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369Volume 19, Issue 3, September 2010 H

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Framing disease: The avian infl uenza pandemic in Australia

SUDEEPA ABEYSINGHE School of Sociology, Australian National University, Canberra, ACT, Australia

KEVIN WHITE School of Sociology, Australian National University, Canberra, ACT, Australia

A B S T R A C T Since 2003, avian infl uenza has recently spread around the world sparking fears of a potential pan- demic. As a result of this, a range of explanations and expectations surrounding the phenomenon were generated. Such social representations of disease depict the issue under discussion and frame reactions to the event. This paper explores the social representations surrounding avian infl uenza in Australia. Methodologically, a textual analysis of media and government documents was conducted in order to uncover the social representations implicit in these accounts. This demonstrated a symbolic framing of avian infl uenza with reference to the Spanish Infl uenza pandemic (1918). Analytically, the study draws upon the concepts of social representations from Durkheim and of risk and symbolic risk in the work of Beck. Overall, it is argued that the framing of avian infl uenza as a risk, mediated through the collec- tive memory of Spanish Infl uenza, characterised the nature of the social representations surrounding the phenomenon. This resulted in the production of symbolic solutions to the threat.

KEYWORDS: sociology; avian infl uenza; social representations; risk; media; infectious disease

INTRODUCTION

The threats of new infectious disease – SARS or avian infl uenza – as impending pandemics have recently come into prominence

in the public domain. In this paper we provide

an account of how avian infl uenza was framed

in Australian media and government sources.

Drawing upon Durkheim’s concept of social rep-

resentations, this paper explores the construction

of avian infl uenza as produced through the pub-

lic narratives of the government and the media

(Nerlich and Halliday 2007). Methodologically,

narrative analysis was utilised to uncover the dis-

courses implicit in the media and government

documents. The study demonstrates an histori-

cal continuity in the construction of epidem-

ics in Australian society through the linking of

avian infl uenza with the Spanish Infl uenza pan-

demic of 1918. As the media and government

documents studied in this paper demonstrate, the

social representations of infectious disease reso-

nate deeply in the collective understanding of

these issues and have led to the rise of risk dis-

courses in regard to an avian infl uenza pandemic,

resulting in a heightening of uncertainty and fear

surrounding this perceived threat.

This paper shows how the symbolic construc-

tion of pandemic threats based on the collective

memory of the Spanish Infl uenza, as demon-

strated in newspaper and government reports,

results in the pursuit of an antiviral defence against

the infl uenza, even when it is known that such

a strategy will not be effective. As we will show,

the Australian Government’s position represents

Sudeepa Abeysinghe and Kevin White

Volume 19, Issue 3, September 2010370

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predominantly affects birds (and even then only

infrequently in a highly pathogenic form) spo-

radic human epidemics caused by various avian

infl uenza viruses have developed throughout

history. Human infections by H5N1 in Hong

Kong (1997), and subsequent cases in vari-

ous areas globally, sparked the generation of a

heightened perception of the threat posed by

this virus (Monto 2005). Thus, although there

had been relatively few instances (just over 300

laboratory-confi rmed cases) of human infection

worldwide (WHO 2008) the risk of a global

pandemic of avian infl uenza had been a possi-

bility that was often reiterated in the discourse

of various social institutions during the height

of the scare.

RISK, RISK COMMUNICATION AND SYMBOLIC INDUSTRIES OF RISK Sociologically speaking, there are a number

of factors that make up the constitution of a

risk. Firstly, for a risk to exist it must fi rst be

acknowledged; it must exist in the political

consciousness (Douglas 1992). Apart from this

characteristic as a constructed and essentially

public entity, risks also display several other

features. These include the necessarily systemic

nature of risks (Beck 1992:21–32). Although

they are unequally distributed, risks also tend

to cross temporal and spatial boundaries and are

characteristically located in the future. The AI

pandemic threat possesses these characteristics.

Thus, as will be seen in the following analysis,

an important feature of risk is the concept of

anticipation. As such, although the perception of

risk surrounding AI lay in the future, this fact

enhances, not diminishes, the sense of dread.

Furthermore, unlike the hazards of early indus-

trialisation, no individual or organisation can be

held directly responsible for the current risks,

as risks are inherent in the social system itself.

Additionally, according to Beck’s characterisa-

tion, while hazards of the past were largely per-

ceptible to the senses, risks of the present (such

as AI) generally remain invisible. Therefore,

a symbolic solution to what is fundamentally a

symbolic issue.

Representations are a ubiquitous and neces-

sary component of social life, since they both

produce a shared understanding and help indi-

viduals to make sense of the world around

them. As such, social representations gener-

ate a collection of explanations and expec-

tations surrounding a given phenomenon.

Importantly, such representations both depict

the issue under discussion and simultaneously

refl ect subjectivities surrounding that issue

(Durkheim 1915; Meštrović 1988). The study

of social representations is thus necessarily of

sociological interest because representations

give insight into both the perception and con-

struction of a given phenomenon under study

(Moscovici 1988).

The production of public representations is

most relevant in circumstances where a frame-

work of interpretations is essential to render inter-

pretable a challenging or unfamiliar occurrence,

such as the event of illness (Rosenberg 1989).

The experience of disease essentially refl ects a

break in the ordinary continuity of social life

(Herzlich and Pierret 1987), and narratives of

disease thus become necessary to render this

disruptive experience intelligible. Furthermore,

such narratives not only provide an explanation

for the specifi c event but also necessarily supply

some interpretation regarding the overall nature

of society and social reality. Representations of

disease are thus an important subject of socio-

logical study. In this paper, the construction of

disease representations is explored through the

analysis of the depictions that surround the phe-

nomenon of avian infl uenza.

