Views & Reviews Review of the Week

Darkness falls

BMJ 2008; 337 doi: (Published 12 November 2008) Cite this as: BMJ 2008;337:a2501
  1. Tom Jefferson, Cochrane Acute Respiratory Infections Group
  1. Jefferson.tom{at}

    We don’t know where the great flu of 1918 came from, or whether it will come again, finds Tom Jefferson

    One of my earliest memories is hearing the words “Stai buono, altrimenti viene a prenderti la spagnola” (“Be good or the Spanish lady will come and get you”). Such was the folk memory of the devastation of Spanish flu that my nanny from Abruzzo used it as a threat to keep me docile. The dark and menacing image that the threat still evokes in me finds an echo in Mark Honigsbaum’s book Living with Enza, whose title is inspired by a gruesome contemporary skipping rhyme: “I had a little bird, its name was Enza, I opened the window, and in-flu-enza.”

    Honigsbaum’s story takes us through the three waves of Spanish flu, in the spring, late summer, and winter of 1918-19. The book aims to redress the scant attention paid to the pandemic in many biographies of those who witnessed its effects by giving us a picture of what it must have been like to live with “Enza” in Britain, through the memories of the …

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