Just over 100 years ago a virulent form of influenza ravaged most of the world. It was mistakenly labelled the Spanish Flu because the first major outbreak occurred in Spain. However, there had been sporadic cases in many countries, including here in the United States. Although medical knowledge and treatment options were severely limited in 1918, the parallels between these two outbreaks are striking.
In 1918, Danbury was experiencing rapid growth due to immigration, thanks to the large number of employment opportunities within the hatting industry. The population of the city was about 25,000. It was common to have a dozen or more factory workers and their family members living in one small apartment, especially when the factories were humming at full strength.
The great influenza pandemic hit New York and Connecticut in September 1918. Headlines and articles from the Danbury News for that month showed the beginning of what was in store for Danbury.
9/1 The site of “ground zero” for New England was Camp Devens in Massachusetts. It was reported that the hospital at Camp Devens had 1,200 beds; 84 of them were occupied by influenza patients.
9/23 An increasing number of influenza cases being were starting to emerge across Connecticut.
9/24 Influenza reached epidemic stage in Norwalk with 18-20 new cases per day. Norwalk Hospital was overflowing, and additional doctors and nurses proved to be a scarce commodity.
9/25 The Army put out a call for nurses, stating it would need 50,000 nurses by July 1919 if the pandemic were to continue.
9/26 The rampant spread of the influenza virus resulted in about 1,500 new cases in Camp Devens in just one day. At that point there was an average of 100 deaths per day, in Camp Devens alone. At that same time, trials of a new influenza vaccine began in Boston.
9/28 The City of Danbury ordered the cancellation of all celebrations until further notice. Congress authorized $1 million in aid for the fight against influenza. (This equates to $18,757,226.26 in 2020 dollars.)
The worst was yet to come as October 1918 would prove to be one of the deadliest and most difficult months in the history of Danbury.
To learn more about Danbury in 1918, including our home front efforts during WWI, please click here!
10/1 The spread of influenza in other areas was being closely monitored. A lack of adequate knowledge on the spread, coupled with a lingering lack of urgency dampened any thoughts of taking action.
October was, once again, Fair Month in Danbury. The Fair was due to open on October 7th and was advertised as being the biggest and best of all Fairs as it would celebrate the 50th anniversary of the Great Danbury Fair.
The Connecticut Health Department claimed that only 1 in 100 cases would be fatal. This also fed the complacency in town.
News from Camp Devens was deplorable. The base hospital had 1,200 beds and they were all filled with overflow. Reportedly there were 1,500 new cases daily in the various Army camps on the east coast, with an average of 100 deaths per day. (By the end of 1918, there would be more American soldiers dead in World War One from the influenza than from all other causes combined.)
There have been reported a scattering of cases in Danbury, but no reported deaths as yet. The first advertisements for patent medicines for the influenza began to appear.
10/2 Trials of a possible vaccine to stop the spread of influenza begin in Boston. The New York City health department warns that the vaccine will not cure the influenza but might provide an easing of the numbers infected. Danbury Hospital is now receiving emergency transfers from other parts of the state. A drive is begun to collect canned good for Danbury Hospital to help feed the sudden influx of patients.
10/3 Influenza continued to spread across New England and unchecked. Meriden was heavily affected. A family of six on Grand Street in Danbury are sick with pneumonia. Their son died in the Merchant Marine Hospital in Boston from influenza. His body was returned to Danbury for burial.
The first 3 deaths are noted in Danbury which were probably due to influenza.
10/4 Norwalk reporting more than 30 new cases of influenza in the past 24 hours. Influenza is now affecting 43 of the 48 states, with the East Coast being hardest hit.
The City of Danbury ordered all public schools closed and private schools followed their lead. Questions began to be raised about the safety of having the Fair. No firm decision was made yet.
10/5 Influenza was spreading through the greater Danbury region. Discussion in Washington, DC, to enact a nationwide closure. The mandate was lifted when no effective means of enforcement were found. Connecticut had refused to follow this Federal mandate.
Norwalk reported over 40 new cases in the previous 24 hours. Norwalk Hospital was completely overwhelmed and other sources for hospitalization were being sought. The Mayor and city council in Norwalk began efforts to close down the city.
All saloons in Boston were ordered closed.
A decision was made to cancel the 1918 Great Danbury Fair.
10/7 The influenza pandemic breaks out in Danbury. The City reports 340 new cases over the weekend. Death count remains low at this point (only 11 deaths in October so far).
Bethel and New Fairfield close their schools.
10/8 The local newspapers reported that there had been 35 deaths in September in Danbury, of which only 7 were probably due to influenza. There had thus far been 11 deaths due to influenza in the first week of October.
10/9 The State Health Department reported more than 30,000 cases of influenza in the state, primarily since the beginning of the month.
The State Adjutant General established new guidelines for military funerals. With so many soldiers dying from influenza and being returned to Connecticut for burial, any military person attending to a funeral was advised to keep “safe distance” from family members.