What is commonly referred to as ‘avian

infl uenza’ in the public domain is actually a

specifi c and highly pathogenic subtype of the

avian H5N1 virus (Monto 2005). The poten-

tial impact of this virus has recently become

entrenched in the public consciousness due

to characterisations of its ability to cause a

human pandemic. Though the H5N1 virus

The avian infl uenza pandemic

Volume 19, Issue 3, September 2010 371

SR H

surrounding risk. Beck argues that the more the

public is aware of a risk (for example through

the risk discourses presented in this analysis), the

greater the risk appears to be (Beck 1992:57).

This therefore, necessitates further action in alle-

viating public feelings of helplessness and dread.

Risks are thereby not only socially created facts

but also important market opportunities – as

risks grow in public importance new demands

are created and the risks also grow in economic

importance (Beck 1992:45). After the creation of

an economic niche, the very existence of indus-

tries surrounding a threat makes it increasingly

diffi cult for notions of risk to be dismantled.

In the case of AI, risk presents itself as a gener-

alised notion of pandemic where the etiological

agent (i.e. the mutated H5N1 virus strain) and

the event of successful human-to-human trans-

mission remain only vague future notions. Due

to the indefi nite nature of this risk, it is impossi-

ble to have a truly preventative action, and rather

a symbolic industry is born (Beck 1992:57).

In this case, the symbolic industry involves the

manufacture of vaccines and treatments which

are likely to be ineffectual in the case of an actual

pandemic. What is necessary is not that the risks

are eliminated (since they cannot be eliminated

unless their very existence is questioned) but

rather that a policy of eliminating risks is imple-

mented. Such reactions are not uncommon, and

instances of the creation of symbolic industries

of risk management have arisen from many

(perceived) ‘social problems’ (Lockie et al 2000). Thus, the politics of AI are part of a process of

collective action surrounding risk, where public

mobilisation necessitates a government response.

Since it is virtually impossible to prepare for a

future threat in a way that both appears to pro-

tect citizens and is actually effectual, the govern-

ment must necessarily subscribe to the symbolic

industries of vaccines and antivirals.

METHODOLOGY Narrative texts, as linguistic and discursive

processes, are of fundamental importance in

knowledge surrounding risks is localised in the

sphere of science, since risk assessment is neces-

sarily based upon causal interpretation. In this

way, this knowledge is easily subject to differ-

ent interpretations and is thereby open to social

defi nition and construction.

Thus, while science is responsible for the

primary production of risk perception, the

invisible and subjective nature of a risk also per-

mits interpretation from other sources (Beck

1992:29). Notably, the media holds a key social

and political position in defi ning risk and com-

municating risks, especially when scientifi c

uncertainty exists. In such cases, notions of

threat are highly susceptible to non-technical

defi nition and construction (van Loon 2002). As

the social and economic importance of ideation

regarding a risk grows, so too does the power of

the mass media as agents of the dissemination of

risk narratives. Thus, the way in which the AI

risk is presented by the media is crucial to the

understanding of the phenomenon as a whole.

Here it will be shown that media reporting of

AI serves to heighten expectations of pandemic

and perpetuate the perception of risk. The

very existence of a large number of newspaper

reports on the issue of AI reinforces the sugges-

tion that the media helps to (re)produce notions

of AI as an issue of primary public interest. This

thereby affects government reactions to the AI

risk, and government measures and media dis-

courses interrelate with each other in a refl exive

manner.

Proposing solutions to AI is problematic

because of the different interpretations of the

level of risk it poses. But once a risk is generated

a solution has to be proposed. In Australia that

solution is found in the stock piling of antivi-

ral drugs. Given the lack of consensus regarding

the validity of these measures, the government

response to the AI threat in terms of vaccine

and antiviral stockpiling appears problematic.

However, one way in which this phenomenon

can be explained is through the use of Beck’s

concept of the rise of symbolic industries

Sudeepa Abeysinghe and Kevin White

Volume 19, Issue 3, September 2010372

SR H

limiting the results to reports in which substantial

commentary was made), and reported in the

general/local news, features, or world news

sections of the newspaper (fi ltering out many

reports made in the fi nancial sections, as the

specifi c commentary of commercial concerns is

not of primary interest in this study) (see Figure

1). The use of this search strategy resulted in

the retrieval of 62 articles published between

January 2004 and March 2007. Although a few

articles were published between 1997 (the time

of the fi rst outbreak) and 2004, and a signifi -

cant number of them from March 2007 to the

time of the commencement of the data analysis

(March 2008), these reports did not conform to

the specifi cations of the search, typically due to

the word count restriction.

The newspaper reports were of primary

interest because the mass media play a role in

both the generation and the dissemination of

representations (Edy 1999; Inglis 1990). The

narratives of the media facilitate the public

understanding of social events by instilling them

with meaning. In fact, the news media can be

viewed primarily as an industry devoted to the

production of representations (Lupton 1994).

forming subjectivities and making the social

world intelligible to those who live in it (Lupton

1994). Sociologically, the analysis of texts is

important in understanding representations of

illness, as narrative texts employ language to

both present and constitute cultural interpreta-

tions of reality (Franzosi 1998). Textual analysis

is utilised in this paper to provide not only an

understanding of infl uential representations of

AI, and anxieties present in Australian society

regarding AI, but also to provide insight into

broader socio-cultural notions of illness, infec-

tion and risk.

In order to study media representations, a

retrieval of articles which focused upon the

subject of AI published by The Australian news- paper was made using the Factiva database.

