Gulf coast flu, 1918

There's a lot of good regional reporting around that most of us don't get to see. Consider the Sun Herald in gulfport, Mississippi. We think of Gulfport as Katrina country these days, but like the rest of the world in 1918 it was pandemic flu territory. Local reporter Kat Bergeron looked back nine decades to that other catastrophe and concluded there are still a lot of missing puzzle pieces.

Nearly nine decades after the 1918-1919 influenza pandemic swept across the Mississippi Coast - and every country in the world - researchers and health officials continue to study and revise death tolls.

Even less seems to be known about how many caught the flu and survived.

Statewide, the Mississippi Department of Health, Bureau of Vital Records, listed 6,219 deaths from influenza in 1918 and 3,013 in 1919, but researchers question the accuracy of record-keeping of that era, not just in Mississippi but across the country. Millions also likely died of flu complications, such as pneumonia. (Kt Bergeron, Sun-Herald)

Neither newspapers nor officials kept people informed.The paper's forerunner, The Daily Herald, was typical:

"Official information as to the number of cases of influenza occurring in the Mississippi Coastal District has been withheld heretofore because of the fear that a certain portion of the population might be tempted to become careless if on a certain day the number of cases reported by physicians should happen to be low.

"It is now believed, however, by health authorities that the people in general have by this time become sufficiently convinced as to the need of precaution, and that it is therefore safe to give figures." (November 1, 1918)

Except that they didn't, not even as they were saying it was permissible to do so. Current estimates are that Mississippi might have been suffering 6000 new cases a day at that time, although you'd never know it from reading the newspaper. But you'd know it other ways:

Are the memories of men like Tommie Dukes Sr., who has an oral history in Southern Miss archives, correct? As an adult, the National Negro League player born in 1906 and raised in the Kiln and Lumberton recalled the flu pandemic of his youth: "And every day they was hauling caskets from Bay St. Louis to the Kiln. You'd see them trucks coming there with caskets."

[snip]

Those who remained healthy still found their lives and mobility drastically altered. School classes were canceled and offices closed, some stores shuttered, especially on weekends, and church choirs fell silent. Hard-hit were the state colleges where panicked parents were not allowed to pull out students because of quarantines.

[snip]

As phone and telegraph operators fell to the flu bug, communication was hampered further; public services were curtailed. Most telling were signs posted on houses in the cities that complied with Frank's dictates. The signs read: "Influenza. Visiting forbidden to and from this house. U.S. Public Health Service."

And there were priorities:

In Mississippi, not all public gatherings were canceled as the surgeon general had dictated. There were fairs, rallies to raise money for U.S. involvement in World War I and a few religious conferences.

Coast communities did what they were asked to do, and Harrison County postponed its fair. Canceled war bond rallies were blamed for organizers not meeting patriotic donation goals, and, not surprisingly, the rallies were one of the first public events brought back.

Bergeron went to Deanne Stephens Nuwer of the University of Southern Mississippi-Gulf Coast, a scholar who researched the 1918 pandemic, to get the bottom line:

"The lesson we should have learned from 1918 is that there needs to be a more cooperative effort at health care. Each state and city was onto itself, even on the Coast, and the resources shared and the knowledge shared could have been so much greater."

If you look at the US pandemic flu plan, you get the feeling they should be reading the local press in Katrina country. Because they don't seem to have learned the lesson.

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Hell, we didn't even learn the advance lesson that National Geographic warned of a few years ago if a Katrina-type storm were to hit N.O. and the Gulf Coast.

Just as with anti-vax crusaders, too few people today were around in 1918 or remember family members affected to know just how horrible this pandemic was.

One bright note that I'm sure you saw: Gary Nabel's group at NIH has developed a vaccine against 1918 H1N1 that protects mice.

Thanks, Abel. I did see it. I checked the PNAS site a few hours ago but the paper is not yet up. It is annoying they release to news media before anyone can read the paper. I have two different news versions, one of which doesn't make sense and the other is incomplete about details. Guess I'll have to wait a few days to see.

My dad who is eighty-six is full of stories about the "Spanish Flu". His family, newly arrived Italian immigrants at the time, lost a brother and more than half of the others contracted flu and survived. My grandfather used to tell how they hand-dug mass graves at the Catholic cemetary because no one else was available to do it. My father was born after the pandemic. His stories, as recalled from his dad are shocking because the officials in the city (Philadelphia) offered very little help. Today, with a population of 300 million less resourceful individuals, I cannot even imagine the results.

The Sun Herald news story is wrong in claiming that deaths in the U.S. due to the 1918-1919 influenza pandemic were undercounted because "Millions also likely died of flu complications, such as pneumonia."

Researchers at the time knew the difficulty of accurate diagnosis, and, therefore, combined official deaths from influenza and pneumonia (all forms) in estimating the death toll. Thus, there was no undercounting of pneumonia cases.

Moreover, the notion that in the U.S. millions likely died of flu complications is contradicted by the lack of corpses. During the pandemic period from September 1918 through June 1919, the flu killed an estimated 550,000 people in the U.S. At the same time, there were approximately 983,000 deaths from all causes other than influenza and pneumonia (all forms). Even if all these other deaths, including those from obvious non-flu causes such as cancer, accident and homicide, were attributed to the pandemic flu, there weren't enough dead bodies to supply the uncounted millions claimed.

U.S. Bureau of the Census, Mortality Statistics 1918 (Washington: Government Printing Office, 1920), p.483 at http://www.cdc.gov/nchs/data/vsushistorical/mortstatsh_1918.pdf p.476

U.S. Bureau of the Census, Mortality Statistics 1919 (Washington: Government Printing Office, 1921), pp.28,499 at http://www.cdc.gov/nchs/data/vsushistorical/mortstatsh_1919.pdf pp.26,495

Correction to my post of Oct. 24, 2006 03:49 AM. The corrected estimate for U.S. deaths from all causes other than influenza and pneumonia (all forms) during the period from September 1918 through June 1919 should be approximately 996,000, not 983,000.