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The Great Pandemic of 1918: State by State

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  • The Great Pandemic of 1918: State by State

    The Great Pandemic of 1918: State by State

    Stories and anecdotes of the impact of the Great Pandemic in individual states were gathered for presentation at Pandemic Planning Summits held in each state.

    <A id=al name=al>Alabama State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    February 22, 2006
    That Great Pandemic also touched Alabama.
    It first appeared in late September 1918 in Florence, Alabama (in the northwest corner of the state). Just three weeks later, over 25,000 cases of influenza in the state had been reported to the U.S. Public Health Service.
    It is impossible to know for sure exactly how many Alabamans were affected by the flu, since regular reports to the U.S. Public Health Service were never made. But it is known that during the last two weeks of October, more than 37,000 cases of the flu erupted in Alabama.
    People around the state died by the hundreds.
    Health care professionals worked tirelessly, and with limited resources to stem the tide of the rising pandemic. A report sent to the U.S. Public Health Service described the conditions under which physicians in Florence were working:
    "...[Doctors were] overwhelmed with work [and] were handicapped by inadequate transportation and two days behind in making calls; many patients . . . had been sick in bunk houses and tents for several days without nourishment, or medical and nursing attention, the sanitary conditions of the bunk houses were deplorable; the mess halls were grossly unsanitary and their operation much hampered by the lack of help; the existing hospitals were greatly overcrowded with patients; and patients were waiting in line several hours for dispensary treatment, and were greatly delayed in obtaining prescriptions at the pharmacy. The epidemic was so far progressed that the immediate isolation of all cases was impossible."
    One man, J.D. Washburn served in a medical unit in Alabama during the war and recalled his experience:
    "We worked like dogs from about seven in the morning until the last patient of the day had been checked in or out-usually about 10 o'clock that night. The men died like flies, and several times we ran out of boxes to bury them in, and had to put their bodies in cold storage until more boxes were shipped in. It was horrible."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Alabama.
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    <HR width="98%" SIZE=1><A id=alaska name=alaska>Alaska State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    April 13, 2006
    That Great Pandemic also touched Alaska.
    When the pandemic flu became rampant in the lower 48 states, Alaska territorial governor Thomas Riggs, Jr. imposed a maritime quarantine and restricted travel to the interior part of the territory. U.S. Marshals were stationed at all ports, trailheads, and river mouths. Schools, churches, theaters, and pool halls were closed.
    In Juneau, residents were instructed to "keep as much to yourself as possible." Fairbanks established quarantine stations, also guarded by Marshals. People were checked periodically for flu and, if healthy, were given armbands reading "OK Fairbanks Health Department." Vaccine was imported from Seattle and distributed throughout the area, though it, of course, didn't work. In Native villages, shamans encouraged people to plant "medicine trees" that could protect against influenza.
    Unfortunately, despite these precautions, influenza spread throughout the territory. Half of Nome's white population fell ill. Walter Shields, Nome's Superintendent of Education, was one of the first to die. The Alaska Native population in Nome was decimated—176 of the 300 Alaska Natives in the region died.
    Elsewhere, entire Native families too sick to feed their fires froze to death in their homes. Many who were brought to a makeshift hospital believed that it was a death house, and so, instead, committed suicide. Spit the Wind, widely considered Alaska's greatest musher, died at the age of 25. He had survived a grueling expedition to the North Pole in which he had been forced to eat his snowshoe lacings, but he couldn't survive the flu.
    On November 7th, the governor issued a special directive to "All Alaskan Natives." Natives were urged to stay at home and avoid public gatherings-something anathema to their communal lives. The pandemic swept through communities, killing whole villages. One schoolbteacher reported that, in her area, "three [villages were] wiped out entirely, others average 85% deaths.... Total number of deaths reported 750, probably 25% [of] this number froze to death before help arrived."
    Because they were so sick with the flu, many Alaska Natives and others were unable to chop wood or harvest moose' so, after the pandemic had passed, many more died of starvation. Some people were forced to eat their sled dogs, and some sled dogs ate the dead and the dying.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes again, it will strike in Alaska.
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    <HR width="98%" SIZE=1><A id=arizona name=arizona>Arizona State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    January 6, 2006
    The Great Pandemic also touched Arizona.
    The leading newspaper of the day was the Arizona Republican. The threat was high enough that it did not publish a paper for a time.
    A "Citizens Committee" deputized a special police force and called upon all "patriotic citizens" to enforce anti-influenza ordinances.
    Each person had to wear a mask in public. Those who coughed or spat without covering their mouths were arrested. The Republican described "A city of masked faces, a city as grotesque as a masked carnival."
    As the disease raged, people took recourse to unusual remedies.
    For instance, Arizona had ratified Prohibition earlier in the year (May 1918) and so the state superintendent of public health turned to nearly 10,000 pints of bootleggers' whiskey that had been confiscated by the sheriff's office.
    Within two days, news of the loophole traveled across the city, and the sheriff's office was besieged with citizens and doctors alike, all of them seeking the "remedy."
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    <HR width="98%" SIZE=1><A id=ar name=ar>Arkansas State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable John Agwunobi
    Assistant Secretary of Health
    Department of Health and Human Services
    July 27, 2006
    The Great Pandemic also touched Arkansas.
    On October 4, 1918, an outbreak was first reported just in Lonoke County. It exploded within days. The following week, the state said, “Serious epidemics have been reported from several points.” Within two weeks of the pandemic’s first appearance, about 1,800 new cases were being diagnosed each day.
    One of those afflicted was James Geiger, the U.S. Public Health Service Officer for Arkansas. He downplayed the threat to the state–possibly to avert a panic–even after he caught the flu, and his wife died from it.
    Segregation meant that African-Americans suffered cruelly. Many could not receive the care they desperately needed, since they could only be treated by doctors and nurses of the same race. It is clear that African-Americans died in high numbers, although the state did a poor job keeping records of their deaths.
    Soldiers also suffered and died from the flu. It is likely that more Arkansans perished from the influenza than from the killing fields of Europe. At least 450 airmen were afflicted at the aviation training facility of Eberts Field in Lonoke County. More than 3,500 soldiers were afflicted at Camp Pike in Pulaski County. To prevent the pandemic from spreading further, the camp was sealed and quarantined. To still the panic, the camp commander insisted that the names of the dead not be released.
    No one will know how many finally fell to the great pandemic. Records are incomplete and many rural districts went unreported, yet echoes of the suffering and loss remain.
    If a pandemic strikes, it will come to Arkansas.
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    <HR width="98%" SIZE=1><A id=cal name=cal>California State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 30, 2006
    That Great Pandemic also touched California.
    The first few cases were reported in Belvedere and San Gabriel in Los Angeles County in the last days of September 1918. The next week, more than 500 cases were reported.
    In Los Angeles, local health officials were optimistic. They said, "If ordinary precautions are observed, there is no cause for alarm."
    They could not have been more wrong. The disease was exploding around the state.
    Within two days of issuing that statement, schools and churches were shut down to prevent the spread of the disease. Theaters were closed—sometimes for good—as they could not withstand the loss of revenue.
    By the first week of November, more than 115,000 cases and hundreds of deaths across the state had been reported.
    Makeshift hospitals were hastily opened to deal with the surge of patients that were overwhelming the health care system.
    In San Francisco and elsewhere, mandates compelled the wearing of masks in public on penalty of fines or even imprisonment.
    The San Francisco Chronicle reported, "The man who wears no mask will likely become isolated, suspected, and regarded as a slacker. Like a man of means without a Liberty Loan button, he'll be shy of friends."


    A rhyme was used to help people remember the ordinance:
    Obey the laws
    And wear the gauze
    Protect your jaws
    From septic paws