The Australian newspaper was chosen due to its status as a national newspaper with a wide-

spread distribution. The initial search locating

all articles containing the phrases ‘avian infl u-

enza’, ‘bird fl u’, ‘avian fl u’, or ‘H5N1’ yielded

over 700 results. The articles to be subject to

analysis were selected by restricting the search

to those using one or more of the terms at least

fi ve times, above 500 words in length (thus

FIGURE 1: SHOWS THE NUMBER OF THE AUSTRALIAN ARTICLES WHICH CONTAIN ANY OF THE PHRASES ‘AVIAN INFLUENZA’, ‘AVIAN FLU’, ‘BIRD FLU’ OR ‘H5N1’ IN THE PUBLISHING PERIOD OF JANUARY 2001 TO AUGUST 2008.

100

Jan-01

Jul-01 Jan-02

Jul-02 Jan-03

Jul-03 Jan-04

Jul-04 Jan-05

Jul-05 Jan-06

Jul-06 Jan-07

Jul-07 Jan-08

Jul-08

Month of Publication

N um

be r

of A

rt ic

le s

The avian infl uenza pandemic

Volume 19, Issue 3, September 2010 373

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in the production of shared notions of reality

(Hastings 1998). Fundamentally, the goal of

government policy is not merely to defi ne the

problem but essentially to effect a solution to

that problem. Thus, unlike the media narrative,

the aim of government policy is to provide

resolutions. However, through the narrative

process, the solution to the problem is neces-

sarily framed within defi nitions of the problem

itself; thus the depiction of the causes of the

problem will serve to create the actions taken

(Atkinson 2000).

THE HISTORICAL CONTEXTUALISATION OF AVIAN INFLUENZA Although avian infl uenza was an emerging

and ‘new’ virus, its characterisation necessarily

refl ects pre-existing ideas regarding infectious

disease (Fleck 1979). This can be attributed to

the fact that one of the ways in which people

come to understand a novel phenomenon is

through reference to an existing comparative

framework (Marková and Farr 1995). Thus,

analogy is one of the primary ways in which

prevailing thoughts and ideas are represented

and organised (Arber 1954; Sontag 1978). The

narratives of AI studied in this paper will be

shown to draw heavily upon analogies to past

infl uenza pandemics. Notably, the Spanish

Infl uenza pandemic of 1918–1919 provides

the dominant model for contemporary under-

standings of AI. In fact, the Spanish Infl uenza

pandemic is a recurring theme in the newspa-

per and government documents.

Within the long general history of human

infection with infl uenza, the Spanish Infl uenza

pandemic of 1918–1919 distinguishes itself as a

fearful event (Crosby 1976). Spanish Infl uenza is

upheld as a prototypical example of an infl uenza

pandemic, despite the surrounding scientifi c

controversy and its atypical epidemiology and

manifestation (Taubenberger and Morens 2006;

Tognotti 2003). Nevertheless, in terms of public

memory of pandemic infl uenza, the Spanish Flu

predominates.

Thus, the media not only refl ect societal norms

and values but also serve to create them. The

relationship between media representations and

public narratives is therefore a constantly refl ex-

ive process (Petts et al 2001). The media also play an important role in suggesting to the pub-

lic what should be viewed as a social problem,

and thus hold a prominent position in political

agenda setting (Ward 2002).

In addition to the analysis of media nar-

ratives, a study of the Australian Federal

Government’s construction of the issue was also

conducted. In order to study government nar-

ratives and actions in response to AI, an analy-

sis of the ‘Australian Health Management Plan

for Pandemic Infl uenza’ (hereafter referred to

as ‘Pandemic Plan’) was conducted. This docu-

ment was produced by the Offi ce of Health

Protection in the Department of Health and

Ageing in May 2006 from an earlier (June 2005)

version. As the defi ning government document

in response to AI – covering the background,

historical precedents, and preparation and pre-

vention strategies – the Pandemic Plan was

studied through comparison and contrast with

the narratives that were provided from an anal-

ysis of the newspapers.

Government policy regarding the AI phe-

nomenon is a manifestation of the social narra-

tives surrounding the threat of pandemic. Thus,

government policy serves to itself construct and

also sustain a system of beliefs surrounding the

reality of AI. It has been noted that govern-

ment policy is produced as a result of existing

societal discourses, including the construction

of the problem by other social institutions such

as the media (Hastings 1998). However, in

addition to being constructed as a reaction to

cultural ideation surrounding AI, the creation

and implementation of government policy in

itself displays narratives of the phenomenon

(Atkinson 2000). This is because policy docu-

mentation must necessarily defi ne the ‘problem’

under question. This defi nition occurs through

social processes of argumentation, which result

Sudeepa Abeysinghe and Kevin White

Volume 19, Issue 3, September 2010374

SR H

The course and impact of Spanish Infl uenza

highlights its status as a source of anxiety. The

Spanish Infl uenza virus/es had spread across

the globe in a matter of weeks (Phillips and

Killingray 2003). Although estimates of morbid-

ity and mortality rates are highly inconsistent,

it is suggested that the death rate ranged from

approximately 20–100 million worldwide. In

Australia, an estimated one million individuals

were infected, with tens of thousands of deaths

(Barry 2004). However, it was not only the high

mortality rates which led to the fear of the ill-

ness. The unpredictability of infection and the

swift nature of death were major causes of pub-

lic alarm (Graves 1969). Additionally, there were

dramatic changes in the structure of social life at

the height of the pandemic. These included the

rise of media hysteria surrounding the disease,

the breakdown of social life through quarantine

(Hyslop 1994) and the more symbolic isolation

of individuals (evidenced through the rise of a

culture of mask wearing and social distancing),

and the breakdown of public and employment

structures (Graves 1969).

