1918-1920 — Influenza and Pneumonia Pandemic — Nationwide ~820,000-850,000
Compiled by B. Wayne Blanchard Oct 2009; modified Jan 2010, Feb 2013, Aug 2013, Oct-Nov 2013, Jan 2014, Dec 2014, Jan 2015, June 2018 and Jan 2020 for website: Deadliest American Disasters and Large-Loss-Of-Life Events. https://www.usdeadlyevents.com/
— ~820,000-850,000. Blanchard range.*
— 850,000 Dauer, Dr. C. C. “The Pandemic of Influenza in 1918-19.” U.S. PHS, 7-19-1957.§
— 850,000 Rosenberg/Peck. “Megadeaths.” Bryant. Handbook of Death & Dying. 2003, 230.
— 845,025 Blanchard high tally. Flu/pneumonia, civilian/military (1918) from State breakouts.
— 819,675 Blanchard low tally. Flu/pneumonia, civilian/military (1918), from State breakouts.
— 700,000 High-end of range. Rockafellar. “‘In Gauze We Trust’…” Pacific NW Quarterly, 111.
— 675,000 Armstrong. Philadelphia, Nurses…Spanish Influenza Pandemic…1918. 2001, 16-20.
— 675,000 Billings, Molly. “The Influenza Pandemic of 1918.” June 1997, modified Feb 2005.
— 675,000 Iezzoni, Lynette. Influenza 1918: The Worst Epidemic in American History. 1999.
— 675,000 Phillips & Killingray (Eds.). The Spanish Influenza Pandemic of 1918-19. 2003, 7.
— 675,000 Ryan, J.R. (Ed.). Pandemic Influenza: Emer. Planning and Community Prep. 2009.
— 675,000 Taubenberger and Morens. “Influenza: The Once and Future Pandemic.” PHR, 2010
— 660,000 Shay, David K. Influenza Pandemics of the 20th Century. CDC, 4-20-2005, slide 30.
— 650,399 Dauer, Dr. C. C. “The Pandemic of Influenza in 1918-19.” U.S. PHS, 7-19-1957.[1]
–<600,000 PBS. “Timeline: Influenza Across America in 1918,” Influenza 1918. 1999.
–<550,000 Shay (80% pop. covered). Influenza Pandemics of the 20th Century. 4-20-2005, slide 8
–~550,000 Stern, Cetron, & Markel. “The 1918-1919 Influenza…” Public Health Rpts., 2010.
— 546,000 Excess flu deaths. Taubenberger/Morens. “Influenza…Once and Future Pandemic.” PHR, 2010.
–>500,000 State of Delaware, Dept. of Health. Delaware Pandemic Influenza Plan. July 2008.
–~500,000 US Dept. HHS. Pandemics and Pandemic Scares in the 20th Century. 2-12-2004 rev.
–~500,000 Kolata, Gina. Flu: The Story of the Great Influenza Pandemic of 1918…” 1999, 5.
— 500,000 Low-end of range. Rockafellar. “‘In Gauze We Trust’…” Pacific NW Quarterly, 111.
— 500,000 Rosenberg/Peck. “Megadeaths,” 231 in Bryant. Handbook of Death…Dying, 2003.
* Blanchard note: In seeking to better understand such a large range, a reading of the sources indicates a number of variables. Some sources, particularly at the lower end, focus on influenza deaths. The larger numbers include influenza and the pneumonia deaths (more than previous years) were attributed to influenza as the cause.
- Dauer note: “It has been estimated that there were about 20,000,000 cases of influenza and pneumonia in the United States in 1918-19, with approximately 850,000 deaths. In 1918 alone, 464,959 deaths from influenza and pneumonia were registered in the registration States [30] and the District of Columbia as compared with 115,526 in 1917 [27 registration States]. This includes deaths in the Army, Navy, and Marine Corps which occurred in registration States. Eighty percent of the deaths in 1918 occurred in the last 4 months of the year.” Dauer adds that “A number of States in which Army camps were located are not included [in the registration States] …so a considerable number of deaths of civilians and of military personnel for 1918-19 are missing which accounts for the difference in an estimated total of 850,000 for the United States and the figure of 650,399 for the registration States.”
Nationwide Subsets:
1917: (115,526) Dauer, C. C. “The Pandemic of Influenza in 1918-19.” U.S. PHS, 7-19-1957.
1918: (430,000-543,482) – influenza and pneumonia
–543,482 Blanchard high tally. Influenza/pneumonia; State breakouts and US Army/Navy.
–519,122 Blanchard low tally, State/local breakouts below, including Army and Navy.
–479,000 Flu and pneumonia. Crosby. America’s Forgotten Pandemic, 2003, 206.
–477,467 33 registration states & DC, flu/pneumonia. Census. Mortality Statistics, 1918, p. 27.
–464,959 Dauer. “The Pandemic of Influenza in 1918-19.” USPHS, 7-19-1957. (Just “Reg. states.)
–430,000 Flu and pneumonia in 1918. KY State Med Assoc. KY Med Jour., V19, 624.
–261,429, Sep-Dec (reporting States). U.S. PHS. Annual Report for FY 1920, p. 212.
— 8,229 Sep 1918.
–140,543 Oct 1918.
— 61,186 Nov 1918.
— 51,471 Dec 1918.
— 200,000, Sep-Nov. Armitage. “The Deadly Pandemic of 1918.”
–189,000 Influenza. Crosby. America’s Forgotten Pandemic, 2003, 206.
Sep 1918-Apr 1919:
— 363,000. 28 States, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p. 212.
Sep 1918-June 1919 (adjusted).
— 675,000. Influenza and pneumonia. Crosby 2003, 206.*
— 549,000. Influenza. Crosby 1989, 206
* Crosby note: “How many Americans of all categories, civilian and military, dies? In 1918, 479,000 died of flu and pneumonia, and in the next year, 189,000. These deaths were concentrated heavily in the last third of 1918 and the first half of 1919. The number of deaths for those ten months was approximately 549,000. But even this colossal number is too low because the Registration Area from which the raw data were drawn in 1918 and 1919 contained only about 80 percent of the nation’s population. The figure must be increased by a fourth of itself. The best estimate for the number of Americans who died of flu and pneumonia from September 1918 to June 1919 is 675,000,” (p. 206)
1919: (101,851-185,440) – influenza and pneumonia
–185,440 Influenza and pneumonia, 33 registration area States and DC. Dauer 1956.[2]
–159,944 Blanchard high range. Flu/pneumonia, State breakouts/Puerto Rico/Army/Navy in US
–158,743 Blanchard low range. Flu/pneumonia, State breakouts/Puerto Rico/Army/Navy in US.
–146,710 Flu and pneumonia, 37 registration States & DC. Mortality Statistics 1919. 1921, p. 7.
–113,000 Influenza and pneumonia, registration States, Jan-Apr. U.S. PHS. 1920, p. 211.
–101,851, Jan-Apr. Influenza/pneumonia, 28 registration States, USPHS. 1920 An. Rpt., p.212.
–43,734 Jan. Influenza and pneumonia,
–22,959 Influenza and pneumonia, Feb.
–22,378
–12,780
— 84,113 Influenza. Census. Mortality Statistics 1920. p. 31.
— 82,217 Influenza US, extrapolation based on 1919 reg. area rate x 1919 estimated US pop.[3]
— 64,493 Pneumonia, registration States. Census. Mortality Statistics 1919. p. 17.
1920: (141,609-220,798 – Influenza and pneumonia.)
–220,798 Influenza and pneumonia deaths, 1920 census pop and Mortality Statistics 1920.*
–192,052 Influenza and pneumonia deaths, 1910 census pop and Mortality Statistics 1920.[4]
–182,205 Influenza and pneumonia, registration area. Mortality Statistics 1920. 1922, p. 17, 51.
–145,538 Pneumonia (US, 1920 census pop.) Census. Mortality Statistics 1920. p. 18.[5]
–141,609 Influenza and pneumonia, State and local breakouts below. Blanchard estimate.
–134,449 Influenza and pneumonia (registration area). Mortality Statistics 1920. 1922, p. 17.
–126,590 Pneumonia (1910 census pop.) Census. Mortality Statistics 1920. p. 18.[6]
–120,108 Pneumonia. Census. Mortality Statistics 1920. p. 51.[7]
— 75,260 Influenza (1920 census pop.) Census. Mortality Statistics 1920. p. 18. [8]
— 72,362 Pneumonia (registration area). Census. Mortality Statistics 1920. p. 17.
— 65,462 Influenza (1910 census pop.) Census. Mortality Statistics 1920. p. 18.[9]
— 62,097 Influenza (registration area).§ Census. Mortality Statistics 1920. p. 17.⁑
* Blanchard extrapolation using registration area death-rates for influenza and pneumonia and 1920 US census pop. The population of the registration area (34 States, DC, 16 cities in non-registration States) was reported as 87,745,921. (Census bureau, William M. Steuart, letter of transmittal, 3-6-1922, p. 5.)
- The “registration” States in 1920 were: CA, CO, CT, DE, FL, IL, IN, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NH, NJ, NY, NC, OH, OR. PA, RI, SC, TN, UT, VE, VA, WA, WI and DC and Territory of HI.
⁑ “The mortality rate from influenza and pneumonia (all forms) for the registration area in 1920 is 208.3 against 222.3 in 1919, and 587 in 1918. An epidemic of considerable proportions marked the early months of 1920 — an epidemic which caused 33 per cent as many deaths as the great pandemic of 1918-19.” (p. 29).
1918 (Low) 1918 (High) 1919 (Low) 1919 (High) 1920 Total (Low) Total (High)
AL 11,328 11,328 5,035 5,035 384 16,765 16,765
AK 1,500 1,500 —— —— —— 1,500 1,500
AZ 2,252 2,252 —— —— —— 2,252 2,252
Ark 4,165 7,000 1,449 1,449 —— 7,000 8,449
CA 15,747 15,747 5,928 5,928 5,846 27,521 27,521
CO 5,762 6,938 1,976 2,363 2,718 10,456 12,019
CT 7,602 8,630 1,583 2,367 3,088 12,274 14,086
DE 1,505 1,505 508 508 468 2,481 2,481
DC 2,572 2,572 744 744 749 4,065 4,065
FL 4,117 4,117 1,165 1,165 827 6,109 6,109
GA >2,192 >2,192 1,508 1,508 490 >4,190 >4,190
HI 149 149 459 459 866 1,474 1,474
ID 9,000 9,000 ——- ——- ——- 9,000 9,000
IL 26,098 26,098 8,922 8,922 13,919 48,942 48,942
IN 9,021 9,021 4,956 4,956 6,230 14,800 14,800
IA 7,954 7,954 ——- ——- ——– 7,954 7,954
KS 6,820 6,820 2,904 2,904 3,201 12,925 12,925
KY 11,771 13,640 6,820 6,820 4,776 23,367 25,236
LA 7,711 7,711 3,310 3,310 2,869 13,890 13,890
ME 3,467 3,800 1,200 1,230 1,759 6,416 6,789
MD 9,494 9,494 2,604 2,604 2,925 15,023 15,023
MA 17,947 45,000(Jan 1919) 4,513 4,513 7,735 30,095 57,248
MI 6,443 6,700 4,997 4,997 5,459 16,899 17,156
MN 7,521 7,740 3,055 3,055 1,512 12,088 12,307
MS 6,219 6,219 4,687 4,687 957 11,863 11,863
MO 15,173 15,727 7,004 7,004 4,021 26,198 26,752
MT 3,982 3,982 1,217 1,217 880 6,079 6,079
NE 4,332 4,332 1,678 1,678 1,862 7,872 7,872
NV 734 800 ——- ——- ——- 734 800
NH 2,000 2,000 1,024 1,024 883 3,907 3,907
NJ 16,837 23,545 5,344 5,344 4,150 26,331 33,039
NM 5,000 5,000 ——- ——- ——- 5,000 5,000
NY 46,993 46,993 18,729 18,729 21,734 87,456 87,456
NC 12,600 13,600 5,955 5,955 5,621 24,176 25,176
ND 2,367 2,367 1,097 1,097 ——– 3,464 3,464
OH 22,099 22,099 9,904 9,904 11,702 43,705 43,705
OK 5,304 5,304 2,254 2,254 ——– 7,558 7,558
OR 2,063 2,063 1,158 1,158 1,331 4,552 4,522
PA 64,724 67,000 20,494 20,494 12,582 97,800 100,076
RI 3,205 3,205 ——- ——– 1,169 4,374 4,374
SC 6,711 6,711 3,012 3,012 675 10,398 10,398
SD 2,108 2,108 ——- ——- ——- 2,108 2,108
TN 7,721(1918-19) 7,721 ——- ——- 1,353 9,074 9,074
TX 14,121 14,121 1,150 1,150 1,384 16,655 16,655
UT 1,828 2,282 1,031 1,031 414 3,273 3,737
VT 1,709 1,800 519 519 124 2,352 2,442
VA 11,951 11,951 5,177 5,177 1,426 18,554 18,554
WA 4,943 5,781 1,910 1,910 1,262 8,115 8,953
WV 2,818 2,818 156 156 190 3,164 3,164
WI 8,022 8,549 3,202 3,022 2,077 13,301 13,828
WY 813 813 362 362 ——- 1,175 1,175
Army 37,626 44,000 ——- ——- ——- 37,626 44,000
Navy 4,000 5,000 ——- ——- ——- 4,000 5,000
- Rico ——- ——– 1,873 1,873 ——- 1,874 1,874
Total 519,122 543,482 158,743 159,944 141,609 819,675 845,035
Influenza and Pneumonia Mortality by Age: Death Registration States, 1917-19*
| Age | 1917 1918 1919
Number of deaths |
||
| All ages | 115,526 | 464,959 | 185,440 |
| Under 1 year | 22,207 | 38,428 | 27,736 |
| 1-4 years | 12,859 | 49,699 | 21,133 |
| 5-14 years | 3,319 | 28,054 | 10.598 |
| 15-24 years | 4,861 | 78,158 | 20,381 |
| 25-34 years | 6,915 | 126,792 | 32,159 |
| 35-44 years | 9,387 | 60,902 | 20,690 |
| 45-54 years | 10,652 | 28,596 | 14,043 |
| 55-64 years | 12,571 | 19,632 | 12,530 |
| 65-74 years | 14,771 | 17,643 | 13,065 |
| 75-84 years | 13,224 | 11,829 | 9,548 |
| 85 years and over | 4,600 | 3,680 | 3,173 |
| Not stated | 160 | 1,546 | 384 |
* Dauer. “The Pandemic of Influenza in 1918-19.” US PHS, National Office of Vital Statistics. 7-19-1957. Dauer notes that “For 1919, area includes 27 States and the District of Columbia; for 1918, 30 States and the District of Columbia; and for 1919, 33 States and the District of Columbia.”
State and Locality Breakouts:
Alabama (16,765)
1918: (11,328)
–11,328 State. AL State Board of Health. Annual Report…Years 1919-20, 1922, p. 60.[10]
–5,447 influenza –5,882 pneumonia
— 7,854 “ Sep-Dec flu/pneumonia. US PHS. An. Rpt…Surgeon Gen…1919. 1920, p. 186.*
— 125 Sep
–3,703 Oct
–2,221 Nov
–1,805 Dec
— 1,486 “ US PHS. Public Health Reports, V34/Pt. 2/N31, 8-1-1919. 1920, p. 1696.
–871 registered influenza
–615 registered pneumonia
–135 Birmingham, Oct 20-26, 1918. HHS. “Alabama.” The Great Pandemic.
— 326 Camp McClellan, 1918, disease. War Dept. An. Rpts., 1919… . 1920, 1833.
— 143 Camp Sheridan ~Montgomery, Oct 1918. War Dept. An. Rpts., 1919… . 1920, 1913.
* Notes that “Influenza was not reportable at the beginning of the epidemic, and the morbidity figures are obviously incomplete.”
Alabama (continued)
1919: (5,053)
–5,053 State. AL State Board of Health. Annual Report…for…Years 1919-20, 1922, p. 25.
–2,332 Influenza
–2,721 Pneumonia
–4,030 Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: ( 384)
— 384. Birmingham, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Alaska (>1,500)
1918: (>1,500)
—>1,500 Natives. Blanchard estimate.*
— 750 Natives, 3 villages. HHS Flu.gov. The Great Pandemic of 1918: State by State.[11]
— 72 Brevig Mission (of 80.), Nov 15-20. Rozell. “Villager’s Remains Lead to 1918 Flu…”
— 176 Nome, Native-Alaskans. Brown. “Epidemics and Pandemic Flu of 1918-1919.”
— 199 Teller, Inupiat. Griest. “The Big Sickness.” 2006 modification.
— 197 Wales (Nome district), Native-Alaskans. Griest. “The Big Sickness.” 2006 mod.
* Chart on p. 78 of Report of the Governor of Alaska to the Secretary of the Interior. 1921, notes that recorded native deaths jumped from 600 in 1917 to 2,123 in 1918, and then down to 751 in 1919. We subtracted 600 from 2,123 to get approximately 1,500. We believe this to be a very low estimate given inadequate specific reporting at the time, other than the loss of life was great, with villages being decimated.
Arizona (2,252)
1918: (2,252)
–2,252 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, p186.
“ — 20 Sep
“ — 848 Oct
“ –1,008 Nov
“ — 376 Dec
— 17 Clarkdale. Peterson. “The Killer Flu of 1918,” CVBugle.com, Camp Verde, 10-20-2009.
— 80 Flagstaff. Stone. “The ‘Scythe’: Spanish Influenza in Northern Arizona, 1918, Part II.”
— 147 “ Arizona Daily Sun, “Flagstaff and the Spanish Flu of 1918,” Jan 22, 2006
— 13 Fort Whipple. Stone. “The ‘Scythe’: Spanish Influenza in Northern AZ, 1918, Part II.”
— 44 Jerome. Peterson, “The Killer Flu of 1918,” CVBugle.com, Camp Verde, 10-20-2009
— 21 “ Stone. “The ‘Scythe’: Spanish Influenza in Northern Arizona, 1918, Part II.”
— 15 Seligman. Stone. “The ‘Scythe’: Spanish Influenza in Northern Arizona, 1918, Part II.”
— 1 Snowflake. Stone. “The ‘Scythe’: Spanish Influenza in Northern Arizona, 1918, Part II.”
— 16 Verde. Peterson, “The Killer Flu of 1918,” CVBugle.com, Camp Verde, 10-20-2009
— 30 Winslow. Stone. “The ‘Scythe’: Spanish Influenza in Northern Arizona, 1918, Part II.”
Arkansas: (5,614-8,449)
1918: (4,165~7,000)
–~7,000 State. Hendricks. “Flu Epidemic of 1918,” Encyclopedia of Ark. Hist. & Culture. 2008.
— 4,165, State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. P. 186.
“ — 91 Sep
“ –1,708 Oct
“ –1,021 Nov
“ –1,345 Dec
— 460 Camp Pike, ~Little Rock, Sep-Oct, 1918, disease. War Dept. An. Rpts., 1919…p. 1875.
1919: ( 1,449)
— 1,449. Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 212.
California: (27,521)
1918: (15,747)
–15,747 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919, p. 186.
— 203 Sep
–5,381 Oct
–6,505 Nov
–3,658 Dec
— 175 Camp Fremont. War Dept. An. Rpts., 1919… Surg. Gen. 1920, p. 1645.
— 187 Camp Kearney (~San Diego), 1918, disease. War Dept. An. Rpts., 1919. 1920, p.1767.
— 2,772 Los Angeles US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919, p.1696.
–2,002 registered influenza deaths
— 679 registered pneumonia deaths
–22 LA, Oct 13, 1918. Van Nuys News. “Influenza Halts Public…,” 10-18-1918.
–11 Oct 14, 1918. Van Nuys News. “Influenza Halts Public…,” 10-18-1918.
— 1,024 Oakland US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p. 1696.
“ –679 registered influenza deaths
“ –345 registered pneumonia deaths
“ –491 Oct 2-Nov 9. Oakland Tribune. “Increase in Influenza…” 11-9-1918.
— 3,500 San Francisco. Minnix. “Behind the Numbers…Influenza Pandemic…1918/19…U.S.”
— 3,420 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p. 1696.
“ –2,396 registered influenza deaths
“ –1,024 registered pneumonia deaths
— 2,122 “ PBS. “Timeline: Influenza Across America in 1918,” Influenza 1918.
–21 “ Dec 27. Oakland Tribune, “Decrease is Shown in S.F. ‘Flu’ Cases,” 12-17-1918
1919: (5,928)
–5,928 “ Jan-Apr. U.S. Public Health Service. Annual Report for FY 1920, p. 213.
1920: (5,846)
–5,890 State, flu/pneumonia/bronchopneumonia/acute bronchitis. Mortality Stats. 1920. 314-15.
–5,846 “ year. Extrapolation, 1920 fatality rate, influenza & pneumonia, x 1920 est. pop.[12]
–5,725 “ flu, pneumonia, bronchopneumonia. Mortality Statistics 1920. 1922, p. 314-15.
–4,262 “ flu and pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p. 314-15.
–2,185 “ influenza. Census Burear. Mortality Statistics 1920. p. 314.
–2,077 “ pneumonia. Census Bureau. Mortality Statistics 1920. p. 315.
–1,463 “ bronchopneumonia. Census Bureau. Mortality Statistics 1920. p. 315.
— 165 “ acute bronchitis. Census Bureau. Mortality Statistics 1920. p. 315.
— 444 Los Angeles, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 295 Oakland, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 730 San Francisco, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Colorado: (12,116)
1918: (5,762-6,938)
–6,938 State, Jan-Dec, flu/pneumonia. Census Bureau. Mortality Statistics 1918. p. 28.
–1,206 “ Jan-Aug, flu/pneumonia. Census Bureau. Mortality Statistics 1918. p.28.[13]
–5,732 “ Sep-Dec, flu/pneumonia. Census Bureau. Mortality Statistics 1918. p. 28.
–1,891 Denver. US PHS. Pub. Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
— 161 registered influenza deaths
–1,730 registered pneumonia deaths
— 146 Silverton, Oct 19-Dec 14, 1918. Leonard. “The 1918…,” Denver Post, 5-3-2009.
1919: (1,976-2,363)
–2,363 State, year. Extrapolation, 1919 mortality rate, flu & pneumonia x 1919 est. pop.[14]
–1,976 State, Jan-Apr. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: (2,718)
–2,718 State, bronchopneumonia, flu, pneumonia. Census. Mortality Statistics 1920. p. 317-18.
— 577 “ bronchopneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 318.
–1,049 “ influenza. Census Bureau. Mortality Statistics 1920. 1922, p. 317.
–1,092 “ pneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 318.
— 603 Denver, Jan-Mar. U.S. PHS. Annual Report for FY 1920, p. 200.
Connecticut: (12,274-14,086)
1918: (7,602-8,630)
–8,630 State, Sep-Dec, flu/pneumonia. USPHS. An. Rpt. …Surg. Gen.…1919. 1920, p. 186.
— 448 Sep.
–5,823 Oct.
–1,297 Nov.
–1,062 Dec.
–1,600 Peak week. HHS Flu.gov. The Great Pandemic of 1918: State by State.
–7,602 “ State of CT. “Influenza Epidemic of 1918-1919,” 1920, p. 272.
–1,139 Bridgeport, year. US PHS. Pub. Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–432 registered influenza
–707 registered pneumonia
— 985 Hartford. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–692 registered influenza –293 registered pneumonia
— 300 Hartford, Nov. HHS Flu.gov. The Great Pandemic of 1918: State by State.
–1,288 New Haven. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
–796 registered influenza deaths
–492 registered pneumonia deaths
Connecticut (continued)
1919: (1,583-2,367)
–2,367 Statewide, Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
–1,583 Statewide. State of CT. Public Docs…State…CT, V. IV, Pt.1, 1920. 1921, p17
1920: (3,089)
–3,089 State, year. Extrapolation, 1920 flu and pneumonia mortality rate x 1920 pop.[15]
–3,089 “ bronchopneumonia, flu, pneumonia. Census. Mortality Statistics 1920. pp. 320-21.
— 894 “ bronchopneumonia. Census Bureau. Mortality Statistics 1920. p. 321.
— 918 “ influenza. Census Bureau. Mortality Statistics 1920. p. 320.
–1,277 “ pneumonia. Census Bureau. Mortality Statistics 1920. p. 321.
— 288 New Haven, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Delaware: (2,481)
1918: (1,505)
–1,505 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. …Surgeon General…1919. p. 186.
— 75 Sep.
–1,223 Oct.
–389 Oct 4-14. HHS. “Delaware” The Great Pandemic…[U.S.] in 1918-1919.
— 97 Nov.
— 110 Dec.
1919: ( 508)
— 508 Statewide, Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: ( 468)
— 468 State, year. Extrapolation, 1920 influenza and pneumonia mortality rate x 1920 pop.[16]
District of Columbia: (4,065)
1918: (2,572)
–2,572 DC, Sep-Dec, flu/pneumonia. US PHS. Annual Rpt. of the Surg. Gen.…1919. p. 186.
— 88 Sep –1,809 Oct — 199 Nov — 476 Dec
–2,028 “ registered flu US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p1697.
— 12 Sep (prior to Sep 30) WP. “City Fights Grippe with Severe Steps,” Oct 3, 1918, 1.
— 7 Sep 30 (24-hr period). Washington Post. “Seven Die of Epidemic,” Oct 1, 1918, p. 4.
— 5 Oct 1 (24-hr period). Washington Post. “Work Hours Changed.,” Oct 2, 1918, p. 1.
— 11 Oct 2 (24-hr period). WP. “City Fights Grippe with Severe Steps,” Oct 3, 1918, 1.
— 11 Oct 3 (24-hr period). WP. “Theaters Closed to Stay Influenza,” October 4, 1918, p. 1.
— 37 Oct 5 (24-hr period). Washington Post. “`Flu’ Grows by 1,300,” Oct 6, 1918, p. 1.
— 24 Oct 6 (24-hr period). Washington Post. “`Flu’ Kills 24 More,” Oct 7, 1918.”
— 40 Oct 7 (24-hr period). Washington Post. “`Flu’ Still Spreads,” Oct 8, 1918, p. 1.
— 34 Oct 8 (24-hr period). Washington Post. “No Crest Yet In ‘Flu’,” Oct 9, 1918, p. 1.
— 47 Oct 9 (24-hr period). Washington Post. “47 More Die of ‘Flu’,” Oct 10, 1918, p. 1.
— 72 Oct 10 (24-hr period) Washington Post. “72 Dead From ‘Flu’,” Oct 11, 1918, p. 1.
— 74 Oct 11 (24-hr period) Washington Post. “74 Die, High Record,” Oct 12, 1918, p. 1, 4.
— 65 Oct 12 (24-hr period) Washington Post. “`Flu’ Under Control,” Oct 13, 1918, p. 1.
— 69 Oct 13 (24-hr period) Washington Post. “New ‘Flu’ Hospital,” Oct 14, 1918, p. 1.
— 77 Oct 14 (24-hr period). Washington Post. “‘Flu’ Reaches Crest,” Oct 15, 1918, p. 1.
— 88 Oct 15 (24-hr period). Washington Post. “88 Deaths by ‘Flu’,” Oct 16, 1918, p. 1.
— 87 Oct 16 (24-hr period). Washington Post. “87 ‘Flu’ Deaths Here,” Oct 17, 1918, p. 1.
— 91 Oct 17 (24-hr period). Washington Post. “91 More Die of ‘Flu’,” Oct 18, 1918. p. 1.
— 95 Oct 18 (24-hr period). Washington Post. “`Flu’ Deaths Climb,” Oct 19, 1918, p. 1.
— 967 Sep-Oct 18. Washington Post. “`Flu’ Deaths Climb,” Oct 19, 1918, p. 1.
— 66 Oct 19 (24-hr period). Washington Post. “Sudden Drop in ‘Flu’,” Oct 20, 1918, p. 18.
— 54 Oct 20 (24-hr period). Washington Post. “`Flu’ Seems on Wane,” Oct 21, 1918, p. 2.
— 74 Oct 21 (24-hr period). Washington Post. “Rise in ‘Flu’ Deaths,” Oct 22, 1918, p. 5.
— 59 Oct 22 (24-hr period). Washington Post. “Worst of ‘Flu’ Over,” Oct 23, 1918, p. 2.
— 54 Oct 23 (24-hr period). Washington Post. “`Flu’ Under Control,” Oct 24, 1918, p. 9.
— 25 Oct 24 (24-hr period). Washington Post. “`Flu’ Deaths Only 25,” Oct 25, 1918, p. 2.
— 31 Oct 25 (24-hr period). Washington Post. “31 Dead of Influenza,” Oct 26, 1918, p. 3.
— 29 Oct 26 (24-hr period). Washington Post. “`Flu’ Deaths Go To 40,” Oct 28, 1918, p. 3.
— 40 Oct 27 (24-hr period). Washington Post. “`Flu’ Deaths Go To 40,” Oct 28, 1918, p. 3.
–1,399 Sep-Oct, 1918 (Totals from above from Washington Post.)
1919: ( 744)
— 744 Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: ( 749)
— 749 Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Florida: (6,109)
1918: (4,117)
–4,117 State, Sep-Dec, flu/pneumonia. USPHS. Annual Rpt. …Surgeon Gen…1919. 1920, p186
— 88 Sep
–2,711 Oct
–371 Oct 5-17, 1918. HHS. “Florida,” The Great Pandemic.
–428 Oct 19-25, 1918. HHS. “Florida,” The Great Pandemic.
— 935 Nov
— 383 Dec
— 245 Camp Johnston (~ Jacksonville), 1918, disease. War Dept. An. Rpts., 1919. 1920, 1756.
Florida (continued)
1919: (1,165)
–1,165 Statewide, Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: ( 827) Bureau of the Census. Mortality Statistics 1920. DC: GPO, 1922, p. 214.
Georgia: (>4,190)
1918: >2,192 (Atlanta for the year, plus Camps Gordon, Hancock and Wheeler.
— 48 State, 24-hr per., Oct 17, 1918. GeorgiaInfo. “Chronology of the 1918 [Flu]…GA.”
— 68 “ by Oct 19, 1918. HHS. “Georgia,” The Great Pandemic.
— 308 “ Oct 20-26, 1918. HHS. “Georgia,” The Great Pandemic.
— 138 “ Oct 26-Nov 2, 1918. HHS. “Georgia,” The Great Pandemic.
— 926 Atlanta, Jan-Dec, flu & pneumonia. Census Bureau. Mortality Statistics 1918. 1920, 28.
— 351 “ Jan-Aug, flu & pneumonia. Census Bureau. Mortality Statistics 1918. 1920, 28.
— 575 “ Sep-Dec, flu & pneumonia. Census Bureau. Mortality Statistics 1918. 1920, 28.
— 750 “ as of Oct 13, 1918. GeorgiaInfo. “Chronology…1918 [Flu]…in GA.”
— 815 “ year; flu/pneumonia. USPHS. Pub. Health Rpts., V34/Pt. 2/N31, 8-1-1919. 1696
— 470 Camp Gordon, 1918, disease. War Dept. An. Rpts., 1919… Surg. Gen. 1920, 1671.
— 656 Camp Hancock (~Augusta), 1918, disease. War Dept. An. Rpts., 1919… . 1920, 1719.
— 140 Camp Wheeler ~Macon, Oct-Nov 1918, disease. War Dept. An. Rpts., 1919…, p. 2001.
1919: —1,508 Statewide, Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: — 490
— 490 Atlanta, year, flu & pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p.559.
— 442 Atlanta, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Hawaii: (1,474)
1918: 149
— 32 State, Sep, flu & pneumonia. US PHS. Annual Rpt. of…Surgeon Gen…1919. 1920, p. 186.
— 28 “ Oct, flu & pneumonia. US PHS. Annual Rpt. of…Surgeon Gen…1919. 1920, p.186.
— 40 “ Nov, flu & pneumonia. US PHS. Annual Rpt. of…Surgeon Gen…1919. 1920, p.186.
— 49 “ Dec, flu & pneumonia. US PHS. Annual Rpt. of…Surgeon Gen…1919. 1920, p.186.
1919: 459
–459 Statewide, Jan-Apr, 1919. USPHS. Annual Report for FY 1920, p. 213.
