.

Vaccination

A few decades later, the British country doctor Edward Jenner came up with a new, less risky technique. In 1796, he discovered that milkmaids could get cowpox, but did not get the dangerous human smallpox.

Cowpox was a milder form of the human variant and it made these women immune to smallpox. The inoculation of healthy people with cowpox would protect them for life, according to Jenner.

At the beginning of 1800, the first inoculation with cowpox was administered in Ostend. The first smallpox inoculations, later called vaccination (from the Latin for cow: vacca), were initiated by a number of surgeons and medical societies.

They tried to convince the population of the benefits through popularizing brochures and lectures. Some doctors also offered inoculations free of charge, such as Joseph Kluyskens in Ghent and Louis Vrancken in Antwerp.

Promoting the cowpox inoculation was also an important pillar of the health policy of the enlightened French administration, which continued under the Dutch and Belgian regime. Local vaccination committees were set up for this purpose.

From 1807 onwards, smallpox inoculation became a condition in various places for access to municipal education and poor relief. In 1818, this was extended to the rest of the Low Countries, including a vaccination registration. People could obtain an inoculation free of charge from a doctor.

Outstanding vaccinators were awarded a medal and a small cash premium. However, as there was no compulsory school attendance at the time, a large proportion of the children were not included. Moreover, the inoculation of healthy people aroused a lot of suspicion, which was sometimes religiously motivated.

The official figures for the years 1830-60 indicate a vaccination rate among young children of 50 per cent on average, but with very large provincial and local differences. This led to new epidemics. For example, a smallpox flare-up in 1865 caused almost 6,000 deaths, and in the early 1870s the spread of the virus during the Franco-Prussian War led to 35,000 deaths.

The Antwerp and Limburg regions were particularly hard hit at the time, as a result of the deportation of French prisoners of war who were interned in the citadel of Antwerp and the camp of Beverlo after the battle of Sedan in 1870.

Compulsory vaccination?

DThe introduction of compulsory vaccination in Europe took place in two phases. Bavaria and Hesse were the first in 1807, quickly followed by other Prussian states, Denmark, Sweden, and then England in the middle of the century.

After the great smallpox epidemic in the 1870s, vaccination became compulsory in most other European countries, and finally also in Spain in 1903. Belgium, together with Austria, was the only European country where vaccination was not made mandatory.

This exceptional situation did not go unnoticed abroad. The leading medical journal The Lancet wrote in 1889 that the anti-vaccination movement hardly needed to campaign here because “indifferentism, which is peculiarly rife in Belgium, seems to answer its purpose”. Medical experts tried to convince the general public of compulsory vaccination, but “it is very doubtful if they will get many people to listen to good advice”.

The reality had little to do with national character. Rather, the young Belgian nation did not want to impose strict rules on its inhabitants. In political circles, compulsory vaccination was seen as a major restriction on individual freedom, despite the country’s higher smallpox mortality rate. The effectiveness of the vaccine was also called into question. In the meantime, it became apparent that several doses were required to achieve lifelong immunity.

In 1911, a draft law on compulsory vaccination was submitted to parliament, but it was not presented again until decades later due to elections, war conditions and other developments. Mandatory vaccination was eventually introduced in 1946, at a time when there were no more victims but vaccination was still necessary to prevent the return of smallpox.

If you want to use one of the dataset mentioned above, do not hesitate to contact queteletcenter@ugent.be.

Or would you like to lend a hand to our new citizen science project www.sosantwerpen.be in which we will study the social inequalities in causes-of-death in the city of Antwerp (1820-1946) with the help of volunteers ?

Do you want to know who the victims of the cholera epidemic were in Antwerp? Then register via sosantwerpen@ugent.be

Sources

UGent Quetelet Center, HISSTER database.
Draft Health Bill 1911, Chamber of Representatives, 5 December 1911.
Proposed Dexters Bill, Chamber of Representatives, 7 August 1945.
Royal Decree on cowpox vaccination, 6 February 1946.

