Influenza Outbreak of 1918-1919
by Steve Case, revised by Lisa Gregory, 2010
Government and Heritage Library
See also: NC and Influenza (WWI); Public Health; Infectious Diseases
Known alternately as "the grippe," the "Spanish flu," and the "Spanish lady," the influenza A strain from this pandemic was particularly virulent, hitting the United States in multiple waves. There were a number of complicating factors that influenced the spread of the epidemic. Coming as it did during the height of the United States' involvement in World War One, such measures as the state took to combat the flu were often overshadowed by the patriotic fervor accompanying the war. In addition, the cause of the disease was unknown, and many hesitated even diagnosing it as influenza. Other diseases, like typoid fever and tuberculosis, were affecting the state at the same time. North Carolina, along with the rest of the nation, was slow to respond with basic measures like temporary hospitals and quarantine areas and relied on volunteers to treat the sick.
The pandemic appears to have struck earliest in Wilmington (Cockrell 311). Thereafter, information from military camps across the state documents the rise and fall of flu. Camps within North Carolina (Greene, Polk, Bragg) as well as those in South Carolina (Sevier, Jackson), to which many North Carolinians were sent for basic training, supplied statistics to the United States Public Health Service, which were compiled in weekly Public Health Reports. Also included in the reports were articles on treatment, court cases, analyses, and telegraphic reports from other countries.
As the pandemic subsided, new hospitals were built around the state to make up for the lack of facilities during the pandemic. The government and those in the medical field recognized and promoted the importance of health education, both for the general public and health professionals. The staggering death toll and the degree to which the medical community struggled to deal with the virulent disease ended up being a "modernizing factor on the state's social health services" (Cockrell 311).
References and additional resources:
Cameron, Annie Sutton. 1919. A record of the war activities in Orange County, North Carolina. 1917-1919. Call #566. Manuscripts Dept. Southern Historical Collection, UNC-Chapel Hill. http://docsouth.unc.edu/wwi/cameron/cameron.html
Cockrell, David L. 1996. "'A blessing in disguise': The influenza pandemic of 1918 and North Carolina's medical and public health communities." North Carolina Historical Review 73(3): 309-27. (At your library)
The deadly virus: The influenza epidemic of 1918. National Archives and Records Administration. http://www.archives.gov/exhibits/influenza-epidemic/
This is a second treatment of North Carolina's Fate During the 1918-1919 Influenza Pandemic
See also: Public Health; Infectious Diseases; Influenza outbreak of 1918-1919
Germany was not the only enemy North Carolinians faced during World War I. A silent foe stalked both soldier and civilian alike and slaughtered some twenty million people worldwide before it finally retreated. This enemy was a new strain of influenza nicknamed the “Spanish Lady” The name came from a rumor that the disease had started in Spain.
Influenza killed almost 500,000 Americans—ten times the number of American soldiers who died in combat during the war. American troop ships returning home with sick soldiers brought the flu to the home front. In a single week in October 1918, an estimated 21,000 Americans died. In North Carolina 13,644 people died before the epidemic finally went away. During its peak in October and November, there were only two kinds of people in the state—those who were sick with influenza and those who were trying to save them.
The illness sometimes lasted seven to ten days. It hit suddenly with chills, a high fever, upset stomach, weakness, and other symptoms. It continued until the patient either recovered or died. Influenza struck without regard to class and race, but the majority of victims were young adults between the ages of twenty and forty. Pregnant women had an especially hard time. Each day local newspapers listed names of citizens who had died since the last issue.
Mrs. C. R. Hudson lived near Oakwood Cemetery in Raleigh and recalled that “they died so fast they could not have proper burials. They couldn't dig graves fast enough.” Dr. W. S. Rankin, secretary of the State Board of Health, recruited doctors and nurses for communities especially hard hit by influenza. The epidemic spread so rapidly that health officials often could not do much except offer advice through newspaper columns and health pamphlets.
Influenza spread when people were in close contact, so local health officers moved swiftly to close public schools and colleges, churches, theaters, fairs, and dance halls. Stores, textile mills, and other businesses also closed. Employees were either sick, afraid of getting sick, or at home taking care of the sick. Tar Heel communities looked like western ghost towns as residents remained inside their homes.
Few communities escaped the epidemic, and even fewer had the resources to care for the sick. Hospitals were not large enough to handle all the patients, so temporary hospitals opened in churches, schools, and armories. Doctors could not answer all of the calls of those affected, especially in farming communities. Many trained nurses had left to care for wounded soldiers, so communities often had to rely on women serving as volunteer nurses. Women also opened nurseries to care for the children of families stricken with influenza and labored in food kitchens to feed the children of the poor. Although the disease crossed all the lines of class and race, segregation policies required separate care for African-American and white victims. Still, white communities readily accepted the services of black nurses to care for their patients.
By the close of 1918, the worst months of the epidemic had passed. North Carolina soldiers in France had carefully followed reports of the flu at home through letters and newspapers. Many soldiers who faced death daily at the front mourned relatives who had died an ocean away from the war.
The citizens of Raleigh believed that those who had served as volunteers should be properly recognized for their work. These men and women had labored tirelessly in caring for others, and some had become ill and died as a result. In the early 1920s, a monument was put up on the Wake County Courthouse grounds in Raleigh. It honored those who had given their lives caring for others during the epidemic of 1918.
At the time of this article’s publication, Tom Belton served as curator of militaria, politics, and society for the North Carolina Museum of History. Belton previously served as executive secretary of the Tar Heel Junior Historian Association.