— 51 Honolulu, Jan 1919 (32 influenza, 19 pneumonia). HHS. “Hawaii,” The Great Pandemic.
— 20 “ Week ending March 1, 1919. HHS. “Hawaii,” The Great Pandemic.
1920: 866 State, influenza. Bureau of Census. Mortality Statistics 1920. 1922, p. 651.
Idaho: (9,000, 1918)
1918: (9,000)
–9,000 Statewide, 1918. Idaho Dept of Health and Welfare. “Idaho Unveils Website to Help…”
— 12 Clarkston, 1918. Bauer. “N. Idaho Town Recalls 1918 Pandemic Flu,” 16 May 2009.
— 50 Lewiston, 1918. Bauer. “N. Idaho Town Recalls 1918 Pandemic Flu,” 16 May 2009.
— 18 Nezperce. Oct 1918. Bauer. “N. Idaho Town Recalls 1918 Pandemic Flu,” 5-16-2009.
Illinois : (48,942)
1918 (26,098)
— 26,098 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt.…Surgeon Gen…1919. 1920, p.186.
— 1,233 Sep
–14,077 Oct
— 5,525 Nov
— 5,263 Dec
— 1,193 Camp Grant, 1918, disease. War Dept. An. Rpts., 1919… Surg. Gen. 1920, 1684.
–~20,000 Chicago. 1918-1919 Influenza deaths in Chicago. Hist. So. of Chicago Encyclopedia.
— 13,971 “ 1918. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p.1696.
“ –6,971 registered influenza deaths — ~7,000 registered pneumonia deaths
— 10,249 “ “Oct 1918 Influenza deaths…Chicago,” Hist. Soc. Chicago, Encyclopedia)
— 78 “ Oct 5. Knoll. “When the Plague Hit Spokane,” Pacific Northwesterner, 1989.
— 381 “ Oct 17. City of Chicago Dept. of Health. Report and Handbook, 1919, p. 40.
— 7,405 “ Oct 10-Nov 2. USGenNet.org. Deadly Epidemics In St. Louis History.
— 900 Great Lakes Naval Center. Dept. of Navy. “The Influenza Epidemic of 1918.” 2009.
1919: — 8,922 State, Jan-Apr, flu/pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: — 13,922
–13,922 State, bronchopneumonia/flu/pneumonia. Census. Mortality Statistics 1920. 344-45.
–13,919 State, year, flu & pneumonia. Extrapolation. Mortality Statistics 1920. 1922, p. 30.[17]
— 3,425 “ bronchopneumonia. Census Bur. Mortality Statistics 1920. 1922, p. 345.
— 5,192 “ influenza. Census Bur. Mortality Statistics 1920. 1922, p. 344.
— 5,305 “ pneumonia. Census Bur. Mortality Statistics 1920. 1922, p. 345.
— 4,163 Chicago, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Indiana: (14,800)
1918: (9,021)
–10,000 State, Sep 1918-Feb 1919. HHS. “Indiana,” The Great Pandemic.
— 9,021 “ Sep-Dec, flu/pneumonia. USPHS. An. Rpt.…Surgeon Gen…1919. p. 186.
— 200 Sep
–3,358 Oct
–2,628 Nov
–2,835 Dec
— 1,393 Indianapolis. USPHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
–437 registered influenza deaths –956 registered pneumonia deaths
1919: — 4,956 State, Jan-Apr. USPHS. Annual Report for FY 1920, p. 213.
1920: — 6,230
–6,228 State, year, flu & pneumonia. Extrapolation. Census. Mortality Statistics 1920. p. 30.[18]
–6,230 “ bronchopneumonia/flu/pneumonia. Census. Mortality Statistics 1920. 347-348.
–1,535 “ bronchopneumonia. Census. Mortality Statistics 1920. p. 348.
–2,295 “ influenza. Census. Mortality Statistics 1920. p. 347.
–2,400 “ pneumonia. Census. Mortality Statistics 1920. p. 348.
— 515 Indianapolis, Jan-Mar, 1920. USPHS. Annual Rpt. for FY 1920, p. 200.
Iowa: (7,954)
1918: (7,954)
–7,954 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt.…1919. 1920, p.186.
— 111 Sep
–2,770 Oct
–2,063 Nov
–3,010 Dec
–6,500 Statewide, 1918. Hibbs. “Postcard 263: 1918 Flu Killed 38 in Iowa City,” 9-25-2004.
— 7 “ by Oct 11, 1918. HHS. “Iowa,” The Great Pandemic.
–28 “ Oct 11-24, 1918. HHS. “Iowa,” The Great Pandemic.
–1,023 Camp Dodge, disease. War Dept. An. Rpts., 1919…. 1920, 1604.
— 625 Des Moines. USPHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p.1696.
–282 registered influenza deaths –343 registered pneumonia deaths
— 38 University of Iowa. Iowa Public Television. Iowa Pathways, “The Great Flu.”
Kansas: (12,925)
1918: (6,820)
–6,820 State, Sep-Dec, flu/pneumonia. USPHS. An. Rpt.…1919. 1920, p. 186.
— 90 Sep
–2,902 Oct
–1,526 Nov
–2,302 Dec
–1,385 Camp Funston, disease. War Dept. An. Rpts., 1919… Surg. Gen. 1661.
— 688 Kansas City. USPHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p.1696.
–125 registered influenza deaths –563 registered pneumonia deaths
1919: (2,904) Statewide, Jan-Apr, 1919. USPHS. Annual Report for FY 1920, p. 213.
1920: (3,201) State, bronchopneumonia/flu/pneumonia. Mortality Statistics 1920. 1922, 350-51.
— 697 State, bronchopneumonia. Census Bur. Mortality Statistics 1920. 1922, p. 351.
— 1,473 “ influenza. Census Bur. Mortality Statistics 1920. 1922, p. 350.
— 1,031 “ pneumonia. Census Bur. Mortality Statistics 1920. 1922, p. 351.
Kentucky: (23,367-25,236)
1918: (11,771-13,640)
–13,640 Statewide, 1918, flu/pneumonia. KY State Med Assoc. KY Med Jour., V19, p. 624.
–11,771 State, Sep-Dec, flu/pneumonia. USPHS. An. Rpt. …Surgeon Gen…1919. p.186.
— 162 Sep
–5,201 Oct
–4,468 Nov
–1,940 Dec
— 848 Camp Taylor ~ Louisville, Sep-Oct 1918, disease. War Dept. An. Rpts., 1919…, 1947.
— 1,476 Louisville. USPHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p.1696.
— 149 registered influenza
–1,327 registered pneumonia
1919: (~6,820) State, flu & pneumonia. KY State Med Assoc. KY Med Jour., V19, p. 624.
1920: ( 4,776)
— 276 Louisville, Jan-Mar. USPHS Annual Report for FY 1920, p. 200.
–4,776 State, bronchopneumonia/flu/pneumonia. Census. Mortality Statistics 1920. p.353-54.
–1,036 State, bronchopneumonia. Census Bureau. Mortality Statistics 1920. p. 354.
–1,838 State, influenza. Census Bureau. Mortality Statistics 1920. p. 353.
–1,902 “ pneumonia. Census Bureau. Mortality Statistics 1920. p. 354.
Louisiana: (11,583)
1918: (7,711)
–7,711 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
— 102 Sep
–4,575 Oct
–2,127 Nov
— 907 Dec
— 410 Camp Beauregard, Sep 20-Oct 20. WWI…Medical Front. “WWI Influenza…Camp…”
— 106 Alexandria, Oct. Atkins. “No Just Cause for Alarm.” Austin, OEM, p. 22.
— 105 Baton Rouge, Oct. Atkins. “No Just Cause for Alarm.” Austin, OEM, p. 22.
— 50 Lake Charles, Oct. Atkins. “No Just Cause for Alarm.” Austin, OEM, p. 22.
— 59 Monroe, Oct. Atkins. “No Just Cause for Alarm.” Austin, OEM, p. 22.
–5,000 New Orleans Lutz. “Influenza in Louisiana,” New Orleans Magazine, July 2009
–2,309 “ Oct. Atkins. “No Just Cause for Alarm.” Austin, OEM, p. 22.
–3,047 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. P. 1696.
–1,752 registered influenza
–1,295 registered pneumonia
— 117 Shreveport, Oct. Atkins. “No Just Cause for Alarm.” Austin, OEM, p. 22.
1919: (3,310) Statewide, Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: (2,869)
–2,869 State, bronchopneumonia/flu/pneumonia. Census. Mortality Statistics 1920. p.362-63.
— 715 “ bronchopneumonia. Census. Mortality Statistics 1920. p. 363.
— 916 “ influenza. Census. Mortality Statistics 1920. p. 362.
–1,238 “ pneumonia. Census. Mortality Statistics 1920. p. 363.
— 562 New Orleans, Jan-Mar, 1920. USPHS. Annual Report for FY 1920, p. 200.
Maine: (6,426-6,789)
1918: (3,467-3,800)
— ~200 State, Sep 24-Oct 24. Maine CDC. 1918 Pandemic Influenza in Maine.
–~2,500 “ Oct. Maine CDC. 1918 Pandemic Influenza in Maine.
— 3,800 “ Sep-Dec. Maine CDC. 1918 Pandemic Influenza in Maine.
— 3,467 “ Sep-Dec, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
— 195 Sep
–1,841 Oct
— 631 Nov
— 800 Dec
1919: (1,200-1,230)
–~1,200 State, Jan-May. Maine CDC. 1918 Pandemic Influenza in Maine.
— 1,230 State, Jan-Apr, influenza/pneumonia. US PHS. Annual Report for FY 1920, p. 213.
1920: ( 1,759)
— 1,759 State, bronchopneumonia/flu/pneumonia. Census. Mortality Statistics 1920. p371-72.
— 496 “ bronchopneumonia. Census. Mortality Statistics 1920. p. 372.
— 591 “ influenza. Census. Mortality Statistics 1920. p. 371.
— 672 “ pneumonia. Census. Mortality Statistics 1920. p. 372.
Maryland: (15,023)
1918: (9,494)
–9,494 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
— 210 “ Sep, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
–7,689 “ Oct, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
— 826 “ Nov, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
— 769 “ Dec, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
–5,267 Baltimore, flu/pneumonia. US PHS. Pub. Health Rpts., V34/Pt. 2/N31, 8-1-1919. 1696 –1,741 registered influenza.
— 1,357 Baltimore, Oct 12-18, 1918. HHS. “Maryland,” The Great Pandemic.
— 150 “ Oct. 19, 1918. HHS. “Maryland,” The Great Pandemic.
— 3,507 “ Oct 10-Nov 2, 1918. USGenNet.org. Deadly Epidemics… St. Louis Hist.
–>2,000 “ by end of 1918. HHS. “Maryland,” The Great Pandemic.
— 767 Camp Meade, Sep-Oct, 1918, disease. War Dept. An. Rpts., 1919… . 1920, 1848.
1919: (2,604) State, Jan-Apr, flu & pneumonia. U.S. PHS. Annual Report for FY 1920, p.213.
1920: (2,925)
— 1,091 Baltimore, Jan-Mar, 1920. USPHS. Annual Report for FY 1920, p. 200.
— 2,925 State, bronchopneumonia/flu/pneumonia. Census. Mortality Statistics 1920. p.374-75.
— 1,057 State, bronchopneumonia. Census. Mortality Statistics 1920. p. 375.
— 691 “ influenza. Census. Mortality Statistics 1920. p. 374.
— 1,177 “ pneumonia. Census. Mortality Statistics 1920. p. 375.
Massachusetts: (30,095-57,248))
1918: (17,947-45,000)
–45,000 State, including up to 1-16-1919. HHS. “Massachusetts,” The Great Pandemic.*
*“In the late 1920’s two PHS statisticians estimated that between Sept. 1, 1918 and Jan. 16, 1919, approximately 45,000 people died from influenza in Massachusetts alone. Horrific as these figures are, many historians believe that the number of influenza-related deaths in Massachusetts during this period was probably higher.“
— 4,953 “ Jan-Aug. Census. Mortality Statistics 1918. 1920, p. 28.
–21,157 “ Sep-Dec (was 1,705 Sep-Dec 1915) Census. Mortality Statistics 1918. p. 28.
–17,947 “ Sep-Dec, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
— 2,293 Sep
–11,449 Oct
— 1,558 Nov
— 2,647 Dec
— 700 “ last week of Sep 1918. Crosby 2003, p.53.
— 1 Arlington, Sep 3-27, 1918. HHS. “Massachusetts,” The Great Pandemic.
— 333 Boston, Sep 3-27, 1918. HHS. “Massachusetts,” The Great Pandemic.
— 156 “ Sep 26, 1918. Crosby 2003, 48.
— 984 “ Sep 30 (the week). HHS. “Mass.,” The Great Pandemic.
— 171 “ Oct 1. Knoll. “When the Plague Hit Spokane,” Pacific Northwesterner, 1989.
— 202 “ Oct 2. PBS. “Timeline: Influenza…America in 1918,” Influenza 1918.
— 1,023 “ Oct 7 (deaths that week). HHS. “Massachusetts,” The Great Pandemic.
— 4,000 “ Sep 8-Oct 25. HHS. “Massachusetts,” The Great Pandemic.
–>2,000 “ Sep-Dec. Armstrong. “Philadelphia, Nurses…Spanish Flu…”
— 3,694 “ Oct 10-Nov 2. USGenNet. Deadly Epidemics…St. Louis History.
–~1,000 “ Celebrate Boston. “The Great Influenza of 1918.”
— 6,389 “ year. US PHS. Public Health Rpts., V34/Pt. 2/N31, 8-1-1919. p.1696.
–4,014 registered influenza deaths –2,375 registered pneumonia deaths.
— 786 Cambridge. US PHS. Public Health Rpts. V34/Pt.2/N31, 8-1-1919. p. 1696.
–472 registered influenza deaths –314 registered pneumonia deaths
— 921 Camp Devens, disease. War Dept. An. Rpts., 1919… Surg. Gen. p. 1577.
— 13 Chelsea. Sep 3-27, 1918. HHS. “Massachusetts,” The Great Pandemic.
— 35 Chelsea Naval Hosp., by 9-11-1918. Crosby 2003, 39-40.
— 7 Everett, Sep 3-27. HHS. “Massachusetts,” The Great Pandemic.
— 939 Fall River. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p.1696.
–729 registered influenza deaths –939 registered pneumonia deaths
— 354 Lawrence. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–211 registered influenza deaths –354 registered pneumonia deaths
— 800 Lowell. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–164 registered influenza deaths –636 registered pneumonia deaths
— 695 Lynn. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–490 registered influenza deaths –205 registered pneumonia deaths
— 1,127 New Bedford. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–88 registered influenza deaths –1,039 pneumonia deaths
— 32 North Andover, Sep-Dec. N. Andover Cit. “History: 1918 Pandemic North Andover.”
— 10 Salem, Sep 3-27, 1918. HHS. “Massachusetts,” The Great Pandemic.
— 931 Springfield. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1697.
–614 registered influenza deaths –317 registered pneumonia deaths
— 994 Worchester, Sep-Dec 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 212.
— 1,294 “ US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1697.
— –757 registered influenza deaths –537 registered pneumonia deaths
Massachusetts (continued)
1919: (4,513) State, Jan-Apr, flu and pneumonia. US PHS. Annual Report for FY 1920, p. 213.
1920: (7,735)
–7,735 State, bronchopneumonia/flu/pneumonia. Census. Mortality Statistics 1920. p. 383-84.
–3,169 “ bronchopneumonia. Census. Mortality Statistics 1920. p. 384.
–1,584 “ influenza. Census. Mortality Statistics 1920. p. 383.
–1,311 “ influenza. Census. Mortality Statistics 1920. p. 227.
–2,882 “ pneumonia. Census. Mortality Statistics 1920. p. 384.
–1,140 Boston, Jan-Mar, 1920. USPHS. Annual Report for FY 1920, p. 200.
— 142 Cambridge, Jan-Mar, 1920. USPHS. Annual Report for FY 1920, p. 200.
— 138 Fall River, Jan-Mar, 1920. USPHS. Annual Report for FY 1920, p. 200.
— 41 Haverhill, flu. Census. Mortality Statistics 1920. p.226.
— 158 Lowell, Jan-Mar, 1920. USPHS. Annual Report for FY 1920, p. 200.
— 42 Lynn, flu. Census. Mortality Statistics 1920, p. 228.
— 68 New Bedford, flu. Census. Mortality Statistics 1920, p. 228.
— 57 Springfield, flu. Census. Mortality Statistics 1920, p. 228.
— 279 Worcester, Jan-Mar, 1920. USPHS. Annual Report for FY 1920, p. 200.
Michigan: (16,899-17,156)
1918: (6,443-6,700)
— 6,443 State, Sep-Dec, flu/pneumonia. USPHS. An. Rpt. …Surg. Gen…1919, p.186.
— 22 “ Sep, flu/pneumonia. USPHS. An. Rpt. …Surg. Gen…1919. p.186.
— 2,451 “ Oct, flu/pneumonia. USPHS. An. Rpt. …Surg. Gen…1919. p.186.
— 6,700 “ Oct-Dec. Averill. “An Historical Perspective…1918 Spanish…”
— 258 “ Oct 1-14. HHS. “Michigan,” The Great Pandemic.
— 922 “ Week of Oct 21. HHS. “Michigan,” The Great Pandemic.
— 160 “ Oct 22. HHS. “Michigan,” The Great Pandemic.
— 1,866 “ Nov, flu/pneumonia. US PHS. An. Rpt.…Surg. Gen…1919. p.186.
— 27 “ Nov 19. Ludington News, “Flu Situation…” 11-20-1918.
— 2,104 “ Dec, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. p. 186.
— 71 “ Dec 29. Marshall Chronicle, MI. “71 Dead,” 12-21-1918.
— 120 Camp Custer, Sep 28-Oct 10. Smith. “Twenty-Six Die Monday,” Traverse City Record
— 2,586 Detroit, Sep-Dec. Crosby. America’s Forgotten Pandemic, 2003, 212.
— 52 “ Oct 22. HHS. “Michigan,” The Great Pandemic.
— 3,814 “ Sep-Oct. Baulch. “When the Flu Ravaged the World,” Detroit News.
— 3,814 “ Sep-Oct US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
Detroit –1,385 registered influenza deaths –2,429 registered pneumonia deaths
— 280 Grand Rapids, Sep-Dec. Crosby. America’s Forgotten Pandemic, 2003, p. 212.
— 434 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p. 1696.
–146 registered influenza deaths –288 registered pneumonia deaths
1919: (4,997) State, Jan-Apr, flu & pneumonia. US PHS. Annual Report for FY 1920, p. 213.
1920: (5,459)
— 5,459 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. p. 228.
— 1,642 State, influenza. Census Bureau. Mortality Statistics 1920, p. 228.
— 3,817 State, pneumonia. Census Bureau. Mortality Statistics 1920. p. 228.
— 2,754 Six cities noted below.
— 2,294 Detroit, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 100 Flint, influenza. Census Bureau. Mortality Statistics 1920. p. 228.
— 194 Grand Rapids, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 50 Lansing, influenza. Census Bureau. Mortality Statistics 1920. p. 228.
— 50 Pontiac, influenza. Census Bureau. Mortality Statistics 1920. p. 228.
— 66 Saginaw, influenza. Census Bureau. Mortality Statistics 1920. p. 228.
Minnesota: (12,088-12,307)
1918: (7,521-7,740)
— 7,740 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. …Surg. Gen…1919. 1920, p. 186.
— 7,521 “ MnSU. EMuseum. “Minnesota History: A Chronology.”
— 120 “ Sep, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. 1920, p. 186.
— 2,277 “ Oct, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. 1920, p. 186.
— 3,329 “ Nov, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. 1920, p. 186.
— 2,014 “ Dec, flu/pneumonia. US PHS. An. Rpt. …Surgeon Gen…1919. 1920, p. 186.
— 1,058 Minneapolis, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 212.
— 1,480 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p1696.
–990 registered influenza deaths –490 registered pneumonia deaths
— 908 St. Paul, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 212.
— 1,164 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1696.
–823 registered influenza deaths –341 pneumonia deaths
1919: (3,055) State, Jan-Apr, flu & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
1919-20:
— 4,200 Minnesota State Univ. EMuseum. “Minnesota History: A Chronology.”
1920: (1,145-1,512)*
— 1,512 State, flu and pneumonia. Census Bur. Mortality Statistics 1920. p. 230-231.
–659 influenza –1,512 pneumonia
— 506 Minneapolis, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 331 St. Paul, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
* MnSU has 4,200 deaths for 1918-1919. US PHS has 3,055 for 1918. Subtracting 3,055 from 4,200 gets 1,145 – which is our low estimate. Census Bureau has 1,512 influenza and pneumonia deaths for 1919 – the high estimate.
Mississippi: (11,863)
1918: (6,219)
–6,219 State. Matrisciano. “Spanish Influenza in Mississippi (1918).” Historical Text Archive.
— 48 Camp Shelby, Oct-Nov, 1918, disease. War Dept. An. Rpts., 1919… . 1920, p.1899.
1919: (4,687) State, flu & pneumonia. Extrapolation. Mortality Statistics 1920. 1922, p. 30.[19]
1920: ( 957)
–957 State. (influenza & pneumonia). Census Bureau. Mortality Statistics 1920. p230-31.
–104 “ (influenza). Census Bureau. Mortality Statistics 1920. p. 230.
–853 “ (pneumonia) Census Bureau. Mortality Statistics 1920. p. 231.
Missouri: (26,198-26,752)
1918: (15,173-15,727)
–15,727 State, flu/pneumonia extrapolation. Census Bureau. Mortality Statistics 1920. p. 30.[20]
–15,173 “ Jan-Dec, flu & pneumonia. Census Bur. Mortality Statistics 1918. 1920, p. 28.
— 3,886 “ Jan-Aug, flu & pneumonia. Census Bur. Mortality Statistics 1918. 1920, p. 28.
–11,287 “ Sep-Dec, flu & pneumonia. Census Bur. Mortality Statistics 1918. 1920, p. 28.
— 1,724 Kansas City, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 212.
— 2,884 St. Louis, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 212.
— 784 “ Oct 10-Nov 2, 1918. USgennet. Deadly Epidemics…St. Louis History.
— 13 “ Oct 16, 1918. HHS. “Missouri,” The Great Pandemic.
— 90 “ by 3rd week, Oct. HHS. “Missouri,” The Great Pandemic.
— 1,400 “ Dec, 1918. USGenNet. Deadly Epidemics in St. Louis History.
— 4,334 “ US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p.1696.
“ — 2,063 registered influenza deaths –2,271 pneumonia deaths
1918-1919:
— >2,300 Kansas City, Sep 1918-early spring 1919. Univ. of Mich. Influenza Encyclopedia.[21]
1919: (7,004)
–7,004 State, flu & pneumonia. Extrapolation. Census. Mortality Statistics 1920. 1922, p. 30.[22]
1920: (4,021 influenza and pneumonia)
–1,023 State, influenza. Census Bureau. Mortality Statistics 1920. p. 230.
–2,998 “ pneumonia. Census Bureau. Mortality Statistics 1920. p. 231.
— 870 Kansas City, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
–1,427 St. Louis, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Montana: (6,079)
1918: (3,982)
–5,000 State. Boswell. “Montana State Canceled School Term Over 1918 Influenza.”[23]
–3,982 “ Flu and pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p. 30.[24]
— 39 Tongue Indian Reservation, late Oct 1918. HHS. “Montana,” The Great Epidemic.
1919: (1,217)
–1,217 State, flu and pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p. 30.[25]
1920: ( 880)
— 880 State, flu and pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p. 30.[26]
Nebraska: (7,872)
1918: (4,332)
— 4,332 State, Sep-Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. p.186.
— 43 “ Sep, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen.…1919. p.186.
— 1,615 “ Oct, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. p.186.
— 1,395 “ Oct 1-Oct 31, 1918. HHS. “Nebraska,” The Great Pandemic.
— 1,197 “ Nov, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 186.
— 1,477 “ Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 186.
— 2,807 “ Oct 1-Dec 17, 1918. Anderson, “A Look…History of Flu…Neb.,” 12-25-2005.
— 2,807 “ Oct 1-Dec 17, 1918. HHS. “Nebraska,” The Great Pandemic.
— 46 Camp Dodge, Oct 8, 1918. Anderson, “A Look…History of Flu…Neb.,” 12-25-2005.
— 113 Lincoln, by 10-26-1918. Anderson, “A Look at…History of Flu…Neb.,” 12-25-05.
— 1,030 Omaha, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 212.
— 160 “ Oct 12-19. HHS. “Nebraska,” The Great Pandemic.
— 1,385 “ USPHS. Pub. Health Rpts., V34/Pt.2/N31, 8-1-1919. 1696.[27]
— 400 Wyuka, Oct-Dec 1918. Anderson, “A Look…History of Flu in Neb.,” 12-25-2005.
1919: (1,678)
— 1,678 Statewide, Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: (1,862)
— 1,862 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 30.[28]
— 307 Omaha, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Nevada: (734-800)
1918-1919:
–734-800 State. Earl, Phillip I. “Think You’re Feeling Sick?”*
* Writes: “In Nevada, the State Board of Health recorded 3,914 cases, of which 734 died. The disease also exacerbated many pre-existing medical conditions and the loss of life may have reached some 800.” Earl, Phillip I. “Think You’re Feeling Sick? … Flu Epidemic of 1918-1919.” State of Nevada, Department of Cultural Affairs. Reprinted in Turner, Dan. “10 Unknown Soldiers, Montello Nevada.”
New Hampshire: (3,907)
1918: (2,000)
–2,000 Statewide. Grens. “Granite State versus Spanish Flu,” NHPR, 10-4-2005.[29]
— 393 “ Oct 6-12. HHS. “New Hampshire,” The Great Pandemic.
— 20 Dover, Oct 1-2, Dover Pub. Libr. “Spanish Flu Epidemic of 1918 Strikes Dover.”
— 35 “ Oct 5-14. HHS. “New Hampshire,” The Great Pandemic.
— 80 “ Sep 20-Nov 14. Dover Pub. Lib. “Spanish Flu Epidemic of 1918 Strikes Dover.”
— 205 Manchester, Oct 6-15. HHS. “New Hampshire,” The Great Pandemic.
— 82 Nashua, Oct 5-14. HHS. “New Hampshire,” The Great Pandemic.
1919: (1,024)
–1,024 State, flu and pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p. 30.[30]
1920 ( 883)
— 883 State, flu and pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p. 30.[31]
New Jersey: (26,331-33,039)[32]
1918: (16,837-23,545)
–23,545 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. p. 30.[33]
–18,306 “ to Jan, 1919. MyCentralJersey.com. “Edison Woman, 92, Gives a Glimpse of 1918…”[34]
–16,837 “ Sep-Dec, flu/pneumonia. US PHS. Annual Rpt…Surg. Gen…1919. p.186.[35]
— 522 Sep
–12,465 Oct
— 2,200 Nov
— 1,650 Dec
–>4,400 State up to Oct 22. Newjerseynewsroom.com. “1918 Spanish Flu was cause…”[36]
— 4,398 State up to Oct 21, 1918. HHS. “New Jersey,” The Great Pandemic.
— 366 “ Oct 22, 1918. HHS. “New Jersey,” The Great Pandemic.
— 1,190 Camden, year, flu/pneumonia. USPHS. Pub. Health Rpts., V34/Pt.2/N31, 8-1-1919. 1696.
— 899 Fort Dix, disease. War Dept. An. Rpts., 1919… Surg. Gen. 1591.
— 1,695 Jersey City, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 212.
— 2,369 “ US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
— 834 registered influenza deaths
–1,498 registered pneumonia deaths
— 2,105 Newark, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 212.
— 2,885 “ US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–1,387 registered influenza deaths
–1,498 registered pneumonia deaths
— 751 Paterson, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 212.
— 1,062 “ US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–240 registered influenza deaths
–822 registered pneumonia deaths
— 976 Trenton. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1697.
–735 registered influenza deaths
–241 registered pneumonia deaths
New Jersey (continued)
1919: (5,344)
— 5,344 State, Jan-Apr, influenza and pneumonia. US PHS. Annual Report for FY 1920, p. 213.
1920: (4,150)
— 1,202 State, influenza. Bureau of Census. Mortality Statistics 1920. 1922, p. 413.
— 2,948 “ pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p. 413.
— 4,150 “ flu and pneumonia. Bureau of Census. Mortality Statistics 1920. 1922, p. 413.
— 626 Newark, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
New Mexico: (5,000)
1918:
— >200 State, by Late Oct. HHS. “New Mexico,” The Great Pandemic.
–1,055-5,000. “ Rees. “Spanish Influenza in [NM], 1918-1919. ABA Health eSource.[37]
–~5,000 “ Melzer. NM Historical Review, Vol. 57, No, 3, July 1982, “A Dark and…”
— 2,000 Apache Ct. Navajos. PBS. “Timeline: Influenza…America…1918,” Influenza 1918.
— 100 Gallup. Stone. “The ‘Scythe’: Spanish Influenza in No. Arizona, 1918, Part II.”
— >80 Gallup. Donovan. “1918: The Year of Death,” Gallup Independent, 11-8-2008.
New York: (87,456)
1918: (46,993)
–46,993 State, Sep-Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. p186.
— 1,185 “ Sep, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. p186.
New York State (continued)
–31,246 “ Oct, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. p186.
— 9,411 “ Nov, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. p186.
— 5,151 “ Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. p186.
— 623 Albany, Sep-Dec. Crosby. America’s Forgotten Pandemic, 2003, 212.
— 787 “ Year. US PHS. Public Health Rpts., 34/N2, 1919, 1696.
–525 registered influenza deaths
–262 registered pneumonia deaths
— 3,279 Buffalo, Year. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.[38]
–1,874 registered influenza deaths
–1,405 registered pneumonia deaths
— 2,474 Buffalo, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 212.
— 300 Camp Mills, Long Island, Oct 1918. War Dept. An. Rpts., 1919… . 1920, 1861.
— 116 Camp Syracuse, Sep, disease. War Dept. An. Rpts., 1919… . 1920, 1938.
— 392 Camp Upton ~Yaphank, Sep-Oct 1918, disease. War Dept. An. Rpts. 1919…, p.1975.
–23,265 NYC, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 212.
–16,705 “ Oct 10-Nov 2, 1918. USGenNet. Deadly Epidemics in St. Louis History.
— 869 “ Oct 22. PBS. “Timeline: Influenza Across American in 1918, Influenza 1918.
–30,736 “ Six weeks prior to Nov 1. HHS. “New York,” The Great Pandemic.
–12,357 “ Week of Nov 1. HHS. “New York,” The Great Pandemic.
–32,000 “ USGenNet. Deadly Epidemics In St. Louis History.
–33,190 “ US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–12,562 registered influenza deaths
–20,662 registered pneumonia deaths
— 1,452 Rochester US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–948 registered influenza deaths
–504 registered pneumonia deaths
— 1,125 Rochester, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 213.
— 623 Schenectady US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
“ –446 registered influenza deaths
“ –177 registered pneumonia deaths
— 404 Schenectady, 1918. Morris. The Influenza Pandemic of 1918-19 and How…, 1986.
— 1,204 Syracuse US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1697.
“ –753 registered influenza deaths
“ –451 registered pneumonia deaths
— 943 “ Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, 213.
— 519 Yonkers. US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1697.
–330 registered influenza deaths
–189 registered pneumonia deaths
1919: (18,729)
— 18,729 State, Jan-Apr, flu and pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: (21,734)
–21,734 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 30.[39]
— 141 Albany, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 635 Buffalo, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 8,747 NYC, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 246 Rochester, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 313 Syracuse, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
North Carolina: (24,176-25,176)
1918: (12,600-13,600)
–13,600 State. Patterson. “Doctors Had No Weapons to Fight 1918 Flu,” Oct 25, 2009.
–13,000 “ McKown. “Oct 1918 – North Carolina and the ‘Blue Death’,” Oct 2008.
–12,600 “ flu and pneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 30.[40]
— 410 Camp Green (~Charlotte), 1918, disease. War Dept. An. Rpts., 1919…. 1920, 1698.
