Produced by the University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan Library

Influenza Encyclopedia

The American Influenza Epidemic of 1918-1919:

A Digital Encyclopedia


Pittsburgh, Pennsylvania

50 U.S. Cities & Their Stories

On October 1, the Pittsburgh Gazette-Times reported the city’s first case of “the so-called Spanish disease” – influenza. The paper noted, however that every section of Pittsburgh had experienced “incipient grip” already.1 Like many across the nation, Pittsburghers simply dismissed milder cases of the disease as unimportant. Few were alarmed. They should have been.

On the other side of the state, influenza was already causing a great deal of alarm. On the same day that Pittsburgh reported its case, the Philadelphia Health Department reported a staggering 635 civilian cases in 24 hours.2 In Harrisburg, Pennsylvania’s Acting Commissioner of Health, Dr. Benjamin Franklin Royer, scrambled to organize the state’s efforts to combat influenza. On October 3, he issued a statewide closure order for saloons, theaters, movie houses, and other places of amusement, and a ban on all public meetings and other gatherings. Public funerals, parades, and visits to the sick were included in the order, but Royer left the issue of closing schools and churches up to local authorities.3

Two hundred miles west, Pittsburghers had a difficult time accepting Royer’s orders given that there were so few cases of influenza in the city. Nevertheless, officials acted. Faced thus far with only news reports of Royer’s order, Pittsburgh’s Mayor Edward Vose Babcock, Director of the Department of Health Dr. W. H. Davis, and Superintendent of Schools William M. Davidson hurriedly met to discuss what to do. The men quickly decided that, as the official order likely would be received in the morning, the city would begin carrying out Royer’s directive immediately, though they the issue of closing schools and churches for the time being.4 Davis reminded physicians that influenza became a reportable disease in Pennsylvania on September 21.5

The next day, Friday, October 4, health and other city officials gathered again for a full day meeting to discuss further Pittsburgh’s response to influenza. Health Director Davis ordered hospitals to end all unnecessary visitations, and requested that they provide a report on available beds in their wards. Churches, while not closed, were asked to limit attendance, to exclude parishioners exhibiting symptoms of illness, and to keep services as brief as possible. Doctors were instructed to report all cases of influenza to the city’s health department. Schools were kept open for the time being, but night school enrollment and classes were halted because they did not have medical inspectors; some 15,000 night school students were affected. Mayor Babcock thought that the measures went too far. “Personally, it appears to me,” he told reporters, “in view of local conditions and in the absence of any epidemic of influenza, that the orders of the [state] Department are too drastic.”6 Nonetheless, there was little Pittsburgh could do other than to follow Royer’s directives.

Within a few days, Pittsburgh had hundreds of cases of influenza. Suddenly in the midst of a rapidly growing epidemic, Director Davis met with the superintendents of all city hospitals to appoint a special Emergency Committee to plan for the creation of temporary hospitals to handle the volume of influenza patients. Davis buttressed his decision to keep schools open by fortifying medical staff in the public school system with 32 new doctors to monitor students closely for symptoms of influenza.7 Churches were not so lucky. Initially allowed to remain open, Davis now ordered churches closed for regular service, although they could remain open during the week for private worship. Jury trials were suspended. Elevator capacity was limited to six passengers. These measures were met with nary a word of grumbling. Such was not the case when Royer banned the sale of liquor by any outlet other than a drug store, and then only with a doctor’s prescription. Liquor associations immediately complained to Davis, who simply read Royer’s order to them and demanded their compliance.8

By Thursday, October 10, when more than 1,300 Pittsburghers had the flu, the Emergency Committee proposed devoting Pittsburgh’s hospitals to the care of the poor as well as any stricken industrial workers or miners living in the city’s over-crowded boarding houses and private homes. To further take the strain off hospitals, the Committee asked all those capable of caring for the sick at home do so. The next day, the Emergency Committee started gathering resources for the first of several temporary hospitals, identifying Kingsley Settlement House at 1707 Penn Avenue as the site of a 130-bed emergency facility.9 Next, the Committee readied a building on the Washington Park playground for a 200-bed hospital and made contingency plans for a canvas hospital close by with another 300 beds.10

