“This malignancy, it was right at our very doors.” Using Manuscripts to Study the Influenza Pandemic of 1918

This post is written by Ryan Reft of the Library’s Manuscript Division.

“Even if there was war,” Susanna Turner of Philadelphia remembered of the 1918 Influenza Pandemic, “the war was removed from us you know … on the other side … This malignancy, it was right at our very doors.”

Yet, as the virus spread across the United States in 1918 and 1919, mobilization for World War I dominated federal concerns. Organizing a response to an invisible, viral enemy took a backseat to martial prerogatives. The press self-censored, avoiding discussions of the disease’s spread in favor of positive stories about the war.  As deaths mounted, fear filled in the informational gaps.

For authorities, it did not help that the first of the pandemic’s three waves, which begin in February and March of 1918, though hardly minor, recorded high morbidity but low mortality, making it difficult to distinguish from the more garden-variety flu. The second, which began in the United States in late August/early September, was far deadlier; the third, beginning in January 1919, was less deadly than the second, but far more lethal than the first.

Military camps served as the site of the second wave’s first invasion in the U.S. It festered in cantonments before spreading to civilian populations, a pattern that is consistent historically. For example, the explosion of cases that struck Camp Devens in September 1918 spread thirty-five miles to the southeast to Boston, where officials had already recorded citizens ill with the disease. U.S. Army Surgeon General William Crawford Gorgas had been tracking the pandemic since mid-June. Though he sounded alarms within the government about the pandemic’s spread, his warnings went largely unheeded.

At the time, no real public health infrastructure existed in the United States. Fellow public health experts viewed United States Public Health Service (USPHS) and civilian surgeon general, Rupert Blue, dimly.  Blue did help to secure a $1 million appropriation toward fighting the pandemic, but he never prepared the agency for crisis and reacted only after the sickness had spread nationally. The agency did produce and distribute broadsides that gave general, guidelines such as “AVOID CROWDS” and “Do not spit on floor or sidewalk.”

The USPHS never committed itself to producing a vaccine either. Instead, leading medical research institutions such as New York’s Rockefeller Institute, New York City Laboratories, and the Army Medical School, among others, led the way in creating a vaccine, though none of those produced ever totally addressed the virus successfully.

Much of the responsibility of battling the outbreak fell to municipalities and the local Red Cross infrastructure in each city. Despite a good response from its local infrastructure, Boston, like other cities struck early by the second wave such as Philadelphia, Louisville, New Orleans, New York, and Pittsburgh, “suffered grievously,” writes historian John Barry.

In the end, the pandemic would fell over 650,000 citizens domestically and between 50 and 100 million people around the world, far more than war that facilitated its devastation.