The Return of the Spanish Lady?
The 1918 Flu Pandemic was one of the greatest killers in history. Is there a chance it could happen again? Part I
Most Memphians reading The Commercial Appeal on the morning of September 19, 1918, probably skipped over a tiny article buried on page three. Headlined "FLUE IN NEW YORK," the three-sentence story casually mentioned that five cases had been reported by that city's health commissioner. Anybody here old enough to remember the devastating yellow-fever epidemics of the 1870s, or even a particularly bad run of flu that hit in 1889, might have been concerned by the second sentence: "More than 100 cases have been reported among seamen and men employed in the foreign service." But still, New York was hundreds of miles away. Why should anyone here worry?
What Memphians -- and for that matter, most of America, if not the world -- didn't realize was this was no ordinary flu. The Spanish influenza, as it came to be called, was an incredibly deadly strain that attacked its victims swiftly, killed many of them, and swept around the globe like a whirlwind. Historian Pete Davies, author of The Devil's Flu, calls it "the worst medical catastrophe in history." Before it was done, it killed as many as 100 million people, and no part of the globe escaped. To put it in perspective, John Barry, author of The Great Influenza: The Story of the Deadliest Pandemic in History, points out: "Spanish influenza killed more people in a year than the Black Death of the Middle Ages killed in a century. It killed more people in 24 weeks than AIDS has killed in 24 years."
And today, more than a few scientists worry that it could happen again. Dr. Robert Webster holds the Rose Marie Thomas Chair with the Department of Infectious Diseases at St. Jude Children's Research Hospital. He is also director of the World Health Organization Collaborating Center at St. Jude -- one of only five in the world dedicated to studying influenza, and the only one that studies the disease's relationship between humans and animals.
"Another worldwide pandemic is absolutely inevitable, with the only question being when," Webster says. "I compare it to a major earthquake occurring along the New Madrid Fault: It happened before; it will happen again. The only question is whether it will happen in 500 years, 50 years, or tomorrow, and if it does, how severe will it be. There is just no way of knowing."
The World at War
By September 1918, Memphians had grown weary of death. But at least it was a long way off. America was embroiled in World War I, and soldiers in France, Belgium, and Germany were being slaughtered by newfangled machines never before used in warfare: machine guns, fighter planes, tanks, and poison gas. In those days, our main source of news was the newspaper, and The Commercial Appeal and the News-Scimitar filled almost every column with articles about the war. Grim headlines on just a single day -- September 1, 1918 -- were typical: "Tanks Throw Back Enemy in Flanders," "Spain Will Seize German Ships," "British Force Foe to Retire," "Mississippi Flyer Tells of Battling Huns," and "324 German Planes Downed." And those were just the main stories. Every article, it seems, had a war theme. A human-interest piece on a female circus performer really had little to do with the war, but still carried this headline: "Circus Star Would Fight Huns If She Could, But She's Only a Girl."
Constant attention was devoted to Memphians who were fighting overseas: "Mt. Zion Bible Class Well Represented on France Battlefields" and "Memphis Girl Is with Hospital Unit in France." Even letters from home were posted on the front pages: "Memphis Soldier Writes of Life in the Trenches" ("not as bad as we expected. We think it will not be very long before it's over, but you never can tell").
Meanwhile, back home, citizens had their own, considerably lesser, problems. Just about everything was rationed or reserved for war use. Goldmith's ads reminded shoppers, "Save our boys from German gas -- by saving peach pits for Uncle Sam." The ground-up pits, it was explained, could be used as gas-mask filters. Wheat was in short supply, and ads for Post Toasties bragged, "They taste twice as good now because you know they save wheat." (They were now made from corn.) Merchants sold "Victory Flour" (a 50/50 mix of flour and corn meal) and everyone was encouraged to plant "victory gardens" so they could grow their own fruits and vegetables.
Gasoline was an especially rare commodity, and once a week newspapers alerted readers, "This is gas-less day. Leave your Tin Lizzie in the garage." Even though, at first, such a measure was voluntary, the papers warned, rather ominously, "Uncle Sam is watching you."
There were more meaningful sacrifices. Practically every able-bodied young man was drafted and rushed to training camps around the country. Some of these camps were jammed with as many as 40,000 men, who lived in hastily constructed wooden shacks or canvas tents, heated by a single wood-burning stove, and the "bathroom" was a common latrine. In the winter, the camps were not only miserable, but with so many men jammed together, they were tinderboxes for any form of disease.
"These circumstances not only brought huge numbers of men into intimate proximity, but exposed farm boys to city boys from hundreds of miles away, each of them with entirely different disease immunities and vulnerabilities," writes Barry. "Never before in American history -- and possibly never before in any country's history -- had so many men been brought together in such a way." Most of the camps had hospitals, but they weren't prepared for the new enemy they were about to fight. Nobody was.
A New Villain Appears
No one is certain why the disease came to be known as the Spanish flu. One theory is that since so many newspapers overseas were censored, they were not reporting this strange new ailment afflicting so many soldiers. It wasn't a good idea, the government thought, to let the "huns" know that an entire army camp was disabled by the flu. Because Spain remained neutral during World War I, however, their reporters covered the new disease, especially when that country's King Alfonso XIII became ill, and many people thought it originated there.