— 95 Greensboro. Patterson. “Doctors Had No Weapons to Fight 1918 Flu,” Oct 25, 2009.
— 54 High Point, Oct-Nov. Patterson. “Doctors Had No Weapons to Fight 1918 Flu,” 2009.
— ~400 Winston Salem. Patterson. “Doctors Had No Weapons to Fight 1918 Flu,” 10-25-2009
1918, Oct-Mar 1919
–>13,000 Statewide. HHS. “North Carolina,” The Great Pandemic.
1919: (5,955)
–5,955 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 30.[41]
–1,097, Jan-Apr ?
1920: (5,621)
–5,621 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 30.[42]
North Dakota: (3,464)
1918: (2,367)
–2,367 State, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon General…1919. 1920, p.186.
–1,378 “ Bismarck Tribune. “101-Year-Old Recalls 1918 Flu Epidemic,” 4-27-2007.
— 1 “ Sep, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon Gen…1919. 1920, p186.
— 745 “ Oct, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon Gen…1919. 1920, p186.
— 987 “ Nov, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon Gen…1919. 1920, p186
— 634 “ Dec, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon Gen…1919. 1920, p186
1919: (1,097)
–1,097 State, Jan-Apr, flu and pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
Ohio: (43,705)
1918: (22,099)
–22,099 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of… Surgeon Gen…1919. 1920, 186
–14,986 “ Kingseed. “The 1918 Influenza Epidemic,” Columbus Monthly, Nov 1999.[43]
— 314 “ Sep, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon Gen…1919. 1920, 186.
— 9,219 “ Oct, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon Gen…1919. 1920, 186.
— 1,541 “ week of Oct 26. HHS. “Ohio,” The Great Pandemic.
— 6,866 “ Nov, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon Gen…1919. 1920, 186
— 5,700 “ Dec, flu/pneumonia. US PHS. Annual Rpt. of the Surgeon Gen…1919. 1920, 186
— 1,101 Camp Sherman, Sep-Oct 1918, disease. War Dept. An. Rpts. 1919, p.1927.
— 1,177 “ Columbuspandemicflu.com. “History – Pandemic Influenza in the U.S.
— 1,867 Cincinnati, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 600 Cincinnati, Oct 4-26, Brady. “Historic Disasters,” Cincinnati Mag., Feb 1982, 104.
— 2,478 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
“ –1,776 registered influenza deaths
“ — 702 registered pneumonia deaths
— 4,515 Cleveland. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
“ –2,817 registered influenza deaths
“ –1,789 registered pneumonia deaths
— 3,576 “ Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 781 Columbus, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 1,035 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p. 1696.
“ –449 registered influenza deaths
“ –586 registered pneumonia deaths
— 617 Dayton, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 713 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p. 1696.
“ –479 registered influenza deaths
“ –234 registered pneumonia deaths
— 716 Toledo, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 985 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1697.
–523 registered influenza deaths
–462 registered pneumonia deaths
— 1,235 Youngstown. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, 1697.
–855 registered influenza deaths
–380 registered pneumonia deaths
1919: ( 9,904)
— 9,904 State, Jan-Apr, influenza and pneumonia. U.S. PHS. Annual Rpt. for FY 1920, p. 213.
1920: (11,702)
–11,702 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. p. 30.[44]
— 510 Cincinnati, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 1,039 Cleveland, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 392 Columbus, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 207 Dayton, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 265 Toledo, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Oklahoma: (7,558)
1918: (5,304)
— 5,304 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surg. Gen…1919. 1920, 186.
— 5,106 “ Sep-Dec. (subtracting 1919 from 1918-Spring 1919)
— 37 “ Sep, flu/pneumonia. US PHS. An. Rpt. of…Surg. Gen…1919. 1920, 186.
— 2,540 “ Oct, flu/pneumonia. US PHS. An. Rpt. of…Surg. Gen…1919. 1920, 186.
— 1,424 “ Nov, flu/pneumonia. US PHS. An. Rpt. of…Surg. Gen…1919. 1920, 186.
— 1,303 “ Dec, flu/pneumonia. US PHS. An. Rpt. of…Surg. Gen…1919. 1920, 186.
— 2,472 Oklahoma City. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, 1696.
1918, Sep- Spring 1919:
— 7,350 State. Oklahoma Historical Society. “Spanish/Swine Flu,” Nov 9, 2009.
1919: (2,254)
— 2,254 State, Jan-Apr, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p213.
Oregon: (4,552)
1918: (2,063)
–2,063 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 26 “ Sep, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 649 “ Oct, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 818 “ Nov, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 570 “ Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 920 Portland, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 1,155 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
–898 registered influenza deaths
–257 registered pneumonia deaths
1918-1920:
— 3,675 State. Oct, 1918-Sep 1920. Allen. Oregon History Project. “Spanish Flu in Astoria.”
1919: (1,158)
— 1,158 State, Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: (1,331)
–1,331 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 30.[45]
— 278 Portland, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Pennsylvania: (97,800-100,076)
1918: (64,724-67,000)
–67,000 State, Sep-Dec, flu/pneumonia. Garrett. “Pandemic Economics…” 2008, p. 79.
–64,724 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 1,404 “ Sep, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 8,732 “ up to Oct 18 (6,081 flu; 2,651 pneumonia). HHS. The Great Pandemic.
–24,000 “ Oct. Minnix. “Behind…Numbers of the Flu Pandemic of 1918-1919…”
–36,938 “ Oct, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
–17,301 “ Nov, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 9,081 “ Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 204 Chester Emergency Armory Hospital. Armitage. “The Deadly Pandemic of 1918.”
— 1,100 Chester and Delaware County. Armitage. “The Deadly Pandemic of 1918.” 1998.
–16,834 Philadelphia US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p1696.
–8,395 registered influenza deaths
–5,861 registered pneumonia deaths
–16,000 Philadelphia 1918. Sapatkin. “The 1918 Flu Epidemic Worse Second Time Around.”
–13,426 “ Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 139 Philadelphia, Oct 4. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
— 171 “ Oct 5. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
— 289 “ Oct 6. PBS. “Timeline: Influenza…America in 1918, Influenza 1918.
— 250 “ Oct 8. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
— 361 “ Oct 9. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
— 528 “ Oct 10. Minnix. “Behind…Numbers of the Flu Pandemic of 1918-19…”
— 517 “ Oct 11. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
— 557 “ Oct 14. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
— 7,600 “ Oct 1-14. Armitage. “The Deadly Pandemic of 1918.” 1998.
— 650 “ Oct 15. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
— >700 “ Oct 16. HHS. “Pennsylvania,” The Great Pandemic.
— 711 “ Oct 17. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
— 606 “ Oct 20. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
–12,191 “ Oct. Lynch. “Flu: It Started with a Cough in the Summer of 1918.”
–12,162 “ Oct 10-Nov 2. USGenNet.org. Deadly Epidemics In St. Louis Hist.
— 5,340 Pittsburgh, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 4,760 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
— 515 registered influenza deaths
–4,245 registered pneumonia deaths
— 711 Reading. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p.1696.
–292 registered influenza deaths
–419 registered pneumonia deaths
— 1,050 Scranton, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 1,244 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
–105 registered influenza deaths
— >300 York. McClure. “York’s Spanish Flu Epidemic of 1918.” York Town Square, 4-13-09.
1918-1919:
–15,700 Philadelphia. USGenNet.org. Deadly Epidemics In St. Louis History.
–12,191 “ PA Historical & Museum Commission. “1918 Influenza Epidemic…” 2013.
1919: (20,494)
–20,494 State, flu and pneumonia. Census Bureau. Mortality Statistics 1920. p. 30.[46]
1920: (12,582)
–12,582 Registration cities, flu/pneumonia. Census Bureau. Mortality Statistics 1920. 1922, 240
— 2,966 Registration cities, influenza. Census Bureau. Mortality Statistics 1920. 1922, 240
— 9,616 “ “ pneumonia. Census Bureau. Mortality Statistics 1920. 1922, 241
— 2,766 Philadelphia, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 1,588 Pittsburgh, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Rhode Island: (4,374)
1918: (3,205)
— 3,205 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt.…Surgeon Gen…1919. 1920, 186.
— 2,300 “ Cassidy. “Epidemic Rhode Island: The Spanish Flu Outbreak of 1918.”
— 253 “ Sep, flu/pneumonia. US PHS. An. Rpt.…Surgeon Gen…1919. 1920, 186.
— 2,218 “ Oct, flu/pneumonia. US PHS. An. Rpt.…Surgeon Gen…1919. 1920, 186.
— 344 “ Nov, flu/pneumonia. US PHS. An. Rpt.…Surgeon Gen…1919. 1920, 186.
— 390 “ Dec, flu/pneumonia. US PHS. An. Rpt.…Surgeon Gen…1919. 1920, 186.
— 1,343 Providence, Sep-Dec. Crosby. America’s Forgotten Pandemic, 2003, 213.
— 1,752 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
–941 registered influenza deaths
–811 registered pneumonia deaths
1920: (1,169)
–1,169 Registration cities, flu/pneumonia. Census. Mortality Statistics 1920. 1922, p. 242-243.
— 303 Registration cities, influenza. Census Bureau. Mortality Statistics 1920. p. 242.
— 866 Registration cities, pneumonia. Census Bureau. Mortality Statistics 1920. p. 243.
— 397 Providence, Jan-Mar. U.S. PHS. Annual Report for FY 1920, p. 200.
South Carolina: (10,398)
1918: (6,711)
— 6,711 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p186.
— 155 “ Sep, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p186.
— 3,611 “ Oct, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p186.
— 1,615 “ Nov, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p186.
— 1,330 “ Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p186.
— 561 Camp Jackson (~Columbia), 1918, disease. War Dept. An. Rpts., 1919… . 1920, 1743.
— 346 Camp Sevier ~Greenville, Sep-Oct, disease. War Dept. An. Rpts., 1919…p. 1887.
— 148 Camp Wadsworth, Spartanburg, Oct-Nov 1918. War Dept. An. Rpts. 1919…, p.1987.
— 178 “ Hamer. Forward Together: South Carolinians in the Great War. P.46.
— 510 Spartanburg. Hamer. Forward Together: South Carolinians in the Great War. P.46.
–~3,000 Statewide, by Oct 25, 1918. HHS. “South Carolina,” The Great Pandemic.
— 4,000 (low est.) “ Hamer. Forward Together: South Carolinians in the Great War. P.46.
–10,000 (high est.) “ Hamer. Forward Together: South Carolinians in the Great War. P.46.
1919: (3,012)
— 3,012 State, Jan-Apr, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p.213.
— 1,577 “ Jan, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p.213.
— 848 “ Feb, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p.213.
— 354 “ Mar, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p.213.
— 233 “ Apr, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p.213.
1920: ( 675)
— 675 Registration cities, flu/pneumonia. Census. Mortality Statistics 1920. 1922, p. 242-243.
— 336 Registration cities, influenza. Census Bureau. Mortality Statistics 1920. 1922, p. 242.
— 339 Registration cities, pneumonia. Census Bureau. Mortality Statistics 1920. 1922, p. 243.
South Dakota: (2,108)
1918: (2,108)
–2,108 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 27 “ Sep, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 519 “ Oct, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 897 “ Nov, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
— 665 “ Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, 186.
–1,847 “ Sep-Dec. Reitzel. “1918 Flu Pandemic in South Dakota Remembered.”
— 218 “ week of Nov 2nd. HHS. “South Dakota,” The Great Pandemic.
Tennessee: (9,074)
1918:
— 26 Chattanooga, Oct 4,10, 1918. HHS. “Tennessee,” The Great Pandemic.
— 27 Knoxville, Oct 15, 1918. HHS. “Tennessee,” The Great Pandemic.
— 724 Memphis, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 996 “ USPHS. Pub. Health Rpts., V34/Pt.2/N31, 8-1-1919. p.1696.
–172 registered influenza deaths
–824 registered pneumonia deaths
— 742 Nashville, Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 1,128 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
–607 registered influenza deaths
–521 registered pneumonia deaths
1918-1919: (7,721)
— 7,721 State. Coggins. “Influenza…1918-19.” TN Encyclopedia of History and Culture.
–>7,700 “ TN State Lib. & Archives. Disasters in [TN]. “Epidemic Scourges…”
— 1,300 Nashville. Coggins. “Influenza…1918-19.” TN Encyclopedia of History and Culture.
1920: (1,353)
–1,353 Registration cities, flu/pneumonia. Census. Mortality Statistics 1920. 1922, p. 242-243.
— 494 Registration cities, influenza. Census Bur. Mortality Statistics 1920. 1922, p. 242.
— 859 Registration cities, pneumonia. Census Bur. Mortality Statistics 1920. 1922, p. 243.
— 336 Memphis, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 254 Nashville, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
Texas: (16,655)
1918: (14,121)
–14,121 State, Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p 186.
— 119 “ Sep, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p 186.
— 517 “ by Oct 25. HHS. “Texas,” The Great Pandemic.
— 2,181 “ by Oct 29 in urban centers. HHS. “Texas,” The Great Pandemic.
— 6,009 “ Oct, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p186.
— 4,425 “ Nov, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p186.
— 3,568 “ Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. p186.
— 303 Camp MacArthur, disease. War Dept. Annual Reports, 1919… . 1920, p. 1819.
— 192 Camp Travis, Oct 1918, disease. War Dept. An. Rpts., 1919… . 1920, 1961.
— 277 Austin Oct-Nov 5. Atkins. “No Just Cause for Alarm.” Austin OEM, 20.
— 117 Beaumont Oct. Atkins. “No Just Cause for Alarm.” Austin OEM, 22.
— 39 Cleburne Oct. Atkins. “No Just Cause for Alarm.” Austin OEM, 22.
— 440 Dallas Oct. Atkins. “No Just Cause for Alarm.” Austin OEM, 22.
— 831 “ US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p.1696.
–407 registered influenza deaths
–424 registered pneumonia deaths
— 131 El Paso Oct 9-16. Cox. “1918 Flu,” TesasEscapes.com.
— 619 “ Oct. Atkins. “No Just Cause for Alarm.” Austin OEM, 22.
— 794 “ (flu & pneumonia). Storey and Kelley. Twentieth-Century Texas, 174.
— 753 Fort Worth. USPHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
— 44 registered influenza deaths
–709 registered pneumonia deaths
— 137 Galveston Oct. Atkins. “No Just Cause for Alarm.” Austin OEM, 22.
— 473 Houston Oct. Atkins. “No Just Cause for Alarm.” Austin OEM, 22.
— 500 “ year. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. p. 1696.
— 630 San Antonio, Oct. Atkins. “No Just Cause for Alarm.” Austin OEM, 22.
— 1,115 “ (flu & pneumonia). Storey and Kelley. Twentieth-Century Texas, 174.
— 1,134 “ US PHS. Public Health Rpts., V34/Pt.2/N31, 8-1-1919. p. 1696.
–196 registered influenza deaths
–938 registered pneumonia deaths
1919: (1,150 – four cities)
— 268 Dallas. Storey and Kelley. Twentieth-Century Texas, 174.
— 338 El Paso. Storey and Kelley. Twentieth-Century Texas, 174.
— 278 Houston. Storey and Kelley. Twentieth-Century Texas, 174.
— 266 San Antonio. Storey and Kelley. Twentieth-Century Texas, 174.
1920: (1,384)
–1,384 Registration cities, flu/pneumonia. Census. Mortality Statistics 1920. 1922, p. 244-245.
— 539 Registration cities, influenza. Census. Mortality Statistics 1920. 1922, p. 244.
— 845 Registration cities, pneumonia. Census. Mortality Statistics 1920. 1922, p. 245.
Utah: (3,273-3,727)
1918: (1,828-2,282)
–2,282 State. Cairns. “Pandemic/Spanish Flu Hits Utahns,” Standard Examiner, 11-21-2009.
–1,828 “ Sep-Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, p.186.
— 23 “ Sep, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, p.186.
— 588 “ Oct, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, p.186.
— 756 “ Nov, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, p.186.
— 461 “ Dec, flu/pneumonia. US PHS. An. Rpt. of…Surgeon Gen…1919. 1920, p.186.
— 73 Ogden. Cairns. “Pandemic/Spanish Flu Hits Utahns,” Standard Examiner, 11-21-2009.
— 610 Salt Lake City. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, 1696.
–379 registered influenza deaths
–231 registered pneumonia deaths
1919: ( 1,031)
–1,031 State, flu/pneumonia. Census Bureau. Mortality Statistics 1919 (V.20). 1921, p. 430-31.
— 803 “ influenza. Census Bureau. Mortality Statistics 1919 (V.20). 1921, p. 430.
— 228 “ pneumonia. Bureau of the Census. Mortality Statistics 1919 (V.20). 1921, p. 431.
Utah (continued)
1920: ( 414)
— 414 State, flu/pneumonia. Census Bureau. Mortality Statistics 1920 (V.21). 1922, p. 244-45.
— 181 “ influenza. Bureau of the Census. Mortality Statistics 1920 (V.21). 1922, p. 244.
— 233 “ pneumonia. Bureau of the Census. Mortality Statistics 1920 (V.21). 1922, p. 245.
Vermont: (2,352-2,442)
1918: (1,709-1,800)
–1,800 Minnix. “Behind the Numbers of the Influenza Pandemic of 1918-1919 in the U.S.”
–1,772 Bazilchuk. “At Nature’s Mercy: Vermonters Prove…Mettle…,” Burlington Free Press.
–1,709 State, Sep-Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, 186.
— 104 “ Sep, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, 186.
–1,268 “ Oct, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, 186.
— 182 “ Nov, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, 186.
— 215 “ Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, 186.
— 265 Crittenden County. Bazilchuk. “At Nature’s Mercy…,” Burlington Free Press.
— 437 Washington County. Bazilchuk. “At Nature’s Mercy…,” Burlington Free Press.
1919: (519)
— 519 State, Jan-Apr, flu/pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 158 “ Jan, flu/pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 137 “ Feb, flu/pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 132 “ Mar, flu/pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 92 “ Apr, flu/pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: (124)
— 43 Barre, Burlington, Rutland. Flu. Census Bur. Mortality Statistics 1920 (V21). p.245.
— 81 “ “ “ pneumonia. Census Bur. Mortality Statistics 1920 (V21). p.246
Virginia: (18,554)
1918: (11,951)
–15,000 State. Minnix. “Behind…Numbers of the Influenza Pandemic of 1918/19 in U.S.”[47]
–11,951 “ Jan-Dec, flu/pneumonia. Census Bur. Mortality Statistics 1918 (V19), 1920, 28.
— 2,266 “ Jan-Aug, flu/pneumonia. Census Bur. Mortality Statistics 1918 (V19), 1920, 28.
— 9,685 “ Sep-Dec, flu/pneumonia. Census Bur. Mortality Statistics 1918 (V19), 1920, 28.
— 9 Alexandria, Oct 19, 1918. Washington Post, “News of Alexandria,” 10-20-1918, p. 2.
— 97 Camp Eustis, flu/pneumonia. War Dept. An. Rpts., 1919… Surg. Gen. 1920, 1632.
— 280 Camp Humphreys, 1918, disease. War Dept. An. Rpts., 1919… . 1920, 1732.
— 808 Camp Lee, 1918, disease. War Dept. An. Rpts., 1919… . 1920, 1779.
— 423 Richmond, Sep-Oct 22, 1918. WP, “’Flu’ Abates in Virginia,” Oct 24, 1918, 3.
— 17 “ Oct 22, 1918. Washington Post, “’Flu’ Abates in Virginia,” 10-24-1918, 3.
— 886 “ Sep-Dec, 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 1,118 Richmond US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
–586 registered influenza deaths
–532 registered pneumonia deaths
Virginia (continued)
1918, Sep 1-Sep 1, 1919:
–15,678 Statewide. HHS. “Virginia,” The Great Pandemic.
1919: ( 5,177)
— 5,177 State, Jan-Apr, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p.213.
1920: ( 1,426)
— 571 Registration cities,* influenza. Census Bur. Mortality Statistics 1920 (V21). 1922, 244.
— 855 Registration cities, pneumonia. Census Bur. Mortality Statistics 1920 (V21). 1922, 245.
— 179 Richmond, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
* Alexandria, Charlottesville, Danville, Lynchburg, Newport News, Norfolk, Petersburg, Portsmouth, Richmond, Roanoke, Staunton.
Washington: (8,115-8,953)
1918: (4,943-5,781)
–5,781 State, year, flu/pneumonia. Census Bureau. Mortality Statistics 1918 (V19), p. 28.
— 838 “ Jan-Aug, flu/pneumonia. Census Bureau. Mortality Statistics 1918 (V19), p. 28.
–4,943 “ Sep-Dec, flu/pneumonia. Census Bureau. Mortality Statistics 1918 (V19), p. 28.
–4,788 “ Sep-Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p186.
— 86 “ Sep, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p186.
–1,389 “ Oct, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p186.
–1,571 “ Nov, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p186.
–1,742 “ Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p186.
— 279 Camp Lewis, 1918, disease. War Dept. An. Rpts., 1919… . 1920, 1793.
— 1,071 Seattle, Sep-Dec. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 26 “ Oct 9. Oxnard Daily Courier. “Seattle is Fighting Influenza Epidemic”
— 1,329 “ USPHS. Pub. Health Reports, V34/Pt.2/N31, 8-1-1919. 1696.
–1,003 registered influenza deaths
— 326 registered pneumonia deaths
— 430 Spokane, Sep-Dec. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 1,045 “ Knoll. “When the Plague Hit Spokane,” Pacific Northwesterner, 1989.
— 535 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1697.
–430 registered influenza deaths
–105 registered pneumonia deaths
— 534 Tacoma. US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1697.
— 51 registered influenza deaths
–483 registered pneumonia deaths
— 120 Yakima. Hindman, Katrina. “The Spanish Flu Epidemic…,” Yakima Herald-Republic.
1918, Oct-Mar 1919:
–1,600 Seattle. Wilma. “Flu Epidemic Hits Seattle on Oct 3, 1918,” HistoryLink.org, 1-1-2000
Washington State (continued)
1919: (1,910)
–1,910 State, Jan-Apr, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
–1,085 “ Jan, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 348 “ Feb, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 251 “ Mar, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 226 “ Apr, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: (1,262)
–1,262 Registration cities,* flu/pneumonia. Census. Mortality Statistics 1920 (V21), p246-47.
— 524 Registration cities, influenza. Census Bur. Mortality Statistics 1920 (V21), 1922, 246.
— 738 Registration cities, pneumonia. Census Bur. Mortality Statistics 1920 (V21), 1922, 247.
— 358 Seattle, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
— 185 Spokane, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
* Aberdeen, Bellingham, Everett, Hoquiam, Seattle, Spokane, Tacoma, Vancouver, Walla Walla, Yakima.
West Virginia: (3,164)
1918: (2,818)
–2,818 State, Oct 15-Nov 15. Meador, M. M. “The Influenza Epidemic of 1918,” 8-27-2012.
— 110 Raleigh County. Wood, “When the Spanish Flu Hit Area,” Register-Herald, 5-2-2009.
1919: ( 156)
— 76 Wheeling, influenza. Census Bureau. Mortality Statistics 1919 (V20), 1922, p. 222.
— 80 Wheeling, pneumonia. Census Bureau. Mortality Statistics 1919 (V20), 1922, p. 223.
1920: ( 190)
— 190 Wheeling, flu/pneumonia. Census Bur. Mortality Statistics 1920 (V21), 1922, p. 246-47.
— 56 Wheeling, influenza. Census Bureau. Mortality Statistics 1920 (V21), 1922, p. 246.
— 134 “ pneumonia. Census Bureau. Mortality Statistics 1920 (V21), 1922, p. 247.
Wisconsin: (13,301-13,828)
1918: (8,022-8,549)
–8,549 State. Minnix. “Behind…Numbers…Influenza Pandemic of 1918/19 in U.S.”
–8,400 “ Sep-Dec. Wisc. Historical Society, “The Worst Flu Season in WI History.”
–8,022 “ Sep-Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p.186
— 164 “ Sep, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p.186.
–2,616 “ Oct, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p.186.
–2,260 “ Nov, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p.186.
–2,982 “ Dec, flu/pneumonia. US PHS. Annual Rpt…Surgeon Gen…1919. 1920, p.186.
–7,200 “ Sep-Dec. Wangermann. “Historian Wangermann Writes About…1918…”
— 268 Madison, Sep-Dec. Mollenhoff. Madison, A History of the Formative Years. 2003, 391
— 1,562 Milwaukee, Sep-Dec. Crosby. America’s Forgotten Pandemic, 2003, p. 213.
— 2,015 “ US PHS. Public Health Reports, V34/Pt.2/N31, 8-1-1919. 1920, p. 1696.
— 379 registered influenza deaths
–2,015 registered pneumonia deaths
— 1,292 Milwaukee County. Wangermann. “Historian Wangermann Writes About…1918…”
— 207 Sheboygan, Sep-Dec. Wangermann. “Historian Wangermann Writes About…1918…”
1919: (3,202)
— 3,202 State, Jan-Apr, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 906 “ Jan, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 648 “ Feb, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 949 “ Mar, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
— 699 “ Apr, influenza & pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
1920: (2,077)
–2,077 Registration cities,* flu/pneumonia. Census. Mortality Statistics 1920 (V21), p. 246-47.
— 658 “ flu. Census Bur. Mortality Statistics 1920 (V21), p. 246.
–1,419 “ pneumonia. Census Bur. Mortality Statistics 1920 (V21), p. 247.
— 606 Milwaukee, Jan-Mar, 1920. U.S. PHS. Annual Report for FY 1920, p. 200.
* Appleton, Ashland, Beloit, Eau Claire, Fond du Lac, Green Bay, Janesville, Kenosha, La Crosse, Madison, Manitowoc, Marinette, Milwaukee, Oshkosh, Racine, Sheboygan, Stevens Point, Superior, Waukesha, Wausau, West Allis.
Wyoming: (1,175)
1918: (813)
–813 State, Sep-Dec, flu/pneumonia. US PHS. Annual Rpt.…Surgeon Gen…1919. p. 186.
— 9 “ Sep, flu/pneumonia. US PHS. Annual Rpt.…Surgeon Gen…1919. p. 186.
–203 “ Oct, flu/pneumonia. US PHS. Annual Rpt.…Surgeon Gen…1919. p. 186.
–364 “ Nov, flu/pneumonia. US PHS. Annual Rpt.…Surgeon Gen…1919. p. 186.
–237 “ Dec, flu/pneumonia. US PHS. Annual Rpt.…Surgeon Gen…1919. p. 186.
–780 “ Oct 1918-Jan 1919. Larson. History of Wyoming, 1990, p. 404.
1919: (362)
— 362 State, Jan-Apr, influenza and pneumonia. U.S. PHS. Annual Report for FY 1920, p. 213.
U.S. Military ( 57,260) World War I
— 57,260 Scanlon and Lester. “Killing them Softly – with the Spanish flu.” NHO, Jan 2014, 11.
U.S. Military (USA and USN) ( ~55,714) 1917-1918
— Blanchard tabulation of Army and Navy figures noted below.
U.S. Army: ( 50,714) — 1917-18
— 50,714 1917-18 disease. War Dept. An. Rpts., 1919…Rpt…. Surgeon General. 1920, p. 1441.
U.S. Army: (37,626-44,000) — 1918
— 47,384 1918, disease. War Dept. An. Rpts., 1919…Rpt…. Surgeon General. 1920, p. 1434.*
— 46,082 1918, disease enlisted. War Dept. An. Rpts., 1919…Rpt…Surgeon Gen. 1920, 1483.
–>44,000 Dauer, C.C. “The Pandemic of Influenza in 1918-19.” U.S. PHS, 7-19-1957.
— 39,371 1918 flu/respiratory. War Dept. An. Rpts., 1919… Surgeon General. 1920, p. 1437.⁑
— 38,600 All of 1918, flu (23,000) and pneumonia (15,600). Crosby 2003, 206.
— 37,266 1918, flu (22,402) and pneumonia (14,864). War Dept. An. Rpt. 1919. 1920, p. 1446.
— 28,729 1918 In U.S., influenza, enlisted. War Dept. An. Rpts., 1919… Surgeon Gen., 1446.
— 16,010 1918 In Europe, disease, enlisted. War Dept. An. Rpts., 1919… Surgeon Gen., 1484.
— 6,481 1918 In Europe, pneumonia, enlisted. War Dept. An. Rpts., 1919… Surg. 1920, 1484.
— 5,072 1918 In Europe, flu, enlisted. War Dept. An. Rpts., 1919… Surg. Gen. 1920, 1484.
— 1,008 1918 deaths on transports. War Dept. An. Rpts., 1919… Surgeon General, p. 1479.[48]
— 662 1918 disease, officers. War Dept. An. Rpts., 1919…Rpt…. Surg. Gen. 1920, 1482.
— 518 1918 In US flu, officers. War Dept. An. Rpts., 1919…Rpt…. Surgeon Gen. 1920, 1482
— 141 1918 In US, pneumonia, officers. War Dept. An. Rpts., 1919… Surg. Gen. 1920, 1482
— 138 1918 In Europe, flu, officers. War Dept. An. Rpts., 1919… Surg. Gen. 1920, 1483.
— 138 1918 Europe, pneumonia, officers. War Dept. An. Rpts., 1919… Surg…. 1920, 1483.
* “Influenza…with lobar pneumonia and broncho-pneumonia, many of the cases of which, no doubt, occurred also with influenza, caused 73.97 per cent of the total deaths for officers from disease, 80.87 per cent of the total deaths from disease for enlisted men, American Troops.” (War Dept. An. Rpts., 1919…Report…. Surgeon General. 1920, p.1435.)
⁑ “Influenza caused 23,007 deaths, a rate of 9.14. In addition to this number of deaths, there were 431 charged to bronchitis; 6,814 to broncho-pneumonia; 8,407 to lobar pneumonia; 450 to pneumonia unclassified, and 262 to pleurisy. If these deaths were added to the deaths from influenza, the total would be 39,371. [~] 82 per cent of all the deaths during 1918 were attributed to the acute respiratory diseases named. The rate would be 15.64 per 1,000.”
U.S. Navy (4,000-5,000) — 1918
— 5,000 All of 1918. Crosby. America’s Forgotten Pandemic, 2003, p. 206.[49]
–~5,000 Dauer, C.C. “The Pandemic of Influenza in 1918-19.” U.S. PHS, 7-19-1957.
— 4,907 Sep-Oct. US Dept. Navy. “Casualties: US Navy…Marine Corps Personnel…”
— 4,000 Aug 31-Dec 31, 1918. Dept. of Navy. “The Influenza Epidemic of 1918.” 2009 update.
Puerto Rico
— 1,873. Statewide, Jan-Apr, 1919. U.S. PHS. Annual Report for FY 1920, p. 213.
Narrative Information
US Navy: “Pandemic of influenza. First outbreak in Navy occurred in January 1918 on USS Minneapolis in Philadelphia Navy Yard, subsequently spreading throughout the Navy, particularly during the outbreak of September/October 1918: 4,907 died and 146,446 sick (influenza, bronchitis and all forms of pneumonia included) 1918. 558 died from influenza in 1919; and 278 in 1920.” (Sep-Oct. US Dept. Navy. “Casualties: US Navy…Marine Corps Personnel…”)
General
Crosby Interview: “Dr. Alfred Crosby, author, America’s Forgotten Pandemic: ‘One of the factors that made this so particularly, frightening was that everybody had a preconception of what the flu was: it’s a miserable cold and, after a few days, you’re up and around, this was a flu that put people into bed as if they’d been hit with a 2 x 4. That turned into pneumonia that turned people blue and black and killed them. It was a flu out of some sort of a horror story. They never had dreamed that influenza could ever do anything like this to people before.’….
“How great a proportion of the population suffered clinically recognizable cases of influenza in the United States in fall 1918 and winter 1919? The USPHS [US Public Health Service] carefully canvassed eleven cities and towns across the nation in 1919 (an admittedly tiny fraction of the total population) and discovered that 280 out of every 1,000 persons of these communities had flu during the pandemic. This figure is similar to others derived in similar surveys in the United States and elsewhere in the world. If the nation as a whole suffered an equal proportion of flu cases, then over one-quarter of the population, 25 million and moiré, had overt cases of the flu in 1918-1919.