10/10 The State Health Department said that all doctors and nurses should be wearing face masks when around patients. It was clear that influenza could spread from close contact as well as from coughing or sneezing.
The outbreak of influenza began to peak by October 15. On that day, Danbury’s Public Health Director noted that there had been 124 new cases over the previous weekend and that the current total in the city was 1,274 cases. New York City was reporting over 650 deaths each day. In Danbury, the monthly total now stood at 33 influenza deaths.
10/16 The first appeals from Danbury Hospital began. They were near capacity and in need of more nurses to assist in the care of the patients. Although there were fewer new cases reported in the previous 24 hours (60 cases) the overall effect on the city remained serious. The total cases exceeded 1,300. Influenza was now at epidemic proportions throughout the country.
By Friday, October 18, the hospital was averaging a census of 60-70 inpatients with 8-10 new admissions each day. The hospital had 32 beds in the men’s wing and 36 beds in the women’s wing—all of them occupied. In addition to the call for more nurses, the hospital was seeking additional help in all departments. Men and women were especially needed for kitchen, housekeeping, and maintenance duties. The monthly death toll from influenza in Danbury stood at 41.
On Monday, October 21, the Danbury News cited a statewide shortage of doctors and nurses. Several conventions in Connecticut had been canceled and the schools and theaters remained shuttered. October’s death count had grown to 56; 113 additional cases of influenza reported in Danbury brought the total to more than 1,400.
The needs of the Army coupled with the spread of influenza among farm workers meant a significant food shortage in the stores along with 25-30% price increases for food. With WWI continuing it was pointed out that higher prices for food would probably persist.
The Governor decreed that all retail stores must close no later than 9 PM until January 2nd. There was another canned food drive for the hospital with 1,500 cans being collected. It was also reported that a student nurse at the hospital had died from influenza.
The supply of coal was also down due to the epidemic affecting a large number of miners, especially in Pennsylvania and West Virginia.
As influenza began to reach its peak in Danbury, plans were developed to convert the Children’s Home on Town Hill into an emergency hospital.
On October 23, the newly developed emergency hospital admitted its first patients. The daily total of new cases continued at about 120 per day. To date there had been 63 reported deaths in Danbury due to influenza. By Saturday, October 26, the epidemic seemed to have plateaued; there were fewer than 50 new cases reported daily. The total cases stood at 2,087 for October. This represented about 10% of the population of Danbury at that time.
The Town Clerk reported that the city had surpassed its previous high number of deaths in a month. There had been 103 deaths up to the 10/25, 73 of them due to influenza. In an average month there would be fewer than 15 deaths reported for all causes.
The weekly update from the City Health Department on Monday, October 28, showed about 40 new cases per day. The monthly death total stood at 121, with 95 due to influenza. The final number for October ended up at 132 deaths, 105 due to influenza.
For the month of October, Wooster Cemetery recorded 55 burials with a 6 burials taking place on one day. This was a record number. (The previous record was 33 burials in one month in 1916 due to an outbreak of polio.)
In October there were 54 ambulance calls. This is remarkable in that there was only one ambulance in the city at that time.
Schools and theaters reopened on Monday, November 11. Children under the age of 16 were not permitted in theaters. Schools had been closed for a total of 5 weeks.
Influenza continued to flare up in the region for 3 more months. Deaths due to influenza were 22 in November, 26 in December, and 22 in January 1919.
There would eventually be another flare-up of influenza in the winter of 1919-20. In February and March of 1920 there were a total of 47 influenza deaths.
The State Health Department reported around 8,450 deaths from influenza in 1918, with over 45% of the deaths occurring in young adults, aged 25 to 39. There were over 108,000 cases reported during 1918.
The horrific scale of the 1918 influenza pandemic—known as the "Spanish flu"—is hard to fathom. The virus infected 500 million people worldwide and killed an estimated 20 million to 50 million victims— that’s more than all of the soldiers and civilians killed during World War I combined.
While the global pandemic lasted for two years, the vast majority of deaths were packed into three especially cruel months in the fall of 1918. Historians now believe that the fatal severity of the flu’s “second wave” was caused by a mutated virus spread by wartime troop movements.
When the Spanish flu first appeared in early March 1918, it had all the hallmarks of a seasonal flu, albeit a highly contagious and virulent strain. One of the first registered cases was Albert Gitchell, a U.S. Army cook at Camp Funston in Kansas, who was hospitalized with a 104-degree fever. The virus spread quickly through the Army installation, home to 54,000 troops. By the end of the month, 1,100 troops had been hospitalized and 38 had died after developing pneumonia.
As U.S. troops deployed en masse for the war effort in Europe, they carried the flu with them. Throughout April and May of 1918, the virus spread like wildfire through England, France, Spain, and Italy. An estimated three-quarters of the French military was infected in the spring of 1918 and as many as half of British troops. Luckily, the first wave of the virus wasn’t particularly deadly, with symptoms like high fever and malaise usually lasting only three days, and mortality rates were similar to seasonal flu.
