Shiloh
Editor, Senior Moderator
Source: http://www.yakima-herald.com/stories/2008/10/17/10-19-08-flu-for-life-in-the-nw
The Spanish flu epidemic -- 90 years later
by Katrina Hindman
Special to the Yakima Herald-Republic
"Nurses are imperatively needed... (Yet) many of the nurses seem
to be unwilling to take
the influenza patients, though there is no more danger
than in handling other patients and this is a war emergency."
-- The Yakima Daily Republic,
Oct. 20, 1918
There is little commemoration of the flu epidemic that swept across America 90 years ago, ultimately spreading worldwide as no disease had ever done.
Commonly referred to by historians as the Spanish flu, the pandemic lasted from 1918 to 1919, spreading as far as the Arctic and remote Pacific islands and claiming young healthy adults as victims. Previous influenza outbreaks predominately affected the young, elderly or otherwise weakened patients.
It's estimated that from 50 million to 100 million people worldwide died from the virus.
In the city of Yakima, a total of 6,000 influenza cases -- or roughly a third of the population -- were reported. That includes 120 fatalities, which accounted for 32 percent of all deaths in Yakima in 1918.
But research also indicates many influenza cases didn't get reported because doctors and nurses were overwhelmed with work.
Historian Alfred Crosby, formerly of Washington State University, investigated this almost forgotten period of history, and ultimately said the virus "killed more humans than any other disease in a period of similar duration in the history of the world."
While a normal flu mortality rate is 0.1 percent, it is believed that from 2 percent to 20 percent of those infected by the influenza virus of 1918 died.
The flu came to Yakima in early October 1918, when residents were hit by the first surge of symptoms.
Warning signs of the virus included a blue tint to the face, coughing up blood, loss of critical intestine lining and uncontrollable hemorrhaging that filled the lungs.
The Yakima Daily Republic reported the first victim was a woman who had been ill for two days before her physician pronounced that, indeed, she had the influenza. She was described as "very ill, her breathing is difficult and she has trouble speaking."
The fear surrounding the flu, already reported elsewhere in the state, had now become a reality.
Schools, churches and movie theaters were ordered closed. The Yakima County health officer, Dr. B.S. Cerswell, and his deputies remained in the office over the Columbus Day holiday weekend, taking a large number of phone calls from people who suspected they had influenza symptoms.
At the same time, health officials continued to reassure community members that the influenza epidemic remained under control.
St. Elizabeth Hospital -- then the only hospital in Yakima County -- initially refused to admit influenza cases.
"We cannot accept patients who have Spanish influenza, on the account of exposing our other patients," the Sister of Providence in charge of the hospital said.
In the early weeks of the pandemic, victims were forced to care for themselves in their homes. Eventually, the rectory of St. Michael's Episcopal Church became a designated emergency influenza hospital.
Bedding and other equipment for the makeshift hospital was donated by other churches or bought by the hospital.
To overcome the panic and alarm felt by hospitals, Health Officer Cerswell offered this statement to nurses in the Oct. 26 issue of The Yakima Daily Republic: "(Although) many of the nurses seem to be unwilling to take the influenza patients, there is no more danger than in handling other patients."
Almost immediately, St. Elizabeth opened its doors to influenza cases, and encountered overwhelming numbers of patients struck by the flu.
On Oct. 28, Yakima County Commissioner Thomas McNair requested that "all department store proprietors postpone their bargain sales that would certainly attract crowds." Warehouse operators were asked heat their buildings so that workers would not be chilled.
By the end of October, the number of cases reported in the city of Yakima totaled 341. Dr. Cerswell estimated the number to be at least five times higher because many light cases weren't reported to the Health Office. The Yakima Daily Republic reported, "Doctors have been so rushed in the last few days that they are unable to send in the cards with names of patients."
The lack of adequate documentation from doctors affected the ability of the Health Office's stenographers to accurately record and send reports to the state.
Physicians advised patients to become inoculated with a anti-influenza/anti-pneumonia serum, given in three doses 48 hours apart. The serum was considered at least partially preventative against influenza and lessened the dangers of the pneumonia.