“The United States Navy, which had more accurate knowledge on its sailors than the USPHS did about civilians, estimated that perhaps as high as 40 percent of naval personnel had flu in 1918.” (Crosby 1989, 205)
“The sum of American sailors and soldiers who died of flu and pneumonia in 1918 is over 43,000, about 80 percent of American battle deaths in the war.” (Crosby 1989, 206)
“The combined battle deaths of personnel of the United States Armed Forces in World War I, World War II, and the Korean and Vietnamese conflicts amount to 423,000, far less than what the nation lost to Spanish influenza in ten months.” (Crosby 1989, 207)
“It should be noted that 550,000 is a conservative estimate. It does not include the thousands who died of such diseases as bronchitis and pleurisy, many of whom were prepared for these infections by attacks of flu. It does not take into consideration at all the fact that, during an influenza epidemic, the death rate for nonrespiratory diseases rises. Sufferers from chronic maladies, such as cardiovascular disease, diabetes, and nephritis, die more readily of those maladies, and the lives of no group in a population afflicted by influenza are in greater jeopardy than those of pregnant women. The peak for deaths from diseases other than flu and pneumonia in fall 1918 came only one week after the peak for flu and pneumonia.” (Crosby 1989, p. 207)
Donovan: “Just how bad was it? One account from the Centers for Disease Control had this to say: ‘The effect of the influenza epidemic was so severe that the average life span in the United States was reduced by 10 years. The mortality rate was 2.5 percent — meaning that 1 person out of every 40 who caught the disease died.’
“The death rate for 15- to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years,” the report said. “One anecdote shared of 1918 was of four women playing bridge together late into the night. A day later three of the four were dead of the flu.”
“An estimated 675,000 Americans died of the flu in 1918 and 1919, more than 10 times the number who had died in World War I. About half of the servicemen who died in the war in Europe died of the flu and not war injuries.” (Donovan. “1918: The Year of Death,” Gallup Independent, Nov 8, 2008.)
Lynch: “The disease began with a cough, then increasing pain behind the eyes and ears. Body temperature, heart rate, and respiration escalated rapidly. In the worst cases, pneumonia quickly followed. The two diseases inflamed and irritated the lungs until they filled with liquid, suffocating the patients and causing their bodies to turn a cyanotic blue-black.” (Lynch. “Flu: It Started with a Cough in the Summer of 1918,” PA Gazette, Nov/Dec 1998.)
PBS: “In Boston the stock market closed. In Pennsylvania a statewide order shut down every place of amusement, every saloon. In Kentucky the Board of Health prohibited public gatherings of any kind, even funerals…. “One agonized official in the stricken east sent an urgent warning west….Hunt up your wood-workers and set them to making coffins. Then take your street laborers and set them to digging graves….“Before it was over, it almost broke America apart…”
(PBS, Influenza 1918, 1999)
Phillips & Killingray (Eds.): “The place of origin of the 1918 influenza virus is much debated. Both North America and China have been suggested, although most evidence points to the former where the infection was first recognized in the mid-West early in March of that year. From the United States influenza swept around the world in three waves and few areas escaped its malignant effect. The first wave in March and April 1918 spread rapidly to war-ravaged Europe and then on to Asia and North Africa, before reaching Australia by July. The mortality rate was fairly low and the outbreak did not occasion excessive concern. The second and highly lethal wave occurred in late August 1918 and re-appeared as a third and less virulent wave in 1919. The virus spread rapidly along the conduits of war and commerce to engulf the entire world in a matter of weeks.” (Phillips & Killingray (Eds.). The Spanish Influenza Pandemic of 1918-19. 2003, pp. 5-6.)
“Various methods were used in the industrial states to try and prevent further spread of the pandemic. Ports were quarantined; public transport, passengers and luggage were fumigated; public buildings – schools and cinemas, but rarely churches or bars – were closed; local legislation instructed people to wear masks and to avoid congregating; advertisements urged to prophylactic values of tobacco and alcohol; many people resorted to prayer and patent medicines. But all measures were seemingly without avail. Hospital wards, doctors’ surgeries and clinics were weighed down with patients. Probably the best advice for sufferers, if it could be followed, was the use of aspirin to lower the body temperature, bed rest and effective nursing care. The vast majority of those infected around the world, in a global population which was predominantly peasant and poor, lacked such knowledge and certainly access to easy means of relief.
“A surprising feature of the 1918-19 pandemic, compared to all other recorded influenza pandemics, was the high incidence of death universally among those aged between 20-40 years, particularly men, the very group that might be thought to be stronger and thus less likely to succumb to influenza. This was the case whether a country was at war or at peace. This age-gender death pattern still remains something of a mystery. The cause may have been genetic or physiological. Another reason may be due to the tendency of many men, out of necessity or masculine impulse, to continue working rather than resting when they were sick. A cold or a slight feeling of being unwell was not sufficient reason or excuse for a man, who was often the sole or major bread-winner, to stop working. The poor, and those living in over-crowded and insanitary conditions, were also more likely to catch and to die from the virus, although patterns of mortality varied from one place to another around the world. Certainly the poor were rendered more vulnerable due to low levels of nutrition and poor physical health.” (Phillips & Killingray (Eds.). The Spanish Influenza Pandemic of 1918-19. 2003, pp. 8-9.)
Reuters: “Strep infections and not the flu virus itself may have killed most people during the 1918 influenza pandemic, which suggests some of the most dire predictions about a new pandemic may be exaggerated, U.S. researchers said on Thursday.” (Reuters. “Study: Strep, Not Flu May Have Killed Most in 1918 Pandemic.” February 6, 2009.)
Rosenberg and Peck: “In 1918-19, a highly contagious virus known as Spanish influenza was responsible for the deaths of 20 million people worldwide; approximately 850,000 of these victims were residents of the United States. This airborne form of influenza spread rapidly, and with devastating effects. Some communities were especially vulnerable; for example, 60% of the Eskimo population living in Nome, Alaska, died within a matter of easy. One-fifth of the global population was infected, as was 28% of the U.S. population.” (Rosenberg/Peck. “Megadeaths.” Bryant. Handbook of Death & Dying. 2003, p. 230.)
Sapatkin: “That so-called Spanish flu turned out to unfold in four major waves in the United States: February to May 1918, September to December 1918, January to April 1919, and December 1919 to March 1920.” (Sapatkin. “The 1918 Flu Epidemic Worse Second Time Around,” Philadelphia Inquirer, May 20, 2009.)
The Encyclopedia of Arkansas History & Culture: “Scientists theorize that the 1918 strain may have begun in rural Haskell County, Kansas, where people lived close to their pigs and poultry. With the entry of the United States into World War I on April 6, 1917, men were drafted and sent to large training camps before being transported to Europe. In February 1918, after visiting their families in Haskell (where there were reports of people dying from severe flu) several soldiers on leave reported back to duty at Camp Funston, part of the Fort Riley complex in eastern Kansas….
“Conditions in 1918 were perfect for spreading the disease as civilian war workers moved around the country, draftees were sent to overcrowded training camps, and soldiers were shipped off to war in the cramped, stuffy holds of troop ships, which became known as “floating caskets.” Influenza spread to American cities and rural areas alike, as well as to the battlefields of France before spreading throughout Europe. It killed eight million Spaniards with terrible speed. Because the press in Spain, a neutral country, was not censored into ignoring the epidemic as combatant countries did (for fear of lowering morale), it became known as the Spanish Flu.”
(The Encyclopedia of Arkansas History & Culture. “Flu Epidemic of 1918,” 2008.)
Chronological
February 1918: “In February 1918, after visiting their families in Haskell [Kansas] (where there were reports of people dying from severe flu) several soldiers on leave reported back to duty at Camp Funston, part of the Fort Riley complex in eastern Kansas.” (“Flu Epidemic of 1918,” The Encyclopedia of Arkansas History & Culture. 2008.)
February 1918: “Although scientists are still arguing over its origins, one theory is that Camp Funston in Kansas, near Fort Riley, was the source. There, in February 1918, a large cattle herd was kept near a huge training center with thousands of men in close quarters, and the virus spread from animals to humans. Initially the disease caused only mild symptoms but with time the virus grew stronger (and lethal) and spread, as troops moved across the country and then overseas.” (Hamer. Forward Together: South Carolinians in the Great War,” 2006, p. 48.) [Have also read, though did not cite, that the skies were dark with smoke from the burning of pig manure near the post for many days, and that this was the possible cause.]
March 1918: “The Spanish flu first struck in March 1918 in the USA, with reports from Detroit, South Carolina and San Quentin Prison of outbreaks of an unusual respiratory disease that was associated with disproportionate increase in deaths among young adults.” (Wilschut, McElhaney and Palache. Influenza. 2006, p. 61.)
March 11, 1918: “At Fort Riley [Camp Funston then], Kansas, an Army private reports to the camp hospital just before breakfast complaining of fever, sore throat, and headache. He is quickly followed by another soldier with similar complaints. By noon, the camp’s hospital has dealt with over 100 ill soldiers. By week’s end, that number will jump to 500.” (PBS. “Timeline: Influenza Across America in 1918,” Influenza 1918.) “Within a month, 1,000 were sick, and almost fifty soldiers were dead. They were strong, healthy young men whose lungs filled with fluid so quickly they drowned, sometimes within twelve hours of feeling sick. Because the lack of oxygen in the blood seemed to turn the victims dark blue, purple, or black, comparisons were drawn to the “Black Death” (most likely bubonic plague) of the Middle Ages. The 1918 flu would go on to kill more people in one year than the Black Death did in a century.” (“Flu Epidemic of 1918,” The Encyclopedia of Arkansas History & Culture. 2008.)
June 22, 1918: “On June 22 the City of Exeter, last port Liverpool, arrived at Philadelphia with 27 Lascars and an English quartermaster so desperately ill with pneumonia that they had to be taken to a hospital immediately.” (Crosby 2003, 29)
July, 1918: “…the port city of Brest in France, where almost half of all U.S. soldiers disembarked, had survived an epidemic of a milder flu strain earlier in 1918, but as John M. Barry states, “the first outbreak with high mortality occurred in July, in a replacement detachment of American troops from Camp Pike, Arkansas.”[50] Camp Pike (renamed Camp Robinson in 1937) in North Little Rock (Pulaski County) was established in 1917 for army basic training. While about eighty percent of Arkansans lived on farms in 1918, Fort Smith (Sebastian County) and the nearby Little Rock (Pulaski County) area each had more than 30,000 residents. With 52,000 men at Camp Pike, its infirmary began admitting up to a thousand men a day. The camp was sealed and quarantined, and the commandant ordered that the names of the dead not be released to the press. Still, more than 500 civilian cases soon appeared in the Little Rock area. James C. Geiger, U.S. Public Health Service officer for Arkansas, downplayed the threat to the state with reassuring statements (possibly to avert a panic), even after he caught the flu and his wife died of it. Arkansas officials did little to prepare for the epidemic, partly based on Geiger’s reassurances and the lack of press coverage in wartime.” (“Flu Epidemic of 1918,” The Encyclopedia of Arkansas History & Culture. 2008.)
August 9, 1918: “On August 9 the U.S. Navy Bureau of Medicine and Surgery in Washington, D.C. issued a precautionary bulletin, warning that influenza was prevalent in Europe, Hawaii, and elsewhere and describing its symptoms, incubation period, and the recommended treatment.” (Crosby. America’s Forgotten Pandemic, 2003, p. 31.)
August 12, 1918: “The Norwegian vessel Bergensfjord arrived in New York harbor on August 12. She had had 200 cases of influenza and three deaths while at sea. Eleven passengers were transferred to a hospital in Brooklyn. They were not placed in isolation wards.” (Crosby 2003, 29)
August-Mid, 1918: “In mid-August 1918 the influenza virus mutated, and with startling virulence and at great speed as a second wave on both sides of the Atlantic and in three continents. In the same week there were outbreaks of flu in three nodal Atlantic ports, in Freetown, Brest and Boston.” (Phillips. The Spanish Influenza Pandemic of 1918-19. 2003, 6.)
August 27, 1918: “Sailors stationed onboard the Receiving Ship at Commonwealth Pier in Boston begin reporting to sick-bay with the usual symptoms of the grippe. By August 30, over 60 sailors were sick. Soon, Commonwealth Pier was overwhelmed and 50 cases had to be transferred to Chelsea Naval Hospital. Flu sufferers commonly described feeling like they “had been beaten all over with a club”.” (PBS. “Timeline: Influenza…America…,” Influenza 1918.)
August 27, 1918: “The first recorded cases of virulent influenza in the United States occurred in Boston. On August 27th, several sailors at the Commonwealth Pier reported sick with influenza. By the next day, there were eight new cases. On the third day, August 29th, there were 58 cases. These men were sent to the Chelsea Naval Hospital; from this hospital, the disease spread rapidly into the city of Boston and the rest of the state.” (HHS. “Massachusetts,” The Great Pandemic.)
August 31, 1918: Flu and pneumonia deaths during the month were 2,800. (Crosby 2003, 48.)
September 1918: “In September of 1918, soldiers at an army base near Boston suddenly began to die. The cause of death was identified as influenza, but it was unlike any strain ever seen. As the killer virus spread across the country, hospitals overfilled, death carts roamed the streets and helpless city officials dug mass graves. It was the worst epidemic in American history, killing over 600,000 — until it disappeared as mysteriously as it had begun…. It would be as if today, with our present population, more than 1,400,000 people were to die in a sudden outbreak for which there was no explanation and no known cure….” (Crosby 1989)
September 1, 1918: The U.S. Naval Hospital in Washington, D.C. “received its first case of influenza on September 1, 1918, and pandemic proportions were assumed very rapidly. The admission rate soon rose to 25 to 30 cases daily.” (Naval Historical Center. “Influenza at the United States Naval Hospital, Washington, D.C.”)
September 3, 1918: “On September 3 the first civilian suffering with flu, undoubtedly of the Spanish variety, was admitted to Boston City Hospital.” (Crosby 2003, 40; see. also: HHS. “Massachusetts,” The Great Pandemic.)
September 4, 1918: “On September 4 the first cases of flu appeared in the Navy Radio School at Harvard across the Charles River in Cambridge, where 5,000 young men were being trained in this newest and most exotic form of communication.” (Crosby 2003, 40)
September 5, 1918: “On September 5 the [MA] state Department of Health released the news of the epidemic to the newspapers. Doctor John S. Hitchcock of the health department warned that ‘unless precautions are taken the disease in all probability will spread to the civilian population of the city’.” (Crosby 2003, 40)
September 7, 1918: “…the first Devens victim, a soldier of Company B, 42nd Infantry, went on sick call…” (Crosby 1989, 5)
Early September, 1918: “Dr. Victor Vaughan, acting Surgeon General of the Army, receives urgent orders to proceed to Camp Devens near Boston. Once there, what Vaughan sees changes his life forever:
“I saw hundreds of young stalwart men in uniform coming into the wards of the hospital. Every bed was full, yet others crowded in. The faces wore a bluish cast; a cough brought up the blood-stained sputum. In the morning, the dead bodies are stacked about the morgue like cordwood.”
“On the day that Vaughan arrived at Camp Devens, 63 men died from influenza.” (PBS. “Timeline: Influenza Across America in 1918,” Influenza 1918.)
September 8, 1918: “The first three pandemic deaths in Boston officially scribed to influenza rather than to pneumonia occurred on September 8: One navy death, one merchant marine, and the first civilian death so diagnosed since early summer. The first case of Spanish influenza had appeared in Cap Devens September 8, four days after the arrival in camp of 1,400 fresh Massachusetts recruits.” (Crosby 2003, 40)
September 11, 1918: “As of September 11, 95 cases of influenzal pneumonia had been or were being treated at Chelsea Naval Hospital [MA]. Thirty-five had died and another 15 or 20 were desperately ill.” (Crosby 2003, 39-40) “On September 11…the navy announced that the pandemic had killed 26 sailors in and around Boston, and the first flu cases were recognized among navy personnel in Rhode Island, Connecticut, Pennsylvania, Virginia, South Carolina, Florida, and Illinois.” (Crosby 2003, 46)
September 13, 1918: “On September 13 Surgeon General Rupert Blue of the United States Public Health Service (USPHS) issued advice to the press on how to recognize the disease and recommended bed rest, good food, salts of quinine, and aspirin for the sick.” (Crosby 2003, 46)
September 18, 1918: The day’s admissions of new cases of influenza at Fort Devens was 1,176 men, bringing the total to 6,674. (Crosby 1989, 5)
September 20, 1918: “As of noon, September 20, the army had accumulated 9,313 cases of flu since the new wave had been recognized in the United States, and the statistics showed that the spread of the disease was accelerating.” (Crosby 2003, 47)
September 21, 1918: “On Sept. 21, 1918…12 soldier-trainees were reported ill at the University of Colorado in Boulder. Four days later, 75 sick students were quarantined in fraternity houses.” (Leonard. “The 1918 Influenza Outbreak,” Denver Post, May 3, 2009.
September 22, 1918: “Henry Scott, 28, of Elkton, dies. The Pennsylvania Railroad lineman and baseball player is the first civilian whose death is blamed on flu in a news report in The Sun [Baltimore]. (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
September 23, 1918: “The Boston Globe reported that in the twenty-four hours preceding 7:00 A.M. of September 23, 66 men, all of them probably in the peak years of physical prowess, had died.” [At Camp Devens, ~30m west of Boston] (Crosby 1989, 6) “By September 23 the number of officially recognized cases in the army in the United States rose to over 20,000.” (Crosby 2003, 47) Elsewhere, in South Dakota, “The first official cases in the state were reported on September 23rd when the state noted “a few scattered cases”.” (HHS. “South Dakota,” The Great Pandemic.)
September 24, 1918: “Boston closes its public schools.” (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
September 25, 1918: “On Sept. 25th, Rupert Blue, the Surgeon General, announced to the Associated Press that the first cases of influenza had been discovered in Minnesota.” (HHS. “Minnesota,” The Great Pandemic.)
September 26, 1918: “…123 Bostonians died of influenza and 33 of pneumonia, and the number of flu cases in Massachusetts was estimated at 50,000.” (Crosby 2003, 48) “…all vestiges of hope that the disease would remain in New England or even east of the Mississippi were gone. It had appeared at navy bases as far away from Boston as Louisiana, Puget Sound, and San Francisco Bay, and twenty army camps from Massachusetts to Georgia and as far west as Camp Lewis, Washington.” (Crosby 2003, 48) In Tennessee it was reported that the disease “had reached epidemic proportions.” (HHS. “Tennessee,” The Great Pandemic.)
September 26, 1918: “On September 26, the State Health Officer of Massachusetts requested immediate aid from the Surgeon General as the disease was spreading very rapidly over the entire state and he was unable to furnish doctors and nurses to the stricken communities. Orders were issued immediately to a number of commissioned officers to proceed to Massachusetts for duty in cooperation with the state authorities.” (HHS. “Massachusetts,” The Great Pandemic.)
September 27, 1918: The American Red Cross Headquarters in Washington “wired all its Division Directors of Nursing to mobilize all forces.” (Crosby 2003, 51)
September 28, 1918: 200,000 gather for a 4th Liberty Loan Drive in Philadelphia. Days after the parade, 635 new cases of influenza were reported. Within days, the city will be forced to admit that epidemic conditions exist. Churches, schools, and theaters are ordered closed, along with all other places of “public amusement.
“Congress approves a special $1 million fund to enable the U.S. Public Health Service to recruit physicians and nurses to deal with the growing epidemic. US Surgeon General Rupert Blue set out to hire over 1,000 doctors and 700 nurses with the new funds. The war effort, however, made Blue’s task difficult. With many medical professionals already engaged in lending care to fighting soldiers, Blue was forced to look for some recruits in places like old-age homes and rehabilitation centers.” (PBS. “Timeline: Influenza Across America in 1918,” Influenza 1918.)
September 1918, Late: “In late September, a physician at Camp Devens provided a chilling description of the situation: “This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed….These men start with what appears to be an ordinary attack of La Grippe or Influenza, and when brought to the Hosp. they very rapidly develop the most viscous type of Pneumonia that has ever been seen. Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up. There is no doubt in my mind that there is a new mixed infection here, but what I don’t know….The normal number of resident Drs. here is about 25 and that has been increased to over 250, all of whom (of course excepting me) have temporary orders – “Return to your proper Station on completion of work”. Mine says “Permanent Duty”, but I have been in the Army just long enough to learn that it doesn’t always mean what it says…We have lost an outrageous number of Nurses and Drs., and the little town of Ayer is a sight. It takes special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce, we used to go down to the morgue (which is just back of my ward) and look at the boys laid out in long rows. It beats any sight they ever had in France after a battle. An extra long barracks has been vacated for the use of the Morgue, and it would make any man sit up and take notice to walk down the long lines of dead soldiers all dressed and laid out in double rows. We have no relief here, you get up in the morning at 5.30 and work steady till about 9.30 P.M., sleep, then go at it again. Some of the men of course have been here all the time, and they are TIRED”.” (HHS. “Massachusetts,” The Great Pandemic.)
October 1, 1918: “Red Cross volunteers in Baltimore make 18,000 face masks to protect those coming into contact with flu victims. Nationally, more than 14,000 new cases are reported in a 24-hour period.” (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
October 2, 1918: “The Public Health Service [Nebraska] believed that influenza was “prevalent throughout the State on October 1.” The disease had undoubtedly erupted there during September.” (HHS. “Nebraska,” The Great Pandemic.)
October 2, 1918: “Boston registers 202 deaths from influenza. Shortly thereafter, the city canceled its Liberty Bond parades and sporting events. Churches were closed and the stock market was put on half-days.” (PBS. “Timeline: Influenza…America in 1918,” Influenza 1918.)
October 3, 1918: “…the Delaware State Board of Health met in an emergency session and ordered most of the state shut down to stem the death toll from influenza. Their order read, in part, “Whereas: A very serious epidemic of influenza is now raging in the state of Delaware…to protect the health of the entire citizenship of Delaware…all schools, theatres, all churches, all motion picture houses, all dance halls, all carnivals, fairs and bazaars, all billiard rooms and pool rooms, all bowling alleys in the entire State of Delaware shall be closed and kept closed until further notice”.” (HHS. “Delaware,” The Great Pandemic)
October 4, 1918: “…New Mexico reported that influenza was present in several places in the state. Within a week, the state was reporting epidemics in the state’s more densely populated areas such as Albuquerque, Gallup and Carlsbad.” (HHS. “New Mexico,” The Great Pandemic.) South Dakota reported on the 4th that “cases have appeared in a number of places”.” (HHS. “South Dakota,” The Great Pandemic.)
October 5, 1918: “Cumberland, Md. Oct 4….It was reported that out of 6,000 men employed on the Cumberland division of the Baltimore and Ohio Railroad, 1,000 have been incapacitated by influenza…” (Washington Post. “1,000 Railroad Men Ill,” Oct 5, 1918, p. 6.)
October 5, 1918: “Seattle, Wash., Oct. 5.—All churches, schools, theaters and other places of public assemblage were ordered closed by proclamation of Mayor Hanson at noon today to check the spread of Spanish influenza. Police officers were immediately sent to the motion picture houses to enforce the order. No church services will be permitted tomorrow.” (San Antonio Evening News. “Influenza Closes Seattle Schools, Theaters, Churches,” Oct 5, 1918, 1.)
October 5, 1918: “Washington, D.C., Oct 5.—Fifty=three additional deaths from influenza were reported at the base hospital here at 2 o’clock this afternoon. This makes a total of 134 deaths from the disease since last Sunday.” (San Antonio Evening News. “Fifty-Three More Deaths at Sherman,” Oct 5, 1918, 1.)
October 6, 1918: “Philadelphia posts what will be just the first of several gruesome records for the month: 289 influenza-related deaths in a single day.” (PBS. Influenza 1918.)
October 7, 1918: “…Gov. Julius C. Gunter [CO] urged local authorities to ban public gatherings. Following the lead of Pueblo, Colorado Springs, and Denver, other towns across the state closed their schools and theaters. By this time, Denver had tallied 37 deaths, and 11 had died in Colorado Springs. Twenty cases of the flu were reported in Fort Lupton, 25 in Alamosa, and from 8 to 12 in Glenwood Springs, Fort Collins, and Durango. Sargents, a town of 130 people southeast of Gunnison, reported 40 cases and six deaths on Oct. 8. Other towns, including La Junta, Rocky Ford, Walsenburg, and Gunnison, though they had not yet verified an outbreak, followed the governor’s advice.” (Leonard. “The 1918 Influenza…” Denver Post, May 3, 2009.)
October 8, 1918: “Justices of the Maine Supreme Court…[fall] into line with other officials in the matter of combating further spread of influenza, by suspending or postponing the current terms of court.” (Maine CDC, Dept. of HHS. 1918 Pandemic Influenza in Maine.)
October 9, 1918: “Twenty-six deaths in Seattle and vicinity in the last 24 hours is the record of the influenza epidemic now sweeping thru this section of the country. Eight deaths were in Seattle, seven at the University of Washington naval training station and ten at Bremerton.” (Oxnard Daily Courier (CA). “Seattle is Fighting Influenza Epidemic,” October 9, 1918, p. 3.)
October 10, 1918: “Cedar Rapids, Ia., – Oct. 10. With more than 600 cases of Spanish influenza reported, the city board of health today ordered all theaters, schools, churches and public gathering places closed until further notice.” (Des Moines News. “Flu Closes ‘Rapid’.” Oct 10, 1918.)
October 10, 1918: Washington Post reports “A shortage of coffins is confronting the undertakers in Washington [DC] as a result of the heavy death toll of the influenza epidemic. Rush orders for caskets have been sent to other cities, but the ravages of the disease elsewhere have likewise caused a great demand, and there is difficulty getting orders filled. At Walter Reed Hospital a score of bodies were held temporarily in the morgue for want of caskets….” (Washington Post. “Coffins Short in District; Aid Asked from Outside,” Oct 10, 1918, p. 10.)
October 11, 1918: “On Oct. 11th, H. M. Guilford, M.D., the head of the Minneapolis Department of Health, ordered all schools, churches, theaters, dance halls, and billiard parlors to be closed for the duration of the epidemic. Noting that there were 2,000 cases in Minneapolis alone, Guilford said “I do not want to be alarmist, but the disease is not controllable by ordinary measures”.” (HHS. “Minnesota,” The Great Pandemic.)
October 12, 1918: “In White Pine County [NV]…a county-wide quarantine was imposed… and this was in effect until December 28th.” (HHS. “Nevada,” The Great Pandemic.)
October 15, 1918: “On Oct. 15, faced with a rising death rate, Denver’s Board of Health banned all meetings, indoors or out. The far-reaching order proscribed social gatherings in private homes and forbade public funerals. A few days later, the board decreed that all businesses except restaurants, drugstores, and hotels were to close by 6 p.m. Streetcars were limited to carrying 65 passengers, and drivers were instructed to keep all car windows open.” (Leonard. Denver Post)
October 16, 1918: Reported in Washington Post that “Every house in Hopewell, Va. Has one or more patients suffering from influenza, according to investigations just completed by Y.M.C.A. secretaries. Both Hopewell and Petersburg have sent out urgent calls for both nurses and doctors to care for the sick as those on the ground are unable to cope with the situation.”
October 17, 1918: “On October 17th, The Kansas City Star [MO] announced that “A DRASTIC BAN IS ON.” All theaters, schools, and churches were closed. Public gatherings of twenty or more persons, including dances, parties, weddings, and funerals were banned. Entertainment in hotels, bars, and restaurants were banned as well. Only twenty-five people were to be allowed in a store at any one time. Street cars were forbidden to carry more than twenty standing passengers. City officials also insisted that all elevators and streetcars be sterilized daily; telephone booths were to be sterilized twice a day. In an attempt to keep city streets clean, streets were deluged in water.” (HHS. “Missouri,” The Great Pandemic.)
October 18, 1918: “On the week of October 18th, the PHS reported that “from October 5 to 15, 158 deaths from influenza and pneumonia were reported from principal cities in Florida.” (HHS. “Florida,” The Great Pandemic.)
October 19, 1918: “The flu had killed 41 residents of the small Navajo community [Fort Defiance] and [Chris Chillie] Juanika, “crazed no doubt by the fear of himself and his family becoming ill and dying of the flu” decided to take some steps to make sure that didn’t happen. He took an axe and killed his wife and five children, chopping them into little pieces. He then committed suicide by hanging himself.” (Donovan. “1918: The Year of Death,” Gallup Independent, Nov 8, 2008.)
October 22, 1918: “869 New Yorkers die of influenza or the resulting pneumonia in a single day. In Philadelphia, the city’s death rate for one single week is 700 times higher than normal.” (PBS. Influenza 1918.)
October 24, 1918: “San Francisco, Oct 24. – The board of health announced tonight that 1407 cases of Spanish influenza had been reported up to late today, bringing this city’s total to 10,283 cases. Eighty-two additional deaths were reported, a total of 385.” (Fresno Morning Republican, CA. “Mask or Arrest, Order,” October 25, 1918, p. 1.)
October 25, 1918: Fresno, CA: “The board of health is in full control in Fresno. Failure to wear a gauze mask today will be regarded as sufficient cause for arrest. Refusal of ‘flu’ sufferers confined in stuffy rooms in lodging houses will be followed by the transportation of the unwilling victim to an isolation hospital despite his protests. If necessary isolation will be forced upon those who have not enough regard for public welfare to isolate themselves….Following a conference at the city hall yesterday afternoon between the board of health, the mayor, the members of the city council and officers of the chief civic organizations of the city, City Attorney Van Meter made public an opinion that the health board is given sufficient powers under Political Code 2979 to enforce all its orders. As a result the police were give orders to begin this morning to enforce the mask rule by arresting those who are too unconcerned with the welfare of others to wear them. As another preventive step Mayor Toomey and the board of Trustees ordered all streets of the entire down town district and in Chinatown to be flushed by the fire department last night. And from today until the end of the epidemic all down town streets will be thoroughly washed with water every day instead of once a week as has been customary. No action was taken toward the closing of saloons. Mayor Toomey said he had been called on the telephone by scores who demanded why the pool halls, schools and churches had been closed and the saloons allowed to remain open. Toomey said he had informed all that he had no authority to close any place of business unless asked to take action by the board of health as a public health measure….Mayor Toomey said he stood ready to close up the entire city, the saloons and every other place, should the board of health demand such action….It was decided at the conference that every case must be isolated and that no persons will be allowed to go to and from sick rooms without completely changing their wearing apparel…. According to official figures given out yesterday, 35 deaths from ‘flu’ have taken place in Fresno County since the discovery of the first case [1st death listed is on Oct. 7].” (Fresno Morning Republican, CA. “Mask or Arrest, Order,” October 25, 1918, p. 12.)
October 31, 1918: “By the end of October…over 17,000 men at Devens had contracted flu and/or pneumonia, one-third of the entire command. Seven hundred eighty-seven of them died…” (Crosby 1989, 11)
October 31, 1918: “October saw the epidemic’s full horror: more than 195,000 people died in America alone. There was a nationwide shortage of caskets. In Philadelphia, the dead were left in gutters and stacked in caskets on the front porches. Trucks drove the city streets, picking up the caskets and corpses. People hid indoors, afraid to interact with their friends and neighbors…. People didn’t want to believe that they could be healthy in the morning and dead by nightfall, they didn’t want to believe that….” (Crosby 1989)
October 31, 1918: “The month turns out to be the deadliest month in the nation’s history as 195,000 Americans fall victim to influenza.” (PBS. “Timeline: Influenza…,” Influenza 1918.)
November 11, 1918: “Armistice Day celebrated as World War I comes to an end. People around the world celebrate in public places without masks.” (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
November 17, 1918: “The U.S. Census Bureau reports that flu has killed at least 78,000 in the nation’s 46 largest cities, nearly double the lives lost in the American Expeditionary Forces over the course of the entire war.” (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
November 20, 1918: “In only five days, influenza leaves 72 of the 80 native Inupiat inhabitants dead in the small town of Brevig Mission, Alaska. Local survivors bury the victims in a mass grave.” (PBS. “Timeline: Influenza Across American in 1918, Influenza 1918.)