Numerous military cases exacerbated the problem of hospital space. To help alleviate the problem, officials at the Elizabeth Steel Magee Memorial Hospital temporarily donated their facility for the care of sick soldiers and student cadets. Quickly, the hospital filled with 260 military cases, with an additional 160 sick soldiers sent to several other area hospitals. Major W. E. Day, a United States Army Medical Corps officer in charge of the quarantines of student cadets at the University of Pittsburgh and the Carnegie Institute of Technology, arranged for 80 more beds at West Penn Hospital, despite being ill himself. He also ordered tents from Harrisburg to be used as a temporary convalescent hospital.11 One physician later reported that Day’s unflagging work during the epidemic resulted in keeping influenza among Pittsburgh’s military personnel within reasonable bounds.12

Influenza continued to tighten its grip on Pittsburgh. On October 16, more than 800 new cases appeared, bringing the total in the city to 4,445.13 A few days later, that total jumped to nearly 7,500. Davis believed that official reports were only capturing about half of the true number of cases. As the situation grew worse, Pittsburgh’s civic and charitable organizations further stepped up their efforts. The local chapter of the Red Cross renewed its efforts to recruit nurses, sending a total of 70 graduate nurses, 40 practical nurses, and 172 aides and helpers to emergency hospitals throughout the county, where they cared for close to 3,000 patients. At the same time, these workers managed more than 12,000 homebound influenza cases.14 To help staff hospitals and help the sick at home, more than 600 members of the Mothers of Democracy organized themselves into volunteer brigades.15 Davis asked city churches to help the Mothers of Democracy by organizing parishioners to engage in home service to aid stricken families.16 On October 26, Roman Catholic Bishop Regis Canevin placed all local resources of the church at the disposal of the health department. At his direction, the Catholic Conference of Charities established relief stations on church property in all 27 of the city’s wards, staffed by teaching nuns who also visited parishioners’ homes to provide home nursing services.17 The sisters at St. Vincent’s Hill and St. Mary’s Lyceum offered their buildings as temporary orphanages.18 The Beechview Moose Lodge donated its clubhouse, and the Twelfth Ward Hunting and Fishing Club volunteered its tents to the Department of Health to use as emergency hospitals.19 The Irene Kaufmann Settlement shouldered responsibility for all nursing service in the Hill District, home to most of Pittsburgh’s Easter European Jews. The Free Burial Association provided poor Jews with burial according to Jewish rites, with shrouds, coffins, hearses, and burial plots free of charge.20 All across the city, volunteers did their best to keep up with the rising tide of cases and the growing cries for help.

Meanwhile, school illness and absenteeism had become a problem, at least as anecdotally recounted by teachers and principals. Superintendent William Davidson estimated that attendance was at 75 percent of normal levels, while Director of School Hygiene Dr. H. B. Burns said that as many as 1,000 students were sick with influenza. To determine the true extent of the illness in Pittsburgh’s schools, City Council member Enoch Rauh pushed through a resolution on October 21 requesting a tally of attendance at the city’s public, parochial, and private schools. The next day, Davidson and Davis presented their findings to the Board of Public Education. Attendance, they found, was down thirty percent from normal levels, meaning some students were 27,000 absent. Of this number, 6,070 – only eight percent of the total student population – had influenza, while the others were absent for other illnesses or because their parents were worried. Fifty-three students and two teachers had died from influenza or pneumonia. Burns informed the Board that, “school, for the five hours that children spend there, is the best possible places for them in the course of this epidemic. He added that medical inspection in Pittsburgh’s schools was amongst the best in the nation. Based on the data and Burns’ opinion, the school board voted to make no move to close public schools.21

On October 23, Davis met with Davidson, Burns, and his bureau heads to discuss the school situation further. The data clearly indicated that the vast majority of student absences were not due to influenza, at least directly. Still, it was abundantly clear that absenteeism had become a significant problem. With nearly forty percent of children out of the classroom (ten percent absenteeism was within normal limits), the chief reason for keeping schools open – medical inspection – was no longer relevant. Davis expected absenteeism due to fear to increase in the coming days. “Under these circumstances,” he announced, “it is not possible to maintain through the schools the medical supervision that would have been possible had the attendance remained standard.” The next day, October 24, Davis ordered Pittsburgh’s public, private, and parochial schools closed, and instructed parents to keep their children at home and off of the city’s streetcars, streets, and playgrounds.22

