ABSTRACT
When the 1918–1920 influenza pandemic struck, exposing the ineffectiveness of disease containment policies, the role of “science at the border” was already in a moment of transition in North America. State discourse moved from excluding to incorporating immigrant bodies into the nation; public policy was meant to respond to the pressures of racism and xenophobia, even while facilitating the labour demands of industrial capitalism. The obvious medical and public health failures of the flu pandemic contributed significantly to a sea change that was already underway. Public health and science increasingly viewed infectious disease as arising from within, not as exotic plagues brought by outsiders. At the same time, involuntary and coercive measures taken to control influenza could not withstand public pressure and a frequent sense of injustice. By the interwar period, public health compulsion gave way to an emphasis on education and surveillance and the development of vaccines for a wider array of diseases. In a renewed climate of international cooperation, disease screening took place at the immigrant point of departure, not the point of entry. Over the next two decades, global health emerged out of a new scientific and public health ethos. The history of the “Great Flu” resonates powerfully today, as it sheds light on such issues as coercion and compulsion versus freedom of movement; the role of national governments in keeping infectious disease at bay; and the potential social equity downsides to measures that are intended as preventive.