November 21, 1918: “Sirens wail, signaling to San Franciscans that it is safe — and legal — to remove their protective face masks. At that point, 2,122 are dead due to influenza.” (PBS)
December 4, 1918: The U.S. public health service publishes an estimate that 300,000 to 350,000 civilian deaths can be attributed to influenza and pneumonia since September 15. The War Department records indicate that another 20,000 deaths have occurred among soldiers.
December 4, 1918: “The chief clerk of the Navajo Indian reservation reports that influenza has taken the lives of more than 2,000 Navajos in Apache County, New Mexico.” (PBS)
December 10, 1918: “Flu takes a jump in Baltimore, with 42 new cases and 15 deaths.” (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
December 31, 1918: “In a third wave, Baltimore records 81 new cases.” (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
January 30, 1920: “New York, Jan. 30. – Despite optimistic statements made by the city health department yesterday the influenza epidemic showed an increase today. Figures made public by Dr. Royal S. Copeland showed 5,532 cases of influenza in the last twenty-four hours, compared with 4,706 yesterday and 351 cases of pneumonia, compared with 549 yesterday. Influenza dead in the last twenty-four hours were 119, and pneumonia, 143.”
January 30, 1920: “Washington, Jan 30. – Reports to the Public Health service on the influenza situation today showed the disease is apparently spreading with equal swiftness in both cold and temperate sections of the country. Washington State reports 540 cases while Texas has 623. Florida reported many cases. The disease also has appeared in rural districts. A telegram from Public Health officials at Honolulu reported numerous cases of influenza arriving there on vessels. State Health officials in South Carolina reported 356 cases to date. Surgeon General Blue again today deemphasized that the situation is not alarming.” (Oswego Daily Times, NY. “Influenza Continues Its Spread,” Jan 20, 1920, p. 1.)
1920: “For the states the highest rates are found for Colorado (287.1), Missouri (261.2), Utah (252.4), Pennsylvania (251.4), and South Carolina (247.3)….For the cities the highest rates appear for Pittsburgh (437.1), Kansas City, Mo. (353.6), Denver (348.3), Youngstown (329.6), and Akron (318.1)….The number of deaths from influenza in 1920 is 62,097, corresponding to a rate of 71 per 100,000 population, as against 84,113 deaths in 1919 and a rate of 98.8.
“With the exception of Delaware and New Jersey, every state has a rate of 40 or more in 1920. However, only one state, Missouri, has a higher rate in 1920 than in 1919. Those showing very high rates in 1920 (all over 100) are South Carolina (137.2), Utah (126.4), North Carolina (116.2), Colorado (110.8), and Tennessee (102.5). The lowest rates are for Delaware (28.6) and New Jersey (37.7). Among the registration cities of 100,000 population or more in 1920, 16 have rates below 40 and 9 have rates above 100. Nashville (123) has the highest rate and Rochester (22.1) the lowest for 1920. The rate for the colored is higher than the rate for the white in every state and every city shown by color.” (Bureau of the Census, U.S. Department of Commerce. Mortality Statistics 1920 (Twenty-First Annual Report). DC: GPO, 1922, pp. 30-31.)
1927: “It is estimated that 21.5 million people worldwide died in the pandemic.” (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
2006: “The World Health Organization lists the death toll from the pandemic as 40 million to 50 million worldwide.” (Baltimore Sun. “The Disease That Shook Baltimore, Oct 20, 2006.)
States
Alabama
HHS: “On October 4th, The Public Health Reports issued their first report from Alabama, noting “an extensive epidemic is reported from Florence and vicinity.” By the time this report was issued, Florence had already been dealing with the pandemic for two weeks. By October 11th, the PHS acknowledged that influenza was in “practically every county in the State.” On October 15th, the PHS glumly noted that “25,811 cases of influenza had been reported in the State.” Because state officials were often too overwhelmed by the pandemic to keep accurate records, they often under-estimated the actual number of influenza cases and influenza-related deaths. It seems likely, in other words, that there were more than 26,000 cases in the state during the week of October 15th.
“In Birmingham the city reported 5,000 cases on October 5th. The high point for deaths appears to have been the week of October 26th when 135 deaths were reported in Birmingham alone.
According to a report sent to the PHS, the physicians in Florence “were overwhelmed with work.” They were also “handicapped by inadequate transportation and two days behind in making calls; many patients [in the nitrate plant situated there] had been sick in bunk houses and tents for several days without nourishment, or medical and nursing attention, the sanitary conditions of the bunk houses were deplorable; the mess halls were grossly unsanitary and their operation much hampered by the lack of help; the existing hospitals were greatly overcrowded with patients; and patients were waiting in line several hours for dispensary treatment, and were greatly delayed in obtaining prescriptions at the pharmacy. The epidemic was so far progressed that the immediate isolation of all cases was impossible. The most urgent indications seemed to be: 1. Supplying all sick people with food. 2. The organization of existing medical personnel for more effective work. 3. The establishment of emergency hospital facilities and the removal of the sickest patients to the emergency hospitals. The pharmaceutical force in the area was inadequate to handle the prescriptions, but fortunately many highly trained chemists were at the Plant awaiting the beginning of operations, and they gladly volunteered for this work….
J.D. Washburn worked in a medical unit in Alabama during the war. Looking back on the pandemic, he remembered “We worked like dogs from about seven in the morning until the last patient of the day had been checked in or out – usually about 10 o’clock that night. The men died like flies, and several times we ran out of boxes to bury them in, and had to put their bodies in cold storage until more boxes were shipped in. It was horrible.”….” (HHS. “Alabama.” The Great Pandemic: The United States in 1918-1919.)
Alaska
HHS: “Although influenza had reached most communities in the United States by late September, the disease did not hit Alaska until late in the fall. This delay allowed public officials to create an influenza policy before the pandemic hit. The territorial governor, Thomas Riggs Jr., imposed a maritime quarantine in an attempt to prevent the spread of the disease. US Marshals were stationed at all ports, trail heads and the mouths of the region’s rivers to ensure that travelers did not bring the disease into any of the territory’s widely dispersed communities. Schools, churches, theaters and pool halls were also closed within these communities.
“In Juneau, citizens were instructed to “keep as much to yourself as possible.” Fairbanks established quarantine stations, also guarded by marshals. Citizens were checked periodically for flu and given armbands reading “OK Fairbanks Health Department.” An experimental vaccine was imported from Seattle and distributed throughout the area in the hopes that it would prevent the spread of the disease. It did not. In Eskimo villages, shamans resorted to more traditional practices: the planting of “medicine trees” was widely believed to protect people against influenza.
“Despite these precautions, influenza spread rapidly throughout the region in the late fall. Half of Nome’s white population fell ill. The Superintendent of Education, Walter Shields, was one of the first to die in the city, but other deaths quickly followed. Nome’s Eskimos who lived in their own village also suffered tremendously: more than half of the village died from influenza.
Because subsistence living was common throughout the territory, influenza killed Alaskans both directly and indirectly. When a family became ill with influenza, no-one was left to feed the fires. Many people simply froze to death in their own homes. Suffering from influenza, many Eskimos and Native Americans found themselves unable to harvest moose or feed their traps and, in the wake of the pandemic, many people died of starvation. In some areas, the situation was especially acute as Eskimos did the unthinkable and ate their sled dogs. In other villages, hungry sled dogs turned on the dead and dying and ate them to survive.
“A clash between western medicine and traditional Eskimos practices further complicated the situation. When western doctors attempted to move Eskimos to makeshift hospitals, many Eskimos reacted with alarm, viewing these as death houses. Patients often responded to their removal to a hospital by committing suicide. The situation worsened when the governor issued a special directive to all Alaskan Natives on November 7th. The directive urged Eskimos to stay at home and avoid public gatherings. The communal nature of traditional Alaskan life made this directive unacceptable to many Eskimos. Many people continued to gather in public and the disease spread quickly throughout many Native Alaskan communities.
“In some areas, influenza decimated whole villages. A schoolteacher reported that in her immediate area “three [villages were] wiped out entirely, others average 85% deaths…Total number of deaths reported 750, probably 25% [of] this number froze to death before help arrived.”
“Influenza slowly declined in Alaska during the late spring of 1919.” (United States Department of Health and Human Services. “Alaska,” The Great Pandemic.)
UAF: 1918. The pandemic flu epidemic spreads to Alaska and rages through 1919. Many Native children, particularly on the Seward Peninsula and in Interior Alaska, are orphaned. In response, a number of new church-sponsored boarding homes open.
“1919. June: Worldwide flu epidemic strikes Unalaska island.” (University of Alaska Fairbanks. Alaska Native History and Cultures Timeline, p. 14.)
Arizona
HHS: “Influenza hit Arizona in late September. The disease probably reached Phoenix first, spreading outward to the rest of the state during the end of September. By October 11th, Flagstaff, Winslow and Holbrook were reporting epidemics. As influenza spread, public health officials were quickly overwhelmed. The epidemic peaked in the state during the first week of November; that week, the state reported deaths from influenza which were four times the state’s annual average.
“City officials and residents reacted to the spread of the disease with alarm. Many Arizonans insisted that the disease was spread by dogs. In Phoenix, as police and city residents killed dogs in an attempt to prevent the spread of influenza, the local paper reported that “Phoenix will soon be dogless.” Schools, theaters and other public areas were also closed for three months.
“In both Tucson and Phoenix, police arrested residents who ventured out in public without a gauze mask. Officials believed that masks prevented the spread of the disease and had required people to wear these to prevent the spread of the disease. When they passed these requirements, city officials and scientific experts were unaware of the fact that influenza is spread by a virus which is small enough to pass through a gauze mask.
”The disease struck the Navajos especially hard. Joseph Schmedding, a trader, who entered a Navajo reservation a few weeks after the epidemic had erupted said that he found 30 Indians, young and old, lying dead in abandoned hogans. In Tuba City, the school was converted into a hospital and the wife of a Navajo trader wrote “for miles around every good winter hogan was deserted [because people feared the infection]. The living moved out into the rain and found what shelter they could in temporary camps.”
“The economy also suffered. By late October, reports indicated that mining productivity for the state was off as a result of the pandemic.
“After peaking in early November, the disease slowly waned during the late fall and early winter. By the late spring, it had begun to disappear from the state.” (HHS. The Great Pandemic: The United States in 1918-1919.)
Stone: “(In Part I, we learned that the 1918 Spanish flu arrived in Prescott on October 2nd and the spread of infection rose and fell like a scythe cutting ripe wheat.)
”By October 8th, Prescott was shut down but not yet officially quarantined. The newspaper warned that there should be “no public gatherings of any sort.” In Jerome, approximately 20 cases of influenza were reported. In the predominately Mormon town of Snowflake, the only physician, Dr. Caldwell, became an early influenza fatality, causing the community of 900 people to put out a call for another doctor.
”On October 9th, the Prescott Journal-Miner reported only 1 new case at Whipple with an article entitled “Spread of Flu is Halted at Fort Whipple.” Two days later there were 18 new cases at the post.
”By October 12th, over 400 cases of flu were reported in Flagstaff, 300 cases in Williams, and Winslow suffered with 375 cases. In Winslow alone, at least 17 people had already died. Fort Whipple had about 75 patients. As for sick Prescottonians, the local paper had little to say.
”By October 14th, 125 people had the disease in Jerome, filling the rooms at the United Verde Hospital. Temporary hospital beds had to be placed in the public school’s annex buildings. Prescott and Winslow also used their public schools as makeshift hospitals. As in the regular hospital facilities of that era, people of Mexican heritage and other “coloreds” were kept segregated from the white patients.
”By October 16th, 21 people in Jerome were dead from the disease. Armed guards were stationed on every road leading into Jerome to insure a strict quarantine. The Verde Copper News listed the dead, all between the ages of 25 and 32, including a young Mexican couple leaving two small children.
”The Prescott papers were fairly tight-lipped about how the influenza was spreading among the civilian population. There was hardly any mention of the fact that the entire town was shut down and that people were requested to wear gauze facemasks in a vain attempt to filter out the virus….The Flagstaff, Winslow, and Jerome newspapers printed a more straightforward accounting of the flu, while the Prescott paper somewhat downplayed it.
”In Winslow, where at least 30 people were now dead, every public school teacher volunteered to help the sick….In Flagstaff there were 80 dead. In Prescott, so many people were sick that the newspaper asked for men to volunteer as nurses at the temporary hospital at the Washington School.
”The Journal-Miner, on November 1st, reported, “After having been dormant for nearly a week, the influenza epidemic flared up again at Fort Whipple and, as a result, more than 20 new cases were reported last night by Colonel Holmberg.” At least to the press, Col. Holmberg claimed that none of the new cases appeared to be serious.
”On November 5th, the Journal-Miner tried to explain why it believed the epidemic didn’t seem as bad in Prescott as in other locales: “Since the influenza made its appearance in Prescott, there are said to have been 125 cases reported with a total death list directly attributable to the disease of some 12, which is less than one percent of the number of cases reported. With the general use of masks and other preventive measures taken, together with the good expected to be accomplished in the expenditure of the funds voted yesterday by the supervisors, it is not believed that Prescott will suffer as greatly from the malady in proportion to population as other places of the state, owing to its comparative freedom from Mexican and foreign population, among which class of residents in other cities the toll has been heavy because of their disinclination to take precautionary measures.” One might point out that 12 dead out of 125 cases is actually about a ten percent death rate.
“World War I ended on the 11th of November, while the flu continued its advance. While some places such as Jerome and Clarkdale were lifting their quarantines, other towns were still in the grip of the fever. In mid-November, Seligman, for instance, reported 150 cases of influenza with 15 deaths. The Coconino Sun reported on November 22nd that the disease had been devastating to the Apache tribe. “So terrible has the influenza become on the San Carlos Indian Reservation that it is impossible to build coffins in which to bury the dead.”….
“By December, it seemed the rate of illness was truly in decline, at least in Prescott and Jerome. Although the schools and churches were still closed, the stricter quarantine policies were lifted and most people looked forward to the coming holidays….
“But the influenza again flared up along the Santa Fe line. “As in the early stages of the disease it is traveling westward from Albuquerque and practically every point on the Santa Fe is being attacked.” The week before Christmas, Fort Whipple was once again placed under quarantine. The soldiers lost their town privileges and could no longer accept dinner invitations in Prescott homes. The officers, however, managed to have their ball before the quarantine went into effect….
”The Spanish flu plagued Arizona until the spring of 1919, affecting every town and nearly every family. But like all viruses, this one eventually burned itself out. After almost six months, the residents of Arizona could get on with their lives without the fear of another Spanish flu outbreak. When spring arrived, the scythe was stilled.” (Stone, Terrance L. “The ‘Scythe’: Spanish Influenza in Northern Arizona, 1918, Part II.”)
Arkansas
Encyclopedia of Arkansas History & Culture: “A deadly influenza outbreak began in 1918 and spread around the world, killing more people than any other outbreak of disease in human history. In Arkansas, the flu killed about 7,000 people, several times more than the state lost during World War I….” (“Flu Epidemic of 1918,” 2008.)
HHS: “Influenza probably reached Arkansas during late September. By early October, state officials were noting that “serious epidemics have been reported from several points.” Most Arkansans lived in rural districts and these were overwhelmingly hard hit by the pandemic.
“Fearing panic, officials were originally reluctant to admit that the pandemic posed a serious threat. James C. Geiger, a commissioned officer for the Public Health Service who was stationed in the state, downplayed the threat to Arkansans with reassuring statements even after he himself had caught the flu and his wife died from it.
“By October, the Arkansas Board of Health was forced to put the state under quarantine. In Pulaski County, home to Little Rock, the quarantine was not lifted until November 4th. Across the state, public schools remained closed even after the quarantine had been lifted. Children under eighteen were confined to their homes until December.
The increased mobility of people in wartime and the comparative lack of immunity among back country dwellers meant that the epidemic swept through many communities. The central part of the state was hit first in late September, but Pettigrew escaped the scourge through the end of October. Charles Crawford reported not a single case in the town on the 25th, but shortly thereafter a public gathering at the Pettigrew school spread the virus so thoroughly that in the space of one weekend not enough people remained well to administer to the sick….
“Segregation meant African-Americans suffering from influenza were treated only by African-American caregivers. Limited numbers of African-American physicians meant that many people suffering from influenza were unable to obtain the services of a physician or nurse. Additionally, as African-Americans were also more likely to suffer from poverty, they tended to be more vulnerable to disease and to die in larger numbers from influenza and related diseases. While records on the deaths of Arkansas’ African-American citizens were poorly kept, it is clear that they died in very high numbers.
“In the state’s two military camps, Camp Eberts in Lonoke County and Camp Pike in Pulaski County, the disease was widespread. Camp Pike was sealed and quarantined and the camp commander insisted that the names of the dead not be released in an attempt to still panic. Across the state, more Arkansans died from influenza in 1918-1919 than died fighting in World War One.
“The disease slowly declined during the late fall of 1918 and it ultimately disappeared from the state in the early spring of 1919.” (HHS. The Great Pandemic: The United States in 1918-1919.)
California
HHS: “By late September, influenza was present throughout the West Coast. Within two weeks of the first reported outbreak in Massachusetts, over 35,000 people throughout California, had contracted influenza. According to state officials, influenza was most prevalent in the southern part of California but the death toll was high across the state. In early November, the number of reported cases peaked at over 115,000. Because officials were overwhelmed by the pandemic and unable to keep accurate records, the actual number of cases was probably much higher than reported.
“In Los Angeles, health officials were optimistic at the start of the pandemic. But by the middle of October, the city had been forced to close schools, churches, theaters, and all other recreational sites. Schools did not reopen for the next four months….
“Although the situation was believed to be slightly better in the northern half of the state, San Francisco also suffered terribly from the pandemic….
“The disease peaked in the fall. Influenza remained prevalent throughout the state during the winter and spring of 1919. The disease did not begin to disappear from the state until the summer of 1919.” (HHS. “California,” The Great Pandemic.)
Colorado
Leonard: After an October 8, 1918 report by Denver’s manager of health, Dr. William H. Sharpley, “The police were instructed to prevent people from spitting on the sidewalks; the tramway was asked to keep streetcar windows open; hospitals were requested to reserve beds for flu patients; and the city sanitation department was instructed to flush downtown streets and sidewalks every night. Over the next few days, police discontinued raiding brothels and picking up vagrants for fear of bringing new germs into jail, and jailers barred lawyers from seeing their clients. Sharpley dispatched inspectors to see that rooming houses were well, ventilated and that employees at soda fountains washed their glasses in hot water….
“During mid- and late October, the flu rapidly marched across the state, leaving few places untouched. By Oct. 14, Denver counted 78 deaths and over 1,200 cases. Nederland, a mountain town without a doctor, reported 50 cases. Sargents, where practically everyone had contracted the flu, desperately needed nurses, but the Red Cross had none available. Colorado Springs asked Denver to send oxygen. Rico in Dolores County was hard hit and without a doctor. The Montrose Daily Press discovered 15 cases in the Uncompahgre Valley. Health officer Isaiah Knott chided Montrose citizens: “If you are sick and do not stay away from social gatherings you have the heart of a Hun.”….
“So many died daily that most of them only rated a single line in long lists. State Board of Health officials counted their blank death certificates in November and concluded that at the rate they were being used, the 1,500 that were on hand would last only two weeks….
“To cut down on visiting, Colorado Springs placarded flu victims’ homes with signs that read “Sickness”….
“By late October, the flu had reached the Southern Ute Indian Reservation in extreme southwestern Colorado where more than 40 Utes eventually succumbed….
“Montrose told pet owners to keep their animals at home. Monument prohibited customers from entering stores; instead, they ordered their goods at the door and waited outside until their requests were filled. Ignacio adopted a similar rule….
“Denver also cast a suspicious eye on its foreigners, especially on North Denver’s Italians. According to the Rocky Mountain News, Sharpley attributed the city’s difficulty in dealing with the flu to “the foreign settlements of the city.” Italians, the paper reported, did not understand health rules. As many as 25 crowded into the rooms of sick persons, and their disregard for the ban on public mourning led Sharpley to send in the police to break up at least one funeral.
”Although quarantining individual homes was common — Denver placarded 5,000 houses in November — large towns could not keep out incoming travelers. That option, however, seemed sensible to smaller towns. Hayden in Routt County discouraged salesmen by telling them that local merchants would not buy from them. Ouray in the San Juan Mountains was even more serious about banning outsiders: It recruited guards to turn back miners from Silverton and Telluride, a measure that might have been effective except that the virus had already infected local residents. In mid-December, the Durango Evening Herald reported that Ouray’s “shot gun” quarantine had failed and that there were 150 cases in the town and 60 at the Camp Bird Mine.
“Gunnison rigorously enforced its rules. County lawmen blocked roads and turned back motorists who tried to enter. Two Nebraskans on their way to Delta tried to run the blockade on Cochetopa Pass, south of Gunnison, and were arrested and jailed. An Alamosa man who tried to sneak into Pitkin, a hamlet northeast of Gunnison, was fined $43. Train conductors warned passengers not to alight at the station, where a step onto the platform meant five days in quarantine. A similar threat at La Veta, more than 100 miles southeast of Gunnison, discouraged motorists from driving north. The Gunnison News-Chronicle urged continual vigilance: “This disease is no joke, to be made light of, but a terrible calamity.” By taking the threat seriously, Gunnison County survived it with only 58 cases reported in 1918, a per capita rate one-fifth the state’s average….
“Steamboat Springs, among the more isolated spots in the state, coasted through most of November without much trouble until suddenly, late in the month, the flu struck. The Steamboat Pilot explained that it could not list all the sick, for simply mentioning the “names of those who were visited by the malady would be almost equivalent to compiling a city directory”…
“Sometimes fear overcame mercy, but usually decency prevailed. Ouray understandably tried to keep sick miners out of town, and gravediggers in Leadville refused to handle any more bodies. But in Cripple Creek, a priest accompanied a doctor on house visits, and Laura Evans, a Salida madam, sent her employees to nurse the ill….
”Some Coloradans drew public health lessons from the grim numbers. Dr. A.L. Davis told the Durango Evening Herald that in 1918 the state of Colorado spent $25,000 to control livestock diseases — about $5,000 more than on the State Board of Health. “Judging by the amount of money spent by the Government,” he said, “sheep and cattle are more valuable than people”.” (Leonard. “The 1918 Influenza,” Denver Post, May 3, 2009.)
Connecticut
State of Connecticut: “The great pandemic of influenza spread from Europe to this country in 1918 and Connecticut was one of the first states stricken by the disease because of its location on the Atlantic coast. Influenza—or “Spanish Influenza,” to use the popular term— appeared in Massachusetts among sailors at the U. S. Receiving Ship on Commonwealth pier, Boston, Mass., August 28, 1918; and similarly the first cases in Connecticut were U. S. Navy patients, several cases being reported on September 1st from the Naval Hospital at New London. The early cases were taken from ships arriving from foreign ports. During the next few days, cases appeared among the personnel of the U. S. Submarine Base in Groton, two miles north of New London, and later it spread to the civilian population. This resulted in the disease being made a “reportable disease” by the State Department of Health on September 12th, 1918, in New London County, and throughout Connecticut on September 18th, 1918.
“The epidemic prevailed with a far greater severity than ever before, sweeping the state in two distinct waves which reached their crests in October and December-January, 1919….
“The influenza epidemic of 1918 and 1919 was the most disastrous epidemic that ever prevailed in Connecticut, taking a toll of 105,056 cases and 7,602 deaths in 1918, and 10,664 cases with 1,583 deaths in 1919. In addition there were in 1918, 2,991 pneumonia deaths (all forms) and in 1919, 1,632 pneumonia deaths (all forms)….
“This epidemic appeared in the United States at the United States Naval Hospital, Chelsea, Mass., August 28, 1918, the first cases being admitted from the U. S. Receiving Ship at Commonwealth Pier, Boston, Mass.
“The disease began in Connecticut on or about September 1, 1918, in New London. During the first ten days of September, nearly 100 cases were admitted to the New London Naval Hospital. On September 10th, 300 men arrived at the Government Station on the State Pier from the Boston Navy Yard, and many cases were reported from this Station during the next few days. The first civilian cases were three men who lived near Fort Trumbull but who worked at the Fort daily.
“The disease spread rapidly throughout the civilian population, as there were nearly 7,000 naval men billeted in civilian homes in and about New London. In New London, there were 901 cases of influenza in September, more than a tenth of the state total of 8,970 cases for that month. In October 936 more cases were reported from the same city.
“While the original focus of infection was from ships at New London, other cases appeared throughout the state toward the end of September, who were soldiers on leave from the New England Army Cantonment, Camp Devens, at Ayer, Mass., or among persons who had visited that camp. Wallingford, Winsted, Windham, Hartland, Rockville and Danbury were among the communities that first reported cases of influenza in the state.
“Although cases appeared throughout the state during September, there was a distinct wave in the manner by which the epidemic swept Connecticut from east to west, reaching its peak in the eastern part about October 4th, the central area about October 15th, and the Housatonic River Valley about October 24th….
The epidemic was successfully kept out of institutions where an absolute quarantine was enforced, but as soon as a person from the outside was allowed to enter and come in contact with persons in a quarantined institution, influenza appeared and ran its course. This was shown in several instances….
“From returns to the Department from health officers and physicians, apparently from thirty to forty per cent. of the population had influenza of more or less severity….
Cases and Deaths from Influenza…During Epidemic
1918
Month Cases Deaths
August ….. 5
September 8,970 305
October 82,057 5,338
November 6,244 1,077
December 7,785 793
1919
January 6,718 758
February 2,232 313
March 1,242 261
April 263 121
May 56 46
_____ _____
Totals 115,567 8,907
….
“The epidemic was particularly fatal to children under five years of age and the age group of 25-39 years….
“There were instances [New Britain] as elsewhere in the state where entire families died of the disease. So many deaths occurred that it was necessary for the engineering department of the city to delegate employees for the purpose of digging graves at the local cemeteries….
“Results of Epidemic
There were 115,567 cases and 8,907 deaths from influenza from August 1, 1918, to May 31, 1919.
There were 2,336 deaths from pneumonia from August I, 1918, to May 3rd, 1919.
The closing of schools, theaters, churches and other public places had apparently no effect on diminishing the spread of the disease.
No influenza vaccine was found to be of any value as a prophylactic or in treating cases.
The epidemic showed the value of the newly organized State Department of Health in furnishing assistance to cities and towns in connection with the epidemic, both in field work and administrative matters.”
(State of CT. “Influenza Epidemic…1918-1919,” Public Docs., V. IV, Pt. 1, 1920, pp. 271-311.)
HHS: “It struck the week of September 11th, laying low Navy personnel in New London. Just two weeks later, about 2,000 cases of influenza were reported in and around the city. On September 27th, the Public Health Service declared, “influenza is prevalent throughout the eastern and southern parts of the state and it appears to be increasing.” It was. Three days later, 9,000 cases were reported. A week later, that number had doubled. Then it redoubled, and redoubled again. By the end of October, an estimated 180,000 people had been struck by influenza. By that point, more than 300 people had died here in Hartford. The Hartford Golf Club became an emergency hospital….
“People begged for – and sometimes demanded – treatment. The Hartford Courant reported that in the town of New Britain (just south of Hartford) one man blocked the car of a local doctor, insisting that he see his daughter. The physician said that he was too overwhelmed with cases to do so. The standoff continued until the mayor intervened and arranged for a doctor to see the man’s daughter.
“The people of Boston were not so fortunate. The pandemic was spreading with equal ferocity through Massachusetts, and the situation in Boston was so bad that those there begged the people of Connecticut to send any doctors or nurses that could be spared. None could be. The emergency was too dire; the pandemic was too overwhelming. The Connecticut Commissioner of Health (John T. Black) was forced to urge doctors and nurses to remain in the state.
“At its peak, the pandemic claimed more than 1,600 lives in a single week. But the total number it took in Connecticut will never be known. Reports are incomplete; the pandemic was too overpowering. But its echoes of terror, of suffering, and of loss remain.” (US HHS Flu.gov. The Great Pandemic of 1918: State by State.)
HHS: “Delaware first reported cases on September 27th. Between October 4th and October 14th, there were 389 deaths from influenza registered in the state. Because state officials were often overwhelmed by the pandemic, they often underestimated the number of deaths. It is likely that the actual number of those who died in Delaware during this period was probably much higher. On October 14th, the PHS noted that new cases of influenza in Wilmington and Delaware were increasing at a slower rate than previously. On October 25th, state officials told the PHS that “the situation in Delaware continues to improve day by day. Fewer cases are reported each day and the new cases seem to be of a milder type. Hospital cases have been reduced one-half. It is stated that the improvement began on October 13th.”
“During the height of the pandemic, the quarantine station at Ready Island (Port Penn) was made into an influenza hospital. State officials in Delaware were so overwhelmed that they tried to send cases to Philadelphia hospitals. These cases were refused as Philadelphia itself was overwhelmed.
“Liberty parties across the state were canceled. Newspapers reported a shortage of caskets. At the University of Delaware, Alumni Hall, one of the oldest buildings on the campus, became a temporary infirmary.
“On October 3, 1918, the Delaware State Board of Health met in an emergency session and ordered most of the state shut down to stem the death toll from influenza. Their order read, in part, “Whereas: A very serious epidemic of influenza is now raging in the state of Delaware…to protect the health of the entire citizenship of Delaware…all schools, theatres, all churches, all motion picture houses, all dance halls, all carnivals, fairs and bazaars, all billiard rooms and pool rooms, all bowling alleys in the entire State of Delaware shall be closed and kept closed until further notice.” This order was lifted on October 27th.
“Influenza remained prevalent throughout the state during the winter and spring of 1919. By the summer, the disease began to disappear from the state. (HHS. “Delaware,” The Great Pandemic: The United States in 1918-1919.)
Armitage: “Delaware County [PA], in proximity to Philadelphia, was clearly at risk of epidemic spread with its active war industries, surging population of workers and overcrowded lodgings. Here the epidemic began with unalarming mildness. On a front page devoted primarily to war news, a headline in The Chester Times on September 21, 1918 announced that influenza had hit Chester [City]. The accompanying story mentioned that there were fifty cases in the City….During the next week the disease spread rapidly, and by October 1, it was reported that Spanish influenza was sweeping swiftly though the City and that physicians were working day and night treating hundreds of cases….
“During the next week, the number of new cases increased explosively. On October 4th, five thousand cases were believed to be in the City, and every physician had at least two hundred cases under care. On October 6th, Dr. Donahoo estimated that there were ten thousand cases in the City, and that each doctor was attending two hundred to three hundred and fifty cases. It was reported that virtually the entire corps of cadets at the Pennsylvania Military College had come down with influenza. A one hundred and twenty-five bed emergency hospital, opened in the National Guard Armory, was soon taxed to capacity and an overflow unit in the Odd Fellows Temple became necessary….
“The munitions plant in Eddystone and the local shipyards were almost paralyzed as workers fell victim to the disease. Many lived in crowded boarding houses and were easy prey to infection. The Health Department found it necessary to issue an order prohibiting the ejection of lodgers who were ill; and, to enforce this edict, the Fuel Administration agreed to stop the delivery of coal to violators. The Emergency Armory Hospital, utilized for treatment of war workers, remained filled to overflow. It was later estimated that of the six hundred patients treated in the Armory during the epidemic, thirty-four percent died or, as Dr. Donahoo said, “went out by the back door.”
“By October 8th the epidemic seemed to have crested; the number of new cases was decreasing, but the death rate continued to rise. Three days later, while fewer new cases were being reported, more deaths occurred than on any other day of the epidemic. Burial became difficult. White’s funeral parlor was used as a mortuary and contained as many as one hundred bodies at one time. There was a shortage of coffins, and pine boxes made at the Sun Shipbuilding & Drydock Co. were used as crude caskets. City Council established a Department of the Disposition of the Dead headed by Colonel Sweeney, a retired army officer, and those who found themselves unable to bury their dead were advised to contact this department. It was estimated that in addition to six hundred deaths in Chester, another five hundred deaths occurred in Delaware County during the epidemic. At one point three hundred and forty-five boxes of dead were stacked at the Lawn Croft Cemetery in Linwood, and finally a steam shovel was brought in to dig a common grave for mass burial.
“The epidemic in Chester [City] and Delaware County lasted about five weeks, gradually disappearing in mid-October, with sporadic cases occurring during the early months of 1919.”
