Influenza Blues

As the influenza season wanes I decided to examine how this disease impacted my ancestors in Michigan. Prior to the late 1880s not many deaths were ascribed to influenza, usually in the single digits each year, but after that numbers of influenza deaths reported to the state were generally larger, culminating in the Spanish Influenza epidemic at the end of WWI.

References for Graph [1-8]

The low numbers of influenza deaths could be an actual trend or they could be an artifact of the abysmal state of data collection at the time (see Why Early Michigan Birth Records Are Unreliable) or the fact that we don't know who provided the cause of death (see Is That Really The Cause Of Death?).  Unfortunately, it's almost impossible to draw conclusions without additional data. It also bears remembering that influenza may have contributed to far more deaths than the numbers indicate because people weakened by influenza are more susceptible to other diseases such as bronchitis or pneumonia. The pneumonia may have been the cause of death, but if not for the influenza that laid someone low in the first place they may never have succumbed.

While the usual pattern of seasonal flu is to prey on the very young or old, the Spanish Influenza virus that spread around the world at the end of WWI fatally attacked the very demographic expected to be most resilient, people in their 20s and 30s. In the years for which the data was provided, most of the influenza deaths in Michigan were in those 70+ or under five, but in 1918, the peak of the Spanish flu in Michigan, young adults were hardest hit: 1,996 deaths in those 20-29 years and 1,521 deaths for those 30-39. [8]

At Fort Custer, they can pinpoint to the hour when Spanish flu struck the base. At 10 a.m. Sunday morning on Sept. 29, 1918 the first soldiers were rushed to the camp hospital. [9] Then “the disease seemed to break out all over camp simultaneously.” [9] With more men continually entering the hospital, a quarantine was put in place by late afternoon Monday. Almost no one was allowed to enter or leave the camp, training exercises were curtailed and intermingling of men from different barracks was prohibited. [9, 10] The importance of taking precautionary measures was exemplified by the 78^th Infantry regiment. As of Monday (Sept 30), the average number of cases “per regiment has been 38. In the 78^th infantry three companies failed to observe the rule which requires that mess kits be boiled for ten minutes and then dried without using cloths. In this regiment the number of men afflicted with respiratory diseases was 669.” [9]

By Monday morning 557 had been admitted to the base hospital and by the end of Tuesday that number was believed to be about 2,000. [9] 5,650 men were in the hospital on October 9, but Camp Custer considered itself lucky because only about 25% of the men in camp had been afflicted while in many places that number was 50% or more. [10] By October 24, the number in hospital was reduced to 1,650 and the admission rate had returned to normal levels. [11] All in all, Fort Custer weathered the storm better than other camps of similar size. In comparison with three other camps, Custer had fewer sick and fewer fatalities. Statistics for deaths/total number of sick patients were also much better: Camp Sherman: 13.14% of those sick with influenza died, Camp Devens 9.78%, Camp Grant 8.66%, Camp Custer 5.95%. [12]

Camp Funston, Kansas in 1918.  This is a file from the Wikimedia Commons.

Although the situation stabilized quickly at Fort Custer, the epidemic was in full swing in Kalamazoo and elsewhere. By early December about 1000 children were absent from school in Kalamazoo, most sick with influenza. [13] The City Commission, meeting as a Board of Health, ordered that all public gatherings were prohibited. “This includes churches, schools, theaters, moving pictures shows, pool rooms, bowling alleys, dance halls, lodge rooms, reading rooms in the Public Library. . . we further order that all street cars, interurban cars, and public conveyances shall have ventilators open regardless of outside temperature and . . . shall be thoroughly cleaned each day.” They also mandated that all new and existing cases of influenza be reported and quarantined until the City Commission rescinded the order. During the meeting it was reported that flu cases “were rapidly increasing, and to such an extent that it was becoming impossible for the force of doctors and nurses available to adequately handle the epidemic.” [13]

The city commission, however, couldn't rigorously enforce regulations and prevent people from coming in contact with potentially sick people like the commanding officers could at a military encampment such as Fort Custer. Kalamazooans could still encounter sick or exposed residents at the five-and-ten stores, though there was debate about allowing them to stay open, as well as other stores. [14] As a result, the epidemic continued. While 1918 was the peak year for influenza deaths in Michigan, at 6,742, 1919 and 1920 each tallied about 3,000 deaths from influenza (see graph).

The Spanish flu came as a shock to our ancestors. Now, we should know better. Wherever pigs, ducks and humans live in close contact this mutable virus will mix and match genes to stir up a potentially lethal new strain. The kind of epidemic experienced at the close of WWI could easily happen again and should come as no surprise when it does.