    Though the pandemic began to subside in November, residents still felt its effects through the holiday season. Citizens were still asked to do their Christmas shopping by phone rather than to travel to stores in person. Shopkeepers were even asked not to hold holiday sales, as they might draw crowds.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to California.
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    <HR width="98%" SIZE=1><A id=connecticut name=connecticut>Connecticut State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    February 2, 2006
    The Great Pandemic also touched Connecticut.
    It struck the week of September 11th, laying low Navy personnel in New London. Just two weeks later, about 2,000 cases of influenza were reported in and around the city.
    On September 27th, the Public Health Service declared, "influenza is prevalent throughout the eastern and southern parts of the state and it appears to be increasing." It was. Three days later, 9,000 cases were reported. A week later, that number had doubled. Then it redoubled, and redoubled again. By the end of October, an estimated 180,000 people had been struck by influenza.
    By that point, more than 300 people had died here in Hartford. The Hartford Golf Club became an emergency hospital. A Public Health Service officer from Hartford named F.S. Echols fell to the pandemic. A nurse named Beatrice Springer Wilde recounted the tragic story of four Yale students that she treated. They had become ill while traveling and decided to get off the train in Hartford. Their last steps were taken from the train station to the hospital, for within twenty-four hours, all were dead.
    People begged for - and sometimes demanded - treatment. The Hartford Courant reported that in the town of New Britain (just south of Hartford) one man blocked the car of a local doctor, insisting that he see his daughter. The physician said that he was too overwhelmed with cases to do so. The standoff continued until the mayor intervened and arranged for a doctor to see the man's daughter.
    The people of Boston were not so fortunate. The pandemic was spreading with equal ferocity through Massachusetts, and the situation in Boston was so bad that those there begged the people of Connecticut to send any doctors or nurses that could be spared.
    None could be. The emergency was too dire; the pandemic was too overwhelming. The Connecticut Commissioner of Health (John T. Black) was forced to urge doctors and nurses to remain in the state.
    At its peak, the pandemic claimed more than 1,600 lives in a single week. But the total number it took in Connecticut will never be known. Reports are incomplete; the pandemic was too overpowering. But its echoes of terror, of suffering, and of loss remain.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Connecticut.
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    <HR width="98%" SIZE=1><A id=dl name=dl>Delaware State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Alex Azar
    Deputy Secretary of Health and Human Services
    February 21, 2006
    That Great Pandemic also touched Delaware.
    In 1918, Delaware was the fourth-smallest state by population in the U.S., with just under a quarter million people. It also ranked as the second smallest state in the nation by land area, after Rhode Island.
    Yet despite its small size, in the fall of 1918, Delaware reported thousands of cases of the Spanish flu, as well as hundreds of deaths from it. Exact numbers of Delawareans affected by the flu will never be known, because regular reports to the U.S. Public Health Service were never made.
    Regardless of the numbers, though, Delaware acted to contain the flu just as many other states had. On October 3, 1918, the Delaware State Board of Health met in an emergency session to stem the death toll from influenza. They shut down most of the state:
    "Whereas: A very serious epidemic of influenza is now raging in the state of Delaware...to protect the health of the entire citizenship of Delaware...all schools, all theatres, all churches, all motion picture houses, all dance halls, all carnivals, fairs and bazaars, all billiard rooms and pool rooms, all bowling alleys in the entire State of Delaware shall be closed and kept closed until further notice."
    This order remained in effect for more than three weeks. Yet even these careful precautions were not enough to control the disease.
    As the situation in Delaware worsened, Delaware became so overwhelmed that the Health Department tried to divert influenza patients to Philadelphia hospitals. The flu, however, knew no state lines. Philadelphia was unable to come to Delaware's rescue, as they too were completely overrun by the disease.
    Nearby, at Memorial Hospital in New Jersey, Mr. John Kingsman, age 36, died on a Monday afternoon. Days earlier, his 17-year-old daughter died in the same spot, though he never knew it. Those taking care of him could not bring themselves to tell him that-just a week after his mother and stepbrother died in Dover-his teenaged daughter was also dead.
    When it comes to pandemics, there is no rational basis to believe that the 21st century will be much different than the past. If a pandemic strikes, it will come to Delaware.
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    <HR width="98%" SIZE=1><A id=dc name=dc>District of Columbia Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 20, 2006
    That Great Pandemic also touched the District of Columbia.
    The city was crowded with people contributing to the war effort, and so as soon as the first cases appeared, the situation became serious.
    That happened around the last week of September. Then the disease spread rapidly. More than 160 cases were reported on October 1. Seven days later (October 8), more than 2,100 people had been attacked by the flu.
    The dead began to multiply. Four hundred forty victims of influenza were reported on the second week of October. More than 730 victims were reported the following week.
    The DC Health Commissioner, Louis Brownlow, faced a shortage of coffins. He resorted to hijacking a shipment of coffins that were passing through the city en route to Pittsburgh.
    In the Sardo funeral home (located in the District), Bill Sardo remembered that:
    "From the moment I got up in the morning to when I went to bed at night, I felt a constant sense of fear. We wore gauze masks. We were afraid to kiss each other, to eat with each other, to have contact of any kind. We had no family life, no church life, no community life. Fear tore people apart."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to the District of Columbia.
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    <HR width="98%" SIZE=1><A id=co name=co>Colorado State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 24, 2006
    The Great Pandemic also touched Colorado.
    It first appeared in late September 1918, when some 33 suspected cases were reported at the University of Colorado. It raged across the state through the month of October, sickening those in the valleys, and bringing down residents of high mountain towns.
    More than 150 people died in a single week here in Denver. Thousands were afflicted (though actual numbers are unknown).
    One of those was Katherine Porter, who would later earn fame and acclaim (including a Pulitzer Prize) for her short stories. One of her best-known works was Pale Horse, Pale Rider, a fictionalized account of her experience in the pandemic.
    Porter contracted influenza while working as a journalist for the Rocky Mountain News. She could not be admitted to the hospital at first, because there was no room. Instead, she was threatened with eviction by her landlady and then cared for by an unknown boarder who nursed her until a bed was open at the hospital.
    Porter was so sick that her newspaper colleagues prepared an obituary and her father chose a burial plot. Her near-death experience changed Porter in a profound way. She said afterward, "It just simply divided my life, cut across it like that. So that everything before that was just getting ready, and after that I was in some strange way altered."
    The lives of countless other Coloradoans were also altered.
    Residents of Boulder experienced a quarantine. So did all of those living in the entire San Juan Basin (in the southwest corner of the state). All gatherings were cancelled, including schools, sporting events, and social outings. Voters and judges alike were required to wear surgical masks during the November election. People were even prohibited to gather for funerals.
    The city of Silverton (located just north of Durango) lost nearly 10 percent of its population, including morticians. Coffins had to be sent from Durango to accommodate the large numbers of the dead.
    The pandemic finally faded, leaving echoes of terror and suffering and loss all across the state.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Colorado.
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    <HR width="98%" SIZE=1><A id=fl name=fl>Florida State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    February 16, 2006
    That Great Pandemic also touched Florida.
    In 1918, Florida's statewide population was around five percent of what it is today-under one million people.
    Despite this scant population, between mid-October and late November 1918, the state reported thousands of cases of the Spanish flu, as well as hundreds of deaths from it.
    The exact numbers of Floridians affected by the flu will never be known, because regular reports to the U.S. Public Health Service were never made.
    Numbers or not, Florida reacted to the flu as so many other states did: City ordinances mandated quarantines and the wearing of facemasks in public, public gatherings were banned, and schools and churches were closed.
    Yet even these careful precautions were not enough to control the disease, even when they were obeyed.
    In the fall of 1918, an Ocala, FL man, Mr. Olson, traveled to Jacksonville, FL for a carpentry job. Jacksonville was inundated with the flu at the time, and despite a citywide quarantine and the use of gauze masks, Olson contracted the flu.
    Eager to return to his hometown and family, he slipped past the quarantine and caught a train back home, bringing the virus with him. Within days of his return, he had infected his family, and was bed-ridden with his son. Olson recovered but others were not as fortunate.
    In 1919, eight-year-old Carl Lindner shared a room in the Marion County hospital with his five-year-old cousin, Philip Townsend. Both had come down with the flu. When young Philip recovered, he asked the nurses where his cousin was. The only answer the nurses could give was that Carl had already gone home. They did not know how to tell a five-year-old that his cousin was dead.
    Within three weeks, Carl's father and maternal grandfather also died from the disease.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Florida.
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    <HR width="98%" SIZE=1><A id=georgia name=georgia>Georgia State Summit: History Supplement
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    January 13, 2006
    The Great Pandemic also touched Georgia.
    It probably arrived during the first week of October 1918, and then spread like a wildfire throughout the state. In just three weeks, from October 19th to November 9th, there were more than 20,000 cases and more than 500 deaths.
    Towns and communities were terribly affected.
    Augusta was the hardest-hit city in the state. Trained nurses were far too few for the many needs, and they too were struck down by the pandemic. As a consequence, nursing students were put in charge of shifts at a local hospital. Schoolteachers were enlisted to act as nurses, cooks and hospital clerks, at an emergency hospital constructed on a local fairground.
    In Athens, the University of Georgia announced that it was indefinitely suspending classes.


    In the town of Quitman, stringent rules were established to combat influenza, which touched almost facet of life:
    • Public gatherings, including indoor funerals, were prohibited
    • Public spitting was outlawed
    • The serving of any beverage was prohibited in public places, unless it was poured into sanitary cups or served in glasses that were thoroughly sterilized each time they were used
    • The accumulation of dust in places of business was prohibited. Merchants were ordered to keep their floors damp enough to keep the dust down
    • All cases of influenza were ordered quarantined. In places where the disease had struck, a placard stating "influenza" had to be displayed