Spanish infl uenza is indeed the disease which

was most often referred to in discussion sur-

rounding AI, and served to provide an analogy

to the potential threat of AI. Of the sources

collected, many of the newspaper articles made

signifi cant reference to the Spanish Infl uenza

(Dayton 2005; Eccleston 2005; Henderson 2005;

Kerin and Mayes 2005; McCracken and Curson

2005; Wood 2006). As a further indication of the

salience of this analogy, one article, ‘Flu of the

Past has Lessons for the Future’ in fact focuses

upon the direct comparison of AI to Spanish

Infl uenza (McCracken and Curson 2005),

thereby reinforcing the idea of a conceptual link

between Spanish Infl uenza and contemporary

events. Furthermore, in addition to the media

references to Spanish Infl uenza, the government

report makes perhaps an even more fundamental

linking of AI to the existing cognitive schema

surrounding that past pandemic. In fact, the very

second line of the introduction to the Pandemic

Plan makes reference to the Spanish Infl uenza

and notes the devastation and high death rate

caused by that event (Offi ce of Health Protection

2006:6). In this way, the government report as a

whole is framed around this initial allusion to the

Spanish Infl uenza pandemic.

Thus, the constant and prominent references

to the historical events of the Spanish Infl uenza

pandemic suggest that this past experience pro-

vides a primary basis of comparison for contem-

porary Australian conceptions of AI. Through

its construction in the context of this incident,

the AI phenomenon is endowed with all of the

social meanings and understandings which are

embedded in the remembrances and interpre-

tations of the Spanish Infl uenza pandemic (see

Olick and Robbins 1998).

However, overall it is diffi cult to compre-

hensively situate the degree to which Spanish

Infl uenza and ideas of contagion in general reso-

nate within the public imagination. For example,

it is suggested by one historian that while indi-

viduals who lived through the Spanish Infl uenza

pandemic retain a sense of dread surrounding

infl uenza, the instance is largely forgotten by

the general public (Barry 2004). In contrast,

Herzlich and Pierret suggest that it is a para-

dox that great epidemics, although ‘entrenched

in culture as deeply as any myth, are no longer

part of the individual consciousness. People no

longer refer to them when speaking of illness

[as other diseases such as cancer have taken pre-

dominance as the prototypical example], and the

fear of the scourge has vanished’ (1978:40). As

Halbwachs (1992) argued in his germinal book

Social Frameworks of Memory, issues of collective memory are not issues of individual memory but

of the group’s memory. Corresponding more

closely to this second approach, the data analy-

sed for this paper serve to suggest that at the col-

lective level narratives of contagion are still very

much alive in contemporary Australian society

in the sources analysed in this paper. Thus, the

textual analysis indicates that the AI threat has in

fact re-awakened long-latent disease narratives

The avian infl uenza pandemic

Volume 19, Issue 3, September 2010 375

SR H

A good example of the wide ranging claims

made about such risk estimates is the reporting

of a statement made by (then Health Minister)

Tony Abbott who suggested that the likeli-

hood of infection in Australia was ‘10 per cent

in any one year’ (Cresswell and Murphy 2005).

Additionally, in association with such specifi c

fi gures, very vague numbers are also forwarded,

such as those suggesting that AI ‘could kill mil-

lions’ (The Australian 2007). Even direct citing of mortality rates, of around 50% by World Health

Organization (WHO 2008) estimates, as evi-

dence of the ‘deadly’ nature of AI is problem-

atic. This is due to the fact that not all infected

individuals will be subject to WHO surveillance

(and are therefore absent from statistical analysis)

(Best 2008).

Regardless, it is not the statistics in them-

selves, but rather the very use of such statis-

tics which creates risk perception. Quoting

large fi gures, a particular means of risk com-

munication, magnifi es notions of risk because

large fi gures necessarily link in the minds of the

audience with a large problem. Statistics cer-

tainly have a useful place in framing knowledge

about society, and can be utilised to simplify

and explain complex social phenomena in a

way that heightens understanding and serves as

a basis for easy comparison. However, statistics

are often treated as objective representations

of the truth (Best 2001; Smith 1985). In con-

trast with this perception, due to their nature as

‘facts’ which are primarily constructed, statistics

are necessarily representations. For example, as

suggested, ‘risk’ is not an objective concept but

is rather in itself a socially produced notion; in

this way, risk statistics are wholly dependent

upon statisticians conceptualisations of what

‘risk’ actually constitutes (Bartholomew 1995;

Heyman et al 1998). Furthermore, according to Hindess (1973), even more critical is the fact

that statistics are produced through collective

activity and are therefore tied to the specifi c

organisational context and the overall cultural

meaning system in which the construction is

and resonated with an historical conception of

contagion in Australian culture (Bashford 2002;

Bashford and Strange 2003).

RISK The analogy with Spanish Infl uenza character-

ises discourses of avian infl uenza through con-

ceptions of threat and linking to past experience.

Furthermore, at its core AI is presented as omi-

nous and worthy of a fearful response because it

is a potentially catastrophic future event. Thus,

even though the probability of an AI pandemic

may be small, the magnitude of destruction

which would be caused in the event of a pan-

demic is necessarily large. This feature situates AI

as a risk, resulting in the widespread develop-

ment of risk discourses. Correspondingly, risk is

one of the most salient notions present in all nar-

ratives of AI.

