‘Great­est killer of all time’

Span­ish flu’s swift spread left hun­dreds dead in Dal­las and 50M world­wide

The Dallas Morning News - - Front Page - By DAVID TAR­RANT Staff Writer dtar­rant@dal­las­news.com

The year was 1918, and Army camps in Texas swelled with young men train­ing to fight in Europe in World War I.

But an in­vis­i­ble en­emy al­ready posed a deadly threat: The Span­ish flu of 1918 killed thou­sands of sol­diers across the coun­try be­fore they ever made it to the bat­tle­field. It swept through cities and towns, spread­ing fear. The flu ul­ti­mately claimed more than 50 mil­lion lives world­wide — in­clud­ing more than 500,000 Amer­i­cans — and in­fected hun­dreds of mil­lions of oth­ers.

One hun­dred years later, as Dal­las faces another deadly flu out­break, the Span­ish flu has been largely for­got­ten by the pub­lic.

But not by those who study vi­ral in­fec­tion and the way it

“They were dead in less than a day. They’d fall ill in the morn­ing, be cough­ing up blood by the af­ter­noon and dead that evening. They drowned in their own blood or from a lack of oxy­gen.”

Dr. Robert Ha­ley, di­rec­tor of UT South­west­ern’s Epi­demi­ol­ogy Divi­sion


“It is prob­a­bly the great­est killer of all time. It killed more peo­ple in the world than any other known epi­demic in his­tory,” said Dr. Robert Ha­ley, di­rec­tor of UT South­west­ern’s Epi­demi­ol­ogy Divi­sion.

A pan­demic like the 1918 Span­ish flu will hap­pen again, Ha­ley said. It’s not a mat­ter of if but when. If the right strain of a hu­man flu virus mixes with the flu virus of a pig and a bird, it can cre­ate a new and far more lethal strain to which hu­mans have lit­tle im­mu­nity.

“Then our goose is cooked,” Ha­ley said.

“It’s go­ing to hap­pen, but we just don’t know when. It’s a num­bers game.”

Flu in North Texas

In Septem­ber 1918, about 150,000 peo­ple lived in Dal­las — around 10 per­cent of the cur­rent pop­u­la­tion.

The front pages of lo­cal news­pa­pers that month were dom­i­nated by news of the war rag­ing in Europe. Closer to home, young men surged into army train­ing camps around Texas and Dal­las, in­clud­ing Camp Dick on the grounds of Fair Park. The State Fair of Texas had been can­celed so the land could be con­verted tem­po­rar­ily into an Army train­ing camp.

The Dal­las Morn­ing News car­ried re­ports of the flu in other parts of the coun­try, in­clud­ing Army posts around the coun­try. The out­break prob­a­bly started in Kansas at Fort Ri­ley, where the first cases were recorded, Ha­ley said. The doc­tor serv­ing the post alerted pub­lic health author­i­ties, but his re­port was ig­nored.

That spring, a mild ver­sion of the flu had shown up without do­ing much harm. But it re­turned in much more vir­u­lent form in late sum­mer. Pre­vi­ous ver­sions of the flu typ­i­cally af­fected the sick, the very young and the very old. This ver­sion at­tacked healthy young adults the hard­est, with the high­est mor­tal­ity rate among those ages 20 to 40, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion.

“That’s why it af­fected young sol­diers,” Ha­ley said.

The virus trig­gered a “cy­tokine storm,” caus­ing a mas­sive over­pro­duc­tion of the cells used to fight off in­fec­tions, which re­sulted in or­gan fail­ure, he said. In many vic­tims, this re­ac­tion to the virus de­stroyed the lungs.

“They were dead in less than a day. They’d fall ill in the morn­ing, be cough­ing up blood by the af­ter­noon and dead that evening,” Ha­ley said. “They drowned in their own blood or from a lack of oxy­gen.”

The flu also could lead to pneu­mo­nia, for which there were no an­tibi­otics.

The flu spread quickly across the U.S., fol­low­ing rail­road lines, said Dr. Peggy Red­shaw, an ex­pert on the Span­ish flu and a pro­fes­sor emer­i­tus of bi­ol­ogy. “It ripped through the rail­road com­mu­nity,” she said.

By the time it hit Sher­man in Septem­ber, panic had set in. “Peo­ple were think­ing this was the end of the world,” said Red­shaw, who has pro­duced a study on the flu’s im­pact on Sher­man.

That month in Dal­las, Camp Dick be­gan to quar­an­tine new men ar­riv­ing at the post to en­sure they weren’t in­fected.

Still, Dal­las city health of­fi­cials didn’t seem overly wor­ried. On Sept. 29, The News car­ried a re­port head­lined “In­fluenza Scare is Rapidly Sub­sid­ing,” which cited “spo­radic cases of Span­ish in­fluenza” that had been re­ported to the City Emer­gency Hos­pi­tal. Dr. A.W. Carnes, the city’s health of­fi­cer, said the lo­cal cases re­sem­bled the old-fash­ioned grip, or cold, and did not ap­proach the pro­por­tions of an epi­demic.

The News ended its story on a pos­i­tive note: “In the opin­ion of the mil­i­tary and civil doc­tors, the Span­ish in­fluenza scare is un­war­ranted by lo­cal con­di­tions. The few cases of grip, it is claimed, are to be ex­pected as the re­sult of the re­cent rainy weather.”