City Versus State

By late-October, Pittsburgh residents were starting to get anxious over when the closure orders and gathering ban might be lifted. Saloon owners and wholesale liquor distributors were particularly eager to have state Health Commissioner Royer rescind his orders. On several occasions, Pittsburgh’s liquor concerns sent delegations to Harrisburg to take the matter up with Royer. In each instance they met without success.23 Mayor Babcock then took up the cause. His first tactic involved asking Commissioner Royer to give local health boards autonomy as local conditions warranted, or to at least set a date for when bans might be lifted. Royer tersely responded that removing bans at this time would be criminal. He softened the harsh terms of his telegram, however, by inviting Babcock to Harrisburg for a face-to-face meeting.24

The meeting was productive. Although Babcock failed in his attempt to have the bans lifted immediately, Royer offered hope they would be lifted in Allegheny County shortly so long as the infection rate continued to decline. Furthermore, Royer dispatched Dr. Wilmer R. Batt, the state’s vital statistics registrar, to assess Pittsburgh’s epidemic situation. A few days later, Batt reported that Pittsburgh’s influenza epidemic was indeed on the decline.25 Taking Batt’s report into consideration, on November 1 Royer announced that Pittsburgh might be allowed to reopen its places of amusement as early as November 4.26 Residents, and especially affected business owners, sighed in collective relief.

Overnight, Pittsburgh’s great expectations were dashed when Royer abruptly announced that Pittsburgh would not be allowed to reopen until November 9. Mayor Babcock was furious. He called the city solicitor and the rest of his cabinet into conference to discuss the city’s options. Emerging from the meeting, Babcock announced that Pittsburgh hereby would return to normal business. Although technically the Mayor did not have the power to rescind the state’s closure order, Babcock knew that Harrisburg relied on local authorities to enforce it. “While the state is, of course, supreme in this respect, the city will refuse to act as its police agent,” Babcock told the public. “If Dr. Royer wants to quarantine the city in punishment, he may try to do so, provided government needs do not interpose a higher power.” For all intents and purposes, Pittsburgh’s closure orders and gathering ban were over. Church and school closures were a local matter; Davis said that churches could resume services on November 3.27

There was little Royer could do. The beleaguered health commissioner was dealing with defiance in other sections of Pennsylvania as well, most notably in Lancaster. There, city officials refused to abide by Royer’s influenza bans. As a result, Royer forbade all trains from entering Lancaster, symbolically quarantining it from the rest of the nation. Pittsburgh, however, was not Lancaster. An industrial powerhouse with a large population, Royer dared not try to isolate the Steel City, especially during wartime. Instead, he issued a statement condemning the city’s actions as an invitation to lawlessness and disorder.28 Many businesses were unfazed and continued with their plans to reopen. Churches were split on whether or not to do so; Catholic clergy prepared their churches to reopen, set to open while many Protestant ministers called for harmony between state and local authorities. While the city and state fought, Davis devised a plan to reopen schools in a week, giving them time to recall teachers and prepare the buildings. It also gave parents time to obtain certificates of health for their children from physicians, as now required by Davis for readmission to school.29

Babcock did not stop there. The spirited mayor accused Royer of being drunk with power, perhaps taking a poke at the health commissioner’s concerns voiced statewide about alcohol consumption during the epidemic. Royer ignored the accusation and instructed Nelson McVicar, the state health department’s legal representative in Pittsburgh, to prosecute all defiant business owners. This legal war only lasted a day, as most theaters, movie houses, and saloons decided to remain closed while the political and legal battle was being fought between the city and the state. The few that opted to tempt fate and open were issued warrants, although a wise McVicar subsequently dropped the cases in order to reward compliance.30

Ultimately, Royer held true to his promise to lift the state-ordered bans on November 9. In Pittsburgh, Davis announced that schools could reopen on Monday, November 18 so long as students were inspected and medically cleared to return to their classrooms. Movie houses and theaters could reopen immediately provided they were clean, well ventilated, and sold only as many tickets as there were seats. Other entertainment venues, such as poolrooms, dance halls, and cabarets, could open but could not allow large crowds to gather for extended periods.31 Other than these restrictions, Pittsburgh was once again free to return to life as usual.