1. Secretary of State of Michigan, Twenty-Ninth Annual Report Relating To The Registry And Return Of Births, Marriages And Deaths in Michigan For The Year 1895 (Lansing, Michigan: Robert Smith Printing Co, 1897), pp. 154-155; digital images, Google Books (http://books.google.com/books: accessed 1 Feb 2013)
   
2. Secretary of State of Michigan. Thirty-Fifth Annual Report of the Secretary of State on the Registration of Births And Deaths Marriages And Divorces in Michigan For The Year 1901. (Lansing, Michigan: Robert Smith Printing Co., 1905), p. lxiv; digital images, Google Books (http://books.google.com/books: accessed 1 Feb 2013)
3. Secretary of State of Michigan. Forty-First Annual Report of the Secretary of State on the Registration of Births And Deaths Marriages And Divorces in Michigan For The Year 1907. (Lansing, Michigan: Wynkoop Hallenbeck Crawford Co., 1909), 39; digital images, Google Books (http://books.google.com/books: accessed 1 Feb 2013)
4. Secretary of State of Michigan. Forty-Second Annual Report of the Secretary of State on the Registration of Births And Deaths Marriages And Divorces in Michigan For The Year 1908. (Lansing, Michigan: Wynkoop Hallenbeck Crawford Co., 1910), p. 25; digital images, Google Books (http://books.google.com/books: accessed 1 Feb 2013)
5. Secretary of State of Michigan. Forty-Third Annual Report of the Secretary of State on the Registration of Births And Deaths Marriages And Divorces in Michigan For The Year 1909. (Lansing, Michigan: Wynkoop Hallenbeck Crawford Co., 1911), p. 43; digital images, Google Books (http://books.google.com/books: accessed 1 Feb 2013)
6. Secretary of State of Michigan. Forty-Sixth Annual Report of the Secretary of State on the Registration of Births And Deaths Marriages And Divorces in Michigan For The Year 1912. (Lansing, Michigan: Wynkoop Hallenbeck Crawford Co., 1914), p. 45; digital images, Google Books (http://books.google.com/books: accessed 5 Feb 2013)
7. Secretary of State of Michigan. Fifty-First Annual Report of the Secretary of State on the Registration of Births And Deaths Marriages And Divorces in Michigan For The Year 1917. (Lansing, Michigan: Wynkoop Hallenbeck Crawford Co., 1920), p. 45; digital images, Google Books (http://books.google.com/books: accessed 5 Feb 2013)
8. State Department of Health. Fifty-Second, Fifty-Third and Fifty-Fourth Annual Report of the Commissioner of Health On The Registration Of Births And Deaths Marriages And Divorces In Michigan For The Years 1918, 1919 And 1920. Lansing, Michigan: Wynkoop Hallenbeck Crawford Co., 1922), pp. 40, 194, 288; digital images, Google Books (http://books.google.com/books: accessed 9 Feb 2013)
9. “Spanish Influenza Hits Camp Custer; Quarantine Is On,” Trench And Camp [Battle Creek, Mich.], 3 October 1918, page 1, column 1, digital images, Kalamazoo Public Library (http://www.kpl.gov: accessed 13 February 2014), Miscellaneous Kalamazoo Publications Collection.
10. “Influenza Situation In Camp Improved Though Many Die Of Pneumonia,” Trench And Camp [Battle Creek, Mich.], 10 October 1918, page 1, column 1, digital images, Kalamazoo Public Library (http://www.kpl.gov: accessed 13 February 2014), Miscellaneous Kalamazoo Publications Collection.

11. “Health Conditions Are Resuming Normal State Within Custer Limits,” Trench And Camp [Battle Creek, Mich.], 24 October 1918, page 1, column 1, digital images, Kalamazoo Public Library (http://www.kpl.gov: accessed 13 February 2014), Miscellaneous Kalamazoo Publications Collection.
12. “In Spite Of Epidemic Local Cantonment Has High Health Standing,” Trench And Camp [Battle Creek, Mich.], 7 November 1918, page 1, column 5, digital images, Kalamazoo Public Library (http://www.kpl.gov: accessed 13 February 2014), Miscellaneous Kalamazoo Publications Collection.

13. “The 'Ban' Again On,” The People [Kalamazoo, Mich.], 12 December 1918, page 1, column 3, digital images, Kalamazoo Public Library (http://www.kpl.gov: accessed 13 February 2014), Miscellaneous Kalamazoo Publications Collection.
14. “About This Closing Order,” The People [Kalamazoo, Mich.], 12 December 1918, page 8, column 1, digital images, Kalamazoo Public Library (http://www.kpl.gov: accessed 13 February 2014), Miscellaneous Kalamazoo Publications Collection.