Interestingly, it was during this time that the flu earned its misnomer. Spain was neutral during World War I and unlike its European neighbors, it didn’t impose wartime censorship on its press. In France, England, and the United States, newspapers weren’t allowed to report on anything that could harm the war effort, including news that a crippling virus was sweeping through troops. Since Spanish journalists were some of the only ones reporting on a widespread flu outbreak in the spring of 1918, the pandemic became known as the “Spanish flu.”
Reported cases of influenza dropped off over the summer of 1918, and there was hope at the beginning of August that the virus had run its course. In retrospect, it was the calm before the storm. Somewhere in Europe, a mutated strain of the Spanish flu virus had emerged that had the power to kill a perfectly healthy young man or woman within 24 hours of showing the first signs of infection.
In late August 1918, military ships departed the English port city of Plymouth carrying troops unknowingly infected with this new, far deadlier strain of Spanish flu. As these ships arrived in cities like Brest in France, Boston in the United States and Freetown in west Africa, the second wave of the global pandemic began.
“The rapid movement of soldiers around the globe was a major spreader of the disease,” says James Harris, a historian at Ohio State University who studies both infectious disease and World War I. “The entire military industrial complex of moving lots of men and material in crowded conditions was certainly a huge contributing factor in the ways the pandemic spread.”
From September through November of 1918, the death rate from the Spanish flu skyrocketed. In the United States alone, 195,000 Americans died from the Spanish flu in just the month of October. And unlike a normal seasonal flu, which mostly claims victims among the very young and very old, the second wave of the Spanish flu exhibited what’s called a “W curve”—high numbers of deaths among the young and old, but also a huge spike in the middle composed of otherwise healthy 25- to 35-year-olds in the prime of their life.
“That really freaked out the medical establishment, that there was this atypical spike in the middle of the W,” says Harris.
Not only was it shocking that healthy young men and women were dying by the millions worldwide, but it was also how they were dying. Struck with blistering fevers, nasal hemorrhaging and pneumonia, the patients would drown in their own fluid-filled lungs.
Only decades later were scientists able explain the phenomenon now known as “cytokine explosion.” When the human body is being attacked by a virus, the immune system sends messenger proteins called cytokines to promote helpful inflammation. But some strains of the flu, particularly the H1N1 strain responsible for the Spanish flu outbreak, can trigger a dangerous immune overreaction in healthy individuals. In those cases, the body is overloaded with cytokines leading to severe inflammation and the fatal buildup of fluid in the lungs.
British military doctors conducting autopsies on soldiers killed by this second wave of the Spanish flu described the heavy damage to the lungs as akin to the effects of chemical warfare.
Harris believes that the rapid spread of Spanish flu in the fall of 1918 was at least partially to blame on public health officials unwilling to impose quarantines during wartime. In Britain, for example, a government official named Arthur Newsholme knew full well that a strict civilian lockdown was the best way to fight the spread of the highly contagious disease. But he wouldn’t risk crippling the war effort by keeping munitions factory workers and other civilians home.
According to Harris’s research, Newsholme concluded that “the relentless needs of warfare justified incurring [the] risk of spreading infection” and encouraged Britons to simply “carry on” during the pandemic.
The public health response to the crisis in the United States was further hampered by a severe nursing shortage as thousands of nurses had been deployed to military camps and the front lines. The shortage was worsened by the American Red Cross’s refusal to use trained African American nurses until the worst of the pandemic had already passed.
But one of the chief reasons that the Spanish flu claimed so many lives in 1918 was that science simply didn’t have the tools to develop a vaccine for the virus. Microscopes couldn’t even see something as incredibly small as a virus until the 1930s. Instead, top medical professionals in 1918 were convinced that the flu was caused by a bacterium nicknamed “Pfeiffer’s bacillus.”
After a global flu outbreak in 1890, a German physician named Richard Pfeiffer found that all of his infected patients carried a particular strain of bacteria he called H. influenzae. When the Spanish flu pandemic hit, scientists were intent on finding a cure for Pfeiffer’s bacillus. Millions of dollars were invested in state-of-the-art labs to develop techniques for testing for and treating H. influenzae, all of it for naught.
“This was a huge distraction for medical science,” says Harris.
By December 1918, the deadly second wave of the Spanish flu had finally passed, but the pandemic was far from over. A third wave erupted in Australia in January 1919 and eventually worked its way back to Europe and the United States. It’s believed that President Woodrow Wilson contracted the Spanish flu during the World War I peace negotiations in Paris in April 1919.
The mortality rate of the third wave was just as high as the second wave, but the end of the war in November 1918 removed the conditions that allowed the disease to spread so far and so quickly. Global deaths from the third wave, while still in the millions, paled in comparison to the apocalyptic losses during the second wave.
A special thank you to Robert Young for compiling much of the 1918 Influenza/Global Pandemic research.