Spanish influenza as a cause of death in Zagreb in 1918

With reference to the fact that so far there have been no comprehensive investigations of the occurrence of outbreak of Spanish influenza in the area of the city of Zagreb, in this study, on the basis of the public records and documents as well as the report given by the Municipal Authorities of the General Administration of the free and royal capital Zagreb, a retrospective analysis of the outbreak of Spanish influenza in Zagreb is given. Since the official reports of the evidence of infectious diseases did not give exact insight in the epidemiological events in 1918, a detailed analysis of the books of autopsy records of the Public health institutions has been done. The aim was to determine the very beginning of Spanish influenza in the city of Zagreb in 1918. It has been found that the first patients suffering from Spanish influenza appeared in July 1918. In the period from 1 September to the end of 1918, a total of 861 persons died because of Spanish influenza and complications caused by pneumonia. The analyzed autopsy records have demonstrated that the usual complication following influenza was pneumonia characterized by hemorrhagic edema. Knowing the tendency of influenza outbreak to recur at regular intervals more eminent onset of the pandemic type similar to that of 1918 may be expected.