Conclusion

Pittsburgh continued to experience cases of influenza and pneumonia throughout the rest of the winter, with a small spike in late-January 1919 that briefly concerned health officials. By the start of February, more than 25,000 Pittsburghers had contracted influenza.32 It was not until April 21, 1919 that the city celebrated its first flu-free 48-hours since the epidemic started, some seven months earlier.33

Overall, Pittsburgh experienced the worst epidemic of any major city in the United States. The average death rate for Eastern cities was 555 per 100,000. By contrast, Pittsburgh’s excess death rate was a whopping 807 per 100,000 people. The Steel City’s ordeal with influenza was even deadlier than that of Philadelphia (748) or Boston (710), two communities where influenza ran rampant in the fall of 1918. Despite advance warning and preparation, organized local leadership, and efficient allocation of resources, Pittsburgh fared horribly during the crisis.

While we know with certainty that Pittsburgh had a very poor outcome, it is difficult to explain why. Despite some grumbling, Pittsburgh officials acted on Royer’s statewide closure order very quickly, even before receiving official word. In fact, Pittsburgh’s closures came even sooner in its epidemic than did Boston’s. At the other end of the epidemic, the few days’ worth of preemptive re-openings that Mayor Babcock unilaterally implemented likely would not account for the severity of the city’s excess death rate. In addition, there is little evidence that many businesses were willing to incur the wrath of state officials by following Babcock’s lead.

There are several significant differences between Pittsburgh and either Philadelphia or Boston, however, that may account for the more severe epidemic in the Steel City. Both Philadelphia and Boston closed schools earlier in their epidemics. Pittsburgh, on the other hand, waited three weeks after implementing other closure orders to extend those closures to schools as well. As a result, Pittsburgh’s various social distancing measures were staggered, and only overlapped by two weeks. Modern epidemiological studies of the 1918 epidemic show that the early, sustained, and layered implementation of such social distancing measures had an impact on the severity of a city’s peak and overall influenza and pneumonia mortality.34 That is, it is not enough to simply utilize multiple measures; those measures should be implemented at the same time so as to create the maximum social distancing possible in a community.

It is also possible that Pittsburgh’s high death rate was in part due to the city’s notoriously poor air quality during the time. A lifetime of exposure to heavy smoke pollution from the city’s coal-fed steel mills may have left many residents more susceptible to respiratory complications from influenza. Several studies over the decades since the 1918 epidemic have shown that historically, Pittsburgh suffered from higher rates of pneumonia than did other areas of the state, especially in the fall and winter months when the weather kept pollution trapped over the city. Other, more recent studies have concluded that high pneumonia mortality is frequently observed in communities with heavy air pollution.35 Combined with the delay in closing schools, Pittsburgh’s pollution may have contributed to the severity of its bout with influenza in 1918.

Notes

1 “Again – the Grip!” Pittsburgh Gazette-Times, 1 Oct. 1918, 6.

2 “11 More Deaths from Influenza” Philadelphia Enquirer, 1 Oct. 1918, 17.

3 “Growth of Epidemic Prompts Drastic Order by Dr. Royer,” Pittsburgh Gazette-Times, 4 Oct. 1918, 1.

4 “City Officials: Warn Public that Health Dept. Order Must be Observed Strictly,” Pittsburgh Sun, 4 Oct. 1918, 1.

5 “All Theaters and Saloons Here are Closed,” Pittsburgh Sun, 4 Oct. 1918, 1.

6 “Influenza Sweeping Nation; Pittsburgh under Quarantine,” Pittsburgh Gazette-Times, 5 Oct. 1918, 4.

7 “Schools Will Help Prevent Epidemic Here,” Pittsburgh Gazette-Times, 6 Oct. 1918, 1.

8 “Lists of Grip Victims Show Big Increase,” Pittsburgh Gazette-Times, 8 Oct. 1918, 1; “Officials Plan Hospitals for Grip Patients,” Pittsburgh Gazette-Times, 9 Oct. 1918, 1.

9 “Epidemic Here Not Alarming, Figures Show,” Pittsburgh Sun, 11 Oct. 1918, 8.

10 “Full Force of Epidemic Yet to Come,” Pittsburgh Gazette-Times, 15 Oct. 1918, 11.

11 “Rapid Spread of Influenza in Pittsburgh,” Pittsburgh Gazette-Times, 10 Oct. 1918, 1, 4; “Maj. Day Hit by Epidemic He is Fighting,” Pittsburgh Gazette-Times, 10 Oct. 1918, 4.