People between the ages of 16 and 45, considered the most susceptible to the virus, were urged to receive the vaccination first. Children had been regarded as the least susceptible to the disease.
The deputy county health officer, W.B. Abbott, advised people with influenza symptoms "to go to bed, get between warm woolen blankets, have plenty of fresh air, avoid drafts and stay there until you are well." Abbott believed that if people would take those practical precautions, there would not be one death out of 10,000. If the illness had developed into a serious condition, then he advised that they seek medical attention.
In early November 1918, Dr. Cerswell made the rounds of the local drug stores to inspect the gauze masks they sold. He found the masks to be inadequate because they only had strings at the top, which left the lower edge loose. "For the masks to be any good they must be tied at all four corners," he said.
The makers of the masks immediately agreed to develop them according to Cerswell's instruction.
Residents of Yakima followed the city regulations that required them to wear masks during business hours. One man questioned such authority by refusing to wear a mask while doing his banking. But when he approached his accustomed banking window, the teller would not accept his deposit. The man threatened to take the matter to courts, but later thought better of it.
At the county courthouse, employees of auditor's office were required to moisten their gauze masks in an antiseptic "dip" every two hours. The solution was kept at boiling point to keep the dipping process sanitary.
The urgent need for medical help in private homes became increasingly evident in Yakima as many families with influenza could no longer care for themselves.
Mrs. G.E. Marcy called for help saying, "Many people who need assistance are not seriously ill ... any women who can wait on sick people (and) prepare food can do the job."
Physicians remained busy, although the flu caseload had noticeably lightened in the city as November began. But the impact of the virus in rural areas became increasingly difficult to track. As a result, rural residents became progressively more handicapped in the fight against influenza.
Margaret Cassidy, the county tuberculosis nurse, volunteered her services in the rural districts where people were unable to get a doctor or nurse. She made calls, gave advice and did what she could to look after the needs of people living in the country. However, her transportation was limited and much of her time was wasted walking and waiting for street cars, she complained by mid-November.
The Yakima Daily Republic carried descriptions of the situation in the rural districts. A Nov. 5 account stated that Japanese residents were especially susceptible to influenza. A Japanese patient living on the Yakama reservation had repeatedly called one of the city's physicians, but that doctor refused to leave his patients in Yakima. When the doctor finally relented and made the house call, he found the patient had died.
But while there, the doctor treated six other Japanese residents and another 23 workers with the preventative serum.
In an open statement to the public in late October, Cerswell declared the height of the epidemic had passed in the city of Yakima.
But as November began, the state of Washington adopted a set of influenza rules that were enacted Nov. 5 in Yakima with an order signed by Mayor Forrest H. Sweet and Cerswell.
The regulations required that "gauze masks of dimensions of not less than 5 inches by 6 inches composed of not less than six layers of surgical gauze ... entirely cover the mouth and nose."
Yakima residents were required to wear the masks while at the following venues: public transportation, buildings, stores, restaurants, offices, places where food was to be prepared, barber shops, cleaning establishments, public gatherings, and pool and card rooms. A violation could result in fine of $5 to $100.
In early December, Yakima residents again became unsettled by a second wave of influenza, but this time it varied in several aspects.
While the first wave rarely attacked children and saw many of the severe cases develop into pneumonia, the second wave showed school children were no longer immune, although they rarely developed pneumonia.
Cerswell and city commissioners believed the serum accounted for the influenza not developing into pneumonia. There were still serious impacts, however: After the first week, 1,200 youngsters remained out of school.
Many more people were afflicted during the second wave, but only a quarter of the number of deaths were recorded.
On Dec. 18, The Yakima Daily Republic reported that the second wave of influenza had reached its peak.
There's no real way to know the cost to the community, or its people, of the influenza that struck Yakima from October through December 1918.
When it appeared that the flu had reached its peak in the city and the number of reported cases began to decrease, the virus had just begun to pick up in the rural districts -- and one of the first victims of the spreading epidemic was accurate record-keeping. Doctors and nurses were overwhelmed as at least a third of the city and county's population was afflicted by the disease.