Literature

Devos, Isabelle. “De negentiende-eeuwse antivaxers”. De Standaard, 23 december 2020.
Gadeyne, Guy. “Maatregelen ter bevordering van de vaccinatie uitgevaardigd door het Centraal Bestuur van het Scheldedepartement (1800-1814)”. Annalen van de Geschied- en Oudheidkundige Kring van Ronse, 23 (1973): 133-171.
Gadeyne, Guy. “Variolatie en vaccinatie tegen de pokken in België sinds de 18de eeuw”. Geschiedenis der Geneeskunde 6, nr. 6 (2000): 364-375.
S.N., “Smallpox and vaccination in Belgium”. The Lancet 133, nr. 3430 (1889): 1048

forgotten flu epidemics

DETAILS

Used database:

HISSTER

Date:

2 June 2020

Category:

Blog post

forgotten flu epidemics

Auteur: Patrick Deboosere, demographer at the VUB’s Interface Demography.

(Only available in Dutch)

De oversterfte door Covid-19 heeft van april 2020 de dodelijkste aprilmaand gemaakt sinds de Tweede Wereldoorlog. Zonder de drastische maatregelen die we intussen allemaal kennen zouden de cijfers zelfs nog flink stuk hoger opgelopen zijn.

Covid-19 is net als griep een virale aandoening. Een vergelijking is dus niet zo gek. De Spaanse griep van 1918-1919 geldt dan vaak als referentie. Aan die epidemie stierven in ons land naar schatting ongeveer 30.000 mensen. Vaak ook jonge mensen. Achteraf bleken sterftecijfers heel sterk te verschillen tussen steden waar quarantainemaatregelen werden genomen en plaatsen waar niets werd gedaan.

Maar niet enkel de Spaanse griep kostte veel mensenlevens. Bij vrijwel iedere griepepidemie kunnen we de verhoogde sterfte registreren. Ook in België is dit het geval.

In recente jaren is aldus gebleken dat verschillende griepepidemieën door ons land zijn getrokken en een spoor aan oversterfte hebben nagelaten. De meest recente golf van griepgebonden oversterfte in België werd opgetekend tussen eind februari en de eerste helft van maart 2018. Ook in januari 2017 was er een kortstondige episode van lichte oversterfte en wat verder terug in de tijd, in februari 2015, was er al een grote oversterfte vastgesteld.

Het is pas recent dat we in Europa binnen verschillende landen dagelijks de sterfte opvolgen en gebruiken om gezondheidscrisissen op te sporen en daar lessen uit te trekken. Een griepuitbraak in vroegere tijden werd dus pas wat later vastgesteld. In tegenstelling tot vandaag kon men de schaal ervan niet meteen opmeten en inschatten. Dat valt goed af te lezen uit de verslaggeving in kranten uit die tijd.

Historisch werden een aantal wereldwijde griepepidemieën als heel bedreigend ervaren en deze zijn dan ook in het collectieve geheugen gegrift. De meest bekende zijn de Aziatische griep van 1957-58 die naar schatting wereldwijd een miljoen mensen het leven zou hebben gekost, de Hong-Konggriep in 1968-69 en de Mexicaanse griep in 2009. Voor 1957-58 merken we in België inderdaad een langdurige periode van oversterfte die start in oktober 1957 en zal aanhouden tot april 1958. Er is geen sprake van een echte piek, maar van maandenlange hoge sterftecijfers. Ook de Hongkonggriep laat in januari-februari 1968 een piekmoment zien. De Mexicaanse griep van zijn kant lijkt in België weinig impact te hebben op de sterfte.

Maar er zijn ook de vergeten epidemieën. Zo hebben we in België twee wintermaanden meegemaakt waarbij de absolute sterftecijfers hoger waren dan de piek die covid-19 in april 2020 heeft veroorzaakt. Het gaat om januari 1951 met 15.399 overlijdens en februari 1960 met 15.425 overlijdens. Gegeven dat de Belgische bevolking kleiner was dan vandaag zijn de bruto sterftecijfers voor die twee maanden hoger dan deze van april 2020, omgerekend naar jaarbasis ongeveer 21 overlijdens op 1000 personen tegenover 16 in april 2020.