12 Studies on Epidemic Influenza. Comprising Clinical and Laboratory Investigations by Members of the Faculty of the School of Medicine University of Pittsburgh (Pittsburgh: University of Pittsburgh, 1919), 5.

13 “Grip Epidemic Victims Now Number 4,445,” Pittsburgh Gazette-Times, 16 Oct. 1918, 1, 2.

14 “Report Shows Fewer Cases of Influenza,” Pittsburgh Sun, 19 Oct. 1918, 3.

15 “Epidemic Adds to Death List in Pittsburgh,” Pittsburgh Sun, 21 Oct. 1918, 4.

16 “Medical Men Unite Forces to Fight Grip,” Pittsburgh Sun, 22 Oct. 1918, 4.

17 “Catholic Aid in Epidemic is Accepted,” Pittsburgh Gazette-Times, 27 Oct. 1918, 2.

18 “Epidemic Adds to Death List in Pittsburgh,” Pittsburgh Sun, 21 Oct. 1918, 1, “Closing Order Will be Lifted on November 9,” Pittsburgh Sun, 1 Nov. 1918, 12.

19 “Fewer Cases of Influenza are Reported,” Pittsburgh Gazette-Times, 17 Oct. 1918, 11.

20 Annual Report of the Federation of the Jewish Philanthropies of Pittsburgh. For the year ending 1918 (Pittsburgh, 1919) 33-34.

21 “Medical Men Unite Forces to Fight Grip,” Pittsburgh Gazette-Times, 22 Oct. 1918, 1; “Children Best in Schools, Says Burns,” Pittsburgh Gazette-Times, 23 Oct. 1918, 7.

22 “City Schools Are Closed by Grip,” Pittsburgh Gazette-Times, 24 Oct. 1918, 1.

23 “Arrests for Drunkenness Show Marked Decrease since Salons are Closed,” Pittsburgh Gazette-Times, 27 Oct. 1918, 6.

24 “Dr. Royer Declines to Lift Closing Ban,” Pittsburgh Sun, 28 Oct. 1918, 1.

25 “Closing Order May be Lifted within Week,” Pittsburgh Sun, 30 Oct. 1918, 8.

26 “Influenza Epidemic Wanes in Pittsburgh; Ban May Soon be Lifted by Authorities,” Pittsburgh Gazette-Times, 1 Nov. 1918, 9.

27 “Influenza ban abrogated by city officials,” Pittsburgh Gazette-Times, 2 Nov. 1918, 1, 5.

28 “Drastic Ban on Lancaster; Dr. Royer Says Liquor Men are Defying State Orders,” Pittsburgh Gazette-Times, 2 Nov. 1918, 5; “Mayor Babcock’s proclamation regarding lifting of ban here,” Pittsburgh Gazette-Times, 2 Nov. 1918, 1.

29 “Royer Awaits Violations of Closing Order,” Pittsburgh Gazette-Times, 3 Nov. 1918, 1.

30 “All Theaters Agree to Obey Influenza Ban,” Pittsburgh Gazette-Times, 6 Nov. 1918, 1, 7.

31 “Schools in City Will Reopen November 18,” Pittsburgh Gazette-Times, 8 Nov. 1918, 9; “All Theaters in City open Today; Royer Gives Ban-Lifting Regulations,” Pittsburgh Gazette-Times, 9 Nov. 1918, 1.

32 “Flu and Pneumonia Cases Show Decrease,” Pittsburgh Sun, 3 February 1919, 1.

33 “City Influenzaless; No Cases Reported,” Pittsburgh Post, 22 April 1919, 2.

34 Howard Markel, Harvey Lipman, J. Alexander Navarro, et al., “Nonpharmaceutical Interventions Implemented by US Cities during the 1918-1919 Influenza Pandemic,” Journal of the American Medical Association, 298 (2007): 644-654; Martin J. Bootsma and Neil M. Ferguson, “The Effect of Public Health Measures on the 1918 Influenza Pandemic in U.S. Cities,” Proceedings of the National Academy of Sciences, 104 (2007): 7588-7593.