    A similar strategy was adopted here in Atlanta. The City Council declared a ban on public gatherings for two months. Schools, libraries, theaters and churches were all closed.
    For better ventilation, streetcars were ordered to keep their windows open, except in the rain.
    Yet despite all those desperate measures, the pandemic still extracted a terrible toll.
    Final casualty figures in Georgia will never be known. After making their initial reports, state officials were simply too overwhelmed to tell the U.S. Public Health Service anything more.
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    <HR width="98%" SIZE=1><A id=id name=id>Idaho State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 27, 2006
    The Great Pandemic also touched Idaho.
    The first cases were reported in Canyon County (northwest of Boise) on September 30th. Within three weeks, the disease was raging all across the state.
    Franklin County (located in the southeastern corner of the state) was one of the many areas hit hard by the pandemic. One of the residents, Watkin L. Roe from the Franklin County Citizen newspaper, sent a letter to Surgeon General Rupert Blue (on behalf of "many prominent citizens") reporting that the pandemic had affected about 1,300 of the county's 7,500-8,000 residents and had killed 31.
    Mr. Roe wanted the Surgeon General's advice on two points. First, he wanted to know if there was "any virtue in the vaccines and serums which the doctors are using." Second, Mr. Roe and his fellow citizens wondered whether or not to close places of public gathering like schools, theaters and picture shows, since although they feared catching the pandemic, they also feared paralyzing business.
    No answer is reported, but similar anxieties were felt across the state.
    Messages were sometimes mixed, as people struggled to inform but not to inflame. For instance, a headline of the Rexburg Journal (northeast Idaho) read "NO OCCASION FOR PANIC," even as the same issue included an order from city officials putting the town under quarantine and banning all public gatherings.
    The Northern Idaho News of Sandpoint (north-central Idaho), declared that there was no cause for alarm over the flu, but then noted that, as a precautionary measure, schools would be closed indefinitely, and churches, picture shows and all public gatherings of every kind would be prohibited. The newspaper also issued a warning to parents to keep their children away from the railway depots as a precaution against infection.
    Though those measures likely helped, many Idahoans were still afflicted.
    In the town of Paris (located in the southeast corner of the state), resident Russell Clark remembered that the mortality rate was around 50 percent. Clark said, "There was a feeling of depression and sadness because neighbors . . . were passing away."
    The final toll that the pandemic took in Idaho will never be known. But the echoes of suffering and loss remain.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Idaho.
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    <HR width="98%" SIZE=1><A id=il name=il>Illinois State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 17, 2006
    That Great Pandemic also touched Illinois.
    Chicago was then the nation's second largest city and the country's largest rail hub. As a consequence, the disease reached the city quickly. Before the disease reached this city, overconfident public health officers proclaimed, "We have the Spanish influenza situation well in hand now."
    Then the disease came.
    Influenza was reported in Chicago on September 27th. Within two weeks, it was epidemic throughout the state. Cities like Kankakee and Rockford were as hard hit as rural sections and coal-mining districts.
    But Chicago saw the most awful impacts. While the pandemic raged toward its dreadful peak, the city saw an average of 12,000 new cases each week. More than 2,100 Chicagoans died during the second week of October. More than 2,300 died during the third week.
    The city ran out of hearses. Signs were posted banning public funerals, and limiting funeral attendees to no more than 10, in addition to the undertaker, the minister, and necessary drivers. No bodies were allowed in churches.
    A U.S. Public Health Services Officer named Jo Cobb, who was working at the city's Marine Hospital wrote to a friend, "Our beds were filled as fast as emptied."
    Navy nurse Josie Brown, who served at Naval Hospital in Great Lakes remembered:
    "The morgues were packed almost to the ceiling with bodies stacked one on top of another. The morticians worked day and night. You could never turn around without seeing a big red truck loaded with caskets for the train station so bodies could be sent home. We didn't have the time to treat them. We didn't take temperatures; we didn't even have time to take blood pressure. We would give them a little hot whisky toddy; that's about all we had time to do. They would have terrific nosebleeds with it. Sometimes the blood would just shoot across the room. You had to get out of the way or someone's nose would bleed all over you."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Illinois.
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    <HR width="98%" SIZE=1><A id=in name=in>Indiana State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 23, 2006
    That Great Pandemic also touched Indiana.
    The pandemic was first recognized within the state on September 20th, 1918. It was reported in Evansville (southwest tip of Indiana) on September 25th, and in Indianapolis five days later. By the week of October 11th, influenza was reported in many places across the state.
    People did all they could to slow the spread of the pandemic. In late September, the Indiana State Board of Health issued an order to all county and city health officers warning them of the pandemic, suggesting preventive measures (like the holding of handkerchiefs over the nose when sneezing or coughing), and calling for the exclusion of those with colds from public gatherings.
    A week later, the Board of Health imposed a ban on all public gatherings. Churches were open for prayer, but not large services. Public funerals were banned.
    Evansville added an anti-spitting ordinance to other measures. The local paper advertised remedies like Dr. Jones' Liniment, Mendenhall's Chill and Fever Tonic, and Father John's Medicine.
    Schools were closed in Indianapolis. Citizens were required to wear masks in stores and streetcars, offices and factories, public buildings and theaters. A ban on Halloween parties and gatherings was credited with saving the city from a worse epidemic.
    Such measures may have lessened its cruelty. During the pandemic, about 12% of Indianans were afflicted with the flu, compared to about 25% of all Americans.
    But the toll across the state was still severe. By the time the pandemic finally passed, at least 150,000 Indianans had been afflicted by the pandemic. About 10,000 had died.
    The victims included a Mrs. Estil Graffis and her husband, who lived in Fulton County (north-central Indiana). Estil died on a Wednesday. Her husband followed her the next Monday. Within a week, influenza had made orphans of their three children. Tragic stories like that of the Graffis' were not uncommon across the state.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Indiana.
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    <HR width="98%" SIZE=1><A id=iowa name=iowa>Iowa State Summit History Supplement
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    February 7, 2006
    The Great Pandemic also touched Iowa.
    The pandemic was already spreading through soldiers stationed in Iowa before it began rising in the civilian population. On October 5th, 1918, the first cases of flu were reported in Des Moines, and on that same day, the Des Moines Tribune reported that local hospitals were refusing any more patients with the flu.
    After just 25 confirmed cases among civilians in Des Moines, the Surgeon General suggested the city close theaters and other public places to prevent a pandemic.
    It was already too late. Within one week, the Public Health Service reported that there were more than 8,100 new cases of the flu (civilian and military) and more than 70 deaths from it, and the number "appears to be increasing."
    The following week, more than 21,000 cases were reported.
    In Des Moines, a general quarantine was established for the entire city. Schools were closed. So were theaters, pool halls and other gathering places.
    With no classes to teach, teachers were paid to contribute to "sanitary detective work." This meant traveling from door-to-door to survey homes for flu sufferers.
    By the time the pandemic finally ran its terrible course, countless people had been afflicted. The final toll that the pandemic took in Iowa will never be known. But the echoes here remain.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Iowa.
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    <HR width="98%" SIZE=1><A id=ks name=ks>Kansas State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    May 31, 2006
    That great pandemic also touched Kansas. In fact, it is likely to have begun here. In late January and February of 1918, a physician in Haskell County (located in the southwestern corner of the state), noticed an outbreak of severe influenza cases.
    The local paper, the Santa Fe Monitor reported (excerpt from The Great Influenza):
    Mrs. Eva Van Alstine is sick with pneumonia. Her little son, Roy, is now able to get up. . . . Ralph Linderman is still quite sick. . . . Goldie Wolgehagen is working at the Beeman store during her sister Eva's sickness.
    That list of the afflicted would be terribly lengthened in the fall.
    An infected soldier from Haskell County is thought to have carried the influenza with him to Camp Funston, near Fort Riley (about an hour's drive west from Topeka). In mid-March an outbreak there afflicted more than 1,100 soldiers, killing 38.
    The disease disappeared for a while, and then returned with a vengeance in the fall. It appeared in Kansas in September, and raged across the state throughout the terrible month of October.
    The first official report of the disease came on September 27th. First 1,000 people were afflicted, and then, 10,000. By mid-October, more than 26,000 people had been afflicted by the flu.
    A soldier from Camp Funston followed the effects of the pandemic there through letters home. On September 29, he wrote:
    We are held up because "influenza," or some such a name, is in the camp. It is some such a thing as pneumonia, and they seem to think it is pretty bad. It is at least bad enough to beat us out of our passes.
    A week later, on October 6th, he wrote, "Lots of them go to the base hospital every day and quite a number of them are 'checking in.' There are between 6 and 7,000 cases in the camp."
    Two days later he wrote:
    I am still playing the part of a "dry nurse," ha-ha. Some name us boys have invented for a gentleman nurse. The roof of our hospital has been leaking in several places and we have been having some time keeping the poor devils dry.
    They are keeping our beds all filled with new patients as fast as we send the old ones "home well" or to the hospital, half-dead. There haven't been so many cases the last 48 hours. I sure hope that they all get well soon, for I am sure getting tired of the job. Don't like to stay up every night the best in the world. We put six more of our boys in bed today. We are getting real short-handed.
    And still the epidemic raged. In Topeka-and elsewhere-hospitals overflowed. Emergency hospitals were opened at the Garfield School and the Reid Hotel. Two infirmaries connected to Washburn College (in Topeka) were opened. The college gym was transformed into "an observation hospital."
    The Secretary of the State Board of Health did all he could to contain the disease-closing schools, churches and theaters; quarantining homes with ill patients; and, limiting the numbers of people in stores and passengers on streetcars.
    Yet, the pandemic still took a terrible toll. The final cost will never be known, but echoes of loss remain.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Kansas.
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    <HR width="98%" SIZE=1><A id=kentucky name=kentucky>Kentucky State Summit: History Supplement
    Opening Remarks Prepared for Delivery
    By the Honorable Alex Azar
    Deputy Secretary of Health and Human Services
    January 20, 2006
    The Great Pandemic also touched Kentucky.
    Kentucky saw its first cases of influenza during the last week of September 1918. Infected troops traveling on the Louisville and Nashville Railroad stopped off in Bowling Green, KY, where they passed the virus on to a few of the local citizens.
    By the time the first week ended, Louisville had already suffered an estimated 1,000 cases of influenza.
    The pandemic grew even worse in ensuing weeks. Louisville alone lost 180 people each week from influenza during the second and third weeks after it struck.
    On October 6, the Kentucky State Board of Health announced the closing of "all places of amusement, schools, churches and other places of assembly."
    Because they were almost certainly simply overwhelmed with combating the disease, Kentucky officials did not even report influenza cases to the U.S. Public Health Service until late October.
    At that point, state officials reported more than 5,000 cases of the flu. Over the next three weeks, they reported over 8,000 more.
    The state was never able to reliably report the deaths that resulted from the flu in Kentucky, but accounts from residents at the time paint a grim picture.
    For instance, in Pike County, Kentucky, a miner named Teamus Bartley called the epidemic, "The saddest lookin' time then that ever you saw in your life."
    He and his brother worked at a coal mine when his brother's entire family came down with the disease. Teamus visited his brother every night, and reported on what he saw:
    "...every, nearly every porch, every porch that I'd look at had--would have a casket box a sittin' on it. And men a diggin' graves just as hard as they could and the mines had to shut down there wasn't a nary a man, there wasn't a, there wasn't a mine arunnin' a lump of coal or runnin' no work. Stayed that away for about six weeks."
    Teamus later said that each night, he saw four or five miners and family members die in the camps.