Op 13 januari 1951 wordt in de Belgische pers melding gemaakt van een “vreselijke griepepidemie in Noord-Engeland”, de zwaarste sinds de griepepidemie van 1918. De “doodgraversploegen moeten worden versterkt” en de economie lijdt onder de massale ziekte. De Gazet van Antwerpen van 16 januari 1951 schrijft dat de griepepidemie volgens de Wereldgezondheidsorganisatie oprukt in twee kolonnes. Er is een infectiehaard in Noord-Spanje en een andere in Zweden. Maar, “de tijdens de oorlog ontdekte sulfamieden en antibiotica” zullen het mogelijk maken “secondaire infecties die de meeste slachtoffers hebben gemaakt tijdens de epidemie van 1918, suksesvol te bestrijden.” De dag voordien had de Gazet van Antwerpen op haar voorpagina ook al over de griepepidemie bericht onder de titel “Belgen bieden hardnekkig weerstand” (GvA 15/1/1951). “Sommige buitenlandse bladen publiceren fantastische berichten over de griep-epidemie in België. Lazen wij niet dat ongeveer 1/3 der Belgische bevolking bedlegerig zou zijn!… God zij dank, zo’n vaart neemt het niet! Ofschoon wij nog niet in het bezit konden komen van officiële statistieken, blijkt het dat de ziekte thans stationnair is en in sommige streken zelfs terugloopt. De bevolking biedt prachtig weerstand. – weerstand die voornamelijk te danken is aan de goede voeding. Zo nochtans de sterfgevallen toenemen, dan is dit niets ongewoons, vermits het sterftecijfer elk jaar stijgt in de wintermaanden.”

Wanneer de Gazet van Antwerpen diezelfde maand (27/1/1951) nog over de griep bericht is het om te verwijzen naar Engeland waar de week voordien 1.099 personen aan de griep zijn gestorven en hoe overal ter wereld schepen uit Engeland in quarantaine werden geplaatst.

Terwijl de griep van 1951 wereldnieuws was omwille van het dodelijk karakter, lijkt het dat de griep in 1960 eerder als ongevaarlijk werd gezien. De Gazet van Antwerpen zal in februari 1960 in meer dan 100 artikels naar de griep verwijzen. Maar de toon is geruststellend. Op 9 februari 1960 titelt de krant op de voorpagina “Veel zieken, maar geen griepepidemie in ons land”. En het artikel stelt “Men mag niet van een griepepidemie in België spreken. Al heerst de ziekte vrijwel overal, zo is het aantal aangetaste personen toch zeer veranderlijk volgens de streken en nergens boezemt zij levendige ongerustheid in. Voorts worden vooral volwassenen door de griep getroffen. Geen enkele school schijnt haar deuren te hebben moeten sluiten, ofschoon de griep van 1960 een kenmerkend sterk besmettelijk karakter heeft, dat haar enigszins op hetzelfde niveau als de epidemische ziekten plaatst. (…) Uit de verklaringen van de zieken en van de overwerkte geneesheren die de duizenden zieken verzorgd hebben, mag men besluiten dat de griepverschijnselen – een griep die dit jaar typisch Belgisch lijkt te zijn, daar zij naar verluidt minder erg is dan de griep die in de overige Europese landen heerst – de volgende zijn: hoofdpijn, rillingen, koorts en algemene vermoeienis. Met sulfamiden en vitaminen C is men de griep spoedig de baas.”

De volgende dagen zal de krant ook vol staan met reclameboodschappen over de griep. “Het staat thans vast, dat de griep 1960 in werkelijkheid niet gevaarlijk is. Ze wijkt voor een doorgedreven behandeling met “ASPRO”, 2 tabletten om de 3 uur, en warme dranken.” (20 februari 1960) De werkelijkheid was echter grimmiger, alleen waren de tijdsgenoten zich er niet van bewust.

Sources:

Data: UGent Quetelet Center, Hisster database.
Quotations: Gazet van Antwerpen, Digital archive.