35 See, for example, Samuel R. Haythorn and Harry B Meller, “Necropsy Evidences on the Relation of Smoky Atmosphere to Pneumonia” American Journal of Public Health, 28 (1938): 479-486[My paper]. For a recent study on pollution and pneumonia, see E. G. Knox, “Atmospheric Pollutants and Mortalities in English Local Authority Areas,” Journal of Epidemiology and Community Health, 62 (2008): 442-447.

Click on image for gallery. A uniform permit for a volunteer at the Pittsburgh chapter of the American Red Cross, dated July 31, 1918. We cannot know for sure, but it is likely that Mrs. Beulah Miller volunteered her services in some manner to help the city care for its ill during the influenza epidemic.
Click on image for gallery. The Elizabeth Steel Magee Memorial Hospital and Nurses Home in Pittsburgh. The hospital was a gift to the city by steel magnate Christopher Magee, who, upon his death, bequeathed nearly his entire estate to its founding.
Click on image for gallery. A rail ticket for the Pennsylvania Line from Pittsburgh to Chicago for the fall of 1918. Whether among troops or civilians, influenza often hitched a ride along the nation’s rail lines.
Click on image for gallery. A view of Sixth Ave. in downtown Pittsburgh, with streetcars in the distance.
Click on image for gallery. The Point – the confluence of the Allegheny and Monongahela Rivers – showing the heavily industrialized landscape along the banks. Today, the area is Point State Park.

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Atlanta, Georgia

Timeline of Events

Excess Death Rate (per 100,000) Daily EventsClick day to view details. Selected Event
graphNational
200Excess Death Rate (per 100,000)
180 
160 
140 
120 
100 
80 
60 
40 
20 
0 
Total Excess Death Rate ###
Total Deaths per 100,000 population over duration of epidemic (roughly 1918 September 14 through 1919 February 22).
 19181919
 AugustSeptemberOctoberNovemberDecemberJanuaryFebruaryMarchApril
Sa273101724317142128512192629162330714212841118251815221815222951219
Fr2629162330613202741118251815222961320273101724317142128714212841118
Th2518152229512192631017243171421285121926291623306132027613202731017
We243171421284111825291623306132027411182518152229512192651219262916
Tu2330613202731017241815222951219263101724317142128411182541118251815
Mo2229512192629162330714212841118252916233061320273101724310162431714
Su21284111825181522296132027310172418152229512192629162329152330613

September 18, 1918

The Second Infantry Replacement regiment at Camp Gordon–approximately 15 miles northeast of Atlanta–is placed under quarantine because of the many influenza cases that have developed within its ranks.

September 21, 1918

Other units at Camp Gordon are placed under quarantine. This means approximately half of the soldiers at the camp are prohibited from leaving. All soldiers are barred from congregating.

September 22, 1918

The United States Public Health Service tells Atlanta residents that they are not in danger from the influenza epidemic now that Camp Gordon has been quarantined.

October 3, 1918

The Georgia State Board of Health issues a warning about influenza, now widely prevalent throughout the state. The Board informs communities that they should expect many more cases of the influenza in the coming days.

October 5, 1918

In cooperation with the United States Public Health Service, the American Red Cross appoints W. Frank Persons, the director general of civilian relief, to assist local health services with financial aid, nurses, and supplies.


The first influenza-related death is reported to Dr. J. P. Kennedy, City Health Officer. The quarantine at Camp Gordon seems to be keeping cases out of Atlanta, but Dr. Kennedy fears that people traveling on trains will infect the local populace.

October 6, 1918

The Atlanta Board of Health makes influenza a reportable disease. Health Officer Kennedy estimates several hundred cases in Atlanta. The Red Cross opens workrooms to volunteers for the first time in the Atlanta chapter’s history. This is to help fill the need for 100, 000 influenza masks requested by Camp Gordon.

October 8, 1918

The Atlanta City Council, after hearing from the Board of Health, issues an order closing theaters, movie houses, schools, churches, dance halls, and billiard rooms. The order will be in place for two months unless the epidemic subsides before then. All public transportation must be run with windows wide open, temperature notwithstanding, except in the case of a heavy rain. Students report to school at the regular time this morning to retrieve books and homework before being dismissed.

October 9, 1918

The Fulton County Board of Health and county school Superintendent J. W. Simmons together decide to close county schools for thirty days, subject to change as conditions develop. The editor of the Atlanta Constitution proposes that out-of-school boys be put to work harvesting cotton crops, which would alleviate the labor shortage caused by the war as well as keep the boys outside in the fresh air and sunshine.

