Idaho History May 10, 2020

Idaho 1918-1919 Influenza Pandemic

(Part 4)

100 Years Ago November 1918

A letter from Challis describes how the citizens of that locality determined to make an effective quarantine against influenza, as follows:

The court and the county board of health and council of defense have clashed in the Challis or Salmon river watershed section of Custer county over Spanish influenza quarantine.

To prevent carriers taking the disease into the Challis section, all roads and highways leading thereto were picketed. In the night, however, parties passed the pickets, and when discovered were placed in quarantine.

They applied to the courts for help, and Judge F. J. Cowen issued a writ for the release of the parties so detained and cited Sheriff Huntington and Dr. C. L. Kirtley, chairman of the Custer county board of health, to appear before him at Arco on November 11 , to show cause why they should not be punished for contempt of court for refusing to release them.

Nov 15, 2018 issue of The Recorder Herald, Courtesy Diana Rackham Nielson
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100 Years Ago (part 2)

The second installment of the moving picture enacted in Custer county over a conflict of authority between local board of health and Judge Frederick J. Cowen is reported in the Boise Capital News of November 14 as follows:

Hundreds of citizens, both men, and women, are barricading the roads leading into the Challis section of Custer county, to keep District Judge Cowen from breaking what they allege to be an established quarantine against the flu. It is claimed there is no rioting, but that it is the calm determination of the citizens to maintain their rights.

Judge Cowen on the other hand, asserts the citizens are thwarting law enforcement, and he informed state officials that bloodshed was feared because of the bitterness shown.

Nov 22, 2018 issue of The Recorder Herald Courtesy, Diana Rackham Nielson

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Policemen stand in a street in Seattle, Washington, wearing protective masks made by the Seattle Chapter of the Red Cross, during the influenza epidemic in 1918. – National Archives

source: Alan Taylor April 10, 2018 “30 Photos of the 1918 Flu Pandemic” The Atlantic
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Genesee News – November 29, 1918

Public Gatherings Resumed

Schools were opened Monday in Genesee following the lifting of the influenza quarantine by the state board of health, but pupils will be watched closely and any one showing signs of illness will be sent home immediately.

The motion picture theater will be opened Thursday evening and again Saturday evening and church services will be resumed as usual Sunday morning.

There have been quite a number of scattered cases of influenza but at no time has it reached the stage of an epidemic here and it is thought that the opening of the schools and resuming of church services and other public meetings will not tend to spread the disease provided caution is shown by those who are ill.

Each one should be vitally interested enough in the health of the community to observe a voluntary quarantine by remaining at home until all danger of communicating the disease to others has past. This is the best safeguard to prevent a further spread.

A few of the rural schools did not open Monday but will wait until Monday, December, 2.

Conditions in Lewiston and Moscow were not such as would warrant the opening of the schools until Monday, December 2, as both places showed a considerable increase in influenza cases following the peace celebrations. Reports this week show that the number of cases shows a decrease.

Kendrick and Troy did not open their schools Monday and a few rural schools were also kept closed.

source: White Spring Ranch Museum/Archive Library, Non-Profit, Genesee, Idaho
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Corpsmen in caps and gowns ready to attend patients in the influenza ward of the U.S. Naval Hospital on Mare Island, California, on December 10, 1918. – U.S. Navy

source: Alan Taylor April 10, 2018 “30 Photos of the 1918 Flu Pandemic” The Atlantic
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American Falls Press, 06 Dec 1918

Lid Is On Tight in American Falls

Business Houses Placed Under Strict Regulations for Ten Day Period in Effort to Overcome the Spread of Influenza.

The lid is on real tight in American Falls until December 16, in an attempt to stamp out the flu. If a strict observance of the regulations fails to accomplish the purpose, or to show material benefits, the other extreme is likely to be employed and everything thrown open.

This is the opinion reflected at the meeting of the city council Wednesday night when the ordinances were passed to put strict regulations into effect.

All business houses are required to close early, and none are to permit more patrons in their establishments at any one time than there are clerks to wait on them.

During the present week there has been a large increase in the number of flu victims. Just how many cases there are is not known, but the situation is believed to he as bad as it has been at any time since the epidemic first made its appearance. Several are sick who show symptoms of the flu, but the cases have not developed far enough to make it certain whether they have the disease or not. The bad cases, as a rule, are being taken to the hospital, and there are four serious cases there now.

