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Monday, June 24

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This week's question was submitted by Rebecca. Thank you!

Q: With the emerging threat of a flu epidemic, I remembered hearing something about the Spanish Influenza outbreak of 1918 and how it caused many, many deaths throughout the whole U.S. What was the effect upon Chicago?

It was the deadliest epidemic in recorded history, claiming as many lives in just one year as the Bubonic Plague claimed in four during the Black Death of the mid-14th century. And yet it is hardly remembered today. The Spanish Influenza of 1918-19 killed between 21 and 40 million people worldwide. In the U.S. alone, an estimated 640,000 people died while another 25 million were infected. In Chicago, more than 8,500 lives were lost to the disease in just eight weeks.

The Spanish Flu, or Spanish Lady as it was sometimes called, earned its nickname from the mistaken belief that the epidemic had begun in Spain. Scientists now believe the deadly disease originated in Kansas -- the result of a sudden, freak mutation. The virus made its first appearance in March of 1918 when, in Fort Funston, Kansas, over 200 soldiers complained of flu symptoms and nearly 50 died from the disease. At the same time, in Detroit, over 1,000 workers from the Ford Motor Company were sent home with the flu. But while the virus popped up in other pockets around the country that spring, it seemed to disappear as quickly as it came. Health officials hardly took notice at the time, and the U.S. had other things on its mind: fighting World War I.

But as the U.S. enjoyed a relatively disease-free summer in 1918, the Spanish Influenza gained a foothold in Europe and began to spread across the continent. That same summer 1.5 million American soldiers were sent to Europe to fight in the War. Devastation struck the U.S. when the infected soldiers and sailors returned from Europe to military bases all over the country, and the epidemic swept the country.

The real epidemic began in the U.S. in Boston in late August, 1918, when three sailors fell ill. Within five days over 250 additional cases were reported. The fatality rate for the disease was nearly 70 percent. Thirty miles outside of Boston, the Camp Devens army base reported over 12,000 cases of influenza amongst the soldiers in just two weeks. Unfortunately, health officials were poorly equipped to deal with the virus and repeatedly insisted the epidemic was "under control" even as the death toll began to rise. The disease moved so fast that it had already spread to Philadelphia before Boston even began to realize the extent of the danger.

Not surprisingly, the epidemic first appeared in the Chicago area at the Great Lakes Naval Training Station about 30 miles north of the city. The first cases were reported on September 11, 1918, and within a week the hospital was crowded with over 2,600 men. In an effort to contain the outbreak, liberty was cancelled for men at the station on September 19, but it was already too late.

According to newspaper reports from the period, for the week ending September 28, 598 new cases of Spanish Influenza were reported in Chicago and 176 deaths. The following week, over 6,000 new cases were reported and more than 600 deaths. By the end of the third week, ending October 14, the number of new cases had jumped to 11,239 with over 1,400 deaths. October 17, 1918 became known as Black Thursday in Chicago when 381 people died and nearly 1,200 more contracted the illness in a single 24-hour period. On that day, Lynette Iezzoni writes in Influenza 1918, "the city ran out of hearses. Passenger trolleys were draped in black and used to collect bodies." (p. 158)

On the other hand, the crime rate in Chicago that October dropped 43 percent.

Precautions against the disease were primitive and largely ineffective. In Chicago, public funerals were banned, and private funerals were limited to 10 people -- including the undertaker. Bars, dance halls, and movie theaters were closed, but churches and schools remained open. Public spitters were arrested. Businesses were asked to stagger their working days to reduce rush-hour crowds on public transportation.

One Chicago man, Peter Marrazo, driven insane by the epidemic, barricaded his family in their apartment, and famously slit the throats of his wife and four children, telling police, "I'll cure them my own way!"

In the end, 300,000 people were affected by the Spanish Influenza in the state of Illinois. The last reported cases of the disease occurred in the first couple of months of 1920. The epidemic ended not because any cure had been found, but because the virus mutated again and the deadly Spanish Influenza strain ceased to exist (sort of).

Can this happen again? Absolutely. In fact, scientists and health officials maintain it is only a question of when, not if. Finally, this column barely scratches the surface of the story of the 1918 influenza epidemic so I encourage you to check out some of the resources listed below for more about this topic.


The American Experience. Influenza 1918.

Billings, Molly. The Influenza Pandemic of 1918.

Cambell, Amanda, et al. Chicago Influenza Outbreak of 1918.

Centers for Disease Control and Prevention. Influenza.

Crosby, Jr., Alfred W. Epidemic and Peace, 1918. Westport, Conn.: Greenwood Press, 1976.

Iezzoni, Lynette. Influenza 1918: The Worst Epidemic in American History. New York: TV Books, 1999.

Kolata, Gina. Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It. New York: Simon & Schuster, 1999.

Have a topic you would like to see in "Ask the Librarian"? Send your suggestions to librarian@gapersblock and it may be featured in a future column.

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Joseph J. Finn / January 8, 2004 2:58 PM

Anyone else have the heebie-jeebies right now?

Cinnamon / January 8, 2004 3:59 PM

Every time one of my co-workers coughs, I find myself resisting the urge to go buy a surgical mask. Michael Jackson doesn't seem so crazy right now.

Naz / January 8, 2004 4:02 PM

I know exactly what you mean, when one of my co-workers....oh wait. I have a home office. I work alone.

When I cough...

miss ellen / January 8, 2004 4:53 PM

cough, cough, cough.

Jenny / January 12, 2004 8:53 AM

The bubonic plague of the 14th century is estimated to have killed 200 million people, far more than the estimated 20-40 million killed between 1918-1919 from the Spanish Influenza. (

The massive destruction of the Spanish Influenza can also be explained by its original viral contamination, whereas the plague turned to pneumatic during its course. It is also interesting to note that the bubonic plague is a natural occurring infection within the US and other countries.

In 2002, two individuals from New Mexico were infected with the plague while in New York. The concern for the bubonic plague as a biological weapon is not unwarranted as Japanese pilots dropped plague-infested rats over China during WWII; furthermore, the United States and Russia both formulated aerosol versions of the plague during the Cold War. In 2003, fears continued as the Homeland Security charged and acquitted Dr. Thomas Butler of Texas Tech University over charges of destruction of 30 plague vitals after fears of US contamination.

Both the bubonic plague and the Spanish influenza should not be overlooked as by-gone historical contaminations that could never occur again.

Alice / January 12, 2004 10:29 AM

I guess I should have been more specific. The BBC article you linked to above says an estimated 200 million people were killed in the 14th century.

This may well be true, but in the column I was specifically referring to only the estimated 25 million people that were killed during the infamous Black Death of 1347-1351.

And, as to your second point, the Spanish Influenza, although viral in origin, was also so deadly because it left the victim vulnerable to pneumonia.

In one of the resources to which I linked above, Molly Billings quotes several medical journals from the period on her "Influenza Pandemic of 1918" page writing, "The danger of an influenza infection was its tendency to progress into the often fatal secondary bacterial infection of pneumonia. In the patients that did not rapidly recover after three or four days of fever, there is an 'irregular pyrexia' due to bronchitis or broncopneumonia (BMJ, 7/13/1918). The pneumonia would often appear after a period of normal temperature with a sharp spike and expectorant of bright red blood. The lobes of the lung became speckled with 'pneumonic consolidations.' The fatal cases developed toxemia and vasomotor depression (JAMA, 10/3/1918). It was this tendency for secondary complications that made this influenza infection so deadly."

But, finally, yes, I agree that either epidemics could happen again.


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