    Even as late as mid-December 1918, Kentucky was so overwhelmed by the disease that a local health officer sent an urgent telegram to Surgeon General Rupert Blue requesting that the U.S. Public Health Service take over the administration of health work until the influenza epidemic had abated.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Kentucky.
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    <A id=la name=la>Louisiana State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    April 25, 2006
    That Great Pandemic also touched Louisiana.
    As the pandemic began to spread around the country in 1918, the president of the New Orleans Board of Health announced that the city's climate would prevent a high mortality rate if the flu ever did come to the city. He would be proven tragically wrong.
    Though exact dates and numbers are not known for sure, the disease probably came to New Orleans during the first week of September-around the same time the steamship Harold Walker set sail from Boston for New Orleans. The pandemic was already raging in Boston, and so, before the Harold Walker arrived in New Orleans, 15 passengers had been struck, and three had already perished. By the time the Harold Walker docked in New Orleans, those afflicted found they were not alone. The pandemic was already raging in Louisiana.
    By the third week of September, thousands were being afflicted. Hundreds were dying.
    By the end of October, 14,000 people in New Orleans had been struck by the flu. More than 800 had died.
    People were desperate for a cure.
    One doctor in New Orleans believed sulfur would "kill the germ." He advised his patients to "put a small amount of sulfur in each shoe each morning, and goodbye influenza." To make sure the sulfur was "working," he told his patients to carry a silver dollar in their pockets. According to the doctor, the silver would change color in reaction to the sulfur emitted by the body.
    The sulfur did not work. Few things did.
    The pandemic finally ended, but the dreadful memories remained.
    A year later, the flu erupted again in New Orleans. By the time it had afflicted just a handful of people, the terror of the previous year was sufficient to trigger alarm. A Public Health Service officer sent an urgent telegram to Surgeon General Blue reporting: "Ten cases influenza...Doctor Kibbe reports spreading rapidly."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Louisiana.
    <A id=md name=md>Maryland State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of the Department of Health and Human Services
    February 24, 2006
    That Great Pandemic also touched Maryland.
    It first appeared at Camp Meade on September 17th, 1918. By September 28th, more than 1,700 cases were reported across the state.
    At that point, Baltimore's health officer declared, "There is no special reason to fear an outbreak in our city." The next several weeks would prove him tragically, terribly wrong.
    Nearly 2,000 cases were reported in the city on October 10th. Sickness often led to death. On the single day of October 19th, 169 people perished because of the pandemic.
    Everyone was out sick. There were too few milkmen, too few firefighters, too few telephone operators, and too few gravediggers. The city didn't have enough workers to process death certificates. Because it was illegal to conduct burials without one, bodies and caskets stacked up inside-and outside-funeral homes.
    Hospitals were overwhelmed. Flu patients filled six wards at Johns Hopkins. Finally, the hospital had to close its doors. Three staff physicians, three medical students, and six nurses perished with the patients for whom they were providing care.
    By the most conservative of counts, at least 75,000 of Baltimore's 600,000 residents were struck by the flu. More than 2,000 died.
    Circumstances were just as terrible all across the state. In Salisbury (located on Maryland's eastern peninsula), about 800 of the town's 11,000 residents were struck by the pandemic. Forty-one percent of the population became ill in the town of Cumberland.
    The total number of Marylanders who perished in the pandemic will never be known. Reports are incomplete; the pestilence was too overpowering. But its echoes of terror, of suffering, and of loss remain.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Maryland.
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    <HR width="98%" SIZE=1><A id=massachusetts name=massachusetts>Massachusetts State Summit History Supplement
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    February 7, 2006
    The Great Pandemic also touched Massachusetts.
    It first came here, to Boston. On August 27th, 1918, two sailors at Commonwealth Pier reported in sick with influenza. The next day, there were eight. By the third day, influenza had struck nearly 60 people.
    That fire soon became an inferno, and within two weeks, 2,000 officers and men had been struck.
    On September 8th, a spark of influenza touched Camp Devens, a military camp near Boston with about 50,000 soldiers. The conflagration that erupted is difficult to comprehend.
    A physician - known only as Roy - described the situation as it appeared in late September. He wrote:
    "This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed....These men start with what appears to be an ordinary attack of . . . Influenza, and when brought to the Hospital they very rapidly develop the most viscous type of Pneumonia that has ever been seen.
    Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis (pronounce "Cy-an-no-sis") extending from their ears and spreading all over the face, until it is hard to distinguish the colored men from the white.
    It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up."
    The pandemic was just as dreadful for civilians. Scarcely six weeks after it touched the first sailor on Commonwealth Pier, the pandemic was raging all across the state. By October 1st, the Public Health Service estimated that there were at least 75,000 cases in the state, excluding those from the military camps.
    At that point, nearly 800 people had already died from influenza here in Boston. Another 200 had perished from pneumonia. By the time the next week ended, nearly 1,300 more Bostonians had died.
    By the time the pandemic finally passed, an estimated 45,000 people had perished in Massachusetts. That is about two-thirds of a sellout crowd at a Patriots game, or more than two consecutive sell-outs at Boston Garden.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Massachusetts.
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    <HR width="98%" SIZE=1><A id=mi name=mi>Michigan State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Alex Azar
    Deputy Secretary of Health and Human Services
    April 5, 2006
    We are also seeing some of the same symptoms from victims of the 1918 strain in victims of today's H5N1. If the H5N1 strain, or any other strain of animal influenza, were to develop into a pandemic strain, no one would have immunity. Let me tell you a little about how Michigan was affected by the 1918 pandemic.
    In late September 1918, Michigan officials reported to the U.S. Public Health Service that "very few cases have been reported." Two weeks later, however, the state failed to report at all, possibly because the deteriorating conditions had made reporting difficult. By October 18th, officials sent but a terse report, saying "50 deaths [from influenza] had occurred in the State." But, by the 25th, they reported that "from October 1 to 18, inclusive, [there were] 11,983 cases and 258 deaths in Michigan." The pandemic seems to have peaked in Michigan by the end of October, with the week that ended on the 26th seeing 21,541 cases and 922 deaths.
    In the Upper Peninsula, a public health nurse named Annie Colon and a physician used a handcar to reach isolated patients in remote logging camps. Colon said, "We worked day and night. We'd ride 20 and 30 miles at night through the deepest woods. We would find ten people all huddled together, fully dressed in a tiny log cabin, and all with fevers over 104 degrees.... We'd hitch a flat car to a handcar with wire, put a board floor on, mattresses over that, plenty over covers and a canvas to cover the top and break the wind, and we'd carry patients 15 or more miles to a decent bed and a chance to live.... Everybody worked hard and long with unselfish spirits."
    The elections in Michigan coincided with the peak of the pandemic. The U.S. Senate election turned on a slim majority-less than 4,000 votes, and there certainly were more than 4,000 people laid low with the flu.
    In late October in Detroit, an eighteen-year-old boy named John Carrico noted that his father "went on home and remained at home until about three o'clock. When he got back, he called up the Red Cross headquarters and told them to send a nurse out to our house tomorrow morning. He certainly is scared of the Spanish influenza. I never saw anyone so scared as he is. If fright will make you sick, well I do believe he will catch the ‘flu' as sure as anything." Though his father's fears were typical, and many around him did have the flu, he wasn't actually sick.
    In Flint, people complained over how many physicians had been drafted. Observing that another doctor in town had been drafted into military service, resident William W. Clark asked, "Should not our citizens as a unit stand behind our board of health in protest to the government against further drafts...until this epidemic has abated?"
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes again, it will strike in Michigan.
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    <HR width="98%" SIZE=1><A id=minnesota name=minnesota>Minnesota State Summit: History Supplement
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    December 14, 2005
    Here in Minnesota, the Paulson family was one of the first to be touched. The Paulsons were residents of the town of Wells, about a two-hour drive to the southwest from Minneapolis.
    Marie Paulson had sent three of her seven children off to the Great War. On September 14th of 1918, she received word that her 22-year old son Walter had caught pneumonia. Within three days, Walter was dead. A day after Walter was buried in Wells, his brother Raymond fell ill. Raymond would die, and so would his sister, Anna Valerius.
    That was just the beginning. On September 25th, the Surgeon General announced that the first cases of influenza had been discovered in Minnesota. Here in Minneapolis, a large number of army recruits who were being temporarily housed at the University of Minnesota became ill.
    In less than a week after influenza was first reported, there were more than 1,000 cases in Minneapolis. On October 10th, all public meetings were banned. On the 11th, all schools, churches, theaters, dance halls and billiard parlors were closed.
    As in Cedar City, the disease continued to spread. By October 17th, the Minneapolis City Health Commissioner estimated that nearly 3,000 people had died due to the disease.
    By the time the pandemic was finally over in Minnesota at the end of 1920, more than 75,000 people had been sickened. Nearly 12,000 were dead.
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    <HR width="98%" SIZE=1><A id=ms name=ms>Mississippi State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Alex Azar
    Deputy Secretary of Health and Human Services
    May 1, 2006
    We are also seeing some of the same symptoms from victims of the 1918 strain in victims of today's H5N1. If the H5N1 strain, or any other strain of animal influenza, were to develop into a pandemic strain, no one would have immunity. Let me tell you a little about how Mississippi was affected by the 1918 pandemic.
    It appeared to come on slowly in the last days of September 1918. Initial reports included "a few cases...from Montgomery and Leake Counties and suspected cases from Meridian."
    The situation quickly worsened. One week after it appeared, Mississippi officials reported to the U.S. Public Health Service that "epidemics have been reported from a number of places in the State," and, "the epidemic is spreading rapidly." By the middle of October, thousands of cases around the state had been reported. And the rates of infection continued to grow.
    In fact, in the last days of October, more than 6,000 new cases of the flu were occurring every day-the flu was everywhere, and no one was safe.
    In 1918, as today, Brooklyn, Mississippi was the rural home to the Forrest County Agricultural High School. Occupying one of the highest points of land in the neighborhood and situated a mile from the small village of Brooklyn, the school was relatively isolated by nature and their self-imposed quarantine.
    Consequently, the flu did not reach the school in the earliest stages of the pandemic. This gave the U.S. Public Health Service Assistant Surgeon General C. Armstrong the opportunity to experiment with a promising new vaccine to inoculate against the flu. This, however, proved unsuccessful.
    In early December, the school was forced to shut down as more than 45 percent of the students-both vaccinated and unvaccinated-fell ill.
    State health reports said, "It is the consensus of opinion of all who observed these cases that there was nothing special in character which differentiated the unvaccinated from the vaccinated."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Mississippi.
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    <HR width="98%" SIZE=1><A id=mt name=mt>Montana State Summit
    Opening Remarks Prepared for Delivery
    By Dr. Ken Moritsugu
    Deputy U.S. Surgeon General
    May 22, 2006
    That Great Pandemic also touched Montana.
    By the time that Montana officials made their first report to the U.S. Public Health Service on October 4, 1918, the pandemic was already sweeping across the state.
    They failed to report for the next two weeks, probably because they were so overwhelmed in combating the disease. By October 21, officials made a report, which although "very incomplete," still told of more than 3,500 cases of flu.
    Montanans became desperate as thousands became sick and hundreds died. When traditional medicines failed, residents of Butte turned to the herbal remedies of Chinese physician, Dr. Huie Pock. His patients claimed that the remedies saved lives. If they did, they did not get to nearly enough people.
    Loretta Jarussi of Bearcreek, Montana recalled young, healthy people passing through her tiny town, only to be reported dead two days later.