It has been decided to postpone the opening of the schools until after the holidays. Churches may be permitted to open earlier, but for the present all indoor and outdoor meetings are under the ban.

The city ordinances were ordered published in both papers, circulars and placards were printed and distributed, and the public is asked to conform to the regulations imposed as strictly as possible.

source: History of Idaho
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Idaho Statesman Dec 22, 1918


source: Idaho Experience
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The Emmett Index January 2, 1919

Flu Ban is on Again

Closing Order Includes Schools, Public Gatherings for Two Weeks

Owing to the vigor displayed by the flu germ since Christmas, representatives of the city and county health boards and the board of education held a conference Sunday and it was deemed advisable to once more put in force a closing order to extend to January 19. At each previous action of this kind the pool halls have been included, and naturally this worked a hardship upon these business houses.

It is maintained by a large number that there is no more justice in closing these than there would be in closing other business houses, since there are at every mail time crowds of people in the post office, and the customary congregation of patrons in barber shops, and other instances are cited. In consideration of these facts, the order excludes these places, but includes theaters, dances, churches, lodges and the like. The schools were also included in the closing order.

It is estimated there are between 240 and 300 cases in the Emmett country, and the doctors are working night and day. Few of the cases are serious, and it is claimed that if the “Flu” had never been heard of the sickness would have been classified as pure and unadulterated old fashioned grip. In spite of closing orders and quarantines it is evident that practically everyone will have it, and the best way is to take it as a matter of course and take good care of yourselves. Don’t neglect even a slight cold. Don’t expose yourself. Stay home as closely as possible when not required to be away on business. In short, be sensible.

C. M. Park has been appointed “Flu Inspector” and is at the service of victims who need help. He will run errands, build fires, chop wood, milk the cow, slop the pigs, mother the kids, put out the cat, wash the dishes, empty the slop, et cetera and so forth. Call him night or day. He never sleeps anyway.

source: Gem County Historical Village Museum [h/t SMc] Chronicling America
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Nurses in Boston hospitals are equipped with masks to fight influenza in the spring of 1919. – National Archives

source: Alan Taylor April 10, 2018 “30 Photos of the 1918 Flu Pandemic” The Atlantic
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Further Reading

Why Was It Called the ‘Spanish Flu?’

The 1918 influenza pandemic did not, as many people believed, originate in Spain.

Evan Andrews Mar 27, 2020

In the spring of 1918, just as the man-made horrors of World War I were finally starting to wind down, Mother Nature unleashed the deadliest strain of influenza in modern history. The virus infected as much as 40 percent of the global population over the next 18 months. Of these, an estimated 20 to 50 million perished—more than the roughly 17 million people killed during the First World War. The pandemic’s grasp stretched from the United States and Europe to the remote reaches of Greenland and the Pacific islands. Its victims included the likes of President Woodrow Wilson, who contracted it while negotiating the Treaty of Versailles in early 1919.

As the pandemic reached epic proportions in the fall of 1918, it became commonly known as the “Spanish Flu” or the “Spanish Lady” in the United States and Europe. Many assumed this was because the sickness had originated on the Iberian Peninsula, but the nickname was actually the result of a widespread misunderstanding.

Spain was one of only a few major European countries to remain neutral during World War I. Unlike in the Allied and Central Powers nations, where wartime censors suppressed news of the flu to avoid affecting morale, the Spanish media was free to report on it in gory detail. News of the sickness first made headlines in Madrid in late-May 1918, and coverage only increased after the Spanish King Alfonso XIII came down with a nasty case a week later. Since nations undergoing a media blackout could only read in depth accounts from Spanish news sources, they naturally assumed that the country was the pandemic’s ground zero. The Spanish, meanwhile, believed the virus had spread to them from France, so they took to calling it the “French Flu.”

While it’s unlikely that the “Spanish Flu” originated in Spain, scientists are still unsure of its source. France, China and Britain have all been suggested as the potential birthplace of the virus, as has the United States, where the first known case was reported at a military base in Kansas on March 11, 1918. Researchers have also conducted extensive studies on the remains of victims of the pandemic, but they have yet to discover why the strain that ravaged the world in 1918 was so lethal.

source: with 5 minute video
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Spanish flu

Soldiers from Fort Riley, Kansas, ill with “Spanish” flu at a hospital ward at Camp Funston

The Spanish flu, also known as the 1918 flu pandemic, was an unusually deadly influenza pandemic caused by the H1N1 influenza A virus. Lasting from spring 1918 through spring or early summer 1919, it infected 500 million people – about a third of the world’s population at the time. The death toll is estimated to have been anywhere from 17 million to 50 million, and possibly as high as 100 million, making it one of the deadliest pandemics in human history.