The Spanish flu epidemic -- 90 years later
by Katrina Hindman
Special to the Yakima Herald-Republic
"Nurses are imperatively needed... (Yet) many of the nurses seem
to be unwilling to take
the influenza patients, though there is no more danger
than in handling other patients and this is a war emergency."
-- The Yakima Daily Republic,
Oct. 20, 1918
There is little commemoration of the flu epidemic that swept across America 90 years ago, ultimately spreading worldwide as no disease had ever done.
Commonly referred to by historians as the Spanish flu, the pandemic lasted from 1918 to 1919, spreading as far as the Arctic and remote Pacific islands and claiming young healthy adults as victims. Previous influenza outbreaks predominately affected the young, elderly or otherwise weakened patients.
It's estimated that from 50 million to 100 million people worldwide died from the virus.
In the city of Yakima, a total of 6,000 influenza cases -- or roughly a third of the population -- were reported. That includes 120 fatalities, which accounted for 32 percent of all deaths in Yakima in 1918.
But research also indicates many influenza cases didn't get reported because doctors and nurses were overwhelmed with work.
Historian Alfred Crosby, formerly of Washington State University, investigated this almost forgotten period of history, and ultimately said the virus "killed more humans than any other disease in a period of similar duration in the history of the world."
While a normal flu mortality rate is 0.1 percent, it is believed that from 2 percent to 20 percent of those infected by the influenza virus of 1918 died.
The flu came to Yakima in early October 1918, when residents were hit by the first surge of symptoms.
Warning signs of the virus included a blue tint to the face, coughing up blood, loss of critical intestine lining and uncontrollable hemorrhaging that filled the lungs.
The Yakima Daily Republic reported the first victim was a woman who had been ill for two days before her physician pronounced that, indeed, she had the influenza. She was described as "very ill, her breathing is difficult and she has trouble speaking."
The fear surrounding the flu, already reported elsewhere in the state, had now become a reality.
Schools, churches and movie theaters were ordered closed. The Yakima County health officer, Dr. B.S. Cerswell, and his deputies remained in the office over the Columbus Day holiday weekend, taking a large number of phone calls from people who suspected they had influenza symptoms.
At the same time, health officials continued to reassure community members that the influenza epidemic remained under control.
St. Elizabeth Hospital -- then the only hospital in Yakima County -- initially refused to admit influenza cases.
"We cannot accept patients who have Spanish influenza, on the account of exposing our other patients," the Sister of Providence in charge of the hospital said.
In the early weeks of the pandemic, victims were forced to care for themselves in their homes. Eventually, the rectory of St. Michael's Episcopal Church became a designated emergency influenza hospital.
Bedding and other equipment for the makeshift hospital was donated by other churches or bought by the hospital.
To overcome the panic and alarm felt by hospitals, Health Officer Cerswell offered this statement to nurses in the Oct. 26 issue of The Yakima Daily Republic: "(Although) many of the nurses seem to be unwilling to take the influenza patients, there is no more danger than in handling other patients."
Almost immediately, St. Elizabeth opened its doors to influenza cases, and encountered overwhelming numbers of patients struck by the flu.
On Oct. 28, Yakima County Commissioner Thomas McNair requested that "all department store proprietors postpone their bargain sales that would certainly attract crowds." Warehouse operators were asked heat their buildings so that workers would not be chilled.
By the end of October, the number of cases reported in the city of Yakima totaled 341. Dr. Cerswell estimated the number to be at least five times higher because many light cases weren't reported to the Health Office. The Yakima Daily Republic reported, "Doctors have been so rushed in the last few days that they are unable to send in the cards with names of patients."
The lack of adequate documentation from doctors affected the ability of the Health Office's stenographers to accurately record and send reports to the state.
Physicians advised patients to become inoculated with a anti-influenza/anti-pneumonia serum, given in three doses 48 hours apart. The serum was considered at least partially preventative against influenza and lessened the dangers of the pneumonia.