    Jarussi said:
    People would come along, and...they'd stop and say hello to us. My mother was very friendly. She loved to see those people. She was kind of lonesome there, you know, just us kids and her. So when anybody passed by, she always stayed with them. And, you know, maybe a week later, they'd say so-and-so died, and they had been past our place. So many people had that flu, and young people, and they died.


    She also recalled what happened when her father contracted the flu. By the time he took the third dose of medicine prescribed by an Army doctor, he felt certain he was going to die.
    He called all the kids around the bed and said, "This is for you," and "You're supposed to do this," and, "This is yours," etc. Then he kind of went into . . . I don't know . . . a sleep, a deep sleep. And Mama thought-she really did-he had died, but he came out of it, and he felt better. But it took two years to get over that.


    Loretta's father was far from alone.
    On November 1st, Montana officials said that at least 11,500 people had been afflicted with the flu over the past three weeks. The toll could have been higher, since officials admitted that their reports were incomplete.
    The final tallies of suffering will never be known, but echoes of suffering and loss remain.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Montana.
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    <HR width="98%" SIZE=1><A id=mo name=mo>Missouri State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    February 23, 2006
    That Great Pandemic also touched Missouri.
    It began burning in both big cities-St. Louis and Kansas City-at about the same time, the first week of October in 1918.
    On October 7th, Henry Keil, the Mayor of St. Louis issued a decree closing "all theaters, moving picture shows, schools, pool and billiard halls, Sunday schools, cabarets, lodges, societies, public funerals, open air meetings, dance halls and conventions."
    Not long afterward (October 17th), the Kansas City Star proclaimed, "A DRASTIC BAN IS ON." It was.
    Ordered closed immediately and indefinitely were all schools, churches and theaters. Public gatherings of 20 or more people were all prohibited, including dances, parties, weddings, or funerals. Crowding in stores was banned. Streetcars were forbidden to carry more than 20 standing passengers. Elevators were sterilized once a day. Telephone booths were sterilized twice.
    Yet the pandemic continued to burn across the state. And scoundrels and heroes stepped forward to seize the opportunity it wrought.
    One Missouri physician wrote to the U.S. Public Health Service offering to sell his miracle influenza cure for the "nominal price of $4.50 per patient." In case the Public Health Service thought that too high a sum, he also offered his services to the Army medical department at a surgeon major's pay.
    Meanwhile, students at the American School of Osteopathy in Kirksville, Missouri (in the northern part of the state, about four hours from St. Louis)], graduated early so that they could join the fight against influenza.
    Despite all those efforts, the pandemic still took a terrible toll. By the end of October, more than 21,000 Missourians had been stricken. More than 500 had perished.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Missouri.
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    <HR width="98%" SIZE=1><A id=ne name=ne>Nebraska State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of the Department of Health and Human Services
    February 23, 2006
    That Great Pandemic also touched Nebraska.
    No one knows when it first came, but by October 1st, 1918, it was already burning throughout the state.
    On October 7th, there were 400 cases of influenza here in Lincoln. Twenty-five hundred more were reported in Omaha (whose population at the time was about 177,000). Rural doctors were taxed to their limit, since by mid-October, some counties were reporting between 250 and 500 cases each day. During the single terrible week when the pandemic peaked (Oct 26th), nearly 21,000 Nebraskans were stricken. Almost 1,500 died.
    During the desperate month of October, Nebraskans did all they could to control the contagion. The mayor of Hastings (located about an hour-and-a-half drive west-south-sest from Lincoln) issued an order closing theaters, churches, schools, pool rooms and card rooms. Schools were closed in Omaha. Indoor meetings were banned, and church services were moved outside.
    Home remedies were as prevalent as they were ineffective. The Hastings Tribune recorded that some Nebraskans wore garlic amulets. Vick's VapoRub was recommended. So were Vacona, a medicated salve, and something called Dr. Pierce's Golden Medical Discovery.
    Nothing worked. By the time that the pandemic finally passed, state doctors estimated that nearly 3,000 Nebraskans had perished because of it.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Nebraska.
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    <HR width="98%" SIZE=1><A id=nh name=nh>New Hampshire State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    May 26, 2006
    That Great Pandemic also touched New Hampshire.
    It came here from Massachusetts, though no one is exactly certain when. But, by the end of September, influenza was already an inferno.
    Here in Concord, a former mayor named Charles Corning reported, "Grippe [influenza] is sweeping over Massachusetts and New Hampshire as fire shrivels the fields, laying out communities and taking a toll of death unprecedented."
    He continued, "A heavy sense of anxiety and apprehension like a dismal cloud in midsummer weighs heavily upon us because of the deadly ravages of the so-called Spanish influenza. Funerals jostle one another so the sable procession goes on."
    The pandemic caused shortages of essential workers. Thirty to forty percent of the employees at the New England Telephone and Telegraph Company were sick, and so the company took out ads, imploring customers to cut out unnecessary calls and not to ask for the operator.