To maintain morale, World War I censors minimized early reports of illness and mortality in Germany, the United Kingdom, France, and the United States. Newspapers were free to report the epidemic’s effects in neutral Spain, such as the grave illness of King Alfonso XIII, and these stories created a false impression of Spain as especially hard hit. This gave rise to the name “Spanish” flu. Historical and epidemiological data are inadequate to identify with certainty the pandemic’s geographic origin, with varying views as to its location.

Most influenza outbreaks disproportionately kill the very young and the very old, with a higher survival rate for those in between, but the Spanish flu pandemic resulted in a higher than expected mortality rate for young adults. Scientists offer several possible explanations for the high mortality rate of the 1918 influenza pandemic. Some analyses have shown the virus to be particularly deadly because it triggers a cytokine storm, which ravages the stronger immune system of young adults. In contrast, a 2007 analysis of medical journals from the period of the pandemic found that the viral infection was no more aggressive than previous influenza strains. Instead, malnourishment, overcrowded medical camps and hospitals, and poor hygiene, all exacerbated by the recent war, promoted bacterial superinfection. This superinfection killed most of the victims, typically after a somewhat prolonged death bed.

Despite its name, historical and epidemiological data cannot identify the geographic origin of the Spanish flu.

The origin of the “Spanish flu” name stems from the pandemic’s spread to Spain from France in November 1918. Spain was not involved in the war, having remained neutral, and had not imposed wartime censorship. Newspapers were therefore free to report the epidemic’s effects, such as the grave illness of King Alfonso XIII, and these widely-spread stories created a false impression of Spain as especially hard hit.

When an infected person sneezes or coughs, more than half a million virus particles can spread to those nearby. The close quarters and massive troop movements of World War I hastened the pandemic, and probably both increased transmission and augmented mutation. The war may also have reduced people’s resistance to the virus. Some speculate the soldiers’ immune systems were weakened by malnourishment, as well as the stresses of combat and chemical attacks, increasing their susceptibility.

A large factor in the worldwide occurrence of this flu was increased travel. Modern transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease. Another was lies and denial by governments, leaving the population ill-prepared to handle the outbreaks.

In the United States, the disease was first observed in Haskell County, Kansas, in January 1918, prompting local doctor Loring Miner to warn the US Public Health Service’s academic journal. On 4 March 1918, company cook Albert Gitchell, from Haskell County, reported sick at Fort Riley, a US military facility that at the time was training American troops during World War I, making him the first recorded victim of the flu. Within days, 522 men at the camp had reported sick. By 11 March 1918, the virus had reached Queens, New York. Failure to take preventive measures in March/April was later criticised.

In August 1918, a more virulent strain appeared simultaneously in Brest, France; in Freetown, Sierra Leone; and in the U.S., in September, at the Boston Navy Yard and Camp Devens (later renamed Fort Devens), about 30 miles west of Boston. Other U.S. military sites were soon afflicted, as were troops being transported to Europe. The Spanish flu also spread through Ireland, carried there by returning Irish soldiers.

The Spanish flu infected around 500 million people, about one-third of the world’s population. Estimates as to how many infected people died vary greatly, but the flu is regardless considered to be one of the deadliest pandemics in history.

American Red Cross nurses tend to flu patients in temporary wards set up inside Oakland Municipal Auditorium, 1918.

An estimate from 1991 states that the virus killed between 25 and 39 million people. A 2005 estimate put the death toll at 50 million (about 3% of the global population), and possibly as high as 100 million (more than 5%). However, a reassessment in 2018 estimated the total to be about 17 million, though this has been contested. With a world population of 1.8 to 1.9 billion, these estimates correspond to between 1 and 6 percent of the population.

This flu killed more people in 24 weeks than HIV/AIDS killed in 24 years. However, it killed a much lower percentage of the world’s population than the Black Death, which lasted for many more years.

The pandemic mostly killed young adults. In 1918–1919, 99% of pandemic influenza deaths in the U.S. occurred in people under 65, and nearly half of deaths were in young adults 20 to 40 years old. In 1920, the mortality rate among people under 65 had decreased sixfold to half the mortality rate of people over 65, but 92% of deaths still occurred in people under 65. This is unusual, since influenza is typically most deadly to weak individuals, such as infants under age two, adults over age 70, and the immunocompromised. In 1918, older adults may have had partial protection caused by exposure to the 1889–1890 flu pandemic, known as the “Russian flu”.