SHiP Workshop

DETAILS

Gebruikte databank:

HISSTER

Datum:

January 2020

Categorie:

Workshop

SHiP workshop

On 10 January the Quetelet Center organised the fourth workshop of the SHiP network (Studying the history of Health in Port cities). At the renovated Monasterium Poortackere in Ghent, participants from 12 different countries discussed the construction of an international codification and classification of individual cause-of-death data. The coding system will facilitate comparisons of mortality datasets such as the Belgian HISSTER across time and place.

See programme for details of the workshop.

Quetelet Center receives citizen science grant!

DETAILS

Used database:

HISSTER

Date:

2020-2023

Category:

Database

Quetelet Center receives Citizen Science grant!

Hilde Crevits, Flemish Minister for Innovation, allocates 1 million euros to 7 Citizen Science projects. These are projects in which scholars at universities, colleges and scientific institutions involve the general public in their research. S.O.S. Antwerp, the proposal of the Quetelet Center, receives one of these 7 grants! Under management of the Quetelet Center, citizens and researchers will study social inequalities in death in nineteenth- and early twentieth-century Antwerp by jointly creating and analyzing a unique database of individual causes-of-death.

S.O.S. Antwerp (Sociale Ongelijkheid in Sterfte) is a project of the Quetelet Center in collaboration with the Public History Institute of Ghent University, the Center for Urban History of the University of Antwerp, the Antwerp City Archives and Histories vzw. More news will follow soon!

For more information about the selected projects you can visit www.ewi-vlaanderen.be/oproep-citizen-science

New database on urban mortality available!

DETAILS

Used database:

HISSTER / URBAN DEATHS

Date:

December 2018

Category:

Database

NEW DATABASE ON URBAN MORTALITY AVAILABLE!

The URBAN DEATHS database was created by Tina Van Rossem as part of her doctoral project “Bruxelles ma belle. Bruxelles mortelle: an investigation into excess mortality in Brussels at the turn of the twentieth century.”

Tina Van Rossem started work on the individual death certificates from Brussels, Liège and Schaerbeek from the year 1910. She collected not only details of the date and place of death of all the deceased, but also data on their occupation, age at death and the witnesses who signed the death certificate. This means the database is an ideal source for anyone interested in average ages at death, occupational structures and high-risk neighbourhoods in these cities.

Interested in using this database yourself? Then contact the staff at the Quetelet Center or check out the URBAN DEATHS page.

Was it more dangerous to work at home or in a factory?

DETAILS

Used dataset

HISSTER

Date:

December 2017

Category:

Scientific publication

WAS IT MORE DANGEROUS TO WORK AT HOME OR IN A FACTORY?

Tina Van Rossem, Patrick Deboosere and Isabelle Devos set to work with the population figures and mortality rates from the HISSTER database. The database contains mortality statistics at the local and regional level, going back to 1841.

Article:

Van Rossem, Tina, Patrick Deboosere, and Isabelle Devos. “Death at work? Mortality and industrial employment in Belgian cities at the turn of the twentieth century”. Explorations in Economic History 66 (2017): 44–64.

Abstract:

“In this article, we reconstruct the sex- and age-specific mortality rates for the 25 largest Belgian cities at the turn of the twentieth century, and we explore their relationship with industrialization. Whereas previous research has focused mainly on the general level of industrial employment, we make a distinction between two production systems: cottage work (i.e., employment at home) and regular industrial production (i.e., centralized employment). Our linear regression models suggest that cities oriented toward cottage industry were more lethal than those oriented toward regular industry. Cities where a substantial percentage of the labor force was engaged in cottage work suffered high mortality rates, which confirms contemporary claims that in Belgium the cottage industry was “the most murderous of all industries.” Regular industrial employment, on the other hand, appears to have been less harmful for men and women alike, both young and old. We do observe, however, a detrimental effect from female regular industrial employment on infant and child mortality. Using contemporary government reports and sociological works, we were able to gain insights into the possible pathways that created these large health discrepancies between production systems. We argue that the health hazards encountered by cottage workers were due to the absence of labor and wage regulations and to the lack of health and safety standards in cottage work. In many sectors of the regular industry—and in heavy industry in particular—numerous regulations of this type had already been enforced by emerging labor union organizations, resulting in improvements in working conditions and higher wages. Furthermore, regular heavy industry seems to have attracted the healthiest workers.”