(Armitage. “The Deadly Pandemic of 1918.” 1998, pp. 25-29.)
Delaware
HHS: “Delaware first reported cases on September 27th. Between October 4th and October 14th, there were 389 deaths from influenza registered in the state. Because state officials were often overwhelmed by the pandemic, they often underestimated the number of deaths. It is likely that the actual number of those who died in Delaware during this period was probably much higher….
“During the height of the pandemic, the quarantine station at Ready Island (Port Penn) was made into an influenza hospital. State officials in Delaware were so overwhelmed that they tried to send cases to Philadelphia hospitals. These cases were refused as Philadelphia itself was overwhelmed.” (HHS. “Delaware,” The Great Pandemic.)
District of Columbia
Washington Post: “The Spanish influenza epidemic in the National Capital continues to grow in alarming proportions, despite the sweeping precautionary steps taken by the District authorities. Health Officer W. C. Fowler said at midnight, however, that there was reason to believe that there would be a marked improvement within few days. Twenty-four deaths and 279 new cases were reported to the health office up to 9 o’clock last night. Dr. Fowler said that it could be reasonably estimated that there are more than 10,000 cases of the dread disease in the District at present, although only a total of 555 had been reported under the regulation which went into effect Saturday. “It will be several days before we will be able to get an accurate line on the number of cases, but meanwhile the public should cooperate in every possible way to prevent further spread of the malady, as the situation is extremely serious,” said Dr. Fowler.
“Danger in Public Gatherings.
“Dr. Fowler last night again emphasized the danger of public gatherings of any character when he urged against fraternal meetings and ordered that there should be no public funerals until further notice. He even prohibited the holding of a public funeral on a church lawn. Another .precautionary measure adopted last night by Dr. Fowler is directed against the influx of persons,
principally relatives of those stricken by the disease, to the District. He issued a statement discouraging outsiders from coming here during the period of the epidemic, pointing out that their presence added to the congestion of the city. “There are absolutely no hospital facilities for more patients and the housing conditions cannot be further taxed without menacing the health of
the District in the present crisis,” he said. “Unless It is positively urgent relatives should remain away from Washington, and needless visiting here is an evil at this time”.” (Washington Post. “`Flu’ Kills 24 More, 279 New Cases in District…,” Oct 7, 1918, p. 1.)
“The War Department detailed 60 men yesterday to act as grave diggers, and they will be assigned today to the various cemeteries. The fifteen District employes and volunteers who volunteered for this work will continue their efforts and with the soldiers. The equipment of the new emergency hospital at Eighteenth and Virginia avenue had progressed far enough yesterday afternoon for the admission of four patients, and cases will be received there from now as they develop up to the number of 500, which will be the bed capacity of the institution. The equipment and the building has been furnished at the expense of the Federal government primarily but not exclusively for war workers….Dr. Orlanda Ducker army surgeon, is in charge at the hospital and Miss Nell B. Turner, former army nurse at the dispensary at Sixth and B streets northwest, is to be superintendent of nurses. Fifty soldiers from Camp Meigs have been detailed to aid in the work of putting the hospital into shape and to aid generally with the work there when it is in full operation.” (Washington Post. “88 Deaths by ‘Flu’,” Oct 16, 1918, p. 1.)
Florida
HHS: “In the Public Health Reports (September 28, 1917), the PHS reported that “cases have appeared at Key West.” The following week PHS reported that “epidemics have been reported from Key West and Pensacola.” On the week of October 18th, the PHS reported that “from October 5 to 15, 158 deaths from influenza and pneumonia were reported from principal cities in Florida. On October 15, it was estimated that 800 cases were under treatment in the civil[ian] population at Key West.” On October 25th, PHS reported “for the period October 5 to 17, deaths were reported as follows: Jacksonville, 234 [Jacksonville had a population of 91,000 and it seems to have been the state’s largest city at the time), Tampa, 30, Miami, 26, Key West, 22, Gainesville, 10, Scattering 49, total 371. The number of deaths increased rapidly from October 5 to 12.” On November 1st, PHS said “It was stated on October 24 that conditions were looking better from all points and that the wave had hit Tampa last.” The high part of the pandemic occurred during the week of October 19th when there were 428 deaths reported that week alone. Exact statistics are not possible for Florida because the state did not report consistently….
“University of Florida, Gainesville: In the crowded conditions on campus, the disease spread rapidly. Hundreds of students and faculty, including President Murphree, were taken ill at the same time. In Murphree’s stead, Vice President James Marion Farr directed the influenza campaign. Women from the Gainesville Red Cross provided most of the bedside care, assisted by healthy students and faculty. Beds were hauled from the dormitories to the Agriculture Building (Floyd-Griffin Hall) where a temporary hospital was set up in an auditorium. The initial outbreak abated as quickly as it struck, but subsequent smaller outbreaks occurred into 1919. No figures on the number of patients treated exist, but the death toll included math professor Herbert Keppel and several students.” (HHS. “Florida,” The Great Pandemic.)
Georgia
HHS: “Georgia state authorities found themselves overwhelmed as influenza cases mounted during late September. State officials were unable to report to PHS during the early part of the epidemic as a result. Influenza probably first emerged in the state during late September. However, state officials filed their first report on October 19. On that date, they claimed that the state had 6,304 cases with 68 deaths. The real number of cases and deaths was probably much higher. The next week saw an increase in the number of cases: 9,637 cases and 308 deaths were reported. The following week, the week ending November 2nd, saw a tapering off of the epidemic with only 4,287 cases and 138 deaths being reported.” (HHS. “Georgia,” The Great Pandemic.)
Hawaii
HHS: “Hawaii’s experience of the influenza pandemic differed from that of the rest of the United States. In the summer of 1918, an early and less destructive wave of influenza arrived in Oahu. While a second and more lethal wave of influenza reached most communities on the mainland by early October, this second wave of influenza did not hit Hawaii until December….
“By the end of the year, the number of cases of contagious diseases reported to the Hawaiian Board of Health was 12,000 more than in the previous year with this increase being almost all due to influenza.
“While mortality and morbidity rates are often impossible to calculate, Hawaii does not appear to have suffered tremendously from the pandemic. In Honolulu, reports sent to the PHS indicate that thirty-two people had died in the city from influenza and sixteen of the city’s residents had died of pneumonia, a related complication, during January. On March 12, 1919, a letter from Chief Quarantine Officer to the Surgeon General stated “that for the week ended March 1st, there were 125 cases of influenza and 20 deaths in the City and County of Honolulu. Influenza was the cause of death in seven of the cases, while the remaining 13 were due to a complicating pneumonia.”
“Influenza remained a problem in the islands until the late spring when it began to slowly disappear.” (HHS. “Hawaii,” The Great Pandemic.)
Idaho
HHS: “On September 30th, officials in Idaho reported that there were several cases of influenza in Canyon County. Within less than two weeks, the state admitted that the number of cases had grown to such an extent that they were unable to track the disease accurately. By late October, cases of influenza were reported in Boise, Coeur d’Alene, Idaho Falls, Lewiston, Moscow, Pocatello, Twin Falls, Wallace and a range of other towns. Rural Idaho suffered terribly from the pandemic….
“State officials and newspapers urged calm. In Rexburg, the local paper insisted that there was “no occasion for panic” but then went on to discuss the need to enforce the town’s quarantine. In Sandpoint, all public gatherings were prohibited even as the local paper maintained that there was no cause for alarm.
“To their dismay, many officials found that quarantines had no real impact on the spread of the disease….
“In Idaho, as elsewhere, the disease simply ran its course, unchecked by actions taken by state, local or federal officials. While influenza rates lessened during the late fall, it was not until the summer of 1919 that the disease began to disappear from the state.” (HHS. “Idaho,” The Great Pandemic.)
Illinois
HHS: “On September 27th, state officials reported to the PHS that several cases of influenza had appeared in Chicago and its vicinity.
“On October 1st, the Illinois State Health Officer telegraphed the PHS, saying, “Situation in communities adjacent to Great Lakes Naval Station shows tendency to improve. Disease spreading along main traveled routes.” The officer was overly optimistic. On that same day, 374 cases were reported in Chicago, with 14 deaths from influenza and 45 deaths from pneumonia. By October 11th, the PHS was forced to acknowledge that “five hundred to six hundred municipalities have reported cases.” By that time, the disease was already epidemic in Chicago, Peoria, Kankakee, and Rockford. Rural communities had also begun to report cases.
“On October 25th, state officials failed to report to the PHS, although they were required to do so. This may have been because state health officials were too overwhelmed by the pandemic to keep accurate records. A week later, the state did manage to submit a report for the state. At that time, officials believed that “the epidemic was abating in the northern” part of the state. However, the pandemic was “developing rapidly in the southern portion. Rural sections and coal-mining districts were said to have been hard hit.” Chicago was still reporting over ten thousand new cases each week. The actual number of influenza cases and influenza-related deaths was probably significantly higher than reported. The epidemic most likely peaked in Illinois during the week of October 26th. Over 40,000 new cases of influenza were reported for the state during that week alone.
“As the nation’s largest rail hub, Chicago was especially vulnerable. Influenza reached the city and, from there, spread to the rest of the country. Although Chicago should have been recognized as being especially vulnerable, public health officers there were overconfident. Even before influenza had reached the city, officials boasted that “we have the Spanish influenza situation well in hand now. Of course, they did not.
“Although Chicago’s officials knew that large gatherings helped spread influenza, patriotic parades remained common. Parade attendees were, however, cautioned to return home immediately after the parade. To minimize the risk of infection, attendees were told to remove all their clothing, rub their bodies dry, and take a laxative. This approach failed to prevent the spread of the disease….
“There was no comfort for the dying. The city ran out of hearses. City officials proclaimed that “there shall be no public funerals held in Chicago over any body dead from any disease or cause whatsoever. No wakes or public gatherings of any kind shall be held in connection with these bodies. No one except adult relatives and friends not to exceed ten persons in addition to the undertaker, undertaker’s assistants, minister and necessary drivers shall be permitted to attend any funeral. No dead body shall be taken into any church or chapel for funeral services in connection with such body.
“Concerned that spitters and sneezers might spread the disease, the Chicago Health Commissioner, John Dill Robertson ordered the police to “arrest thousands, if necessary, to stop sneezing in public!”….
Influenza remained prevalent throughout the state during the winter and spring of 1919. By the summer, the disease had begun to fade in Illinois.” (HHS. “Illinois,” The Great Pandemic.)
Indiana
HHS: “The disease was first reported as being present in Indiana on September 20th. Influenza swept across the state from north to south in two separate waves. The first and most lethal of these waves began in October 1918 and lasted into February 1919.
“The first official report from the state appeared in The Public Health Reports during October. State officials reported that an epidemic had developed in Evansville beginning in the last week of September. By October 11th, state officials were forced to admit that “the disease has been reported from a number of places” in the state. On October 25th, state officials believed that the situation had begun to improve, although they admitted that the number of pneumonia cases was increasing. Officially, the state reported 154,600 cases between September and February. Today, historians and epidemiologists believe that the actual number of influenza cases in the state was about 350,000. Approximately 10,000 deaths from influenza occurred in Indiana during this period.
“Overall, the epidemic in Indiana was slightly less severe than it was elsewhere in the United States.
“On September 27th, in response to a request from the PHS, the Indiana State Board of Health issued an order to all county and city health officers warning them of a pandemic and suggesting preventive measures. Among their recommendations was a suggestion that authorities tell people who are ” compelled to cough or sneeze to hold cloth or paper handkerchiefs over their nose.” Officials were also told that “persons with colds must be excluded from public gatherings.”
“On October 6th, the Indiana Board of Health, in compliance with orders from the PHS, banned all public gatherings. The order was rescinded, however, soon after it had been imposed. The Secretary of the Board of Health had been out of town when the order was imposed. Insisting that “the [federal] government cannot prescribe what a state board of health can do,” the Secretary was prepared to defy the federal authorities—even at the cost of a few lives. On October 9th, the State Board of Health re-imposed the ban on all public gatherings. Churches could be open for prayer and meditation but not for large services. Public funerals were banned.
The ban was scheduled to be lifted on midnight of October 26th. It would have been lifted sooner, but following reports of continued cases from 43 counties, the Board decided to keep the ban in place.
“As elsewhere, doctors stepped in to fill the breach, providing money and support for patients….
“The disease peaked in the state during the fall. However, influenza remained prevalent throughout the state during the winter and spring of 1919. By the summer, the disease had slowly begun to disappear from the state.” (HHS. “Indiana,” The Great Pandemic.)
Iowa
HHS: “On October 5th, influenza cases were reported in Des Moines and Dodge City. By October 11th, the disease was reported in Des Moines, Dodge City, and Onawa. By October 11th, the PHS was reporting 8,169 cases with 72 deaths. The PHS added, somewhat ominously, that the number of cases “appears to be increasing.” On October 25th, 136 localities in the state reported 2,513 new cases and 28 deaths. The disease peaked in the state during the week of October 19th, when there were a total of 21,117 cases….
“On October 9th, Dr. Guilford Sumner, the state health commissioner, banned all indoor funerals for influenza victims. From that date forward, only outdoor funerals were permitted….
“On October 5th, The Des Moines Tribune reported that local hospitals were unable to care for influenza patients and hospital staff had begun to refuse to admit patients with the flu. In Marshalltown, the YMCA was transformed into an emergency hospital to care for influenza patients.
“The situation in Des Moines was so dire that the Surgeon General himself suggested that city officials close all of the theaters and other public places to prevent the spread of the disease….
“In November, the end of World War I meant victory parades in many Iowa cities and towns. In Des Moines, crowds gathered for a two hour parade; this gathering may have exacerbated the spread of influenza. In the wake of this parade, city officials required citizens to wear masks in the hopes that the masks would limit the disease; the masks failed to protect the citizens….
“The disease peaked in the state during the fall. However, influenza remained prevalent throughout the state during the winter and spring of 1919. By the summer, the disease had slowly begun to disappear from the state.” (HHS. “Iowa,” The Great Pandemic.)
Kansas
HHS: “Kansas is often considered to be ground zero for the 1918 pandemic.
“In late January and early February of 1918, a local physician in Haskell County noticed a rash of severe influenza cases. Although the physician had seen many cases of influenza throughout his career, these cases were extraordinary. Influenza, usually a mild disease, had suddenly become a killer. Over the course of the next two months, influenza ran rampant through Haskell County, cutting a swath among the county’s residents.
“At the time, few public health experts viewed influenza as a threat and local physicians were not required to report outbreaks to the federal, or even state, authorities. However, this outbreak was so unusual that the local physician contacted the Public Health Service, sending them a report on the epidemic in his community. Back in Washington, PHS officers viewed the outbreak as unusual enough to merit a mention in the Service’s weekly report on public health in the United States and abroad. But because they were preoccupied with epidemics of more severe diseases, the Public Health Service did not send any officers to Kansas to investigate the outbreak. By mid-March, the outbreak appeared to have run its course. Certainly, it had disappeared from Haskell County.
“That spring, a few medical journals published articles on the outbreak, but outside of these articles there was no real discussion of the outbreak or what it might mean.
“Because the country was at war, farm boys from isolated communities such as Haskell County were on the move. During the spring, a soldier from Haskell County probably brought this new and virulent form of influenza to Camp Funston, a military camp in Kansas. By mid-March, Camp Funston was in the throes of an influenza epidemic. More than eleven hundred soldiers stations there were ill with influenza; thirty-eight of these men died at Funston that spring. These deaths were highly unusual. However, the death rate in March was lower than the death rate which would characterize influenza in the fall.
“Despite this early and highly severe outbreak, state officials in Kansas were not especially vigilant at monitoring influenza rates during the spring and summer of 1918.
“When the disease re-emerged in the fall of 1918, Kansas failed to provide the Public Health Service with a report, although they were required to do so on September 27th. On October 4th, state officials simply informed the Public Health Service that “cases have been reported from a number of places in the State.” A week later, state officials provided more detail, saying that “one thousand three hundred and twenty five cases were reported” during the first week of October. As state officials were often too overwhelmed to keep accurate records, this was probably an under-estimate of the number of cases in the state at that time.
“By mid-October, authorities noted with some concern that “cases in Kansas are increasing.” By late October, over 26,800 cases of influenza had been reported since the outbreak began in September. Influenza rates continued to climb even higher while deaths mounted.
“Finally, in early November, officials provided an optimistic report: “with a few exceptions in the large industrial centers, all communities…have reported an abatement, both in the severity and number of cases.”….
“The disease peaked in the state during the late fall. It remained prevalent throughout the state during the winter and spring of 1919.” (HHS. “Kansas,” The Great Pandemic.)
Kentucky
HHS: “Influenza first appeared in Kentucky about September 27th. On that date, troops traveling from Texas on the Louisville and Nashville Railroad stopped off in Bowling Green. There, soldiers left the train to explore the city. They infected several local citizens before returning to the train and traveling on.
“When the flu appeared in Louisville, local officials did not submit a report for the cases which they had. Yet the situation in Louisville clearly dire, as the Public Health Service calculated that the city had about 1,000 cases during late September. The decision by the PHS to calculate Louisville’s figures is unusual. Generally, the PHS did not calculate mortality or morbidity numbers for different cities. Their decision to do so for Louisville probably indicates that there were a significant number of cases in the city by that time.
“By the second and third week of the epidemic, Louisville was experiencing about 180 deaths a week from influenza. The situation continued to be bad throughout the fall and into December. On December 12th, a local health officer sent a telegram to Surgeon General Rupert Blue requesting that the PHS take charge of the city until the epidemic passed.
“A military camp located near Louisville, Camp Taylor, was harder hit than the city itself. This was because the disease tended to strike younger people more aggressively. Enlisted men at the camp totaled approximately 40,000 soldiers. These men were from Kentucky and Indiana. During the week of October 19th, there were 3,772 cases at Camp Taylor alone, which would indicate an extremely high rate of infection….
“The pandemic peaked in the fall of 1918 but influenza remained prevalent throughout the state during the winter and spring of 1919.” (HHS. “Kentucky,” The Great Pandemic.)
Louisiana
HHS: “On September 14th, the steamship Harold Walker arrived at the New Orleans Quarantine station from Tampico, Mexico. The ship had left Boston on September 1st; influenza was widespread in Boston at that time. Since leaving Boston, three deaths had occurred on board the ship. By the time she ship arrived in New Orleans, several members of the crew were ill, with temperatures ranging from 99.6 to 103.28. All of these patients complained of pain in the head, cough, pains in the chest, back and extremities. Although state officials pointed to the steamship’s arrival as the cause of the pandemic in the city, influenza had probably arrived earlier, during the first week of September. Certainly, by the following week, the state was reporting that “cases have been reported from a number of places in the State.” By the second week of September, the disease was epidemic at Alexandria, Pineville, Lake Charles and other places. That week, “15,494 cases were reported officially in Louisiana.” State officials glumly noted that the disease could be found across the state….
“Influenza had been widespread throughout the state during the fall. Cases gradually lessened during the winter and spring. By the summer, the disease had disappeared from the state.” (HHS. “Louisiana,” The Great Pandemic.)
Maine
HHS: “Because it was a rural state with a small population, Maine lacked a strong public health system. Tracking influenza under these circumstances was difficult. However, during the first week of October, state officials did send a report to the Public Health Service, stating that “the disease is epidemic at Eastport and Portland.”….Across Maine, influenza rates remained high during the fall, winter and spring. The disease gradually disappeared during the summer.” (HHS. “Maine,” The Great Influenza.)
Maine CDC: “Influenza waxed and waned in Maine throughout late 1918 and the first six months of 1919. The 1918 State Department of Health report states that Maine “was one of the first in the U.S. to take action requiring influenza to be reported by physicians to local boards of health, and by the latter to the State Dept of Health; and giving local boards of health authority to institute modified quarantine”….
“Between September 1918 and May 1919:
- Almost 47,000 cases reported of influenza, though it did not become reportable until early October, and even then, the Department of Health and newspapers claimed the disease was underreported by many physicians.
- From September to December, 1918 there are 3,800 deaths from influenza recorded;
- The first 5 months of 1919, about 1,200 deaths
- For a total of about 5,000 deaths….
- The death rate from influenza in the preceding years ranged from 1 to 6 per 10,000. In 1918, that death rate was 32.
- One-half of these 5,000 deaths were in the month of October, 1918.
- About 50% of those who died were ages 20 – 40. The years preceding the pandemic, 3% of deaths from influenza were in this age group.
- Although one well known book on the 1918 pandemic reports northern Maine as having escaped the effects of this event, Department of Health reports and area newspapers from the time confirm Aroostook County with the highest reported death rate in Maine. Cumberland also endured high fatality rates.
- Although some areas of central Maine reported lower mortality, reporting was overall very sporadic and dependent on individual physicians, so county comparisons are limited.
- In 1 ½ years of American combat in WWI, 1,026 Mainers died while serving in the military.
- Over half of these died from influenza.” (Maine CDC. 1918 Pandemic Influenza in ME.)
Maryland
HHS: “The first cases of influenza in Maryland appeared at Camp Meade on September 17th. As the death rate from influenza rose, military officials began equating influenza deaths with those on the battlefield. A memorial service for those who died during the pandemic at Camp Meade was held and the presiding officer read the names of each dead soldier. As each name was read, the Sergeant saluted and said “Died on the field of honor, sir.” By September 28th, when the state filed its first official report with the Public Health Service, state officials believed that there were 1,713 cases in the state. The real number, however, was probably much higher. By October 12th, state officials were reporting 24,300 cases. By mid-October, there were so many cases that state officials were unable to file a report. On November 16th, the number of cases had dropped to 4,929 and state officials were better able to provide reports to the Public Health Service. The PHS believed that the epidemic in Maryland had traveled along the state’s transportation networks. The virulence of the disease was believed to be strongest in the areas where the disease appeared first, thus, Fort Meade was hardest hit. These assumptions were, however, just that—assumptions. The Public Health Service lacked any real evidence to support their beliefs.
“In Cumberland, 41% of the population became ill. City officials converted buildings on the city’s main street into emergency hospitals but there were only three nurses to staff these hospitals. Officials asked the Maryland Board of Health for additional nurses but the nurses never appeared. By early October, the local Red Cross chairman was lamenting that “the matter seemed far beyond control…Reports were spreading fast that ‘this one’ or ‘that one’ had died without doctor or nurse and it was a panic indeed.”
“In Baltimore, the city’s health officer believed that there was “no special reason to fear an outbreak in our city.” But by the end of September, cases of influenza had soared and the situation had become serious. Yet officials remained reluctant to take action. Insisting that “drastic measures” would cause panic and lower people’s resistance to disease, city officials resisted closing schools and banning public gatherings.
“By October 10th, the number of new cases in Baltimore had reached at least 1,962. By the following week, the week ending October 18th, 1,357 deaths from influenza had been reported in Baltimore. Over 150 deaths from influenza occurred on October 19th alone….
“Slowly and reluctantly, Baltimore city officials implemented sterner measures, closing schools and outlawing public gatherings. But by then it was too late. At least 75,000 of the city’s residents had contracted influenza and more than 2,000 had died from the disease. During a more typical influenza season, fewer than five deaths would have occurred in Baltimore.
“Influenza faded in November, although it lingered well into the winter and spring of 1919. By the summer, the disease had disappeared from most of the state.” (HHS. “Maryland,” The Great Pandemic.)
Massachusetts
HHS: “The first recorded cases of virulent influenza in the United States occurred in Boston. On August 27th, several sailors at the Commonwealth Pier reported sick with influenza. By the next day, there were eight new cases. On the third day, August 29th, there were 58 cases. These men were sent to the Chelsea Naval Hospital; from this hospital, the disease spread rapidly into the city of Boston and the rest of the state.
“Within two weeks, over two thousand military officers and men stationed in the Boston area had influenza. By September 3rd, Boston City Hospital had admitted its first civilian influenza patient. On September 8th, the disease had reached Camp Devens, a military camp near Boston which had 50,000 soldiers. As young adults were especially vulnerable to the 1918 influenza virus, the camp was quickly decimated by the disease.
“In late September, a physician at Camp Devens provided a chilling description of the situation: “This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed….These men start with what appears to be an ordinary attack of La Grippe or Influenza, and when brought to the Hosp. they very rapidly develop the most viscous type of Pneumonia that has ever been seen. Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up. There is no doubt in my mind that there is a new mixed infection here, but what I don’t know….The normal number of resident Drs. here is about 25 and that has been increased to over 250, all of whom (of course excepting me) have temporary orders – “Return to your proper Station on completion of work”. Mine says “Permanent Duty”, but I have been in the Army just long enough to learn that it doesn’t always mean what it says…We have lost an outrageous number of Nurses and Drs., and the little town of Ayer is a sight. It takes special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce, we used to go down to the morgue (which is just back of my ward) and look at the boys laid out in long rows. It beats any sight they ever had in France after a battle. An extra long barracks has been vacated for the use of the Morgue, and it would make any man sit up and take notice to walk down the long lines of dead soldiers all dressed and laid out in double rows. We have no relief here, you get up in the morning at 5.30 and work steady till about 9.30 P.M., sleep, then go at it again. Some of the men of course have been here all the time, and they are TIRED.”….
“By October 1st, state officials were reporting that “there were at least 75,000 cases in the State, exclusive of cases in the cantonments,” the military camps where soldiers were stationed. During the week ending September 30th, 788 deaths from influenza and 196 deaths from pneumonia were registered in Boston; the actual number of deaths was likely much higher….
“Although influenza rates declined slightly in the late fall, the disease remained prevalent throughout the state into the spring. It was not until the summer of 1919 that influenza had begun to disappear from the state.” (HHS. “Massachusetts,” The Great Pandemic.)
Michigan
HHS: “According to state officials, very few cases of influenza existed in Michigan during September. During the first few weeks of October, the state failed to provide the Public Health Service with a report, although they were required to do so. This failure may indicate that the situation had deteriorated, making it difficult for public health officials to produce accurate reports. On October 18th, the state finally sent in a short report, saying simply that “50 deaths [from influenza] had occurred in the state.” The number of deaths was probably much higher at this point. By October 25th, the state was better organized and they reported that during the first two weeks of October, there were 11,083 reported cases of influenza and 258 deaths in the state. On October 22nd alone, 4,516 cases and 160 deaths were reported, showing that the disease was spreading rapidly. In Detroit, 1,367 cases and 52 deaths were reported for October 22nd. By the third week of October, 21,541 cases were reported for the state overall. Again, these numbers were probably too low; state officials often under-reported the numbers of cases and deaths in their communities. However, the epidemic does appear to have peaked during that week as 922 deaths from influenza were reported for that seven-day period….
“The disease peaked in the state during the fall. The pandemic continued throughout the winter and spring, although the situation was less severe than it had been in the fall. By the summer, influenza had, for the most part, disappeared from the state.” (HHS. “Michigan,” The Great Pandemic.)
Minnesota
HHS: “On Sept. 25th, Rupert Blue, the Surgeon General, announced to the Associated Press that the first cases of influenza had been discovered in Minnesota. The head of the Minnesota State Board of Health, Henry Bracken, was surprised to hear this and he quickly sent a telegram to the Surgeon General for evidence that influenza was indeed present in the state. But within two days of his sending the telegram, Bracken heard from his own employees that at least one case of influenza had occurred in Wabasha. By September 28th, reports of cases poured into Bracken’s office. Minneapolis, North Branch, and the village of Wells, in southern Minnesota, all reported cases. Soldiers stationed at Fort Snelling and sailors staying at Dunwoody Institute were infected. Student recruits who were boarded at the University of Minnesota became ill as well.
“Less than a week after the first report drifted into the state health board, more than a thousand cases of “The Spanish Flu” were reported in Minneapolis alone. The University of Minnesota decided to postpone the start of its fall semester, at least until the epidemic had died down. Edward Slater, a physician working at University Hospital in Minneapolis, became ill with influenza and then died on Oct. 6th. His was one of the first reported deaths from influenza in the state. Two days later, the Red Cross mobilized to aid those who had succumbed to the virus….
“Influenza peaked during the fall of 1918. During the winter and spring, the disease continued to be widespread but the number of cases did decline. By the summer, influenza had all but disappeared from the state.” (HHS. “Minnesota,” The Great Pandemic.)
Mississippi
HHS: “On September 27th, the state reported that “a few cases have been reported from Montgomery and Leake Counties.” There were suspected cases in Meridian. By the 4th of October, state officials noted that “epidemics have been reported from a number of places in the State.” By October 11th, worried state officials were saying that “the epidemic is spreading rapidly.” By the 18th, twenty-six localities reported 1,934 cases; the real number of cases was probably much higher. Influenza was now widespread in nearly all parts of the state. Worse yet, officials believed that the number of cases was steadily increasing. By late October, the number of new cases still numbered in the thousands.” (HHS. “Mississippi,” The Great Pandemic.)
Missouri
HHS: “State officials first reported on the presence of influenza in Missouri on October 11, 1918. However, influenza had appeared in the state long before that date. By the third week of October, 3,765 influenza cases and 90 deaths had been reported from St. Louis, with 558 cases and 13 deaths being reported for October 16th alone. State officials, however, rarely had access to accurate figures and the actual number of cases and deaths was probably higher than that. On October 25th, state officials maintained that “conditions are either stationary or improving” in the state. But on October 24th, the situation took a turn for the worse. Influenza began spreading into rural districts. Between October 26th and 28th, the situation continued to be dire, with rural and urban areas across the state reporting high numbers of cases and deaths.” (HHS. “Missouri,” The Great Pandemic.)
Montana
Boswell: “BOZEMAN — Influenza once canceled classes for almost an entire term at Montana State University. Over 90 years ago, while the Spanish flu was on its way to killing 50 million people around the world, five million in the United States and 5,000 in Montana, students registered for the fall 1918 term at MSU, then called Montana State College. Within a month, the epidemic struck the college. School officials called off classes until after Christmas.” (Boswell. “Montana State Canceled School Term Over 1918 Influenza.” MSU News Service, May 20, 2009.)
HHS: “Montana was slow to report the presence of influenza. This was not surprising. Many states, especially rural ones had difficulties assembling staff and getting them to report diseases even before the 1918-1919 pandemic. On October 4th, state officials sent their first official report to the Public Health Service. The report noted that “the disease is epidemic in Sheridan and Fergus Counties. Cases have been reported from other counties.”
“Although state officials were required to provide follow-up reports to the Public Health Service after their initial report, Montana failed to do so. This failure may indicate that officials were overcome by the epidemic. By late October, however, state officials finally sent a follow-up report to the PHS. Admitting that their records “are…very incomplete,” officials said that there were over 3,500 cases of influenza among the state’s white population. On Tongue Indian Reservation, the situation was especially severe, with over a thousand cases and thirty-nine deaths. Throughout early November, state officials noted glumly that the disease was increasing….
“The disease tapered off slightly after November but influenza continued to be pervasive throughout the state during much of the winter and spring of 1919.” (HHS. “Montana,” The Great Pandemic.)
Nebraska
HHS: “On October 21st, the Nebraska State Board of Health placed a ban on all public gatherings. In Hastings, on October 10th, the mayor ordered theaters, churches, schools, pool rooms, and card rooms to be closed. Hastings College was quarantined. Fearing that students would attempt to break the quarantine, military pickets were placed around the perimeter of the college to prevent students from leaving. Despite this measure, the college continued to allow students who had family in town to visit them, thereby rendering the quarantine ineffective.” (HHS. “Nebraska,” The Great Pandemic.)
Nevada
HHS: “Nevada was slow to report the presence of influenza. This was not surprising. Many states, especially rural ones had difficulties assembling staff and getting them to report diseases even before the 1918-1919 pandemic. Nevada, which was the smallest state in the Union in terms of its population, had never been consistent in reporting to the Public Health Service.
“On October 15th, public health officials sent their first report to the PHS admitting that there were at least 38 cases of influenza in the state. Eleven days later, state officials reported new cases while noting that deaths from influenza were occurring across the state. By late November, Nevada had ceased to report to the Public Health Service. The disease had not yet disappeared from the state, however….
“Some state officials wanted to establish quarantine stations at the state’s borders to prevent the disease from spreading further into Nevada. As in other states and localities, there were bans on public gatherings in an attempt to prevent the disease from spreading. In White Pine County, for example, a county-wide quarantine was imposed on October 12th and this was in effect until December 28th.