The communication of risk – the media One of the ways in which the media manages

to communicate the strong likelihood (or even

inevitability) of an AI pandemic is through the

use of statistics, estimates of probability and

numbers. For example, it is maintained that the

AI pandemic will be disastrous in terms of the

economy (The Australian 2007), and the problem has necessitated massive governmental spending

(such as the ‘$100 million-plus order’ of anti-

virals – Gluyas 2005). These large numbers are

suggestive of the size of the problem. However,

more potent even than these economic fi gures,

are reported estimates of infection and death

tolls. These statistics vary widely, but nonethe-

less are usually large. For example, one article

suggests that ‘over 2.6 million Australians’

would become infected and ‘13,000’ would die

(Kerin 2005), while several others quote one sci-

entist’s estimates of between 5 million to 150

million deaths worldwide (Henderson 2005).

Importantly, the derivation of these fi gures is

never explained, contributing to a generalised

sense of risk.

Sudeepa Abeysinghe and Kevin White

Volume 19, Issue 3, September 2010376

SR H

bioterrorist threats (Rudd 2005). Equally

alarming are comparisons to other infectious

agents that are either highly destructive or

grotesque such as Ebola virus, Nipah virus,

bovine spongiform encephalitis (Kerin 2005;

Maegraith 2004) and (especially common, as

already discussed) the 1918 Spanish Infl uenza.

The language of invasion and war (Cresswell

2006) and images of combat against a stealthily

approaching enemy (Dayton 2005) are simi-

larly used to illustrate the geographical prog-

ress of infection and heighten notions of threat

and attack. As reported in ‘Bird Flu to Strike

UK Exports’, we must ‘live with the constant

threat’ of outbreak (The Australian 2007). In such a way, threatening characterisations of AI

predominated. It is also important to note that

these metaphors and assertions were also fre-

quently performative in that they change the

defi nition of the situation under consideration

(Austin 1962). By framing the phenomena in

this way, the reader is compelled to think and

act as though AI corresponded to these repre-

sented realities.

The communication of risk – the government Through its use of all the abovementioned

devices, it is therefore clear that the media for-

warded a narrative of high risk. However, the

comparison of media and government discourses

provides an interesting juxtaposition. Unlike the

suggestions of threat constructed in the media,

the government narrative regarding risk was

much less menacing. Here, it was suggested that

there is ‘…no evidence that the H5N1 virus can spread effi ciently from human-to-human,

and there is no immediate threat to the health

of Australians’ (Offi ce of Health Protection

2006:6). The Pandemic Plan called for restraint

due to the fact that the government holds an

interest in maintaining an awareness of AI with-

out going to the extent of alarming the pub-

lic over its existence (Gray and Ropeik 2002).

This is also seen in other calming expressions

embedded. In this way, statistics are generated

for political and professional purposes and

refl ect the structure of social relations (Forde

1988; Paterson 1981).

Combined with this use of intimidating fi g-

ures is the concept of certainty in the ampli-

fi cation of risk. In the vast majority of the

newspaper articles pandemic infl uenza was por-

trayed as an inevitability. For example David

Nabarro, leader of the United Nations taskforce

investigating AI, is cited as stating ‘I am almost

certain that there will be another pandemic

soon’ (Powell 2005) and in another instance it is

maintained that ‘Britain’s chief scientist warned

that at least 50,000 British citizens would die

“when, not if” the avian infl uenza took hold

of Britain’ (Gluyas 2005). This second claim

particularly reinforces the notion of inevitabil-

ity; we are told that (a minimum of) 50,000

Britons will die as a result of AI. Such a sug- gestion is guaranteed to heighten perceptions of

threat. Furthermore, it was also reported that

‘H5N1 is considered the biggest disease threat

to humanity’ (The Australian 2005), thereby raising its status above all other health concerns.

This concept of threat was also exaggerated

through reporting of the geographical progress

of the disease, where AI was portrayed not as

sporadic individual cases and clusters but rather

as marching steadily across borders and entire

continents. Here, individual cases in Romania

and Nigeria were depicted as the incursion of

the disease into the whole of Europe and Africa

(Bita 2006).

In addition to numbers, the use of language

heavily mediated the way in which the AI phe-

nomenon was constructed, especially in con-

veying narratives of risk. This is seen through

the description of the H5N1 virus as (to list a

few) ‘deadly’ (Hawkes 2006), ‘aggressive’ (The Australian 2005) and a ‘lethal storm’ (Eccleston 2005), and the comparison of AI with events

which spark panic in the public consciousness

such as the Boxing Day tsunami (Eccleston

2005), Hurricane Katrina (Nason 2005) and

The avian infl uenza pandemic

Volume 19, Issue 3, September 2010 377

SR H

science and medicine fail to adequately explain

it (Herzlich and Pierret 1987).

Furthermore, although the government con-

veyed a less threatening concept of risk than the

media narrative, one of the methods used to

convey the notion of risk in the Pandemic Plan

mirrors a technique used by the media. This is

the reference to past pandemics, including the

Spanish Infl uenza. As already shown, the Spanish

Infl uenza pandemic provides a frame of refer-

ence for AI narratives and links AI with exist-

ing fears. In the same way, an entire segment

of the Plan (section 1.4.) is devoted to a discus-

sion of the history of pandemics. This therefore

depicts AI as rooted in what is conceptualised as

the historical struggle of humanity against infec-

tious disease (Foege 1991; McNeill 1976; Watts

2003). Again, the historical comparison made in

this instance lends to the further creation of risk

perception, through the conceptual linking with

past pandemics. The government narrative of

risk, therefore, while less strident than the media

narrative, nonetheless situates AI as a phenom-

enon of great concern.