In fact, later researchers believe the "Spanish" flu actually started at an army base in Kansas, quickly spread to other camps, and then swept overseas and back, as troops were moved throughout the country by railroad. A national epidemic became a worldwide pandemic in a matter of weeks. No matter what you called it, however, this was a particularly lethal form of influenza. Victims first came down with chills, then bone-numbing aches and pains, and blinding headaches. As their lungs began to fill with fluids, oxygen levels dropped in their bodies, and their skin turned a shocking shade of blue -- a process called cyanosis. Death soon followed. Victims who somehow survived all this often died a few days later of pneumonia or meningitis.
Government officials who came to the camps left stunned by the devastation. This was like nothing they had ever seen before. One of this country's most imminent physicians, Dr. William H. Welch, co-founder of the Rockefeller Institute for Medical Research, visited Boston's Camp Devens. After watching an autopsy and noting that the dead soldier's lungs were sodden with blood, he told his colleagues, "This must be some new kind of infection, or plague." Another doctor noticed that the normally unflappable Welch was "quite excited and obviously very nervous. It was the only time I ever saw him really worried and disturbed."
He had good reason to be nervous, for the speed of the disease was especially alarming. An epidemiologist at Yale reported, "We have had a number of cases where people were perfectly healthy and died within 12 hours." Dr. Victor Vaughan, a former president of the American Medical Association, came to a horrifying conclusion: "If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear from the face of the earth."
Another disturbing factor was the age of the victims. Flu normally strikes -- and kills -- children and older adults. The Spanish flu proved deadly to people between 20 and 60, and nobody knew why. "It killed the young and strong," writes Barry. "Those with the most to live for -- the robust, the fit, the hearty, those raising young sons and daughters -- they were the ones who died."
Laboratories and universities across the country began to gather tissue samples from corpses and worked furiously on a vaccine, but nobody could even decide if the flu -- if that's even what it was -- was caused by a bacteria (which might respond to the proper antibiotic) or a virus (which wouldn't). Meanwhile, as the scientists worked day and night, soldiers died by the thousands. The hospital at Camp Devens, built to hold just a few hundred patients, was soon filled with more than 6,000 desperately ill flu victims. It was a nightmarish situation at bases across the country. The commander of Camp Grant in Rockford, Illinois, became so distraught by so many soldiers dying there that he committed suicide. "His death was not listed as a casualty of the epidemic," writes Barry. "Nor did his sacrifice stop it."
And despite the best government efforts to keep the bad news at bay, with so many people dying, it was inevitable that newspapers finally began to pick up the story. And as the disease spread across the land, so did panic.
Cities in the Northeast were particularly hard-hit. Philadelphia reported more than 7,000 deaths in two weeks. The city ran out of coffins, so victims were buried in mass graves. The death toll in New York City exceeded 33,000. And then the flu slowly began to move south. On September 20, 1918, Memphians had to be alarmed to read "Spanish Influenza Found in Little Rock." The next day, cases were reported in New Orleans.
Nothing to Fear
The first victim from Memphis was probably a young soldier named John Cooper. According to his Commercial Appeal obituary, he had joined the Marines in August and had been unlucky enough to be sent to Camp Devens. Just two weeks after arriving, he died there in the camp hospital. The official cause of death was listed as "meningitis" but he almost certainly died of the flu, along with so many others there.
Medical authorities had not yet announced -- because they didn't know -- that the flu was spread by human contact. So, in retrospect, city officials here did two things incredibly foolish. They allowed the opening of the Tri-State Fair in late September, and then announced a Liberty Bond drive to take place October 1st, which would include "the most spectacular military parade ever seen in Memphis."
Meanwhile, residents here began to feel uneasy. "Health Officials Watchfully Waiting," said one newspaper story. "No Cases Yet in City." That "Yet" part wasn't very reassuring. The next day, The Commercial Appeal reported that Spanish influenza had now spread to nine army camps, with Camp Devens reporting more than 6,500 cases. Each day, people began to die by the dozens, then by the hundreds, throughout New England, and the flu was now rampant in Little Rock, New Orleans, Charleston -- everywhere it seemed.
Even so, editorials admonished readers, "There is not the least reason to grow panicky over the matter." Newspapers across the nation urged readers, "Don't Get Scared!" and "Don't Let Flu Frighten You to Death." One Arizona newspaper implied that the fear of the flu was in itself dangerous, telling its readers, "The people during an epidemic who are most fearful are usually the first ones to succumb to the disease."
Those editors, apparently, were not reading their own newspapers and noting the growing list of obituaries. But again, although government researchers knew they were faced with a grave public-health menace, others remained in a state of denial. Barry notes, "No national official ever publicly acknowledged the danger of influenza." Just the opposite, in fact. This was only the flu, they insisted, and nothing worse than a common cold. Because the weather had been mild, said one reporter, "lightweight clothing has not been given up." Once people started to wear sweaters, "people will be less susceptible to the attacks of the germs."