    There were also terrible shortages of doctors and nurses. During the peak of the pandemic (around mid-October), a public health worker from the town of Berlin (located in northeast New Hampshire) reported:
    It is hardly possible for me to describe the conditions in this community. I am the only experienced public health worker here with the exception of the staff. Saturday, I cared for forty patients, from four to nine sick in one family. Everything possible is being done. There are only seven doctors in the city.


    The final toll that the pandemic took in New Hampshire will never be known. But the echoes here remain.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to New Hampshire.
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    <HR width="98%" SIZE=1><A id=nj name=nj>New Jersey State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    May 31, 2006
    That Great Pandemic also touched New Jersey.
    The first person to fall victim to the Spanish Flu in New Jersey was a soldier at Fort Dix who had just returned from Europe. It was the ultimate irony: to survive the perils of the battlefields of the Great War, only to fall deathly ill once returning home.
    In the fall of 1918, that irony was beginning to play out throughout the country and around the world. Many others would suffer that same cruel fate in the days ahead.
    On September 27th, the state health officer announced that the disease "was unusually prevalent" throughout the state. Within the next three days, more than 2,000 new cases were reported.
    Scarcely a week later (October 6th) that terrible tally of the afflicted was equaled in a single city-Gloucester City (near Philadelphia).
    The speed with which the disease killed was as shocking as the number of people it affected. One insurance agent recalled that, during the pandemic, "deaths were so sudden that it was almost unbelievable. You would be talking to someone one day and hear about his death the next day."
    A New Jersey physician said that it was a common experience to speak with someone who appeared to be healthy one day and then come across them a few days later on the autopsy table.
    New Jersey battled the disease as well as it could. On October 10th, the state banned all public gatherings.
    Some experimented with a new vaccine. When it failed, alternative "medicines" were used, ranging from whiskey to red onions and coffee.
    None of them worked.
    In Newark, the city's medical community tried a large-scale public education campaign. They sent pamphlets on prevention and treatment to every household. Crowds were avoided and public funerals were banned to prevent the spread of the disease.
    But despite these efforts, the disease raged on.
    Medical facilities were quickly overwhelmed. The city of Newark purchased a vacant furniture warehouse to be used as an emergency hospital to help handle the overflow. Nurses and physicians were in short supply as well, as so many of New Jersey's healthcare professionals were in the war effort overseas.
    Those health care workers who could help worked around the clock to do whatever they could. One physician treated more than 3,000 patients in one month. He recalled:
    There was no need to make appointments. You walked out of your office in the morning and people grabbed you as you walked down the street. You just kept going from one patient to another until late in the evening.
    Still, the dead bodies accumulated faster than they could be buried. At first, city employees and firemen helped to dig graves. Then teams of horses were used to plough trenches which could be used as mass graves.
    On a single day-October 22nd-more than 7,000 new individuals were afflicted, and 366 were lost. Incomplete reports to the U.S. Public Health Service show that by that day, more than 150,000 New Jersey residents had been sickened with the flu. More than 4,400 had died.
    By November, the disease finally began to relent, but countless families lay devastated in its wake.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to New Jersey.
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    <HR width="98%" SIZE=1><A id=nm name=nm>New Mexico State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 28, 2006
    That Great Pandemic also touched New Mexico.
    No one is sure when the pandemic first arrived, though it may have been carried into Carlsbad (southeast corner of the state) by members of an out-of-own circus. On October 4th, there were reports of "a few cases" in "several places." A week later, epidemics were reported in Albuquerque, Gallup (west of Albuquerque), and Carlsbad. And the pandemic continued to spread.
    In some cases, Smith and Wesson and Colt stood in the way. Fearing introduction of the disease, armed vigilantes from across the state stopped trains from flu-ridden regions and forced passengers to get back aboard and return from where they came.
    Those fears were well founded. The flu was afflicting thousands of New Mexicans, and claiming the lives of hundreds.
    But on one occasion, fear proved more fatal than the flu itself.
    A Las Vegas (east of Santa Fe) family, the Gardunos, all fell ill with influenza. Mrs. Clara Garduno succumbed to the disease first, and was soon pronounced dead. Health Department officials demanded that she be buried immediately to prevent the spread of the disease, and her husband secured the services of an undertaker.
    Because three of her children were also very ill at the time of her death and not expected to survive, Clara's grave was left uncovered to allow prompt burial of the children as soon as they too perished. Two of the children died the next day, and as the undertaker began to bury the children, Frank Garduno asked to see his wife's body one last time.
    To his horror, he discovered that his wife had not been dead at the time she was buried after all. In his fear and haste to bury influenza victims, the doctor who had pronounced Clara dead had been mistaken. She had been buried alive, only to suffocate in her coffin.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to New Mexico.
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    <HR width="98%" SIZE=1><A id=ny name=ny>New York State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    July 27, 2006
    That Great Pandemic also touched New York.
    The first sparks appeared during the last week of September 1918, when some 61 New Yorkers were diagnosed with the Spanish flu.
    The pandemic soon became a raging fire. Less than two weeks after it first appeared, more than 2,500 New Yorkers were afflicted. Tens of thousands would follow them to the hospital. Thousands would follow to the morgue.
    Nearly 4,000 New Yorkers perished from the pandemic during the first three weeks of October. At the same time, more than 4,500 more died in cities all across the state. In Rochester, 213 perished in one week.
    Doctors fell alongside the patients they were caring for. One was Dr. George Gorrill, the superintendent of Buffalo State Hospital. There were far too few caregivers to begin with, for their thin red line had been stretched taut by the demands of World War I.
    In an effort to fill those depleted caregivers, the junior and senior classes of the Buffalo Medical School were pressed into service. Shortly afterwards, the sophomore class joined them.
    But there were still too few to care for all that had been afflicted. Acting Health Commissioner for the City, Franklin Gram said:
    “It was no uncommon matter to find persons who had waited two or three days after having repeatedly phoned or summoned physicians, suffering and dying because every physician was worked beyond human endurance.”
    All across the state, entire families were stricken with the disease at once.
    In Albany, the Altman family, including nine-year-old Stella, her mother, and her three younger siblings, fell ill. Stella later remembered, “There was no help to be found anywhere; everyone was too busy caring for their own families.” Stella’s mother died, but the children could not attend her funeral, for they were too ill.
    The Steins of New York City’s South Center Street were also afflicted. A charity worker who checked in on them found a baby dead in its crib and the remaining seven members of the family seriously ill.
    In Brooklyn, a man named Michael Wind was six years old when the flu came to the city. He remembered:
    When my mother died of Spanish influenza, we were all gathered in one room, all six of us, from age two to age twelve. My father was sitting beside my mother's bed, head in his hands, sobbing bitterly. All my mother's friends were there, with tears of shock in their eyes. They were shouting at my father, asking why he hadn't called them, hadn't told them she was sick. She had been fine yesterday. How could this have happened?
    Unable to cope, Wind’s father left his children at the Brooklyn Hebrew Orphan Asylum. The Asylum was soon filled with 600 children, most of them orphaned by the flu.
    The great pandemic filled not only the orphanages of New York City, but also its hospitals and morgues. More than 90,000 New Yorkers were eventually afflicted. More than 12,000 perished.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to New York.
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    <HR width="98%" SIZE=1><A id=nc name=nc>North Carolina State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 21, 2006
    That Great Pandemic also touched North Carolina.
    The pandemic appeared in late September of 1918. On September 27th, 400 cases were reported in Wilmington. Additional cases were reported here in Raleigh.
    It then spread like wildfire across the rest of the state. By October 4th, influenza was striking people in 24 counties, and epidemic in Raleigh and Wilmington. It burned through Fayetteville not long afterward.
    Authorities did what they could to contain its spread. On October 5th, the State Board of Health called on the authorities of communities where the pandemic appeared to "promptly . . . close the school and all public meetings."
    However, Dr. W.S. Rankin of the State Board of Health refused to approve the use of rum in emergency hospitals due to lack of evidence that it was effective against influenza. Instead the Board called for treatments of "sunshine and open air." Calomel, a purgative (and insecticide), was also prescribed.
    Residents suffered terribly when the pandemic struck.
    For instance, Selena W. Saunders, who accompanied a nurse in the textile town of Cramerton (located a few miles west of Charlotte) recalled:
    "This new disease . . . struck suddenly, spent itself quickly in a burning three-day fever, often leaving its victim dead. The people lost faith in the remedies they had relied on all their lives, and they became frantic. Some of them locked themselves in their house, and refused to open the door for anyone.... Merchants nailed bars across their doors, and served the customers one-at-a-time at the doorway. We found whole families stricken, with none able to help the others. In one family the mother died without knowing that her son, who lay in the adjoining room, had died a few hours earlier."
    In the city of Goldsboro, a resident named Dan Tonkel remembered:
    "I felt like I was walking on eggshells. I was afraid to go out, to play with my playmates, my classmates, my neighbors. I was almost afraid to breathe. I remember I was actually afraid to breathe. People were afraid to talk to each other. It was like-‘don't breathe in my face, don't even look at me, because you might give me germs that will kill me.' "
    Tonkel added:
    "Farmers stopped farming; merchants stopped selling. The country more or less just shut down. Everyone was holding their breath, waiting for something to happen. So many people were dying; we could hardly count them. We never knew from one day to another who was going to be next on the death list."
    By the time the pandemic passed, at least 13,000 North Carolinians had perished.
    One of the victims was Ernest Carroll, who may have been infected while he was serving soup to those afflicted with influenza at the Tabernacle Baptist Church here in Raleigh. After he passed, Temple Baptist named its kitchen and dining hall after him.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to North Carolina.
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    <HR width="98%" SIZE=1><A id=nv name=nv>Nevada State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    February 17, 2006
    That Great Pandemic also touched Nevada.
    In 1918, Nevada's statewide population was less than four percent of what it is today-just 77,000 people. Yet between mid-October and late November, the state reported several hundred cases of the Spanish flu, as well as scores of deaths from it.
    The exact numbers of Nevadans affected by the flu will never be known, because regular reports to the U.S. Public Health Service were never made.
    Yet Nevadans reacted to the flu as those in so many other states did: City ordinances were passed that mandated the wearing of facemasks in public. All public gatherings were banned. In White Pine County (located in east-central Nevada), a countywide quarantine was enforced for over two and half months to help quell the spread of the pandemic.
    Nevada even considered establishing quarantine stations along the state's borders to secure it from the disease.
    However, these precautionary measures were not always popular. In Elko County (located in north-east Nevada), a schoolteacher named Eleanor Holland complained to fellow teachers that mandatory mask wearing was a ridiculous burden.
    A short time later, she contracted the flu and nearly lost her life. She later recalled, "It didn't seem so funny when I came down with the flu and nearly died. Fortunately, none of the other teachers got it though they all helped take care of me."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. This is not Stephen King. It happened in 1918, and if a pandemic strikes, it will come to Nevada.
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    <HR width="98%" SIZE=1><A id=nd name=nd>North Dakota State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 9, 2006
    That Great Pandemic also touched North Dakota.
    On September 27, 1918, the Bismarck Tribune reassured readers worried about the Spanish flu, noting, "Doctors believe that if the people of North Dakota exercise ordinary care they need not fear the ravages of this disease."
    They could not have been more wrong.
    The first official notice that the flu was in North Dakota came to the U.S. Public Health Service in early October, when 75 cases were reported in Rockford in Eddy County (three hours to the northeast of Bismarck).
    The onset of the flu was sudden and devastating. In less than a week, an optimistic Fargo Forum headline: "Spanish Influenza Hasn't Hit Fargo," yielded to a report of more than 100 cases.
    North Dakotans tried to stem the rising tide of the disease. Schools, churches, and businesses were closed. Public gatherings of any kind were banned. All places of amusement, including dances, theaters, and pool halls, shut their doors. Transporting patients with influenza on trains became a crime.
    Nothing worked. And North Dakota's health care community was overwhelmed.
    By the second week of October, nearly 6,000 people had been afflicted. Hundreds died. The young and healthy were the worst struck. Of 173 listed influenza deaths in the Fargo Forum, 122 (70%) were between the ages of 18 and 35.
    One was Christian G. Lucas, the eldest son of the mayor of the city, who died at the age of 21. Christian was a young man of great promise who wanted to do his part in the war effort. He entered the hospital the very day he received his induction orders from the Naval Aviation Corps.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to North Dakota.
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    <HR width="98%" SIZE=1><A id=oh name=oh>Ohio State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    February 17, 2006
    That Great Pandemic also touched Ohio.
    It was already raging by the time the first cases were reported to the U.S. Public Health Service on October 4th.
    Ohioans reacted like many others across the country in attempting to contain the disease-they banned public meetings, closed the doors of colleges and public schools, and outlawed behaviors thought to spread the disease, such as spitting.
    All was to little avail.
    As the disease continued to spread, makeshift hospitals were set up to treat the sick. One such auxiliary hospital was the Majestic Theater at Chillicothe, Ohio (located about 45 miles south of Columbus), where there were so many victims that they were described as being, "stacked like cordwood."
    The flu-and the fear of it-was everywhere. Advertisers and opportunists used it to sell their goods. It even featured in the popular cartoon, "Polly and Her Pals." It depicted the protagonist wearing a "bacteria bib" and bemoaning the fact that she never caught anything as "fashionable" as the Spanish influenza.
    But thousands in Ohio did catch the flu. By the last week of October, Ohio reported 125,000 cases of the Spanish flu. That week, more than 1,500 Ohioans died.
    More continued to fall. One Ohioan who died was the father of former (Ohio) Governor Jim Rhodes. Another was a nun, Sister Raphael O'Connor, who died just days before her fifty-eighth birthday while nursing influenza victims.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. This is not Stephen King. It happened in 1918, and if a pandemic strikes, it will come to Ohio.
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    <A id=ok name=ok>Oklahoma State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 29, 2006
    The Great Pandemic also touched Oklahoma.
    The pandemic made its first appearance on September 26th, by bracketing Oklahoma City with simultaneous eruptions in Tulsa (northeast of Oklahoma City) and Clinton (southwest of Oklahoma City). By October 4th, more than 1,200 Oklahomans in 24 counties had been afflicted with the flu.
    The pandemic raged through Oklahoma throughout the terrible month of October.
    In Tulsa, an emergency hospital was opened under the aegis of the Red Cross. Some 260 Tulsans were eventually admitted. Twenty eventually died.
    Here in Oklahoma City, the Food and Drug Administration had to cancel a previously scheduled meeting. Three hundred people in the city were sick with the flu, making anything of the sort simply impossible.
