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The pandemic of 1918-1919 occurred in
three waves
Influenza Strikes
http://1918.pandemicflu.gov/the_pandemic/01.htm
Throughout history, influenza viruses have mutated and
caused pandemics or global epidemics. In 1890, an
especially virulent influenza pandemic struck, killing
many Americans. Those who survived that pandemic and
lived to experience the 1918 pandemic tended to be less
susceptible to the disease.
From Kansas to Europe and Back Again:
Where did the 1918 influenza come from? And why was it
so lethal?
In 1918, the Public Health Service had just begun to
require state and local health departments to provide
them with reports about diseases in their communities.
The problem? Influenza wasn't a reportable disease.
But in early March of 1918, officials in Haskell County
in Kansas sent a worrisome report to the Public Health
Service. Although these officials knew that influenza
was not a reportable disease, they wanted the federal
government to know that ?18 cases of influenza of a
severe type? had been reported there.
By May, reports of severe influenza trickled in from
Europe. Young soldiers, men in the prime of life, were
becoming ill in large numbers. Most of these men
recovered quickly but some developed a secondary
pneumonia of ?a most virulent and deadly type.?
Within two months, influenza had spread from the
military to the civilian population in Europe. From
there, the disease spread outward? to Asia, Africa,
South America and, back again, to North America.
Wave After Wave:
In late August, the influenza virus probably mutated
again and epidemics now erupted in three port cities:
Freetown, Sierra Leone; Brest, France, and Boston,
Massachusetts.
In Boston, dockworkers at Commonwealth Pier reported
sick in massive numbers during the last week in August.
Suffering from fevers as high as 105 degrees, these
workers had severe muscle and joint pains. For most of
these men, recovery quickly followed. But 5 to 10% of
these patients developed severe and massive pneumonia.
Death often followed.
Public health experts had little time to register their
shock at the severity of this outbreak. Within days,
the disease had spread outward to the city of Boston
itself. By mid-September, the epidemic had spread even
further with states as far away as California, North
Dakota, Florida and Texas reporting severe
epidemics.
The Unfolding of the Pandemic:
The pandemic of
1918-1919 occurred in three waves. The first
wave had occurred when mild influenza erupted in the
late spring and
summer of 1918. The second wave occurred with an
outbreak of severe influenza in the fall of 1918
and the final wave occurred in the spring of 1919.
In its wake, the pandemic would leave about twenty
million dead across the world. In America alone, about
675,000 people in a population of 105 million would die
from the disease.
Find out what happened in your state during the
Pandemic
Mobilizing to Fight Influenza:
Although taken unaware by the pandemic, federal, state
and local authorities quickly mobilized to fight the
disease.
On September 27th, influenza became a reportable
disease. However, influenza had become so widespread by
that time that most states were unable to keep accurate
records. Many simply failed to report to the Public
Health Service during the pandemic, leaving
epidemiologists to guess at the impact the disease may
have had in different areas.
World War I had left many communities with a shortage
of trained medical personnel. As influenza spread,
local officials urgently requested the Public Health
Service to send nurses and doctors. With less than 700
officers on duty, the Public Health Service was unable
to meet most of these requests.
On the rare occasions when the PHS was able to send
physicians and nurses, they often became ill en route.
Those who did reach their destination safely often
found themselves both unprepared and unable to provide
real assistance.
In October, Congress appropriated a million dollars for
the Public Health Service. The money enabled the PHS to
recruit and pay for additional doctors and nurses. The
existing shortage of doctors and nurses, caused by the
war, made it difficult for the PHS to locate and hire
qualified practitioners. The virulence of the disease
also meant that many nurses and doctors contracted
influenza within days of being hired.
Confronted with a shortage of hospital beds, many local
officials ordered that community centers and local
schools be transformed into emergency hospitals. In
some areas, the lack of doctors meant that nursing and
medical students were drafted to staff these makeshift
hospitals.
The Pandemic Hits:
Entire families became ill. In Philadelphia, a city
especially hard hit, so many children were orphaned
that the Bureau of Child Hygiene found itself
overwhelmed and unable to care for them.
As the disease spread, schools and businesses emptied.
Telegraph and telephone services collapsed as operators
took to their beds. Garbage went uncollected as garbage
men reported sick. The mail piled up as postal carriers
failed to come to work.
State and local departments of health also suffered
from high absentee rates. No one was left to record the
pandemic? s spread and the Public Health Service? s
requests for information went unanswered.
As the bodies accumulated, funeral parlors ran out of
caskets and bodies went uncollected in morgues.
Protecting Yourself From Influenza:
In the absence of a sure cure, fighting influenza
seemed an impossible task.
In many communities, quarantines were imposed to
prevent the spread of the disease. Schools, theaters,
saloons, pool halls and even churches were all closed.
As the bodies mounted, even funerals were held out
doors to protect mourners against the spread of the
disease.
Public officials, who were unaware that influenza was a
virus and that masks provided no real protection
against viruses, often demanded that people wear gauze
masks. Some cities even passed laws requiring people to
wear masks. Enforcing these laws proved to be very
difficult as many people resisted wearing masks.
Advertisements recommending drugs which could cure
influenza filled newspapers. Some doctors suggested
that drinking alcohol might prevent infection, causing
a run on alcohol supplies. Some folk healers insisted
that wearing a specific type of amulet or a small bag
of camphor could protect against influenza.
States passed laws forbidding spitting, fearing that
this common practice spread influenza.
None of these suggestions proved effective in limiting
the spread of the pandemic.
Communications During the Pandemic:
Public health officials sought to stem the rising panic
by censoring newspapers and issuing simple directives.
Posters and cartoons were also printed, warning people
of the dangers of influenza.
Although the Public Health Service was aware that much
of the nation? s large immigrant population did not
speak or read English, posters used English almost
exclusively. But even native English speakers found the
posters and directives confusing. And limited
understanding of influenza, combined with the rapidity
of its spread, meant that these directives were often
ignored or poorly understood.
Fading of the Pandemic:
In November, two months after the pandemic had erupted,
the Public Health Service began reporting that
influenza cases were declining.
Communities slowly lifted their quarantines. Masks were
discarded. Schools were re-opened and citizens flocked
to celebrate the end of World War I.
Communities and the disease continued to be a threat
throughout the spring of 1919.
By the time the pandemic had ended, in the summer of
1919, nearly 675,000 Americans were dead from
influenza. Hundred of thousands more were orphaned and
widowed.
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