October 10, 1918

Health Officer Kennedy urges physicians to report influenza cases, erroneously telling them that it is required by federal regulation.

October 12, 1918

Health Officer Kennedy reports that influenza conditions in Atlanta are better than in many other cities. He also reports that there has been no marked change in the influenza situation.

October 15, 1918

Health Officer Kennedy believes that banning public gathering for one more week is necessary. He states that public health precautions are impacting the effects of influenza, but more deaths from pneumonia complications are to be expected. He adds that many sick people do not have influenza as they believe, but rather coryza.


Southeastern Fair authorities and Georgia Board of Health Director Dr. T. F. Abercrombie issue an order that all fair attendees must wear an influenza mask.


The Atlanta Theater Managers’ Association decides to launch a group protest of the closure order. They feel that it is unfair that entertainment venues such as the Southeastern Fair can continue while theaters must be closed. The Association compared the cleanliness of their theaters to some unhealthy attractions at the fair. Health Officer Kennedy states that the danger from influenza will pass by the end of the week, and that the closure order can be lifted then.

October 16, 1918

Large crowds attend the Southeastern Fair. Many people are having difficulty obtaining the face masks required to enter. The Atlanta Red Cross announces that they will provide enough masks, free of charge, for all attendees.

October 17, 1918

Eighty telephone operators–15% of the workforce–are home sick with influenza, severely impacting the ability for important calls to be connected. Residents are asked to refrain from making unnecessary telephone calls.

October 18, 1918

Health Officer Kennedy tells the public that the influenza situation is not worsening, despite recent increase in cases. He adds that Atlanta has suffered less than other large cities, especially those in the Northeast.


The local chapter of the Red Cross puts out a call for one hundred volunteers to help assemble influenza masks at the “colored Red Cross work room at 167 Auburn Avenue.”

October 19, 1918

Health Officer Kennedy announces that influenza has reached its peak in Atlanta. He warns that the death toll will continue to rise over the course of the next week or two before it begins to subside.

October 22, 1918

Health Officer Kennedy is optimistic that theaters will be allowed to open by the end of the week, and that churches will soon be able to conduct indoor services without a permit.

October 25, 1918

Health Officer Kennedy indicates that the closure order will likely be rescinded, but that a special meeting of the Board of Health will need to occur first. H. M. Patterson, president of the board, did not say when the board would next meet. The Board of Education states will definitely not open schools before November 4.

October 26, 1918

The closure order and public gathering ban are lifted. Schools are scheduled to reopen on Monday, November 4.

October 28, 1918

Atlanta theaters reopen to large crowds.

November 4, 1918

Atlanta schools reopen.

November 9, 1918

After receiving a federal report, Health Officer Kennedy announces that only three other American cities (Grand Rapids, Cambridge, and Spokane) had lower death rates during the epidemic than Atlanta.

November 17, 1918

Reports indicate that influenza cases in Atlanta are increasing.

December 4, 1918

Acting School Superintendent Charles S. Culver announces that, because of the time lost during the closure order, the school year will end on June 20 instead of June 1.

December 13, 1918

Influenza cases are on the rise in Atlanta. Health Officer Kennedy tells residents to prepare for an increased death rate for the next several weeks.

December 17, 1918

The Atlanta Red Cross forms a committee to aid public health authorities in ending the influenza threat in the city. The public safety committee of the Atlanta Chamber of Commerce decides not to recommend another public gathering ban, and instead would like to urge individuals to take precautions against sneezing, coughing, and spitting in public, and to ventilate streetcars and places of public amusement. Health Officer Kennedy agrees with the recommendations.

December 20, 1918

Reports indicate that the recent spike in influenza cases is subsiding.

December 21, 1918

The Red Cross, Associated Charities, and Anti-Tuberculosis Society form a Clearing House Committee to reduce redundancy in the reporting of cases and the managing nursing care and post-epidemic charity. All reports made to the health department will now be routed to the secretary of the Clearing House Committee.

December 22, 1918

The epidemic continues to subside. Health Officer Kennedy states that even though physicians are not reporting every new case of disease, the lower death rate is reflected in the number of burial permits.

December 31, 1918

With the epidemic over, the Board of Health once again takes over requests for nursing and medical aid from the Clearing House Committee.