SYMBOLIC INDUSTRIES OF RISK The government and the media narratives also

diverge in respect to their depictions of sci-

entifi c solutions to the threat. Here, while the

dominant government narrative appears to mir-

ror that of the media, where scientifi c progress

is upheld through the production of vaccines

and antivirals, a secondary narrative of uncer-

tainty regarding scientifi c progress in regard to

AI occasionally also surfaces. One of the most

interesting facets of the government narrative

regarding science is the oscillation between the

dependence upon antivirals and vaccines and

the acknowledgement that the scientifi c under-

standing of AI has not reached the stage where

the effective production of these is possible. This

confl icting discourse leaves the government in a

position whereby it needs to rely upon vaccines

and antivirals while simultaneously questioning

the effi cacy of such actions. Thus it is suggested

used throughout the Plan, suggesting that there

is ‘little danger’ of effective human transmis-

sion, ‘little chance’ of infection to consumers

of poultry products, and pointing to ‘high stan-

dards’ of infection control and hygiene prac-

tices in Australia. It was thereby maintained that

Australians are at low risk, and effective patterns

of surveillance and safety are likely to keep the

community protected. This is not, however, to

suggest that AI presented no threat at all. AI

‘remains a concern because of the high fatality

rate’ (Offi ce of Health Protection 2006:12), and

because a pandemic is likely to evolve in coun-

tries which do not uphold Australian standards

of sanitation.

Another area where the government dis-

course differs from that produced in the media

is in notion of certainty. Throughout much of

the newspaper reporting, a rhetoric of certainty

was espoused whereby the AI pandemic was

seen as a defi nite future event. In contrast, the

government acknowledged the current lack

of certainty surrounding the phenomenon.

For example, in the introduction to the Plan

it is suggested that ‘the chances of another

infl uenza pandemic are unknown’ (Offi ce of

Health Protection 2006:6). In fact, the con-

cept of uncertainty permeates throughout the

document, not only in regards to the likelihood

of a pandemic but also in regards to the evi-

dence surrounding the phenomenon. Thus it

is suggested that ‘there is no evidence of effi -

cient human-to-human transmission. Scientifi c

opinion about whether H5N1 will become

better adapted is mixed’ (Offi ce of Health

Protection 2006:12). However, although

the media and government narratives of cer-

tainty are opposed, the government’s concept

of uncertainty does not effect to diminish the

notion of risk. Here, the fact that scientists are

uncertain about the future and effects of AI

only tends to reinforce the notion that we have

been caught unprepared. This narrative there-

fore fi ts in with the tendency for societies to

perceive a health threat as more risky where

Sudeepa Abeysinghe and Kevin White

Volume 19, Issue 3, September 2010378

SR H

cause concern. Perhaps as a reaction to such ten-

sions, though the primary narrative is that of

the ability of scientifi c progress to remove these

uncertainties, there is also a competing secondary

narrative. This is appreciable in various instances

where AI is treated as more complex than a

solely technical/scientifi c issue. Furthermore,

in the appendix of the Plan, a narrative of the

fl uid nature of scientifi c facts is also expressed.

This includes the acknowledgement of shifts in

scientifi c thinking (Offi ce of Health Protection

2006:50) and addresses the ‘current evidence’ of

the effi cacy of antivirals. It is even suggested here

(and not in the main document) that the best use

of antivirals may be in a containment strategy:

…there is no conclusive data showing that anti- viral treatment can save lives. In the absence of such evidence, some individuals with pan- demic infl uenza will receive treatment, because it can decrease the spread of the virus (Offi ce of Health Protection 2006:49).

The use of antivirals to control pandemic

spread (and not primarily as treatment) is an

interesting concept, but one which is likely to be

controversial. It is perhaps telling that this narra-

tive of antivirals as containment is not introduced

in the main document (where a symbolic argu-

ment of antivirals as treatment is presented) but

only in the appendix. Thus, although scientifi c

dominance is evident throughout AI narratives,

the position of science and scientifi c industries

in coping with the risk is generally symbolic and

somewhat confl icted.

CONCLUSION This research demonstrates the social location of

contemporary debates surrounding pandemics

in socio-historical collective memories. Utilising

the work of Durkheim on social representations

and of Beck on risk, it was shown how these two

theoretical constructs can be useful heuristically:

social representations and risks are synergisti-

cally refl exive, and we show how this process

has manifested itself in this particular case study.

that a vaccine which ‘gives good protection

against a pandemic virus can only be developed

after that strain appears’, yet it is also maintained

in the very next paragraph that:

…it is possible that a vaccine using the [cur- rent] H5N1 strain of infl uenza may give partial protection if that strain changes and spreads more easily among humans…The government is committed to buying a substantial amount of the H5N1 vaccine [against the current strain] as soon as it is proven safe and effective. (Offi ce of Health Protection 2006:13).

Note the numerous qualifi ers (possible, may,

partial, if) that indicate the uncertainty of the

proposition that a vaccine using the current

strain will be effective. However, despite this high

degree of uncertainty, the government had made

a sizable economic commitment to stockpil-

ing these vaccines. This decision is replicated in

the case of antiviral medications. Here it is sug-

gested that ‘evidence about the effectiveness of

antivirals is limited and mixed’ (Offi ce of Health

Protection 2006:13), however:

…antivirals may have some effectiveness in preventing infection and in treating pandemic infl uenza. Antivirals have received much atten- tion in Australia as a possible response…the National Medical Stockpile includes one of the largest per capita supplies of antivirals any- where in the world (Offi ce of Health Protection 2006:13).