“The disease slowly declined in the state during the late fall, resurging in the winter and gradually disappearing in the summer of 1919.” (HHS. “Nevada,” The Great Pandemic.)
New Hampshire
Dover Public Library: “The news reports of October 3rd were grim. “Dover is in the grip of an epidemic, the extent of which has never been known by the oldest inhabitant. The general affliction is influenza, followed by pneumonia in a vast majority of cases, nearly all of which prove fatal. Deaths have been on the increase since Monday morning, with an unprecedented death toll up to Thursday night. Many new cases of influenza and pneumonia were reported by physicians today, and during the last 24 hours, deaths have occurred almost hourly….The undertakers like the physicians are having sleepless nights caring for the dead, and early this morning no less than five bodies of dead soldiers from the training camp at Durham lay side by side at the undertaking rooms of Tasker & Chesley.” The Wentworth Hospital was full to capacity, and had to close its doors to visitors. Newspapers had pages and pages of obituaries of flu victims…
“By October 10, the situation seemed to be improving. The number of deaths was decreasing as was the rate of new cases. Local doctors and health officials were encouraged by October 17 as the number of new cases continued to drop and there had been only six deaths in the last 48 hours. The health department began to consider repealing the ban on public meetings….
There was a brief resurgence of flu cases in early December, but the flu seemed to be milder. Health Officer Whiteley stated December 16 that there had been more than 2,000 cases of influenza in Dover during the epidemic which began “September 20, when the first death occurred and ending on November 14th., with the last death there were 80 deaths in all from influenza and pneumonia combined, 60 of the deaths being from the latter”….
“Wentworth Hospital summed up the epidemic well in their report in the 1918 Annual Report of the City of Dover:
“When the epidemic of influenza reached us it found the entire force of the hospital already greatly over-worked. We prepared, as be we could, for this epidemic, but no one of us could appreciate how much would have to be done and neither did we know how virulent the disease was and how many of the nursing force would fall ill when exposed. Of the twenty-one nurses in the hospital at different times, eighteen developed influenza, fortunately not all at the same time and not all were seriously ill. There were, however, fourteen of the working force ill at one time, and the hospital was full to capacity. We had room for only the seriously ill patients and these we took in as fast as we could.
Many of the patients were at death’s door when admitted and had reached that condition without medical or nursing care. It is not my intention to dwell upon the horrors of the influenza situation, horrors shared by every hospital in the country taking in influenza patients. The difficulty of controlling delirious patients reached a point beyond the experience of any of us. Those who saw it through from the beginning have night-mare memories that time can never wholly efface.”
(Dover Public Library. “Spanish Flu Epidemic of 1918 Strikes Dover.”)
HHS: “Influenza undoubtedly spread from Massachusetts, which was very hard hit, into New Hampshire. Unlike Massachusetts, New Hampshire was a very rural state; of all the New England states, New Hampshire suffered the least from influenza. That said, influenza still had a significant impact on the state….
“On Oct 4th, influenza rates were still increasing in Portsmouth. By October 18th, however, the PHS reported that “conditions are said to be improving” in Portsmouth and across the state. From October 5th to the 14th, state officials reported 82 deaths at Nashua and 35 at Dover. Between October 6th and the 15th, inclusive, 205 deaths were reported at Manchester alone. The reports were probably underestimates, with the actual number of deaths being much higher.
“The epidemic appears to have peaked during the week of October 12th, when 393 deaths were reported for the state. Influenza remained prevalent throughout the state until the summer of 1919.” (HHS. “New Hampshire,” The Great Epidemic.)
New Jersey
HHS: “In Newark, the first cases were reported on September 25th. Under the guidance of the city’s mayor, Newark’s medical community met to discuss methods of dealing with the disease. The meeting led to a massive educational campaign, with pamphlets on prevention and treatment sent to every household in the city. Although launched with great fanfare, the campaign failed to contain the pandemic. Influenza rapidly spread throughout Newark. Dead bodies accumulated without being buried. City employees were recruited to dig graves and a hundred firemen volunteered to help bury the dead. Rather than individual graves, teams of horses dug trenches to bury the dead. Because public funerals were banned to prevent the spread of the disease, no one complained….
“An experimental vaccine was tested on Newark’s residents. It proved ineffective, and people turned to whiskey and opiates for cures. One physician recommended that his patients eat red onions and drink coffee. He bragged that this treatment was quite effective as he had a low mortality rate among his patients. Guide’s Pepto-Manghan and Pope’s Cold Compound were also advertised as cures. Despite the boasts of physicians and drug manufacturers, none of these treatments were effective.” (HHS. “New Jersey,” The Great Pandemic.)
New Mexico
HHS: “On October 4th, New Mexico reported that influenza was present in several places in the state. Within a week, the state was reporting epidemics in the state’s more densely populated areas such as Albuquerque, Gallup and Carlsbad. By late October, outbreaks were widespread and over two hundred deaths had been reported. The actual number of deaths was probably much higher than reported. By early November, the situation had begun to improve but concerns regarding influenza were still high.
“Across the state, armed vigilantes refused to allow visitors from flu-ridden regions to disembark from trains, forcing them to return to their place of origin at gun-point. State officials were equally alarmed and voting was disrupted by the pandemic in early November. Turn-out was especially low and the senate seat was won by a very small margin.” (HHS. “New Mexico,” The Great Pandemic.)
New York
HHS: “On September 27, the PHS reported that, as of September 21, there were 61 cases in New York City. The epidemic had undoubtedly begun well before the 21st. By October 4th, the PHS was reporting that “outbreaks have occurred at Buffalo and at New York City.” On October 11th, the PHS said that “Epidemics have been reported from Maybrook town (Orange County), Montgomery (Orange County), North Tonawanda, and Oswego. School and theaters had not been closed.” By October 18th, state officials admitted that influenza was prevalent throughout the state.
“Although state authorities were too overwhelmed by the pandemic to keep accurate records, they did attempt to record deaths. By late October, New York City, Albany, Buffalo, Schenectady and Syracuse reported elevated death rates. During the week of November 1st, the PHS reported a total of 12,357 deaths in New York City. For the previous six weeks a total of 30,736 deaths were reported. The actual number of influenza-related deaths during this period was probably much higher.” (HHS. “New York,” The Great Pandemic.)
North Carolina
HHS: “On September 27th, North Carolina reported to the Public Health Service. With cases reported from Raleigh and Wilmington, officials tersely noted “all the hospitals are crowded.” By the first week of October, the disease was epidemic at Raleigh and Wilmington. A week later, officials reported that the situation was especially bad in Fayetteville. By the final week of October, officials had become cautiously optimistic, saying that the situation “is improved.” By November 2nd, “a general improvement for the state was noted.” Influenza did remain prevalent throughout the state but officials believed, correctly, that the worst had passed….
“In the wake of the pandemic, local newspaper accounts estimated that between October of 1918 and March of 1919, over thirteen thousand North Carolinians died from influenza. Because man deaths went unrecorded, this figure is questionable and probably too low.
“During the pandemic, officials in North Carolina were quick to take action. In early October, the State Board of Health, with the advice of the government and State Superintendent of Schools, called on the authorities of every town or community where influenza had appeared to promptly close the schools and ban all public meeting….
“The state’s many mill towns suffered tremendous losses from the pandemic. Overcrowding, poor sanitation, and poverty all served to exacerbate the number of cases and deaths in these regions….
“On October 24th, Charlotte was quarantined. At the time, there were 400 reported cases in Charlotte with many more in nearby Camp Greene.
“On Nov. 14th, the Wilmington Morning Star reported an outbreak of influenza on a ship docked in the Cape Fear River. The government vessel, City of Savannah, had arrived two days earlier carrying 1,900 Puerto Ricans to Fayetteville to aid in the construction of Camp Bragg. By the time the ship left Wilmington harbor, 28 of the Puerto Rican laborers were dead from influenza….
“Although influenza peaked in the state during the fall, the disease remained prevalent in North Carolina during the winter and spring of 1919.” (HHS. “North Carolina,” The Great Pandemic.)
McKown: “On October 3, 1918, Governor Thomas Bickett issued the first order in North Carolina’s battle with an enemy which would prove more deadly to the state than the soldiers of the Central Powers against whom troops from North Carolina were fighting thousands of miles away in Europe. A hitherto unknown strain of influenza had appeared in Wilmington and was spreading west over the state, following the rail lines. North Carolinians were familiar with older forms of influenza, often called the “grippe,” which were debilitating but only occasionally deadly. The new type of flu struck fast, causing two or three days of high fever which, in a distressingly large number of cases, led to death. The lungs of victims filled with fluid and their skin turned a dark blue, as their respiratory system failed and their tissue was starved for oxygen. The old influenza was most dangerous for the weak or elderly; the new flu preyed on the young and healthy.
“The influenza epidemic overwhelmed North Carolina’s medical community and rudimentary public health system. The medicines and folk remedies on which people customarily relied were useless. The state’s primary public health response—forbidding public gatherings and quarantining victims—began late and was almost impossible to enforce. When local public health services failed or where they were nonexistent, people working through war-preparedness groups and the Red Cross, organized volunteers to visit the sick and fetch medicine or food. Emergency kitchens were set up to cook for those too sick to help themselves.
“What was happening in North Carolina was a part of the worst influenza pandemic in modern times. Present day research has identified the cause of the disease as an influenza A virus strain. The virus produced a violent reaction in the human immune system, which ironically led to the disease being deadliest among those whose systems were strongest, the young and fit. The virus swept in three waves through the populations of Europe and North America, already dislocated by World War I, and eventually spread to all parts of the earth. Overall, as many as 20 million people may have died.
“More than 13,000 of those dead came from North Carolina. Influenza killed people in all walks of life and was particularly deadly on those who cared for the sick, both professional and volunteer. It killed with something like the speed of modern warfare: in many cases less than 48 hours passed between the first sneeze and the last breath; the president of the University of North Carolina died near the beginning of the epidemic; his successor died a month later. Soldiers in crowded training camps were especially vulnerable. At the railroad station that served Camp Greene near Charlotte coffins were stacked from floor to ceiling, taking home the bodies of young soldiers who never saw the war.” (McKown. “October 1918 – NC and the ‘Blue Death’,” This Month in NC History, Oct 2008.)
Patterson: “One report estimated that in a five-month period 1 million Tar Heels — more than a third of North Carolina residents — caught the flu as it swept across the state in three waves in 1918 and early 1919. Many survivors reported that they had never been as sick before or since. Or as frightened….
“The flu first appeared in early 1918, but the initial wave attracted little attention. That’s because it proved only slightly more deadly than the seasonal variety. All that changed in the fall. The second wave began in late September and death rates began to soar. By early October, state and local officials realized the need for action. On Oct. 4, state health officials urged communities to close schools and theaters and ban public gatherings, including worship services, weddings and funerals. “Move promptly,” warned Dr. W.S. Rankin, the secretary of the State Board of Health. “Human life is at stake.”….
“Health officials and newspapers tried to forestall a panic, often giving out misinformation. “At best, they communicated half-truths, or even out-right lies,” John M. Barry, an author and historian, wrote in a paper on the flu in 2006. “As terrifying as the disease was, the officials made it more terrifying by making little of it, and they often underplayed it.”
“That appeared to be the case in Greensboro. Front page headlines in local newspapers, the Daily News and the Record, focused on the progress of World War I, not the flu, which ultimately killed more Tar Heels than the fighting in Europe.
“On Oct. 13, the Daily News predicted there might be 1,000 flu cases in Greensboro and an equal number in Guilford County. “While the outlook was darker yesterday than before,” the paper said that day, “it is pointed out there is no reason for any undue alarm.” But the paper’s readers felt differently. Survivors talked about being afraid to leave their homes, associate with neighbors, or even breathe….
“Obtaining accurate death tolls became an impossibility. Most authorities today believe tallies were under reported because health officials were so busy treating the sick that they didn’t have time to provide precise numbers….
“Businesses shut down or curtailed operations because of high rates of absenteeism. A mill in Burlington closed when only six out of nearly 100 employees showed up for work.
“Doctors and nurses — many of their number had joined the war effort — couldn’t keep up as flu cases increased. Communities issued calls for medical help, but state officials had no one to send….
“Army camps, mill villages and college campuses became breeding grounds for the flu. In Stokesdale, C.G. Knight lost two sons in two weeks. Both died at Camp Jackson in South Carolina. James E. Wood, who had been a member of the Student Army Training Corps at the University of North Carolina, wrote about the struggle in what is now Our State magazine in April 1990. “The infirmary was filled with sick and dying boys,” Wood wrote. “Mothers came to Chapel Hill to nurse their sons and they died, too.”
“So many died, survivors recalled, that graveyards looked like freshly plowed fields.
“The people lost faith in the remedies they had relied on all their lives and they became frantic,” wrote Selena W. Saunders, who inspected conditions in a North Carolina mill village. “Some of them locked themselves in their house and refused to open their door to anyone.”….
“It got so bad, the fire department was designated as the headquarters for everything,” C.W. “Moon” Wyrick, a former fire chief, recalled in a 1969 story in the Record. “Firemen filled the prescriptions, helped with the sick, made caskets, embalmed the dead and buried them. Sometimes as many as 18 a day died.”
“By early November, the outbreak appeared to have passed. In Greensboro and many other localities, officials lifted the restrictions. But then came the Armistice ending World War I, and people took to the streets, celebrating with parades and speeches. Soon thereafter, more flu cases erupted and officials reinstituted the restrictions.
“By early 1919, in most places, the flu had disappeared. Many figured it had consumed all the available victims it could consume.
“So many people had died that life expectancy in 1918 fell by nearly 12 years.” (Patterson. “Doctors Had No Weapons to Fight 1918 Flu,” Oct 25, 2009.)
North Dakota
HHS: “In late September, as influenza swept across the country, newspapers in North Dakota asserted that “if the people of North Dakota exercise ordinary care they need not fear the ravages of this disease.” On September 27th, the Fargo Forum proudly boasted that the “Spanish Influenza Hasn’t Hit Fargo.”
“Within a week, the situation had changed. Fargo reported a hundred cases of influenza on October 4th. One day later, on October 5th, Jamestown reported 1,000 cases….
“By October 10th, the situation had worsened across the state and the Bismarck paper was reporting pleas from Jamestown for volunteers to fight the epidemic there. On the 19th of October, state officials, fearing that the disease was spreading too rapidly, issued orders forbidding trains to transport patients suffering from influenza….
“The epidemic began to wane during late November. It continued to be pervasive throughout the state during the winter and spring of 1919. By the late spring of 1919, the disease had begun to disappear from the state.” (HHS. “North Dakota,” The Great Pandemic.)
Bismarck Tribune (ND): “To contain the outbreak, public health officials ordered all schools to close, as well as all churches, theaters and public meetings. But the flu virus spread with cruel efficiency nonetheless, first arriving in North Dakota on Sept. 14 in New Rockford, apparently carried by a Marine home on leave from service in World War I. By Oct. 6, 125 cases were reported in Fargo – a number that mushroomed to 2,000 just three days later.
“Three doctors and 14 nurses died throughout the state. Churches and schools served as temporary hospitals. Desperate appeals for volunteers went out.
“North Dakota’s official death toll was 1,378, a number contemporary health officials believe was grossly underreported. Applying the national mortality rate, North Dakota’s death toll probably was closer to 3,235.” (Bismarck Tribune (ND). “101-Year-Old Recalls 1918 Flu Epidemic,” Apr 27, 2007.)
Ohio
HHS: “Although the Public Health Service had required states to report the presence of the disease on September 27th, officials in Ohio failed to comply with this directive. This failure to report may indicate that officials in Ohio were overwhelmed by the pandemic. The state finally managed to file its first report on October 26th. In this report, they indicated that there were at least 125,000 cases in the state on October 18th. The disease had undoubtedly been prevalent in the state for some time before that date. During the week of October 26th, there were 1,541 deaths from influenza alone. Because officials had a difficult time collecting data, these figures were probably inaccurate. It seems likely that the real number of cases and deaths was much higher.
“Cleveland was especially hard hit by the pandemic. During the first weeks of the pandemic, the state reported roughly 168 deaths from influenza per week. By the third week of the pandemic, the city’s death rate had soared, with 682 deaths from influenza being reported each week. Dayton suffered greatly from the pandemic as well, with a high of 137 deaths registered there during the third week of the pandemic. By late October, Cincinnati was under siege as well, reporting 22,000 cases of influenza.
“Influenza was not, however, confined to the cities. Rural communities across the state also experienced high rates of influenza as well as significant numbers of deaths from influenza or pneumonia.
“Across the state, colleges temporarily closed their doors. In some cases, campus buildings became makeshift hospitals which treated influenza patients….
“The pandemic peaked during the fall. It gradually declined during the winter and spring. By the summer, it had disappeared from the state.” (HHS. “Ohio,” The Great Pandemic.)
Oklahoma
HHS: “State officials reported the presence of influenza in Tulsa and Clinton on September 26th. The disease had undoubtedly been prevalent in the state before that date. By October 4th, 1,249 cases had been reported in 24 counties. By mid-October, the situation had become so overwhelming that state officials were forced to resort to generalities, saying simply “many cases are reported from all parts of the State.” On October 26th, the situation was reported as “bad in the eastern half of the state but fairly good in the western half.” Reports were still “very incomplete” although officials did note that conditions were improving in Oklahoma City. Cases were reported as follows: “Adair County, 700; Pontotoc County, 1,000; Grady County, 150; Garfield County, 600 and Texas County, 15 – total, 2,456.” As authorities found it difficult to keep accurate records, the real number of cases was probably much higher….
“The pandemic peaked in the fall. Cases gradually declined during the winter and spring. By the summer, influenza had disappeared from the state.” (HHS. “Oklahoma,” The Great Pandemic.)
Oregon
HHS: “On October 18th, Oregon officials reported that cases of influenza had occurred in Eugene, Portland, Corvallis, Baker, Pendleton and other places. The disease had undoubtedly been prevalent in the state for some time but officials were optimistic, believing that they had the situation under control. By late October, however, state officials were forced to admit that their reports were incomplete and the situation was probably worse than they were prepared to admit….
“Small towns across the state were especially hard hit. In Denio, a public health nurse expressed her concerns about the situation there, saying “there is no food, no bedding and absolutely no conception of the first principles of hygiene, sanitation, or nursing care.” In an attempt to deal with the crisis, a hotel was transformed into a hospital. But even then, the situation was still serious and the nurse begged those outside the community to “send supplies before we get snowed in for the winter.”
“Medford became the first city in the state to ban public gatherings. Churches, movie theaters, schools, and anyplace “where people congregate” closed. But the disease continued to spread and on October 23rd, city officials required all residences with a case of influenza to post a quarantine sign….
“As elsewhere, the disease began to decline in late November. The disease remained prevalent throughout the state during the winter and spring of 1919.” (HHS. “Oregon,” The Great Pandemic.)
Pennsylvania
Lynch: “In Pennsylvania, the influenza epidemic began almost unnoticed in the middle of September. First a few cases, and then the numbers began to rise rapidly. Worried state health authorities decided to add influenza to the list of reportable diseases. Their concern increased when 75,000 cases were reported statewide. The worst was still ahead. Philadelphia was about to become the American city with the highest death toll in one of the three worst epidemics in recorded history.”
Oct 4, 1918: “Philadelphia businessmen are up in arms about the epidemic. More cases mean more employee absences and fewer customers. It is no longer business as usual, but business if possible. In desperation, the Bell Telephone Company runs the following full-page notice in the newspapers:
Telephone Service Faces A Crisis
The situation is one which the public must meet squarely — 800 operators — 27% of our force — are now absent due to the influenza. It is every person’s duty to the community to cut out every call that is not absolutely necessary that the essential needs of the government, doctors and nurses may be cared for.
“….Weeping women in West Manayunk block the car of Dr. Joseph Schlotterer, who is making a house call, and permit him to leave only after he treats 57 neighborhood children.
“Frantic shoppers strip pharmacy shelves bare. The press of customers is so great that the Philadelphia College of Pharmacy and Temple University suspend classes so that pharmacy students can help fill prescriptions. Most are for whiskey, which, now that saloons are closed, is available only in drugstores. Rather than wait to become a statistic, people turn to home remedies: goose-grease poultices, sulfur fumes, onion syrup, chloride of lime.
“Snake-oil artists hawk their useless potions in newspaper ads:
Use Oil of Hyomei. Bathe your breathing organs with antiseptic balsam.
Munyon’s Paw-Paw Pills for influenza insurance.
Sick with influenza? Use Ely’s Cream Balm. No more snuffling. No struggling for breath.
“….Major Griffith, in charge of the SATC [Students Army Training Corps] at Penn, warns that campus residents who fail to keep their windows open will be severely punished. The Hospital of the University of Pennsylvania is quarantined, and no visitors are permitted. The SATC commandeers two of the University’s largest fraternity houses — Delta Psi and Phi Kappa Psi — and fits them out as emergency hospitals. Due to the shortage of physicians, third- and fourth-year Penn medical students volunteer to take care of the patients.”
Oct 6, 1918: “The Philadelphia Inquirer derides the closing of public places:
What are the authorities trying to do? Scare everyone to death? What is to be gained by shutting up well-ventilated churches and theaters and letting people press into trolley cars?
What then should a man do to prevent panic and fear? Live a clean life. Do not even discuss influenza… Worry is useless. Talk of cheerful things instead of disease.
“The Inquirer heeds its own admonitions and relegates all further news of the epidemic to its back pages.”
Oct 10, 1918: “Philadelphia hospitals are filled to overflowing. Hospital beds are set up in the Armory. The Medico-Chirurgical Hospital, closed to make room for the construction of the new Benjamin Franklin Parkway, is reopened. The University of Pennsylvania, together with Jefferson College and Hahnemann Medical College, recruits 300 fourth-year medical students to aid overworked physicians.
”Isaac Starr, M’20, is assigned to the Medico-Chirurgical Hospital. With only a single lecture about influenza to guide him, he finds there is little he can do, other than get the dead out of the way for the living. He never sees the faces of his fellow workers. They are gowned and masked like himself.
The Philadelphia Public Ledger uses the epidemic as a stick in its long-running battle with State Senator Edwin H. Vare and his political machine. A front-page article claims that Vare holds the street-cleaning contracts for South Philadelphia, where mortality is heaviest. Besieged by outraged residents, the Bureau of Street Cleaning agrees to sprinkle the streets with disinfectant.”
Oct 11, 1918: “Penn students join with off-duty policemen to relieve the shortage of hospital stretcher-bearers, carrying in the living only to exchange them for the dead. Other Penn student-volunteers at the University Settlement House help in the dispensary and operate a soup kitchen for children whose parents are too ill to feed them. After 12 Penn dental students are stricken, the University closes the Dental School, noting that “working over patients’ mouths subjects the men to the danger of contracting the disease”….”
Oct 14, 1918: “A new health menace threatens: the dead are not being buried fast enough.
More than 500 corpses are awaiting burial, some for more than a week. The Office of the Coroner cannot keep up with the demand for death certificates. Cold-storage plants are used as temporary morgues, and the J.G. Brill Company, manufacturers of trolley cars, donates 200 packing crates to be used as coffins. Prisoners from the House of Correction team up with seminarians from St. Charles Seminary to dig graves, as the cemeteries cannot keep up with the demand.
”To deal with the problem of hundreds of unburied corpses, volunteers drive horse-drawn carts through the city streets, calling people to bring out the dead. Wagonloads of bodies, each tagged for identification, are buried at Potter’s Field at Second and Luzerne Streets, where the Bureau of Highways is digging trenches for graves. Only the promise that bodies can be reinterred when the epidemic abates persuades grieving relatives to give up their loved ones to the “dead wagons”….
Oct 16, 1918: “The heavy death toll attracts human vultures. Some cemeteries raise burial fees to $15 and tell families they will have to dig the graves themselves. Several undertakers increase the price of their services by 500 percent.
“Unscrupulous pharmacists inflate the price of cheap whiskey — usually the only treatment prescribed for influenza — to $52 a gallon. Enterprising barkeeps defy the Board of Health ban on saloons with back-door sales. One saloon owner argues with the Vice Squad that he is only looking after the health of his regular customers. The ferries are jammed with people anxious to get to Camden, where the bars are still open. The daily mass exodus causes Dr. Henry Davis, chief of the Camden Board of Health, to close the city’s saloons “in the interest of public health. Thousands of the lowest people of Philadelphia came over the river and created great disorder. They were the vilest men and women that have visited Camden”.”….
Oct 17, 1918, Philadelphia: “The city’s hospitals are placed under police supervision, with patrol cars serving as ambulances. The Red Cross Home Service, besieged by servicemen overseas for information about their families, frequently sends no reply. The families do not wish them to know their loved ones have died.
”Countless deeds of charity help rescue the forgotten members of society — the destitute, the orphaned, the retarded, and the friendless. Sisters of the Holy Child comfort and care for youngsters in a West Philadelphia home for “backward children” after all the staff have fled. Emergency Aid members visit shabby boarding houses where hundreds lie ill with no one to assist them and arrange for their care.
“A man who sneezed is forcibly ejected from a trolley by his fellow passengers.”….
Oct 27, 1918: “As quickly as the epidemic had come, it left. Churches reopened on October 27 in Philadelphia. Schools, theaters, vaudeville houses, and bars followed in quick succession. Penn’s Dental School reopened. Delta Psi house and Phi Kappa Psi house, used as emergency hospitals, became a barracks and a naval officers’ mess hall, respectively. Penn student volunteers returned to their studies.” (Lynch. “Flu: It Started with a Cough in the Summer of 1918,” PA. Gazette, Nov/Dec 1998.)
HHS: “Because influenza tended to strike cities very hard, Pennsylvania was one of the hardest hit states in the country.
“In late September, state officials were optimistic about the situation. At the time, there were “comparatively few cases” among the state’s residents. A few cases had occurred at Hog Island and some had occurred in Pittsburgh but officials saw no need for concern at that point. Within a week, however, state officials were forced to adopt a different tack. Influenza now raced through the state’s large cities, reaching epidemic proportions in Philadelphia and Pittsburgh by October 4th. On October 11th, the Public Health Service reported that “the disease is said to be especially prevalent in the industrial districts of Philadelphia and vicinity, in the Lehigh Valley anthracite region and in scattering sections of the bituminous coal fields.” On October 18th, state officials reported that “6,081 deaths from influenza and 2,651 deaths from pneumonia had been registered in Pennsylvania. The greater number of these deaths occurred in Philadelphia.” Grim as these numbers were, they were probably inaccurate: overwhelmed by record numbers of deaths, state officials often under-reported the death toll.
“By October 25th, official estimates claimed that there were 350,000 cases in the state, 150,000 of which were in Philadelphia alone. By November 1st, state officials resumed some of their former optimism, noting that “a rapid decline in the number of deaths has taken place in Philadelphia.” The disease probably had peaked in the state during the week of October 16th. In Philadelphia, over seven hundred city residents had died on that day alone. This was more than had died on any previous day in the city’s history; even the infamous yellow fever epidemic of 1793 had caused fewer deaths.
“In Pittsburgh, the crest of the pandemic lagged three weeks behind Philadelphia and the rest of the state. Faced with a mounting death toll, the city suffered from a shortage of coffins. The situation was not helped when the Washington DC Health Officer seized two railways cars as they passed through his city. The cars were loaded with coffins intended for Pittsburgh….
“In Wilkes-Barre, the city’s armory became an emergency hospital….
“In Philadelphia, Dr. Wilmer Krusen, Director of the Department of Health and Charities warned against “fright or panic.” On October 3rd city officials closed all schools, churches, theaters and places of amusement. As the situation worsened, an emergency telephone switchboard was established at Strawbridge and Clothier Department Store, one of the city’s largest stores. Firemen, garbage collectors, policemen, and city administrators all fell ill. The city’s only morgue overflowed. Designed to handle thirty-six bodies, it had over five hundred. Stacked in the hallways of the morgue, bodies rotted. To ease the pressure on the city’s morgue, convicts were ordered to dig graves. But even this failed to solve the problem, and desperate city officials opened five supplementary morgues….” (HHS. “Pennsylvania,” The Great Pandemic.)
Rhode Island
Cassidy: “In Rhode Island, the fall version of the flu (there had been a less deadly version in the Spring) began at Newport’s Navy base in early September. Within 10 days, over 30 sailors died in the Naval District. It easily spread out into the community. By October 3, the Newport Daily News reported that “Camphor, whiskey and onions are in great demand by persons who have their own notions about keeping off the disease, but the health authorities are not offering any suggestions in this line”….
“According to many sources, liquor provided some protection and some cure, but this was a source of friction between Newport, which was dry, and the rest of the state. The Newport Daily News triumphantly reported that “the internal use of alcohol in the present situation is substantiated by medical publications. In brief, the argument is that alcohol puts to sleep the blood corpuscles which otherwise would work to destroy the disease germs, and hence has a direct tendency to increase the disease.”
“Providence volleyed back that Newport would never have succumbed to the disease in the first place if it hadn’t been dry, and quoted studies on the efficacy of the use of booze in the treatment of pneumonia.” (Cassidy. “Epidemic Rhode Island: The Spanish Flu Outbreak of 1918,” Rhode Island Roads.)
HHS: “Although the state did not report their mortality and morbidity figures to the Public Health Service (PHS) until November, the first cases of influenza in Rhode Island probably occurred during early or mid September. On November 1st, state officials finally filed their first report with the PHS. This report stated that between September and November, deaths from influenza had averaged about fifty per day. However, as state officials were often incapable of collecting accurate reports during the height of the pandemic, the actual death toll was probably higher than reported….
“Emergency hospitals were set up in Pawtucket, Woonsocket, Warwick, and Westerly. In Westerly, city officials turned an abandoned school was turned into a hospital, complete with new wiring and plumbing overnight. Like most other states, Rhode Island found itself facing a severe shortage of nurses. With over two-thirds of the state’s registered nurses working for the war effort, state officials were forced to rely on student nurses.” (HHS. “Rhode Island,” The Great Pandemic.)
South Carolina
HHS: “South Carolina experienced its first serious outbreak of influenza during the spring of 1918. This outbreak occurred at a military base, Camp Sevier, which was located near Greenville. Following this outbreak, influenza disappeared from the state during the summer of 1918.
“In late September, the disease returned in a deadly form. By September 27th, when federal authorities demanded that all local officials provide accurate assessments of influenza in their communities, one hundred cases had been reported in Newberry.
“By early October, the disease had spread into the upper reaches of the state. Officials estimated that there were 1,500 cases. In Charleston and Newberry the disease was epidemic. By October 11th, state officials reported that “the disease is prevalent throughout the State, especially in the northern part.” By the 18th, the situation had deteriorated and there were over 30,000 reported cases in the state. Charleston officials reported that the city had over 775 cases. However, as state officials were often incapable of collecting accurate reports during the height of the pandemic, the actual death toll was probably higher than reported.
“On October 25th, the Public Health Service noted some “improvement in conditions, with a daily decrease in the number of new cases.” Officials believed that the pandemic was rapidly approaching its crest. State officials confirmed by noting “All reports indicate continued improvement throughout the State. The most significant improvement is becoming manifest in the Northern Peedee and Santee River sections. Reports from Clarendon, Williamsburg, and Georgetown Counties show that the epidemic is under control there. It is estimated that 80,000 cases have occurred.” Official estimates maintained that there were about 3,000 deaths at that point. However, because inconsistent and inaccurate reporting took place, the actual number of deaths was probably much higher….
“Because young adults were most susceptible to this form of the influenza virus, military camps were struck especially hard by the pandemic. At Camp Jackson, the camp’s residents had already endured epidemics of measles and meningitis when influenza struck in mid-September. Several hundred soldiers quickly fell ill with influenza and were admitted to the Base Hospital. More became infected and the hospital was soon overflowing with men who were too ill to stand. A large section of the camp became an extension of the hospital. More than 5,000 persons were treated for influenza and at least 300 died from the disease.
“Influenza remained a threat throughout the winter and spring of 1919. By the summer, the disease had begun to disappear.” (HHS. “South Carolina,” The Great Pandemic.)
