Just over one hundred years ago, New York Health Commissioner Royal S. Copeland responded to the threat of “Spanish” influenza reaching the United States with the reassuring, if completely misguided, prediction that “there is nothing to be alarmed about so far as I can see.” Yet the part of Copeland’s warning that “went viral,” to use a modern term, was his declaration that kissing should be avoided. If kissing was deemed necessary, a handkerchief should be used to prevent direct contact with the lips.
The 1918 article’s headline, “If You Must Kiss, Kiss via Kerchief, is Warning,” set the tone for similar proclamations across the US: “Flu May Get You, Should You Kiss” from the Salt Lake Telegram; “Aw, What’s the Use! ‘Don’t Kiss, Except thru a Handkerchief,’ Expert Advises” from the Topeka State Journal; “Kiss Through Handkerchief to Avoid the Influenza” in Vermont’s Norwich Bulletin; and “To Avoid Influenza. People Advised Not to Kiss ‘Except Through Handkerchief’” in Washington’s Evening Star.
Most newspapers reproduced the same article text from a New York wire report, although each added its own headline. On August 17, 1918, the Indianapolis Star published the warning under the provocative headline, “Want to Kiss and Escape Grip? Use Handkerchief!” The first paragraph warned persons wanting “to avoid the Spanish influenza or the common garden variety of the same disease” should not kiss “except through a handkerchief.” After stating that Copeland advised “osculatory restraint,” using a specialized term for a common human behavior, the article ended with a remarkably optimistic, yet wholly unfounded, prediction: “Asserting that it was ‘simply influenza,’ without the fever, headaches, delirium, and nervous disorders associated with the Spanish variety, [Copeland] said that every precaution would be taken to prevent the spread of the disease.”
The national attention to this warning a century ago serves as a cautionary tale of how the American media might respond to a serious health danger today. In this sense, recognizing how information circulates during a public health crisis is almost as important as understanding how a virus circulates among a population. As we anticipate future epidemics or other public health crises, the skills of contextual interpretation are vital to ensuring that public trust in authoritative information facilitates adherence to necessary health measures.
Influenza and Osculation
Despite the humorous tone evident in these commentaries, in fact, Copeland’s list of “don’ts” included many specific actions now recommended by public health authorities: don’t use common eating utensils, don’t use drinking cups used by others, don’t remain near persons who cough and sneeze, and don’t spit in public spaces. Although many newspapers offered a summary of these recommendations, others ignored them and instead exaggerated the warnings about kissing. The Evening Capital and Maryland Gazette and several other papers expanded on this advice by republishing an editorial, often under the headline, “Influenza and Osculation,” which began with: “If your friend or your relative or your best beloved has a runny cold, don’t kiss him or don’t kiss her and don’t kiss them. They may have the ‘Spanish Flu.’” The editorial confidently assured readers that “dangerous germs” were spread by coughing, sneezing, or kissing within a five foot radius, but if people “will learn to keep a distance” from those who are sick, “they will be quite reasonably safe.” People in confined spaces such as trains or street cars should learn to cover their cough and blow their noses “with as much decency as possible.” Returning to the theme in the headline, the editorial concluded: “Kissing should be foregone during the period of the illness. Affection can be expressed without it, and the kisses will be none the less desirable when danger is over.”