Again, although the government acknowl-

edges that the effi cacy of antiviral use is question-

able, a commitment is made to the stockpiling of

this medication.

However, although it is evident that the gov-

ernment subscribes to these symbolic industries,

it is also clear throughout the Pandemic Plan that

these measures raise numerous questions. It is

not only the effi cacy, but also the timing of the

administration of medication, the possibility of

viral adaptation causing antiviral resistance, and

the equitable distribution of medication which

The avian infl uenza pandemic

Volume 19, Issue 3, September 2010 379

SR H

The Australian (2005) ‘EU scrambles as bird fl u moves west’ 15 October 2005: 19.

The Australian (2007) ‘Bird fl u to strike UK exports’ 6 February 2007: 8.

Barry, J. M. (2004) The great infl uenza: The epic story of the deadliest plague in history Penguin: London.

Bartholomew, D. J. (1995) ‘What is statis-

tics?’ Journal of the Royal Statistical Society 158(1):1–20.

Bashford, A. (2002) ‘At the border: Contagion,

immigration, nation’ Australian Historical Studies 120:345–348.

Bashford, A.; and Strange, C. (2003) ‘Isolation

and exclusion in the modern world’ in Strange,

C. and Bashford, A. (eds) Isolation: Places and practices of exclusion Routledge, London: pp. 1–21.

Beck, U. (1992) Risk society: Towards a new moder- nity Sage Publications: London.

Best, J. (2001) Damned lies and statistics: Untangling numbers from the media, politi- cians, and activists University of California: Berkeley.

Best, J. (2008) ‘Birds – dead and deadly: Why

numeracy needs to address social construction’

Numeracy 1(1):1–14. Bita, N. (2006) ‘All eyes on the enemy waiting by

our door’ The Australian 8 July 2006: 24. Cresswell, A. (2006) ‘Bird fl u sparks multi-

talented infections test’ The Australian 25 February 2006: 28.

Cresswell, A.; and Murphy, K. (2005) ‘Qantas

asked to bring Aussies home if bird fl u strikes’

The Australian 27 October 2005: 1. Crosby, A. W. (1976) Epidemic and peace

Greenwood Press: Westport.

Dayton, L. (2005) ‘Science races bird fl u clock’

The Australian 29 October 2005: 28. Douglas, M. (1992) Risk and blame: Essays in cul-

tural theory Routledge: London. Durkheim, E. (1915 [1965]) The elementary forms of

the religious life Free Press: New York. Eccleston, R. (2005) ‘Pandemic on the wing’ The

Australian 9 September 2005: 15. Edy, J. (1999) ‘Journalistic uses of collective

memory’ Journal of Communications Spring 49 (2):71–85.

Two sources of social representations of Avian

Infl uenza were analysed. The government and

the media sources analysed here have similari-

ties and differences. Both produce narratives

situating avian infl uenza through the collective

memory of the (catastrophic) Spanish Infl uenza

pandemic. However, while the media emphasise

threat and risk and calls for a scientifi c, antiviral-

based solution, the government is more circum-

spect and neither amplifi es the risk nor promises

solutions which cannot be delivered. This leaves

it with a problem which is resolved by appeal to

the symbolic industries of risk prevention; in this

case the antivirals. Hence symbolic representa-

tions of disease lead to symbolic solutions. Future

research in this area could move into other sub-

stantive areas of sociological interest, mobilising

both the theoretical and methodological frame-

works established in this paper. In particular this

includes the shaping of the pandemic discourse

by other stakeholders such as pharmaceutical

companies, who given the emphasis antiviral

and vaccines, are likely to be key to the pan-

demic response. Other research could also focus

on the way in which representations of disease

act as barometers of social integration, for exam-

ple, examining the attribution of blame through

exclusionary discourses.

ACKNOWLEDGEMENTS The authors would like to thank the anony-

mous reviewers of this paper for their helpful

comments and forbearance during the review

process.

References Arber, A. (1954) The mind and the eye: A study of

the biologist’s standpoint Cambridge University Press: Cambridge.

Atkinson, R. T. (2000) ‘Narrative of policy:

The construction of urban problems and

urban policy in the offi cial discourse of British

Governments 1968-1998’ Critical Social Policy 20:211–232.

Austin, L. J. (1962) How to do things with words Clarendon Press: Oxford.

Sudeepa Abeysinghe and Kevin White

Volume 19, Issue 3, September 2010380

SR H

Fleck, L. (1979) Genesis and development of a scien- tifi c fact University of Chicago Press: Chicago.

Foege, W. H. (1991) ‘Plagues: Perception of risk

and social responses’ in Mack, A. (ed.) In the time of plague: The history and social consequences of lethal epidemic disease New York University Press: New York, pp. 9–21.

Forde, O. (1988) ‘Is imposing risk awareness

cultural imperialism?’ Social Science and Medicine 47(9):155–159.

Franzosi, R. (1998) ‘Narrative analysis – Or why

(and how) sociologists should be interested in

narrative’ Annual Review of Sociology 24:517–554. Gluyas, R. (2005) ‘Flu drug will be made in

Australia’ The Australian 18 October 2005: 3. Graves, C. (1969) Invasion by virus: Can it happen

again? Icon Books: London. Gray, G. M.; and Ropeik, D. P. (2002) ‘Dealing

with the dangers of fear: The role of risk com-

munication’ Health Affairs 21(6):106–116. Halbwachs, M. (1992) On collective memory Coser,

L.A. (trans/ed) University of Chicago Press:

Chicago.

Hastings, A. (1998) ‘Connecting linguistic struc-

tures and social practices: A discursive approach

to social policy analysis’ Journal of Social Policy 27(2):191–211.