South Dakota
HHS: “The first official cases in the state were reported on September 23rd when the state noted “a few scattered cases.” By October 4th, the state was reporting that “cases have appeared in a number of places.” By October 11th, influenza was widespread, with cases reported from “many points in the State.” The situation continued to worsen. During the week of November 2nd, there were 218 deaths from influenza across the state. This week may have been the high point of the disease in the state.
“Among the many victims of the disease were some of the state’s most prominent citizens. Peter Norbeck, the governor of South Dakota, became ill with influenza and was admitted to St. Joseph’s Hospital in Deadwood. He had contracted the flu on a business trip to Lusk, Wyoming. Like most influenza patients, he developed a very high fever. However, his case was not regarded as critical and he was released from the hospital after a few days.
“Concerns focused on prevention and sanitary ordinances were put into effect. In Rapid City, people who spit on the sidewalks were arrested and fined. A Rapid City police officer was arrested under the ordinance and fined $6, a considerable sum at the time. All funerals were held out doors to prevent the spread of influenza and, in some cities and towns, pedestrians were required to present a doctor’s note stating that they had recovered from the flu and were no longer contagious. Public gatherings were banned leading to the indefinite closings of churches, theatres, schools, pool halls. The University of South Dakota shut down to prevent the spread of the flu….
“The disease slowly began to decline in the state during the latter part of November. Influenza did not disappear from the state until the late spring of 1919.” (HHS. “South Dakota,” The Great Pandemic.)
Tennessee
Coggins: “In Tennessee, small towns were infected as severely as larger cities; the DuPont company town of Old Hickory, near Nashville, was hardest hit. On September 28, 1918, influenza struck many workers at the E. I. DuPont Munitions Plant. This plant was particularly vulnerable due to its large labor force (over 7,500 people) and their close proximity during working hours. Since flu was easily transmitted to others through airborne droplets from sneezes and coughs, it spread rapidly through the plant and out into the community. As one in four citizens contracted the flu, public gatherings, including religious services, civic events, movies, school classes, and court sessions, had to be canceled. Temporary hospitals were established wherever space could be found, and doctors and nurses were recruited from Nashville and surrounding areas to deal with the crisis. More than 1,300 Nashvillians (most from Old Hickory) died of the flu in 1918-19. In fact, so many died that the basement of the Nashville YMCA, converted to a temporary morgue, literally overflowed with bodies.” (Coggins. “Influenza Pandemic of 1918-19.” TN Encyclopedia of History and Culture. 1998.)
HHS: “On September 27th, the state reported to the PHS that “two suspicious cases were reported at Memphis.” By October 1st, there were 95 cases in Memphis, and ten days later it was reported to PHS that there had been at least seventy-six deaths in Nashville. Between October 4th and October 10th, there were at least 27 deaths in Chattanooga. On October 15th, there were 27 deaths in Knoxville. By the 25th, the state was reporting that “conditions are greatly improved in nearly all cities and towns, but the disease is slowly spreading in rural districts and mining regions.” On October 27th, “conditions were better in mining camps generally and…reports from rural communities in a few counties indicated that the disease is not yet prevalent at these points.”
“While numbers are difficult to predict, one historian has put Nashville’s cases at approximately 40,000 cases and 468 deaths. Although the state did not report to the PHS until late September, it appears that the disease appeared in Nashville in early September, becoming noticeable on September 16th. By the 26th, the disease had reached epidemic proportions. The epidemic began in South Nashville, a densely populated part of the city which had many industrial workers. From there it spread into East Nashville and the center of the city. Eventually, the disease hit the less densely populated areas of North and West Nashville. Ultimately, North and West Nashville became the centers of highest incidence.
“The city was ill-prepared to deal with the pandemic. There were only about 250 doctors present
The city was ill-prepared to deal with the pandemic. There were only about 250 doctors present in the city at the time as many were fulfilling an active-duty role with the military. Compounding the problem, many of the physicians in the city contracted influenza and were unable to work. Nashville recognized early on that relief measures had to be implemented, landing the responsibility on the city’s public health nurses, who were given the task of classifying and treating cases by severity.
“Establishment of emergency hospitals was ruled out as there were too few physicians and nurses to staff them. Patients were isolated in their homes, forcing medical practitioners to travel to patients’ homes in order to administer care. Admission to a hospital required certification by a physician.” (HHS. “Tennessee,” The Great Pandemic.)
Texas
HHS: “Texas first reported the disease as being present in the state on the 23rd of September. However, the disease was probably present in the state before that date. As early as September 12th, newspapers were reporting that fears of the disease spreading into the state were common. On September 23rd, state officials reported the presence of influenza in Williamson County, Kaufman County and Bosque County. By the 4th of October, thirty-five counties reported influenza; these counties reported anywhere from one to tow thousand cases. A week later, the disease was reported present in seventy-seven counties, with the number of cases varying from one to four thousand cases per county. During the week of the 18th, the state failed to report; this failure may have been because officials were overwhelmed. On the 25th, the state reported a total of 26,062 cases and 517 deaths since the beginning of the pandemic. By October 29th, the state had reported 106,978 cases and 2,181 deaths in just the state’s urban centers. Because state officials were so overwhelmed and because it was difficult for states to collect data, these numbers were probably inaccurate. The actual number of cases and deaths was probably much higher.
“In El Paso, a quarantine was imposed on October 26th. A day later, a PHS officer glumly noted “there has been a great deal of protest…how the situation will end I do not know…the question is what will the health officer be able to do with the lawyers, who no doubt by tomorrow will be ready to advise their patrons to open up their places of business.”
“Like many southern states, Texas segregated its medical care. Mexican residents of the state were often treated in their own hospitals and communities as were African Americans….
“The disease peaked in the state during the fall. Influenza remained pervasive during the winter and spring, although the situation had improved. By the summer, the disease had begun to disappear from the state.” (HHS. “Texas,” The Great Pandemic.)
Utah
HHS: “The first cases in Utah undoubtedly appeared in the military camp at Fort Douglas. Like many states with a large rural population, Utah did not provide a report to the Public Health Service in the early weeks of the pandemic. This may have been because they were overwhelmed by the spread of the disease or it may have been because the state did not have enough public health officials available to make the weekly reports the Public Health Service demanded. By the middle of October, when the state made its first report, the disease could be found throughout the state.
“Quarantines were imposed. In Ogden City no one was allowed in or out of the city without a note from a doctor….
“The disease waned during the late fall but it remained present throughout the winter and spring of 1919.” (HHS. “Utah,” The Great Pandemic.)
Vermont
HHS: “After Massachusetts, Vermont, along with Connecticut, was the hardest hit of the New England states. On September 27th, 1918, the Public Health Service noted that “indefinite reports of influenza at many places have been reported.” During the final week of September, there were over 6,000 cases in the state. By October 4th, influenza could be found throughout the state. The largest outbreaks were at Middlebury, St. Johnsbury, Lydonville, St. Albans, Montpelier, Barre, Randolph and Northfield. Because officials were quickly overwhelmed by the disease, most reports regarding influenza cases and deaths were probably inaccurate. However, it does seem that the disease probably peaked in Vermont during the week of October 12th.
“State officials were unable to provide the Public Health Service with any type of record of influenza-related deaths….
“By November 1st, however, state officials were cautiously optimistic, nothing that “the situation was improving.” Influenza remained prevalent throughout the state during the winter and spring of 1919. By the summer, the disease had begun to fade in Vermont and across the United States.” (HHS. “Vermont,” The Great Pandemic.)
Virginia
HHS: “On September 11th, several sailors in Norfolk reported ill with influenza. At that time, state officials saw no cause for concern and it was not until nearly two weeks later that officials filed their first report with the Public Health Service. According to that report, influenza had now spread across the state. Petersburg, Newport News, Norfolk, Portsmouth, Pittsylvania and a variety of other places were all now reporting cases of severe influenza. On October 4th, officials formally stated that influenza was “epidemic in many parts of the State.” Four days later, the disease was so pervasive that authorities closed the State Fair. And on October 15th, officials estimated “that there were at least 200,000 cases in the State.” Because state officials were often overwhelmed and unable to track the epidemic effectively, the actual number of cases was probably much higher.
“By October 26th, the situation had shifted and authorities began to be more optimistic, noting that “the situation was gradually improving.” Certainly, the peak of the epidemic had passed….
“Richmond city officials banned public gatherings, including weekend parties, church services and other events. The John Marshall High School became an emergency hospital. Lawrence Price was appointed Director of Emergency Influenza Work in Richmond….
“During the summer of 1919, influenza had begun to disappear from the state. State officials still worried, however, that the disease would return. In the fall of 1919, the Virginia State Board of Health released the following statement. It was published throughout the state.
“State-Wide Campaign for the Prevention of Influenza: Richmond, Va.,
“October 9– With a field force numbering ten or twelve, the State Board of Health and the State Tuberculosis Association are driving hard to launch in the hundred counties of Virginia a campaign for the prevention of the influenza epidemic which swept Virginia last year, claiming a death toll of 15,678.
A year ago last September there were 19,500 cases of influenza reported by physicians, besides a great number that were probably not seen by physicians or otherwise recorded.
During the twelve months ending September 1, 1919, there were 139,000 cases reported, with a total of 15,678 deaths. Of the death toll, about 4,700 were of persons between the ages of twenty to thirty, in the very prime of young manhood and womanhood.
To prevent the recurrence of the tragic story of last year, a determined effort is being made to organize the forces of the state in a great campaign for prevention.”
“Much to the relief of state officials, the influenza season of 1919-1920 proved to be significantly milder than that of 1918-1919.” (HHS. “Virginia,” The Great Pandemic.)
Washington
HHS: “Public health experts in Washington officially reported the presence of influenza on September 27th, saying “a number of cases have been reported in the vicinity of American Lake.” Influenza had actually appeared in the state earlier.
“On September 17th, recruits from Philadelphia arrived at the Puget Sound Naval Yard; eleven of these recruits were ill with influenza. By September 20th, Camp Lewis had 173 cases of influenza. On September 23rd, 10,000 people gathered to witness a review of the state’s National Guard Infantry. While the camp’s medical officer acknowledged that the camp was suffering from a minor epidemic of influenza, he insisted that there was no need to worry. In doing so, he made a serious miscalculation as the disease spread outward from the camp into the surrounding areas. By September 25th, influenza had already reached epidemic proportions in Seattle (although the city did not officially report the disease as epidemic until much later).
“In late September, worried state officials asked the Public Health Service if they should impose an intrastate quarantine to prevent the spread of the disease. Believing that a quarantine would have little effect, the Public Health Service cautioned against imposing a quarantine.
“By the week of October 11th, schools were closed across the state and public gatherings prohibited at Seattle, Bremerton, Pasco, Prosser, Sultan and Port Angeles. The closing of schools failed to slow the spread of the pandemic, especially in cities such as Bremerton which already had 1,000 cases of influenza.
“By the third week of October, the state was forced to admit openly what they had long known: “the disease is epidemic at Seattle and Spokane.” State officials did, however, note that “Tacoma says that the situation there is not critical.” This was the only bright spot as the Public Health Service noted grimly that “cases of the disease are reported as occurring throughout the State.”
“In Seattle, the old City Hall and one of the dormitories at the University of Washington became emergency hospitals. City residents were forbidden to gather, even for religious purposes. When ministers complained, the overwhelmed mayor replied ‘Religion which won’t keep for two weeks is not worth having.’
“On October 29th, the wearing of masks became mandatory in Seattle. One day later, state legislators made the wearing of masks mandatory across the state. Enforcing this law proved difficult and people often removed the masks, most dramatically when they gathered to celebrate Armistice Day. Although officials did not know this, the masks that were implemented in this era did little to prevent the spread of influenza.
“Influenza rates began to wane during late November. However, the disease continued to be a serious threat throughout the winter. In late December, a PHS officer informed the Surgeon General that men at various military camps in the state were still “coming down with influenza,” necessitating that they remain at these camps throughout January. Across the state, concerns regarding influenza remained high and officials cautioned against re-opening schools before January and March.
“Influenza peaked in the fall of 1918 but it remained prevalent throughout the state during the winter and spring of 1919.” (HHS. “Washington,” The Great Influenza.)
West Virginia
HHS: “State officials in West Charleston first reported the presence of the disease on September 27th. A week later, ninety-four cases and two deaths were officially reported; the actual number of cases and deaths was probably much higher. By the second week of October, the epidemic had peaked, with the highest number of cases being reported.
“In Berkeley County, even the fate of criminals was altered by the pandemic. James Horvatt who was alleged to have forged a forty dollar check was brought to trial before the county court on September 27th, just as influenza was entering the state. While in jail awaiting trial, Horvatt had contracted influenza from a fellow prisoner, Robert Smith. On the day Horvatt was brought to trial, Smith died from influenza. Horvatt himself was very ill from the disease. However, when offered a continuance, he refused to take it. Instead, Horvatt went to trial and the disease spread among those who were in the courtroom that day. Three lawyers who engaged in proceedings that day contracted influenza and died three days after Horvatt’s trial was concluded. Three more people, the judge, the county clerk and the assistant prosecuting attorney in the Horvatt case, along with their immediate families all contracted the disease and came close to death. In reaction, the local paper in Martinsburg published some advice on how to deal with influenza: “Don’t Worry, Stop Talking about it, Stop Thinking about it, Avoid People who have it.”….
“West Virginia University was closed during the epidemic and a fraternity house on campus was turned into an emergency hospital. In Morgantown, theaters and churches were closed and public meetings banned.
“At the West Virginia School for the Deaf and Blind in Romney, about two hundred pupils and employees were stricken. The school hospital and dormitories were filled with the sick. Several nurses became ill and were admitted to the hospital as patients. Teachers and local residents stepped in and served as nurses, caring for influenza patients. Later, two Red Cross nurses came from Parkersburg to assist in the crisis.
“The disease hit coal mining areas harder than other regions. By October, so many West Virginians were either ill themselves or caring for those suffering from influenza that a local committee estimated that only 20% of people were able to attend to their normal duties. Only two mail carriers, for example, were available in Martinsburg. Grave diggers there also found themselves overwhelmed. For several weeks, the diggers found themselves facing a backlog of at least two dozen graves which needed to be dug each day.
“Governor Cornwell asked for assistance from the Public Health Service and four medical interns were sent from the University of Maryland. Despite this help, most West Virginians had no contact with trained health practitioners during the pandemic….
The disease peaked in the state during the fall. It remained prevalent, however, throughout the state during the winter and spring of 1919.” (HHS. “West Virginia,” The Great Pandemic.)
Wisconsin
HHS: “Wisconsin officials did not provide influenza reports to the Public Health Service until October 18th. This was unusual as most states began reporting on or around September 27th. This failure to report may indicate that the influenza pandemic had caused a serious crisis in the state. However, the state’s failure to report may also simply indicate that the Wisconsin State Board of Health was poorly organized before the outbreak.
“On October 18th, state officials noted that “new cases are reported from localities.” On October 25th, officials informed the Public Health Service that “reports of the disease have been received from a large number of places, in some of which the disease is increasing and in others decreasing.” On November 1st, the state released a more extensive report: “On October 28th, it was stated that the situation in southern Wisconsin was clearing up but that the disease was expected to spread further into the northern part of the State. Outside of Milwaukee, 3,379 cases were reported for the week ending October 19th, with 4,109 cases being reported for the following week. During that same two week period, Milwaukee claimed to have just under 5,000 cases of influenza, with slightly over two hundred deaths. The actual number for both cases of influenza and deaths were probably much higher.
“While the state did not report during the early part of the pandemic, it is clear that the pandemic had reached Wisconsin long before October. The first deaths from influenza had occurred in Milwaukee during the week of September 14th.
“Despite the state’s inability to report to the federal government about influenza, the Wisconsin State Board of Health did hold a special meeting on October 2nd to discuss the situation. They issued regulations which called for all of the state’s physicians to treat influenza. Physicians came out of retirement to comply with this order. Medical practitioners were also required to report cases to the local health officer. Officials hoped that this directive would help them to track the disease.
“Quarantines were immediately imposed on residences, even if only one case of influenza existed in the residence. Only medical practitioners were permitted to enter these homes. The quarantine could be lifted only after residents provided proof that no one in the house had had a temperature for at least four days. Once residents had complied with this directive, they also needed to air thoroughly before it could be opened to admit outside visitors.
“Hospital procedures were strictly regulated during the pandemic. Hospitals forbid visitors access to hospital rooms with influenza patients. Only medical practitioners were permitted to enter the rooms of these patients.
“Funerals were to be limited to family members only. On October 10th, Wisconsin’s health officer, Cornelius Harper, ordered all public institutions in Wisconsin closed….
“The disease peaked in the fall. Although influenza remained pervasive throughout the state during the winter and spring, the number of cases did decline slightly during early 1919. By the summer, the disease had begun to disappear from the state….” (HHS. “Wisconsin,” The Great Pandemic.)
Wyoming
HHS: “Wyoming did not report the presence of influenza until the middle of October, long after the Public Health Service had requested that states provide information about influenza. Influenza had, however, hit the state by late September. With thousands of the state’s citizens ill, public health officials were overwhelmed and unable to keep accurate records.
“Communities across the state rallied in response to the epidemic. In Sheridan, the women of the Red Cross who had spent the war rolling bandages, sewing hospital garments and surgical dressings, knitting socks, helping soldiers in transit, and collecting used clothing now began carrying for influenza victims. An emergency hospital intended only for influenza patients was created in Sheridan. Eighteen of the hospital’s patients died of the disease. When organizers began planning a war memorial for Sheridan, citizens called for the memorial to include the names of the many soldiers from the area who had died, not in combat, but from influenza….
“Although influenza rates peaked in Wyoming during the late fall, the disease remained prevalent throughout the state during the winter and spring of 1919.” (HHS. “Wisconsin,” The Great Pandemic.)
- S. Army
War Department: “The total time lost as a result of sickness and injuries during the year 1918 amounted to 56,924,804 days. Of this loss of time 40,692,302 days were on account of disease, 12,545,442 days as a result of battle injuries…. The average number of men absent each day from duty of the entire military force was about 155,957, or approximately six divisions of troops. Of diseases influenza was the most important cause of loss of time among officers and enlisted men for both American and native troops, in all countries where United States troops were serving with the exception of that of American troops in the Philippine and Hawaiian Islands where gonorrhea was the first cause. For officers influenza caused 22.76 per cent of the total loss of time for disease; for enlisted men, American troops, 22.21 per cent, and for native troops 27.92 per cent of the total. Bronchitis was the second important cause of loss of time for officers; tuberculosis of the lungs third. These two diseases caused 7.17 per cent and 4.58 per cent of the total, respectively. For enlisted men, American troops, mumps was the second most important cause of loss of time, causing 7.35 per cent of the total, and gonococcus infection was third with 5.88 per cent.” (War Dept. An. Rpts., 1919…Rpt….Surgeon General. 1920, p. 1435.)
“The points that stand out with particular distinctness are…influenza…was probably present in the camps and associated with the virulent pneumonias in this country and in Europe during the latter part of 1917 and the early part of 1918. The epidemic declined during the cold dry weather in the winter, increased again with the advent of the chilly damp weather in the spring, then declined to a comparatively low rate to continue throughout the summer and again increased in the autumn of 1918 to reach the height of the great pandemic;…it was more prevalent in the United States among the white troops than among the colored, and particularly more prevalent among the white troops from the South than among the colored from the South…the admission rates were higher for the whites from the South than for the whites from any other section of the country. The rates for the soldiers from the east North Central States were next highest and probably the rates for the soldiers of the densely populated eastern States were the lowest….” (War Dept. An. Rpts., 1919…Rpt…. Surgeon General. 1920, p. 1438.)
- S. Navy
U.S. Navy: “Boston, Massachusetts Naval facilities suffered one of these initial outbreaks, and from there the disease moved rapidly inland and down the coast. In local epidemics lasting a few weeks to a month, what was then called “Spanish Influenza” sickened a large percentage of the Navy’s people. From 31 August to 31 December 1918 it left over four thousand dead, nearly one percent of the Sailors and Marines then on active duty, and about double the number killed in World War I combat. Generally, the epidemic was most severe ashore, especially at training facilities. Worst hit was Great Lakes, Illinois, with more than 900 deaths, nearly 500 in just one late September week. Afloat, many ships were afflicted and some disabled. Notable among the latter was the armored cruiser Pittsburgh, stationed at Rio de Janeiro, Brazil, with the majority of her 1100-man crew sick and 58 dead. The patrol vessel Yacona had 95 cases, more than eighty percent of her small complement.
“Though not disabled, the Navy’s transports were hit hard, with fatalities running especially high among troops en route to France. The huge Leviathan, with more 9000 on board, had 2000 ill and 91 dead during a voyage that began on 29 September 1918. The much smaller Siboney lost 38 men in an early October trip. Among the many other badly impacted transports were Agamemnon, America, Northern Pacific and Von Steuben. The outbreaks on transports took place just as the U.S. was pushing troops into France at a rapid pace, striving to maintain military momentum during the war-winning fall offensive. So important did this seem that it was officially stated that the lives lost to influenza on transports “contributed just as directly to the cause as any that were sacrificed amid actual scenes of battle”. Later in October, though, with victory in the offing, it was deemed prudent to suspend much trans-Atlantic troop movement.” (Dept of the Navy, Naval History Command. “The Influenza Epidemic of 1918.” 2009 update.)
Historycentral.com: “By this time, an influenza epidemic was raging in the United States and Europe and had taken countless lives. From its first appearance, special precautions had been taken on board America to protect both her ship’s company and passengers from this scourge. The sanitary measures had succeeded in keeping all in the ship healthy. However, this group of soldiers—who had come on board at Boston where the epidemic had been raging—brought the “flu.” As a result, 997 cases of “flu” and pneumonia occurred among the embarked soldiers during the passage to France while 56 cases broke out among the 940 men in the crew. Before the transport completed the round-trip voyage and arrived back at Hoboken, 53 soldiers and 2 sailors had died on board. This comparatively low death rate (some ships lost considerably more men) can be attributed to the almost super-human efforts of the ship’s doctors and corpsmen, as well as the embarked units’ medical personnel. Forty-two of the 53 deaths among the troops occurred during the time the ship lay at anchor at Brest from 29 September to 2 October.” (Historycentral.com. “America.”)
U.S. Naval Hospital, Washington, D.C.: “During the epidemic 568 cases were admitted. One hundred and fifty-seven of them developed pneumonia, of whom 31 died, a percentage of 20. Of those cases of pneumonia not treated with serum, 28 died, a percentage of 25. Forty-six cases were treated with serum and 3 died, a percentage of 6.5.” (Naval Historical Center. “Influenza at the United States Naval Hospital, Washington, D.C.”)
Peters: “During and after the pandemic of influenza which swept our country a little over a year ago, a small army of scientific investigators began and they have continued their researches ever since, forsooth, in the hope of discovering the cause and mode of transmission. Its every phase has been studied, in most instances on a broad basis, and much valuable information has been adduced; yet during all of this time not much has been done in a big way to relieve the victims of influenza, and their number is legion.
“”I’m not feeling right,” “I haven’t my usual pep,” “I’m all in since I had the flu,” are household expressions and so commonplace that we pay little attention to them, yet we know now that very
few subjects of influenza escaped without some pathologic changes. The virulence of the disease has been productive of many sequelae, some very apparent and others quite as obscure.
“Shattered homes, health and income, inability to work, impaired efficiency, loss of earning power, mental anxiety and distress, coupled with the high cost of living, completed the chain of horrors following the ravages of the epidemic. The economic results of the influenza epidemic were first felt by the various social agencies of Cincinnati early in February. All of the institutions caring for dependent persons, especially children, were crowded….
“Following the epidemic last spring, we were attracted by the number of prominent citizens who died suddenly. Further inquiry invariably brought forth the history of an attack of influenza during the pandemic. Such issues being usually cardiac in origin, this was supposedly the cause in most cases. But what type of heart disease was responsible, a myocardial infection, a conduction defect, or a serious valvular lesion? Further, could such a condition be diagnosticated in a routine way; and, if so, could an adjustment of corporal activity or other directions prevent?
“These and other considerations prompted Dr. Julien E. Benjamin to make special cardiac examinations on selected cases complaining of cardiac distress. The electrocardiograph and polygraph observations will be published later in a special article. In his preliminary report Dr. Benjamin gives us some interesting data. The greatest distress was noted among those who had influenza during the first wave in October. The symptoms complained of in most cases were inordinate fatigue or exhaustion, weakness, dyspnea on slightly more than normal exertion, tachycardia and precordial distress.” (Peters. After Effects of Influenza in Cincinnati. 10-28-1919.)
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[1] For 1918 and 1919; in 1918, 30 “registration” States and DC; in 1919, 33 “registration States and DC.
[2] From table: “Influenza and Pneumonia Mortality by Age: Death-Registrations States, 1917-19.”
[3] For 1919, the influenza death rate per 100,000 in registration States was 78.3 (Mortality Statistics 1920, p.19). The estimated 1919 US pop was 105,003,065, not counting Hawaii (Mortality Statistics 1920, p. 10).
[4] Blanchard extrapolation using registration area death rates for influenza and pneumonia and 1910 US census pop.
[5] Blanchard extrapolation. Pneumonia mortality rate, reg. area, was 137.3 per 100,000 x 106M, 1920 census.
[6] Blanchard extrapolation. Pneumonia mortality rate, reg. area, was 137.3 per 100,000 x 92.2M, 1920 census.
[7] “In 1920 the number of deaths due to pneumonia (all forms) is 120,108. Of these, 64,001 are due to lobar pneumonia, 47,746 to bronchopneumonia, and 8,361 to pneumonia (unqualified). The death rate from pneumonia (all forms) in 1920 is 137.3. This is 13.5 higher than that for 1919, which had the record low rate (123.5).”
[8] Blanchard extrapolation. Influenza mortality rate, reg. area, was 71.0 per 100,000 x 106.0M, 1920 census.
[9] Blanchard extrapolation, Influenza mortality rate, reg. area was 71.0 per 100,000 x 92.2M 1910 census.
[10] In 1917 there were 392 influenza deaths and 3,387 pneumonia. In 1915 there were 520 pneumonia deaths.
[11] We do not know which three villages, thus one or more could be one of those noted herein.
[12] Mortality Statistics 1920, p. 30, shows a 1920 CA I&P mortality rate of 164.5 per 100,000. Multiplied this times 1920 CA estimated population of 3,554,000. (CA Dept. of Finance, Demographic Research Unit. 2012.)
[13] Deaths from influenza and pneumonia (all forms) the first eight months of 1915 were 939.
[14] Mortality Statistics 1920, p. 30, shows a 1919 CO I&P mortality rate of 253.5 per 100,000. Multiplied this times 1919 estimated population of 932,388. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[15] Mortality Statistics 1920, p. 30, shows a 1920 CT I&P mortality rate of 221.5 per 100,000. Multiplied this times 1920 Conn. population of 1,394,324. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[16] Mortality Statistics 1920, p. 30, shows a 1920 DE I&P mortality rate of 207.1 per 100,000. Multiplied this times 1920 Del. Population of 226,199. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[17] Mortality Statistics 1920, p. 30, has 1920 IL I&P death rate of 213.2 per 100K; multiplied times 1920 IL pop. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[18] Mortality Statistics 1920, p. 30, shows a 1920 IN I&P mortality rate of 211.7 per 100,000. Multiplied this times 1920 IN Population of 2,942,210. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[19] Mortality Statistics 1920, p. 30, shows a 1919 MS I&P mortality rate of 261.8 per 100,000; multiplied times 1919 MS Population of 1,790,618. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[20] The mortality rate for MO for 1918 was 476.6 per 100,000. The 1910 census had the pop. at 3,293,335. (Demographia.com. “US Population by State from 1900.”) Thus the math works out to 15,727.
[21] Cites: An. Rpt. Hospital and Health Board of Kansas City, [MO]…Year Ending April 21st, 1919 (KC, 1919), 22.
[22] Mortality Statistics 1920, p. 30, shows a 1919 MO I&P mortality rate of 206.1 per 100,000; multiplied times 1919 MO population of 3,398,353. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[23] We suspect that the 5,000 figure refers to 1918 and 1919 combined, or some portion of these two years.
[24] Extrapolation. Mortality Statistics 1920, p. 30, shows a 1918 MT I&P mortality rate of 762.7 per 100,00; multiplied times 1918 MT population of 522,185. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[25] Extrapolation. Mortality Statistics 1920, p. 30, shows a 1919 MT I&P mortality rate of 225.4 per 100,000; multiplied times 1919 MT population of 539,988. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[26] Extrapolation. Mortality Statistics 1920, p. 30, shows 1920 MT I&P mortality rate of 157.8 per 100,000; multiplied times 1920 MT population of 557,791. (US Census Bureau. Estimates of Population… 1923, p. 14.)
[27] 970 registered influenza deaths and 415 registered pneumonia deaths.
[28] Extrapolation. Mortality Statistics 1920, p. 30, shows 1920 NE I&P mortality rate of 143.1 per 100,000; multiplied times 1920 NE pop. of 1,301,737 (US Census Bureau. Estimates of Population… 1923, p. 14.).
[29] Cites NH Dept. of Commerce records.
[30] 1919 NH I&P mortality rate of 231.6 per 100K x 1919 NH 442,439 pop. (Census. Estimates of Pop.… 1923, 14).
[31] 1920 NH I&P mortality rate of 199.0 per 100K x 1920 NH 443,728 pop. (Census. Estimates of Pop.… 1923, 14).
[32] For 1918 we are using the more conservative US PHS report on the last four months of 1918.
[33] 1918 NJ I&P mortality rate of 769.4 per 100K x 1918 NJ 3,060,301 pop. (Census. Estimates of Pop…1923, p14).
[34] Cites NJ Dept. of Health.
[35] Reflects last four months of the year, whereas larger Census Bureau’s Mortality Statistics figure presumably reflects entire year, and conceivably more accurate data in that it was published two years later than the PHS report.
[36] Cites May 26, 2006 address by then-U.S. Secretary of Health and Human Services Mike Leavitt.
[37] The lower figure is cited from Spidle, Jake W. Doctors of Medicine in New Mexico: A History of Health and Medical Practice, 1886-1986. Albuquerque: University of New Mexico Press (1986), 236. The 5,000 estimate is from Greenfield, Myrtle. A History of Public Health in New Mexico. Albuquerque: Univ. of NM Press (1962), 16. We suspect the 5,000 mortality figure refers to 1918-1919 influenza and pneumonia.
[38] 1,874 registered influenza deaths and 1,405 registered pneumonia deaths.
[39] 1920 NY I&P death rate of 205.4 per 100K x 1920 pop. of 10,581,700 (Census. Estimates of Pop.…1923, p. 14.).
[40] 1918 NC I&P death rate of 503.1 per 100K x 1918 pop. of 2,504,608 (Census. Estimates of Pop.… 1923, p. 14.).
[41] 1919 NC I&P death rate of 234.4 per 100K x 1919 pop. of 2,540,952 (Census. Estimates of Pop.… 1923, p. 14.).
[42] 1920 NC I&P death rate of 218.1 per 100K x 1920 pop. of 2,577,296 (Census. Estimates of Pop.… 1923, p. 14.).
[43] “According to state health department records, 14,986 deaths were attributed to influenza statewide in 1918.”
[44] 1920 OH I&P death rate of 201.4 per 100K x 1920 OH pop. of 5,810,498 (Census. Estimates of Pop. …1923, 14.)
[45] 1920 OR I&P death rate of 168.8 per 100K x 1920 OR pop. of 789,087 (Census. Estimates of Pop. …1923, p. 14).
[46] 1919 PA I&P mortality rate of 236.5 per 100K x 8,665,687 1919 PA pop. (Census. Estimates of Pop. 1923, p.14.)
[47] Since this is so much higher than the Census Bureau figures for 1918, we assume this figure is for 1918-1919.
[48] “According to reports furnished the most important cause of admission was influenza.” (War Dept. 1920, 1471)
[49] “The United States Navy lost 4,000 of its personnel out of 5,900 killed by all forms of disease in 1918.” Cites: Office of the Surgeon General. Annual Reports of Navy Department, 1919. Page 2505.
[50] Barry, John M. The Great Influenza: The Epic Story of the Deadliest Plague in History. New York: Viking, 2004.