How Brazil dealt with past epidemics

. Mar 16, 2020
hospital epidemics During the Spanish flu outbreak, one of São Paulo's finest country clubs was turned into a hospital. Photo: Ed.Um

“Avoid crowds, above all at night. Don’t make any visits. Take hygienic precautions with your nose and throat (…) Avoid fatigue or physical exertion. At the signs of the first symptoms, sick persons should go to bed, as rest will help the curing process and reduce complications and contagion. (…) The elderly should apply these precautions more rigorously.”

As fears over the Covid-19 pandemic begin to spread across Brazil and Latin America, the advice given above could easily have been included in a Health Ministry pamphlet. However, this excerpt was taken from the now-defunct newspaper Correio da Manhã, and printed in October 1918, to warn against Brazil’s worst-ever pandemic: the Spanish flu.

biggest epidemics</h2> <p>One of the <a href="">deadliest pandemics in human history</a>—claiming the most lives since the Black Plague crisis in the 14th century—the Spanish flu killed between 1 and 6 percent of the world&#8217;s population in the late 1910s, with some 35,000 deaths in Brazil.</p> <p>The Spanish flu even claimed the life of Brazil&#8217;s president-elect Rodrigues Alves, who had previously served as president between 1902 and 1906, but was unable to take office for a second term in 1918.</p> <p>The virus spread to Brazil by water, with the first reports surging from sailors in the northeastern state of Fortaleza. Cases soon began popping up throughout the region and in São Paulo, overflowing the country&#8217;s incipient and insufficient public health service.&nbsp;</p> <p>As a matter of fact, the Spanish flu was <a href="">Brazil&#8217;s deadliest enemy during World War I</a>. While Brazilian troops didn&#8217;t actually engage in combat, 90 percent of the country&#8217;s sailors sent to the war ended up catching the fever. Roughly 10 percent of the crew died, thanks to a combination of dehydration, a lack of exposure to the virus’s first wave, and lungs damaged by pollution from ships.</p> <p>Playwright Nelson Rodrigues would later call the pandemic &#8220;death without a funeral,&#8221; as public garbage trucks would circulate towns, collecting corpses, in images similar to that of the Black Plague. &#8220;From one day to the next, everyone started dying.&#8221;</p> <h2>The Vaccine Rebellion</h2> <p>Even before the Spanish flu, however, another public health crisis had already hit the country, during the first term of Rodrigues Alves as president.</p> <p>In 1904, the then-capital city of Rio de Janeiro was amid a process of industrialization which saw the population almost double in the space of 10 years. With this expansion, the city became incredibly cramped, with poor families (literally) living on top of each other in high-density tenements called <em>cortiços</em>.</p> <figure class="wp-block-image"><img loading="lazy" width="790" height="474" src="" alt="vaccine rebellion epidemics brazil" class="wp-image-33021" srcset=" 790w, 300w, 768w, 610w" sizes="(max-width: 790px) 100vw, 790px" /><figcaption>On October 29, 1904, one magazine seemed to predict the revolt that would take over Rio days later: &#8220;not even with an army will [Oswaldo Cruz] contain people&#8217;s rage against mandatory vaccines.&#8221; Image: O Malho/1904</figcaption></figure> <p>This quickly led to a huge health issue, as diseases such as yellow fever and smallpox spread across the city like wildfire. Besides the high mortality rate of Rio de Janeiro&#8217;s residents, the various epidemics in the city scared away foreign businessmen and tourists, which President Alves claimed was getting in the way of the country&#8217;s economic development.</p> <p>The president declared that the city would have to undergo a complete overhaul of its sanitation controls, putting physician Oswaldo Cruz in charge of designing the program.</p> <p>The city was successful in quelling the <a href="">epidemic of yellow fever</a>, but smallpox was a different matter altogether. Controlling the disease required a vaccine, and the government passed a decree forcing smallpox inoculation for the entire Brazilian population in 1904.</p> <p>While aiming at an improvement to public health, the government&#8217;s plan was overbearing. It would be compulsory for every citizen, and proof of vaccination would then become a form of identification, required in order to rent real estate, obtain employment, or get married. There was also the provision of fines for anyone who didn&#8217;t get the vaccine.&nbsp;</p> <p>The residents of Rio de Janeiro revolted, with large-scale protests that turned violent in confrontations with the police. The compulsory vaccination law was what put the people over the edge, but anger about the poor state of public services and the city&#8217;s disarray turned the revolt into one of general dissatisfaction.</p> <p>The Vaccine Revolt was notable for nearly bringing around a military coup, as groups within the Army attempted to use the unrest to overthrow the government. They were unsuccessful, however.</p> <p>While the government eventually backed down on the compulsory vaccine, the Revolt was quelled by force, with hundreds of protesters arrested, jailed, and tortured. Four years later, a smallpox epidemic hit the city and killed some 6,000 people.

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Euan Marshall

Originally from Scotland, Euan Marshall is a journalist who ditched his kilt and bagpipes for a caipirinha and a football in 2011, when he traded Glasgow for São Paulo. Specializing in Brazilian soccer, politics and the connection between the two, he authored a comprehensive history of Brazilian soccer entitled “A to Zico: An Alphabet of Brazilian Football.”

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