    Doctors spent themselves to the limit in helping those afflicted by the pandemic. In the city of Enid (north of Oklahoma City), a patient being cared for by Dr. David Harris remembered him chewing on a snatched drumstick, trailing broth across the bed sheets, and taking a pulse with his free hand.
    But despite those exhausting efforts, the pandemic still took a terrible toll in Oklahoma.
    No one can be sure of the total losses Oklahoma suffered, but when it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Oklahoma.
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    <HR width="98%" SIZE=1><A id=or name=or>Oregon State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 30, 2006
    The Great Pandemic also touched Oregon.
    No one is certain when it first did so, for by the time the first reports were made in mid-October, the pandemic had already erupted all over the state—from Pendleton (in the northeast corner) to Portland, and from Baker (near Pendleton) to Eugene.
    The city of Medford (located in south-central Oregon) became the first to impose a ban on all public gatherings, when E.B. Pickel, the Health Officer, and C.E. "Pop" Gates, the mayor, issued an edict closing "all places of amusements, theaters, moving picture shows,... churches, lodges, schools, and all public meetings of every description where people congregate—same to be in effect until said epidemic has subsided."
    When the situation became worse, the city required all residences where someone had been afflicted with the flu to post a blue sign with the words, "Contagious, Influenza" prominently displayed.
    Later in the pandemic wave, the Medford City Council issued an order requiring all persons in the city conducting business, riding, or walking the streets, to wear masks. There weren't enough masks at first, so all types of masks "from women's veils to handkerchiefs" were used.
    Local Red Cross volunteers made masks for Medford, and they provided vital services in other communities as well. For instance, in Klamath Falls (located west of Medford), Red Cross volunteers not only made masks, they also made pneumonia jackets (of warm flannel), and other needed articles. The need for such supplies was so severe that the Red Cross kept its doors open seven days a week simply to keep up.
    One public health nurse reported dire circumstances from the countryside. She declared, "there is no food, no bedding, and absolutely no conception of the first principles of hygiene, sanitation, or nursing care."
    There were some stories of success. For instance, a four-year-old from Portland reportedly recovered from the flu after her mother dosed her with onion syrup and buried her from head-to-toe in glistening raw onions—for three full days.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Oregon.
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    <HR width="98%" SIZE=1><A id=pa name=pa>Pennsylvania State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 20, 2006
    That Great Pandemic also touched Pennsylvania.
    Earlier, I noted John Barry's description of what happened in Philadelphia. Let me give you a fuller picture now.
    On September 27th, 1918 Pennsylvania optimistically reported that "comparatively few cases" had been reported among the civilian population. Then influenza took hold.
    On October 4th, the state reported that the disease was epidemic in Pittsburgh and Philadelphia. Nearly 15,000 cases were counted in the first 18 days of October, and the dreadful toll continued to climb.
    Philadelphia was one of the hardest hit cities in United States. As the disease spread, essential services collapsed. Nearly 500 policemen failed to report for duty. Firemen, garbage collectors, and city administrators fell ill.
    The city's only morgue overflowed. It was built to handle 36 bodies, but contained more than 500. Bodies accumulated in the morgue's hallways and lay there rotting. Five supplementary morgues were eventually opened. Convicts were recruited to dig graves. There were never enough coffins, and people would steal them from undertakers when they could.
    Public gatherings were banned to restrict the spread of the disease. Streetcars were shut down. Schools, churches, and places of public meeting were closed, and so were theaters and places of amusement.
    The human cost was unbearable.
    Selma Epp remembered her family's experience with the flu:
    "[We] made up [our] own remedies, like castor oil [and] laxatives...everyone in our house grew weaker and weaker. Then my brother Daniel died. My aunt saw the horse-drawn wagon coming down the street. The strongest person in our family carried Daniel's body to the sidewalk. Everyone was too weak to protest. There were no coffins in the wagon, just bodies piled on top of each other. Daniel was two; he was just a little boy. They put his body on the wagon and took him away."
    While the disease was raging in Philadelphia, some 50,000 people in Pittsburgh were being afflicted. So were thousands of others throughout the state.
    Nearly 24,000 Pennsylvanians died during the first month of the disease. By October 25th, after the first wave of the pandemic had passed, it was estimated that 350,000 people had been struck with the flu (about 150,000 of whom were Philadelphians).
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Pennsylvania.
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    <HR width="98%" SIZE=1><A id=rhode name=rhode>Rhode Island State Summit: History Supplement
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    January 13, 2006
    All of New England was affected by the pandemic. It was first noted in Massachusetts and then rushed like a wildfire through the rest of the region.
    It is not certain exactly when in September of 1918 that the pandemic first reached Rhode Island, but it is certain that the toll was terrible.
    One of those it took that sad September was a young sailor named John Stanley Harman. His tragic story was told by the Providence Journal. John was a hospital apprentice in the Naval Reserve. After nursing two men though the flu, he too was struck down.
    John lived only 36 hours afterwards. A Miss Alice Wood was at his bedside when he died. She was John's fiancée. They were to have been married on October first.
    During the pandemic, Rhode Island experienced shortages of medical personnel. Part of that shortage was due to the pandemic taking down trained personnel. It was also due to the fact that three-quarters of Rhode Island's nurses (230 of 300) had volunteered for national duty during the pandemic's early stages.
    Because of the shortage, student nurses took to caring for patients. They were busy. Emergency hospitals were set up in several Rhode Island cities: Pawtucket, Woonsocket, Warwick and Westerly. In Westerly, an abandoned school was turned into a hospital - complete with new wiring and new plumbing - almost overnight.
    Many of those not caring for the sick were trying to contain it in other ways. In Providence, as in many other places, there was a debate about whether or not to cancel all public gatherings.
    One of the surprising dissents came from Charles V. Chapin, the head of the Rhode Island Department of Public Health and a nationally recognized expert in public health.
    Dr. Chapin said that banning all assemblies would do little good since the disease had already spread through the state. He said that the disease would have to take its course - and take with it as many as it would.
    The toll was as grim as Dr. Chapin's advice. By the first week of November, the state was reporting "50 deaths per day" to the U.S. Public Health Service. By the time the pandemic flu finally departed, between 2,000-2,500 Rhode Islanders had fallen to it.
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    <HR width="98%" SIZE=1><A id=sc name=sc>South Carolina State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 2, 2006
    That Great Pandemic also touched South Carolina.
    The first mention of influenza in South Carolina appeared on September 27, 1918 in the state's public health reports. Four days later, a telegram reported 1,500 cases in the state.
    By the end of that month, an estimated 80,000 cases had occurred, resulting in some 3,000 deaths.
    While overall figures for the state cannot be known for sure, it is clear that thousands of cases each week sprung up in cities around the state during the high points of the pandemic. Columbia, for example, endured 4,427 cases during the second week of October.
    Nearby, the disease also struck hard at Camp Jackson. There, the base hospital overflowed with men too ill to stand, and an entire section of the camp became an extension of the hospital. More than 5,000 soldiers were treated for influenza and approximately 300 died from the disease.
    Here in Columbia, at the time there were two hospitals: Columbia, with about 100 beds, and Baptist, which had less than 50. With a citywide population of more than 37,000, these hospitals were completely overwhelmed by the pandemic.
    Columbia, and all of South Carolina, reacted as many states and cities around the country did:
    Schools and businesses were closed, public gatherings were banned-even the state Supreme Court shut its doors. The wearing of gauze masks was strongly encouraged, and institutions with space to spare, such as the University of South Carolina, became auxiliary hospitals.
    Eucapine, Vick's VapoRub, and other patent medicines became popular and were touted as cures. The governor even permitted the use of then-illegal alcohol because doctors were advocating its use as a remedy and nothing else seemed to be working.
    Even as late as 1920, the pandemic wore on in South Carolina.
    On January 26, C.V. Akin, an epidemiological aide stationed in Columbia, sent a telegram to U.S. Surgeon General Rupert Blue:
    "Reports indicate existence [of] influenza [in] mild epidemic form [in] South Carolina... No great concern felt but if disease continues spread considerable suffering will be occasioned by total lack nurses who will undertake epidemic duty. [The] Secretary [of the] State Medical Association wishes to know what material help can be expected from service if epidemic becomes serious. Please advise..."
    On the same day, Surgeon General Blue responded:
    "General relief [for] influenza not available under current epidemic appropriation which provides during this year [for the] control [of] interstate spread only. Consequently [we are] unable [to] render intrastate assistance. Application for nursing assistance should be made direct to local Red Cross chapter or Division Manager."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to South Carolina.
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    <HR width="98%" SIZE=1><A id=sd name=sd>South Dakota State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 9, 2006
    That Great Pandemic also touched South Dakota.
    In late September, the State reported "a few scattered cases" to the U.S. Public Health Service. Within a week, there were a few hundred. And the virus continued to spread.
    Governor Peter Norbeck came down with the disease after a business trip in Lusk, Wyoming, and was admitted to St. Joseph's Hospital in Deadwood (six hours west of Sioux Falls, just 15 miles east of the Wyoming border). The governor survived, but others were not as fortunate.
    South Dakotans tried to dam the rushing flow of influenza with preventative measures and sanitary ordinances.
    Public gatherings were banned. Churches, theatres, schools, pool halls, and other public places were closed indefinitely. The University of South Dakota closed its doors. All funerals were to be held outdoors to avoid passing the disease among dense crowds.
    In Rapid City, spitting on the sidewalks was made illegal. No one was exempt. A city police officer was arrested under the statute and fined $6 for committing the offense-a considerable sum in 1918.
    In some cities and towns, pedestrians were even required to carry a doctor's note verifying that they had already had and recovered from the flu and were, therefore, no longer capable of catching or spreading the disease.
    Newspapers suggested Hood's Sarsaparilla, Pepitron, and Foley's Honey and Tar as cures. They also offered advice to help people avoid the flu, such as:
    "When talking to another person stand at least two or three feet away."
    "Keep yourself comfortably dressed and eat plenty of wholesome foods."
    "Keep your home well ventilated and have plenty of fresh air in it at all times."
    But nothing seemed to work. By the time the pandemic finally peaked, thousands of South Dakotans had been afflicted. More than 200 had perished.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to South Dakota.
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    <HR width="98%" SIZE=1><A id=tn name=tn>Tennessee State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    April 10, 2006
    That Great Pandemic also touched Tennessee.
    It began in late September with "two suspicious cases" being reported in Memphis. Four days later, that number leapt to 95 cases. By the middle of the month, Memphis alone was fighting more than 6,000 thousand cases of the flu and it was spreading from urban to rural areas.
    The situation in Nashville was even worse.
    At the height of the pandemic, Nashville had scarcely 250 doctors. Many of the physicians succumbed to the flu themselves.
    Shortages of essential personnel often compounded the crisis even further. A lack of sanitation workers in the city allowed sewage to accumulate in the streets, raising concerns about other diseases.
    Emergency hospitals could not be opened to accommodate the growing numbers of patients because they could not be staffed. Most patients were isolated in their homes and treated there, if they could get medical attention at all.
    A physician attending a father in a family of 11 told him that he had contracted the flu from his family. When he asked his patient who would care for them, the father could only reply, "I don't know."
    That was true for Tennesseans all across the state.
    Those sickened were often left to fend for themselves—neighbors refused to come to the aid of neighbors for fear that they too would be struck.
    The disease was indiscriminant, and unpredictable.
    One Tennessee physician wrote in his medical journal: "The man who dug his neighbor's grave today might head the funeral procession next week. No telling who would be next."
    People fought back with what they had.
    All across the state, businesses deemed nonessential were told to close. Schools and churches were shut down and public gatherings were to be avoided whenever possible. The Nashville Street Railway and Light Company was instructed to run their cars with the windows open to allow the cars to air out.
    Dr. E.L. Bishop, of the state Board of Health, offered his advice by condemning "promiscuous kissing ...especially that of the nonessential variety." He said, "[a] kiss of infection...may truly be the kiss of death."
    One judge authorized the then-prohibited liquor that had been seized by the police for use as a treatment for influenza. The city health officer was promptly inundated with demands for the "remedy." According to the local paper, supplicants "thronged [his]...office and overwhelmed the luckless physician. Business was halted—but there was no halt in the tramp, tramp, tramp of the boys marching up the steps to the office."
    The tramp, tramp, tramp of tragedy marched on too.
    No one knows how many Tennesseans were afflicted. But in the last two weeks of October, when the pandemic was at its peak, nearly 11,000 people were struck. More than 650 fell. Across the course of the pandemic, one historian estimated that Nashville alone battled some 40,000 cases, and lost 468 people.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Tennessee.
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    <HR width="98%" SIZE=1><A id=tx name=tx>Texas State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 27, 2006
    The Great Pandemic also touched Texas.
    Reports of pandemic fears preceded the disease into Texas by about two weeks. But by September 23, there were definite accounts of it near Austin and Dallas. On October 4th, 35 counties were reporting the presence of influenza, with anywhere from one to 2,000 cases per county.
    The pandemic kept rising. The victims kept falling. And people kept searching for ways to contain the pandemic and sustain themselves through it.
    El Paso imposed a quarantine.
    The Dallas Morning News declared that surviving the pandemic required "medical attention, good nursing, fresh air, nutritious food, plenty of water, and cheerful surroundings."
    The Texas State Board of Health offered schools several suggestions on ways to prevent flu outbreaks.
    The Board wrote:
    "Every day . . . disinfectant should be scattered over the floor and swept. All woodwork, desks, chairs, tables and doors should be wiped off with a cloth wet with linseed, kerosene and turpentine. Every pupil must have at all times a clean handkerchief and it must not be laid on top of the desk. Spitting on the floor, sneezing, or coughing, except behind a handkerchief, should be sufficient grounds for suspension of a pupil. A pupil should not be allowed to sit in a draft. A pupil with wet feet or wet clothing should not be permitted to stay at school."
    But despite those efforts, the pandemic took a terrible toll on Texas. By the end of October, more than 106,000 Texans in the state's urban centers had been afflicted. More than 2,100 had died.
    The echoes of fear and loss resounded loudly—so loudly that when 221 cases of influenza were diagnosed in Dallas over a year later (January 25th, 1920), the State Director of Public Health sent an urgent message to Surgeon General Rupert Blue advising him of the situation and asking for his guidance on any other control measures other than the general ones already being applied. The Surgeon General sent back simply, "Service has no additional measure to suggest."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Texas.
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    <HR width="98%" SIZE=1><A id=tribal name=tribal>Tribal Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    May 18, 2006
    Great Pandemic also touched tribes.
    A group of Indian students in Lawrence, Kansas were the first to feel its bite, in March of 1918. The pandemic retreated, but then returned with terror in the fall.