According to historian John M. Barry, the most vulnerable of all – “those most likely, of the most likely”, to die – were pregnant women. He reported that in thirteen studies of hospitalized women in the pandemic, the death rate ranged from 23% to 71%. Of the pregnant women who survived childbirth, over one-quarter (26%) lost the child.

Another oddity was that the outbreak was widespread in the summer and autumn (in the Northern Hemisphere); influenza is usually worse in winter.

Modern analysis has shown the virus to be particularly deadly because it triggers a cytokine storm (overreaction of the body’s immune system), which ravages the stronger immune system of young adults. One group of researchers recovered the virus from the bodies of frozen victims and transfected animals with it. The animals suffered rapidly progressive respiratory failure and death through a cytokine storm. The strong immune reactions of young adults were postulated to have ravaged the body, whereas the weaker immune reactions of children and middle-aged adults resulted in fewer deaths among those groups.

In fast-progressing cases, mortality was primarily from pneumonia, by virus-induced pulmonary consolidation. Slower-progressing cases featured secondary bacterial pneumonia, and possibly neural involvement that led to mental disorders in some cases. Some deaths resulted from malnourishment.

American Expeditionary Force victims of the Spanish flu at U.S. Army Camp Hospital no. 45 in Aix-les-Bains, France, in 1918

The second wave of the 1918 pandemic was much more deadly than the first. The first wave had resembled typical flu epidemics; those most at risk were the sick and elderly, while younger, healthier people recovered easily. By August, when the second wave began in France, Sierra Leone, and the United States, the virus had mutated to a much more deadly form. October 1918 was the month with the highest fatality rate of the whole pandemic.

This increased severity has been attributed to the circumstances of the First World War. In civilian life, natural selection favors a mild strain. Those who get very ill stay home, and those mildly ill continue with their lives, preferentially spreading the mild strain. In the trenches, natural selection was reversed. Soldiers with a mild strain stayed where they were, while the severely ill were sent on crowded trains to crowded field hospitals, spreading the deadlier virus. The second wave began, and the flu quickly spread around the world again. Consequently, during modern pandemics, health officials pay attention when the virus reaches places with social upheaval (looking for deadlier strains of the virus).

The fact that most of those who recovered from first-wave infections had become immune showed that it must have been the same strain of flu. This was most dramatically illustrated in Copenhagen, which escaped with a combined mortality rate of just 0.29% (0.02% in the first wave and 0.27% in the second wave) because of exposure to the less-lethal first wave. For the rest of the population, the second wave was far more deadly; the most vulnerable people were those like the soldiers in the trenches – adults who were young and fit.

In January 1919 a third wave of the Spanish Flu hit Australia, then spread quickly through Europe and the United States, where it lingered through the Spring and until June of 1919. It primarily affected Spain, Serbia, Mexico and Great Britain, resulting in hundreds of thousands of deaths. It was less severe than the second wave but still much more deadly than the initial first wave.

In spring 1920 a very minor fourth wave occurred in isolated areas including New York City, the United Kingdom, Austria, Scandinavia, and some South American islands. Mortality rates were very low.

Even in areas where mortality was low, so many adults were incapacitated that much of everyday life was hampered. Some communities closed all stores or required customers to leave orders outside. There were reports that healthcare workers could not tend the sick nor the gravediggers bury the dead because they too were ill. Mass graves were dug by steam shovel and bodies buried without coffins in many places.

After the lethal second wave struck in late 1918, new cases dropped abruptly – almost to nothing after the peak in the second wave. In Philadelphia, for example, 4,597 people died in the week ending 16 October, but by 11 November, influenza had almost disappeared from the city. One explanation for the rapid decline in the lethality of the disease is that doctors became more effective in prevention and treatment of the pneumonia that developed after the victims had contracted the virus.

Another theory holds that the 1918 virus mutated extremely rapidly to a less lethal strain. This is a common occurrence with influenza viruses: there is a tendency for pathogenic viruses to become less lethal with time, as the hosts of more dangerous strains tend to die out.

excerpted: from Wikipedia

Link to Idaho 1918-1919 Influenza Pandemic (Part 1)
Link to Idaho 1918-1919 Influenza Pandemic (Part 2)
Link to Idaho 1918-1919 Influenza Pandemic (Part 3)