Hawkes, N. (2006) ‘Bird fl u “more widespread but

less deadly” ’ The Australian 11 January 2006: 9. Henderson, M. (2005) ‘Summit on global bird fl u

response’ The Australian 7 October 2005: 10. Herzlich, C.; and Pierret, J. (1987) Illness and self in

society Johns Hopkins University Press: London. Heyman, B.; Henriksen, M.; and Maughan, K.

(1998) ‘Probabilities and health risks – A

qualitative approach’ Social Science and Medicine 47:1295–1306.

Hindess, B. (1973) The use of offi cial statistics in soci- ology: A critique of positivism and ethnomethodology McMillan Press: London.

Hyslop, A. (1994) ‘Old ways, new means:

Fighting Spanish infl uenza in Australia’ in

Bryder, L. and Dow, D. A. (eds) New countries and old medicine: Proceedings of an International Conference on the History of Health and Medicine Pyramid Press: Auckland, pp. 54–60.

Inglis, F. (1990) Media theory: An introduction Basil Blackwell Inc.: Oxford.

Kerin, J. (2005) ‘Customs seizures in bird fl u alert’

The Australian 26 September 2005: 7. Kerin, J.; and Mayes, A. (2005) ‘Army may help if

bird fl u hits’ The Australian 6 October 2005: 3. Lockie, S.; Lyons, K.; and Lawrence, G. (2000)

‘Constructing green foods: Corporate capi-

tal, risk, and organic farming in Australia and

New Zealand’ Agriculture and Human Values 17:315–322.

Lupton, D. (1994) Moral threats and dangerous desires: AIDS and the news media Taylor and Francis: London.

Maegraith, D. (2004) ‘Across the species divide’

The Australian 26 January 2004: 10. Marková, I.; and Farr, R. (1995) Representations

of health, illness, and handicap Harvard Academic Publishers: Chur.

McCracken, K.; and Curson, P. (2005) ‘Flu of the

past has lessons for the future’ The Australian 19 November 2005: 29.

McNeill, W. H. (1976) Plagues and peoples Anchor Press: New York.

Meštrović, S. G. (1988) Émile Durkheim and the reformation of sociology Rowman and Littlefi eld Publishers: Totowa.

Monto, A. S. (2005) ‘The threat of an avian infl u-

enza pandemic’ New England Journal of Medicine 352(4):323–325.

Moscovici, S. (1988) ‘Notes towards a description

of social representations’ Journal of European Social Psychology 18:211–250.

Nason, D. (2005) ‘US vows $9.5 bn to control

bird fl u’ The Australian 3 November 2005: 10. Nerlich, B.; and Halliday, C. (2007) ‘Avian fl u:

The creation of expectations in the interplay

between science and the media’ Sociology of Health and Illness 29(1):46–65.

Offi ce of Health Protection. (2006) Australian health management plan for pandemic infl uenza. Department of Health and Ageing, Federal

Government of Australia: Canberra.

Olick, J.; and Robbins, J. (1998) ‘Social memory

studies: From “collective memory” to the

historical sociology of mnemonic practices’

Annual Review of Sociology 24:104–140. Paterson, K. (1981) ‘Theoretical perspectives in

epidemiology – A critical approach’ Radical Community Medicine 2:23–33.

The avian infl uenza pandemic

Volume 19, Issue 3, September 2010 381

SR H

Tognotti, E. (2003) ‘Scientifi c triumphalism and

learning from the facts: Bacteriology and the

‘Spanish Flu’ challenge of 1918’ The Journal of the Society for the Social History of Medicine 16(1):97–110.

van Loon, J. (2002) Risk and technological culture: Towards a new modernity Routledge: London.

Ward, I. (2002) ‘Media power’ in Summers, J.;

Woodward, D.; and Parkin, A. (eds) Government, politics, power and policy in Australia Pearson Education: Frenchs Forest, pp. 401–415.

Watts, S. (2003) Disease and medicine in world history Routledge: New York.

Wood, A. (2006) ‘Let’s be vigilant about the (low)

risk of bird fl u’ The Australian 19 April 2006: 12. World Health Organisation. (2008) Avian

infl uenza: Timeline of major events World Health Organization: Geneva available at: http://

www.who.int/csr/disease/avian_infl uenza/

Timeline_08_06_17.pdf. (Accessed 03 July

2008).

Received 16 December 2009 Accepted 09 June 2010

Petts, J.; Horlick-Jones, T.; and Murdock, G. (2001)

The social amplifi cation of risk: The new media and the public HSE Books: Sudbury.

Phillips, H.; and Killingray, D. (2003) ‘Introduction’

in Phillips, H. and Killingray, D. (eds) The Spanish infl uenza pandemic of 1918-1919: New perspectives Routledge: London, pp. 1–26.

Powell, S. (2005) ‘Indonesia desperately lacks bird

fl u drugs’ The Australian 1 October 2005: 12. Rosenberg, C. (1989) ‘Disease in history: Frames

and framers’ The Milbank Quarterly 67(Suppl. 1):1–16.

Rudd, K. (2005) ‘Downer ducks bird fl u’ The Australian 1 October 2005: 24.

Smith, A. (1985) ‘The epidemiological basis of

community medicine’ in Smith, A. (ed.) Recent advances in community medicine 3 Churchill Livingstone: Edinburgh.

Sontag, S. (1978) Illness as metaphor Penguin: Harmondsworth.

Taubenberger, J. K.; and Morens, D. M. (2006)

‘1918 Infl uenza: The mother of all pandem-

ics’ Emerging Infectious Disease 12(1):15–22.

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