People between the ages of 16 and 45, considered the most susceptible to the virus, were urged to receive the vaccination first. Children had been regarded as the least susceptible to the disease.
The deputy county health officer, W.B. Abbott, advised people with influenza symptoms "to go to bed, get between warm woolen blankets, have plenty of fresh air, avoid drafts and stay there until you are well." Abbott believed that if people would take those practical precautions, there would not be one death out of 10,000. If the illness had developed into a serious condition, then he advised that they seek medical attention.
In early November 1918, Dr. Cerswell made the rounds of the local drug stores to inspect the gauze masks they sold. He found the masks to be inadequate because they only had strings at the top, which left the lower edge loose. "For the masks to be any good they must be tied at all four corners," he said.
The makers of the masks immediately agreed to develop them according to Cerswell's instruction.
Residents of Yakima followed the city regulations that required them to wear masks during business hours. One man questioned such authority by refusing to wear a mask while doing his banking. But when he approached his accustomed banking window, the teller would not accept his deposit. The man threatened to take the matter to courts, but later thought better of it.
At the county courthouse, employees of auditor's office were required to moisten their gauze masks in an antiseptic "dip" every two hours. The solution was kept at boiling point to keep the dipping process sanitary.
The urgent need for medical help in private homes became increasingly evident in Yakima as many families with influenza could no longer care for themselves.
Mrs. G.E. Marcy called for help saying, "Many people who need assistance are not seriously ill ... any women who can wait on sick people (and) prepare food can do the job."
Physicians remained busy, although the flu caseload had noticeably lightened in the city as November began. But the impact of the virus in rural areas became increasingly difficult to track. As a result, rural residents became progressively more handicapped in the fight against influenza.
Margaret Cassidy, the county tuberculosis nurse, volunteered her services in the rural districts where people were unable to get a doctor or nurse. She made calls, gave advice and did what she could to look after the needs of people living in the country. However, her transportation was limited and much of her time was wasted walking and waiting for street cars, she complained by mid-November.
The Yakima Daily Republic carried descriptions of the situation in the rural districts. A Nov. 5 account stated that Japanese residents were especially susceptible to influenza. A Japanese patient living on the Yakama reservation had repeatedly called one of the city's physicians, but that doctor refused to leave his patients in Yakima. When the doctor finally relented and made the house call, he found the patient had died.
But while there, the doctor treated six other Japanese residents and another 23 workers with the preventative serum.
In an open statement to the public in late October, Cerswell declared the height of the epidemic had passed in the city of Yakima.
But as November began, the state of Washington adopted a set of influenza rules that were enacted Nov. 5 in Yakima with an order signed by Mayor Forrest H. Sweet and Cerswell.
The regulations required that "gauze masks of dimensions of not less than 5 inches by 6 inches composed of not less than six layers of surgical gauze ... entirely cover the mouth and nose."
Yakima residents were required to wear the masks while at the following venues: public transportation, buildings, stores, restaurants, offices, places where food was to be prepared, barber shops, cleaning establishments, public gatherings, and pool and card rooms. A violation could result in fine of $5 to $100.
In early December, Yakima residents again became unsettled by a second wave of influenza, but this time it varied in several aspects.
While the first wave rarely attacked children and saw many of the severe cases develop into pneumonia, the second wave showed school children were no longer immune, although they rarely developed pneumonia.
Cerswell and city commissioners believed the serum accounted for the influenza not developing into pneumonia. There were still serious impacts, however: After the first week, 1,200 youngsters remained out of school.
Many more people were afflicted during the second wave, but only a quarter of the number of deaths were recorded.
On Dec. 18, The Yakima Daily Republic reported that the second wave of influenza had reached its peak.
There's no real way to know the cost to the community, or its people, of the influenza that struck Yakima from October through December 1918.
When it appeared that the flu had reached its peak in the city and the number of reported cases began to decrease, the virus had just begun to pick up in the rural districts -- and one of the first victims of the spreading epidemic was accurate record-keeping. Doctors and nurses were overwhelmed as at least a third of the city and county's population was afflicted by the disease.