But later in that article, the same reporter noted, "The Boston doctors put on gas masks to treat it, considering it very contagious." He didn't mention whether they were wearing sweaters.
By September 22nd, most people began to understand that the flu was becoming a life-and-death crisis. "The so-called Spanish influenza, having spread over a large part of Europe, has made its appearance in several American seacoast cities," Dr. Olin West with the Tennessee Board of Health told reporters, "and it is practically certain that the disease will become rapidly disseminated throughout the states." Calling the disease a "grave danger," West admonished against "promiscuous coughing or spitting" and suggested that "discharges from the mouth, throat, nose, and other respiratory passages should be avoided." What's more, "during epidemics, crowds should be avoided."
Nobody paid any attention to that last part. Yet.
Perhaps everyone was confused by all the contradictions. After all, the September 23rd edition of The Commercial Appeal actually reported "INFLUENZA ON DECLINE." That was positioned right above other articles that announced "2,000 Cases at Great Lakes," "Influenza Hits Camp Jackson" in Florida, and "New Cases at Newport" in Rhode Island.
It wasn't on the decline at all. The epidemic was just getting started.
If the news confused readers, it didn't help that the medical community handed out plenty of odd recommendations. The surgeon general of the Army told reporters that people should "avoid needless crowding," which was good advice, but also that they should "choose and chew your food well," which wasn't. Another suggestion was, "When the air is pure, breathe all you can, deeply" -- but how could anyone know when the air was pure? What's more, he said everyone should "avoid tight clothes, tight shoes, and tight gloves." In general, he advised, "Seek to make nature your ally, not your prisoner."
The "Spanish Lady" Visits Memphis
Finally, on September 25th, the newspapers confirmed what everyone had feared. Dr. Neuman Taylor, head of the Memphis Health Department, admitted, "A few cases have been reported in this city, but" -- and here is that same refrain -- "there is no cause for alarm."
No? The very next day, the young son of one of Memphis' most prominent families died of the Spanish influenza. His obituary described the classic symptoms. Elliott Fontaine, a teller at the Union and Planters Bank, came home from work "complaining that he was tired out and was feeling the bad effects of a heavy cold, which was later pronounced to be grippe [an old name for the flu]. Pneumonia rapidly developed and resulted in his death yesterday morning." The young man died in his bedroom in the family mansion, known today as the Woodruff-Fontaine House at 680 Adams, and was buried in the family plot at Elmwood.
Fontaine was probably the first flu victim to die in this city. But soldiers from Memphis continued to succumb to the flu in camps across the country: Charles H. Hudson at the Naval station at Hampton Roads, Virginia. John Rice Thornton at the Navy base hospital in Chelsea, Massachusetts. Anthony Barcigalupo at the Chicago naval training station. Barcigalupo must have been a popular fellow; his obituary noted that "more floral designs were placed on the grave than at any other funeral held recently in Memphis." The family plot in Calvary Cemetery "was insufficient to hold all the flowers."
Even so, the city held its Liberty Bond parade. On October 1st, more than 70,000 people ("the greatest crowd ever seen on Main Street") enjoyed the "great patriotic pageant," which featured bands, floats, rows of tanks and rolling armament, and "marching soldiers." There's no telling how many of those soldiers were already sick with the flu.
Three days later, The Commercial Appeal reported, "INFLUENZA CRIPPLING MEMPHIS INDUSTRIES." The article noted that "the total number of cases runs into the thousands." The police and fire departments were decimated, along with the Memphis Street Railway Company and the Cumberland Telephone Company. Memphians were urged to be patient with the transportation system, and to make only "urgent" calls.
This "pesky little germ" as the reporters described it, "has taken all sorts of liberties with high officials." Seemingly surprised that a disease would kill important people as well as the poor, the newspapers acknowledged that many judges and attorneys had the flu: "Possibly 20 deaths have occurred as a result of the disaster."
Coming in our December issue:
Every day, the news grew worse here. Schools, churches, and all "places of amusement" were closed because of the flu, and the situation quickly grew so dire that even funerals were prohibited. The Commercial Appeal finally urged people to pray -- what else could they do?
NEXT MONTH: We learn how Memphis battled the Spanish influenza, and take a look at researchers around the world working today to prevent another pandemic -- this time from the newly discovered Asian flu -- "the nastiest virus I have seen in 30 years" -- according to one authority.
"This is a detective story," says another scientist. "Here was a mass murderer that was around 80 years ago and who's never been brought to justice. And we're trying to find the killer."
special thanks to Bonnie Kourvelas with St. Jude children's research hospital.
Primary sources: John Barry,
The Great Influenza: The Story of the Greatest Pandemic in History (Penguin, 2004); Pete Davies, The Devil's Flu: The World's Deadliest Influenza Epidemic and the Scientific Hunt for the Virus That Caused It (Henry Holt & Company, 2000); and Gina Kolata, Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It (Farrar, Straus and Giroux, 1999).