    Few American newspapers carried stories about what was happening, but by October 14th, the Commissioner of Indian Affairs was requesting aid for those that were falling ill on various reservations.
    The Navajo were especially hard hit. Cases of abandonment by relatives were common because the disease was so widespread and so feared. A trader named Joseph Schmedding who entered a Navajo reservation a few weeks after the pandemic erupted, found 30 Indians, young and old, lying dead in abandoned hogans.
    In Tuba City, on the Navajo reservation in Arizona, a school was converted into a hospital. The wife of a Navajo trader wrote, “For miles around every good winter hogan was deserted [because of fear of the infection]. The living moved out into the rain and found what shelter they could in deserted camps.”
    In Utah, the spread of the disease was helped by the traditional burial practices of the Pahvent Indians (members of the Ute tribe), who were camped near the town of Meadow. One white who visited the camp said, “There were lots of dead bodies in tents and families...around dead bodies...singing and chanting.” Meadow’s only doctor was sick with influenza, and could not and did not treat the Indians in the area.
    In Alaska, the pandemic swept through communities, killing entire villages of Eskimos and Alaska Natives. A schoolteacher reported that in her immediate area, “Three [villages were] wiped out entirely, others average 85 percent deaths…. Total number of deaths reported 750, probably 25 percent . . . froze to death before help arrived.”
    An Eskimo village near Nome, Alaska was decimated: 176 of 300 died. The disease spread rapidly, and entire families too sick to feed their fires froze to death in their homes. Spit the Wind, a 25-year-old considered Alaska’s greatest musher, died. He had survived a grueling expedition to the North Pole during which he had been forced to eat his snowshoe lacings, before the pandemic caught him.
    Many Eskimos and Alaska Natives were so sick that they were unable to chop wood and harvest moose. Consequently, they died of starvation after the pandemic passed.
    Final tallies will never be known but it was estimated that about 24 percent of the Indians living on reservations across the United States were afflicted by the pandemic. Of those, nine percent died.
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    <HR width="98%" SIZE=1><A id=uh name=uh>Utah State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 24, 2006
    The Red Cross held a fundraiser in Cedar City. The organizers created a goddess of Liberty, and following the statewide practice of wearing masks, also put one on her.
    Similar measures were applied elsewhere. All across the state, church meetings, private parties and all public gatherings were cancelled or limited. Spitting was fined. Facemasks were mandatory.
    Ogden City was placed under quarantine. No one could come in or out without a note from a doctor. In Panguitch (near Brice Canyon), Margaret Callister, a young child at the time, remembered, "Dead people were all around us, three or four to a family." To keep her and her siblings healthy, Margaret's mother put sacks of herbs around their necks.
    In the town of Meadow (south-central Utah), resident Lee Reay remembered:
    "No one had ever seen the germs of the disease. No one knew where the germs were coming from. We only knew the germs were carried by air and had gotten inside our house. We plugged up the keyholes with cotton so air couldn't get in, sealed the doors and the cracks around the doors because we thought the outside air was contaminated. One particular family, I remember, closed up every possible avenue of letting fresh air into the house. They even closed the damper on the stove. They plugged up keyholes on the door, sealed windows and stayed inside, re-breathing their own air."
    When the town's only doctor became sick, Martha Adams, a local healer gave some herbs to William Reay. He stewed the herbs and added other ingredients (including bacon and honey). The "medicine" was bottled and labeled "Influenza Medicine." Reay's son remembered "it wasn't real medicine, of course, but it made people feel better because they thought it was medicine."
    Others tried alcohol. Although Utah was a dry state, health officials allowed doctors to administer it as a preventative.
    Public health measures appeared to have a positive impact in places. For instance, the mandatory wearing of facemasks in Park City (on penalty of arrest) was credited with lessening the impact of the pandemic.
    But people still died. And because of the pandemic, funerals were limited in size. For instance, the service of LDS Church President Joseph Fielding Smith (who died on November 19, 1918) was attended by just a few family members.
    His was just one of many. No one is certain of the final numbers, but thousands of Utahans were afflicted by influenza. Hundreds died.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Utah.
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    <HR width="98%" SIZE=1><A id=vermont name=vermont>Vermont State Summit: History Supplement
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    January 12, 2006
    The Great Pandemic also touched Vermont.
    Vermont was one of the hardest-hit states in New England. The pandemic's arrival was sudden, its spread was rapid, and its toll was shocking.
    It is impossible to say with certainty how many people were touched by the flu. Physicians simply stopped reporting new cases to the Public Health Service when they became overwhelmed with treating the sick. Incomplete records of five weeks when the state was battling the flu show that almost 23,000 Vermonters were struck.
    Those who were fortunate enough to escape the flu were still struck with the tragic experience of watching friends suffer and loved ones die.
    One of those individuals was a man named Frank Eastman. Mr. Eastman worked for a small power company in Montpelier, which would eventually become the Green Mountain Power Corp.
    He described the spread of the disease in a diary that he kept at work. On Friday, September 27, Mr. Eastman wrote that nine members of his crew were sick. The very next day, five more had fallen ill. Deaths began to occur about two weeks later. Mr. Eastman recorded, "Carpenter Wiley died this morning and the switchboard operator this afternoon."
    By the time the pandemic had run its course through Vermont, countless people had been affected. Almost 1,800 people had died.
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    <HR width="98%" SIZE=1><A id=va name=va>Virginia State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 23, 2006
    That Great Pandemic also touched Virginia.
    Navy personnel in Virginia were afflicted with influenza in early September, though the state did not report those cases for about two weeks.
    By the last week of September, the pandemic had taken hold in Newport News and Norfolk, and in Petersburg and Portsmouth. It raged all across Virginia throughout the cruel month of October.
    Virginians did what they could to contain it. Schools were closed. Public meetings and weekend parties were banned. Even the State Fair was closed early on account of the flu.
    Doctors gave succor and support to all the patients they could, although supplies ran short and many were stricken themselves.
    In Alexandria, the town's two doctors visited hundreds of patients a day, dispensing their concocted treatment of atropine capsules (belladonna) and whiskey.
    In Richmond, Dr. Bernard Reams resorted to a treatment that had begun to fall from favor in the 1880s—soaking the legs and feet of his patients in scalding water and then swaddling them in blankets until they were red and sweating.
    Some Virginians resorted to their own home remedies. For instance, John Brinkley, a sharecropper in the town of Max Meadows (western part of the state, about two hours north of Greensboro), believed that "a little fresh air could be fatal." So he sealed his family in his living room around a fire in a wood stove. For seven days the family remained in the room with the fire. On the eighth day, the house caught fire and the Brinkleys were forced to evacuate.
    Fresh air didn't kill Mr. Brinkley's fears. And neither did influenza. But many other Virginians were not so fortunate.
    By mid-October, Virginia had seen more than 200,000 cases of influenza. By the end of the year, more than 15,000 Virginians would die.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Virginia.
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    <HR width="98%" SIZE=1>Washington State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Alex Azar
    Deputy Secretary of Health and Human Services
    April 14, 2006
    On September 27th, 1918, Washington officials first reported the presence of influenza, saying that "a number of cases have been reported in the vicinity of American Lake." This official report came ten days after the pandemic actually appeared in the state, when recruits from Philadelphia arrived at the Puget Sound Naval Yard—eleven of the recruits were ill with the flu.
    On September 23rd, 10,000 people gathered to witness a review of Washington's National Guard Infantry. Though the camp's medical officer acknowledged there was a minor epidemic underway, he insisted there was nothing to worry about. His miscalculation helped enable the flu to spread. By the 25th, influenza was epidemic in Seattle.
    By October 11th, Washington officials reported that "schools have been closed and public gathering prohibited at Seattle, Bremerton, Pasco, Prosser, Sultan, and Port Angeles. On October 7, it was estimated that there were 1,000 cases of influenza at Bremerton." Many of the schools that were closed didn't open until January or March 1919.
    By October 18th, it was concluded that "the disease is epidemic at Seattle and Spokane." And, over that week, "7,349 cases were reported." The following week, 5,322 cases were reported.
    On October 29th, Seattle made wearing masks mandatory, and the rest of the state followed suit the next day.
    In Seattle, the old City Hall and one of the dormitories at the University of Washington became emergency hospitals. Public gatherings were banned, even church attendance. In response to complaints from ministers, the mayor said, "Religion which won't keep for two weeks, is not worth having."
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes again, it will strike in Washington.
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    <HR width="98%" SIZE=1><A id=wvirginia name=wvirginia>West Virginia State Summit: History Supplement
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    January 12, 2006
    The Great Pandemic also touched West Virginia
    Charleston saw its first cases of influenza on September 28th when 7 cases occurred. Over the next five weeks, there were more than 2,300 cases, and more than 200 deaths.
    More cases followed, but they were not recorded. Around the middle of November, Charleston authorities stopped reporting to the U.S. Public Health Service. It's likely that they were simply too overwhelmed.
    The crisis was just as acute in Martinsburg WV (located in the northeast corner of the state). So many people were either sick themselves or were caring for people suffering that a local committee estimated that only two out of every ten people were able to attend to their normal duties.
    Gravediggers could not keep up with the demands for their services in Martinsburg. For several weeks, gravediggers maintained a backlog of at least two-dozen graves, which needed to be dug each day.
    Burials themselves were quick. Funerals were banned, as were all other public meetings, churches were closed and theaters were shut.
    The local Martinsburg newspaper published a list of "Some Don'ts that Should be Followed, Don't Worry, Stop Talking about it, Stop Thinking about it, Avoid People who have it."
    Such Don'ts were hard to do. For instance, a James Horvatt was brought to trial before the Martinsburg-area county court on September 27, 1918 for allegedly forging a $40 check. Horvatt had contracted the flu while in jail waiting his trial, and was very ill from the disease when he appeared in court.
    The disease spread among those who were in the courtroom with him that day. Three lawyers who engaged in proceedings contracted influenza and died within three days after Horvatt's trial was concluded. Three others, the judge, the county clerk and the assistant prosecuting attorney in the Horvatt case, all contracted the disease and came close to death. So did their immediate families.
    It was said that nearly every family lost someone. One family that experienced such a loss was that of an infant who would grow up to become one of the Nation's longest-serving Senators. The mother of Senator Robert Byrd was actually a North Carolinian. She died of influenza when he was just one year old, and an aunt and uncle from West Virginia took him in.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to West Virginia.
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    <HR width="98%" SIZE=1><A id=wi name=wi>Wisconsin State Summit
    Alex M. Azar II, Deputy Secretary
    U.S. Department of Health and Human Services
    March 15, 2006
    Let me tell you a little about how Wisconsin was affected by the 1918 pandemic.
    On October 2nd, 1918, Wisconsin's State Board of Health held a special meeting to discuss the spreading flu. They issued a series of regulations that called for "every physician engaged to treat influenza...to report [this]...to the local health officer."
    In Oshkosh, on October 8th, a newspaper headline stated, "Views of doctors on how to handle grip don't agree. All say situation is serious. Some urge prompt closing and quarantines." By then 103 cases had been reported in the area. Each time a case was reported, an influenza placard was placed on the door of the residence. In accordance with state regulations, no one was supposed to enter except nurses, doctors, or clergymen. The placard read: "Warning! Influenza here. This card must not be removed without authority. Milk dealers must not deliver milk in bottles."
    It wasn't until October 10th that the State's health officer, Cornelius Harper, ordered all public institutions in Wisconsin closed.
    By this time, Neenah had reported its first influenza cases. And the same day, cases in Oshkosh climbed to 163. They reported having a shortage of flowers for funerals. Weeden Drug Company started to advertise for its "Spanish Flu medicines and cures," and the Oshkosh Savings and Trust Company ran several ad campaigns for wills.
    Adolf O. Erickson, a hardware storeowner and Sunday school teacher in Winchester, chronicled the flu in his diary. He wrote that a physician injected eight shots of camphor oil directly into his brother's legs and arms to treat the raging temperatures caused by the flu.
    On October 22nd, a vaccine from Mayo Hospital was distributed in Oshkosh. It was supplied "gratis." Three inoculations, one a week, were recommended over a period of six to nine months to "confer immunity." Many were vaccinated, but, of course, it proved tragically ineffective.
    Four Oshkosh nurses served in the Red Cross—Myrtle Chapman, Nellie Folkman, Clara Barnett, and Lydia Zwicky—graduates of the training school at Mercy Hospital. They were involved in emergency work at Camp Custer that included caring for patients suffering from influenza. Through their work, all four contracted the flu. Only one, Nellie Folkman, survived.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes again, it will strike in Wisconsin.
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    <HR width="98%" SIZE=1><A id=wy name=wy>Wyoming State Summit
    Opening Remarks Prepared for Delivery
    By the Honorable Mike Leavitt
    Secretary of Health and Human Services
    March 10, 2006
    That Great Pandemic also touched Wyoming.
    It is unclear when it first appeared, but by the end of September 1918, it was already raging across the state.
    Communities rallied in response to the epidemic.
    In Sheridan, the women of the Red Cross, who had rolled bandages and knit socks in support of the war effort, began caring for influenza victims. An emergency hospital just for influenza victims was set up in the city, yet 18 people still died.
    In Thermapolis (located in central northwest Wyoming), religious authorities found themselves hard pressed. A Catholic priest there traveled long distances to care for scattered parishioners stricken with influenza. It was not uncommon for him to return after four-day trips and find that some of those in his flock had died and been buried in his absence.
    In Casper, church services were cancelled and funerals were held in the open air. To limit the spread of the disease, everyone was required to wear masks while shopping, and only limited numbers of people were allowed in stores.
    Children sent out of the state for schooling became victims in more ways than one. For instance, Alice Dodds, the daughter of a Wyoming rancher, contracted the flu while at a boarding school in Nebraska. Her teachers could not care for her, for they too had the flu. Instead, Alice's parents came to take her home, and Alice later remembered sitting at the train depot, surrounded by people wearing masks.
    By the time the pandemic finally passed through Wyoming, thousands of people had been afflicted. It was reported that at least 800 had perished.
    When it comes to pandemics, there is no rational basis to believe that the early years of the 21st century will be different than the past. If a pandemic strikes, it will come to Wyoming.
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    http://www.pandemicflu.gov/general/g...demic3.html#ok
    Last edited by Laidback Al; November 17th, 2006, 02:52 PM. Reason: Fixed text and gov link
    "We are in this breathing space before it happens. We do not know how long that breathing space is going to be. But, if we are not all organizing ourselves to get ready and to take action to prepare for a pandemic, then we are squandering an opportunity for our human security"- Dr. David Nabarro

  • #2
    Re: The Great Pandemic of 1918: State by State

    Quote:

    In the town of Paris (located in the southeast corner of the state), resident Russell Clark remembered that the mortality rate was around 50 percent. Clark said, "There was a feeling of depression and sadness because neighbors . . . were passing away."
    The final toll that the pandemic took in Idaho will never be known. But the echoes of suffering and loss remain.

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