But in Fort Worth, where Camp Bowie had al­ready re­ported 40 cases of the flu, Army lead­ers im­posed a ban on sol­diers com­ing to­gether for dances or for watch­ing movies, play­ing pool, and the like.

De­spite the risk, on Sept. 28, Dal­las went ahead with one spe­cial gath­er­ing.

Pa­rade drew thou­sands

Thou­sands of res­i­dents flocked down­town to see 5,000 civil­ians and 2,500 sol­diers march in a pa­rade as part of the Fourth Lib­erty Loan cam­paign to sell bonds to fund the war ef­fort. As the band played “For Your Boy and My Boy” and other pa­tri­otic songs, huge crowds spilled across Main and Elm streets. “By tens of thou­sands the cit­i­zen­ship watched and cheered and ap­plauded . ... It sim­ply was Dal­las show­ing what she in­tends to do when the loan drive opens to­mor­row.”

Af­ter the pa­rade, flu cases in­creased ex­po­nen­tially, ac­cord­ing to a re­port in The News on Oct. 4, 1918. A to­tal of 76 cases were re­ported on Oct. 3, twice as many as were re­ported the pre­vi­ous two days. The News also re­ported the city’s first flu death that day. Pier­pont Balder­son, 15, died at St. Paul’s Hos­pi­tal. Af­ter be­ing stricken with the flu, he came down with pneu­mo­nia.

Carnes hes­i­tated to im­pose a quar­an­tine, though other city lead­ers urged him to do so and nearby mil­i­tary camps were al­ready iso­lat­ing the sick. On Oct. 12, Mayor Joseph E. Lawther de­cided to take the mat­ter into his own hands, or­der­ing a tem­po­rary halt of all pub­lic gath­er­ings, in­clud­ing the clos­ing of pub­lic and pri­vate schools, col­leges and uni­ver­si­ties, and churches.

That day, 725 more cases were re­ported to the City Emer­gency Hos­pi­tal, bring­ing the city’s over­all to­tal to 3,444. That was al­most 20 times more than the 185 to­tal cases re­ported just nine days ear­lier on Oct. 3.

Fort Worth’s Camp Bowie had 40 cases of the flu, The News re­ported on Sept. 27. By Oct. 6, that num­ber had jumped to “nearly 2,000” cases and four deaths.

Many cases of the flu were never of­fi­cially recorded. “The record-keep­ing was ter­ri­ble,” Red­shaw said.

En­tire fam­i­lies hit

The flu did not dis­crim­i­nate, hit­ting the well-off and the poor, in­clud­ing en­tire fam­i­lies. A story on Oct. 26 quoted a nurse say­ing that a fam­ily of nine peo­ple of Mex­i­can her­itage had all been stricken by the flu, in­clud­ing three in the last stages of pneu­mo­nia. When a land­lord threat­ened to evict a sick fam­ily, United Char­i­ties stepped in to pay the rent. The group also pro­vided gro­ceries and med­i­ca­tion for oth­ers who were too sick to work.

Doc­tors and nurses also came down with the flu, im­pair­ing the city’s abil­ity to care for the sick.

Oc­to­ber proved to be the worst month. But the epi­demic con­tin­ued to un­fold into De­cem­ber be­fore fi­nally wind­ing down in the spring of 1919.

It is dif­fi­cult to de­ter­mine the full im­pact of the flu epi­demic. The Dal­las Evening Jour­nal es­ti­mated the city was hit with more than 9,000 cases of the flu and 350 deaths from in­fec­tion. On Dec. 13, The News re­ported that 456 res­i­dents had died from the flu or pneu­mo­nia since Oct. 1.

For all of Texas, the num­ber of deaths in Oc­to­ber in­creased 257 per­cent over Septem­ber. Nearly 7 of ev­ery 10 deaths re­ported to the state were caused by in­fluenza and re­lated ill­nesses, in­clud­ing pneu­mo­nia.

Fort Worth med­i­cal author­i­ties re­ported three deaths to ev­ery birth in Oc­to­ber alone.

The end of World War I was an­nounced on Nov. 11, 1918. But the flu con­tin­ued into the spring of 1919 be­fore fi­nally burn­ing out.

In the end, Ha­ley and other ex­perts be­lieve that Span­ish in­fluenza prob­a­bly short­ened World War I — as the epi­demic swept through the ranks of friend and foe alike.

Closer to home, with the war over and the flu sub­sid­ing, all sol­diers at Camp Dick at Fair Park were given passes for Christ­mas. And within a year, the State Fair of Texas was back up and run­ning.

It was called the Vic­tory Fair.

Na­tional Mu­seum of Health

Span­ish in­fluenza vic­tims crowded into an emer­gency hos­pi­tal in 1918 at Camp Fun­ston at Fort Ri­ley in Kansas. The flu hit healthy young adults the hard­est, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion. “That’s why it af­fected young sol­diers,” said Dr. Robert Ha­ley, di­rec­tor of UT South­west­ern’s Epi­demi­ol­ogy Divi­sion.

2007 File Photo/Staff

In the archives at the J. Erik Jon­s­son Cen­tral Pub­lic Li­brary are the orig­i­nal coroner re­ports from the 1918 flu pan­demic in Dal­las, but many cases of the flu were never of­fi­cially recorded.

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