Public health interventions and epidemic intensity during the 1918 influenza pandemic

Hatchett et al. 10.1073/pnas.0610941104.

Regression Coefficients

Timing (95% CI)

P

Interventions (95% CI)

P

Model

Timing

-28.4

(-61.5, 4.8)

0.09

--

--

Interventions before CEPID = 20

--

--

-11.1

(-20.1,-2.0)

0.02

Timing + interventions

0.7

(-49.7, 60.0)

0.98

-11.2

(-26.4, 3.9)

0.13

Outcome: Excess weekly P&I deaths

Measure of interventions

(a) Peak

(b) Normalized peak

(c) 1918 total

(i)

Number of interventions before 10/100,000 CEPID

-0.48

P = 0.051

-0.46

P = 0.06

-0.27

P = 0.29

Number of interventions before 20/100,000 CEPID

-0.67

P = 0.003

-0.65

P = 0.005

-0.49

P = 0.045

Number of interventions before 30/100,000 CEPID

-0.47

P = 0.055

-0.51

P = 0.04

-0.26

P = 0.31

Number of interventions before 40/100,000 CEPID10

-0.30

P = 0.24

-0.38

P = 0.13

-0.05

P = 0.85

(ii)

CEPID at time of first intervention

0.13

P = 0.60

0.12

P = 0.63

0.05

P = 0.83

CEPID at time of second intervention

0.52

P = 0.03

0.44

P = 0.08

0.38

P = 0.14

CEPID at time of third intervention

0.54

P = .02

0.52

P = 0.03

0.30

P = 0.24

CEPID at time of fourth intervention

0.61

P = 0.009

0.63

P = 0.007

0.36

P = 0.15

CEPID at time of fifth intervention

0.55

P = 0.02

0.67

P = 0.003

0.27

P = 0.30

CEPID at time of sixth intervention

0.26

P = 0.31

0.44

P = 0.08

0.05

P = 0.84

(iii)

CEPID at time of closing schools

0.54

P = 0.02

0.63

P = 0.007

0.25

P = 0.34

CEPID at time of closing theaters

0.56

P = 0.02

0.72

P<0.001

0.17

P = 0.52

CEPID at time of closing churches

0.43

P = 0.08

0.54

P = 0.03

0.10

P = 0.69

CEPID at time of closing dance halls

0.03

P = 0.90

0.04

P = 0.87

0.15

P = 0.57

CEPID at time of other closures

0.33

P = 0.19

0.34

P = 0.18

0.24

P = 0.34

CEPID at time of making influenza notifiable

0.01

P = 0.97

-0.07

P = 0.79

0.11

P = 0.67

CEPID at time of bans on public gatherings

0.46

P = 0.06

0.56

P = 0.02

0.27

P = 0.30

CEPID at time of imposing case isolation

0.16

P = 0.53

0.14

P = 0.59

0.13

P = 0.63

CEPID at time of bans on public funerals

-0.09

P = 0.75

0.09

P = 0.72

-0.40

P = 0.10

Outcome: Excess weekly P&I deaths

Measure of interventions

(a) Peak

(b) Normalized peak

(c) 1918 total

(i)

Number of interventions before 30/100,000 CEPID7

-0.51

P = 0.04

-0.52

P = 0.03

-0.35

P = 0.17

Number of interventions before 50/100,000 CEPID7

-0.74

P = 0.0007

-0.71

P = 0.001

-0.55

P = 0.02

Number of interventions before 100/100,000 CEPID7

-0.73

P = 0.0009

-0.77

P = 0.0003

-0.43

P = 0.08

Number of interventions before 150/100,000 CEPID7

-0.53

P = 0.03

-0.65

P = 0.005

-0.25

P = 0.33

Number of interventions before 200/100,000 CEPID7

-0.43

P = 0.09

-0.49

P = 0.046

-0.26

P = 0.31

(ii)

CEPID7 at time of first intervention

0.25

P = 0.33

0.20

P = 0.44

0.20

P = 0.43

CEPID7 at time of second intervention

0.67

P = 0.004

0.62

P = 0.009

0.47

P = 0.06

CEPID7 at time of third intervention

0.71

P = .002

0.68

P = 0.003

0.48

P = 0.052

CEPID7 at time of fourth intervention

0.76

P = 0.0004

0.81

P = 0.0001

0.45

P = 0.07

CEPID7 at time of fifth intervention

0.69

P = 0.002

0.81

P = 0.0001

0.36

P = 0.16

CEPID7 at time of sixth intervention

0.43

P = 0.08

0.60

P = 0.01

0.18

P = 0.48

(iii)

CEPID7 at time of closing schools

0.67

P = 0.003

0.74

P = 0.0006

0.37

P = 0.14

CEPID7 at time of closing theaters

0.63

P = 0.007

0.78

P = 0.0002

0.24

P = 0.35

CEPID7 at time of closing churches

0.62

P = 0.007

0.75

P = 0.0005

0.23

P = 0.37

CEPID7 at time of closing dance halls

0.15

P = 0.55

0.15

P = 0.56

0.27

P = 0.30

CEPID7 at time of other closures

0.42

P = 0.09

0.44

P = 0.08

0.27

P = 0.29

CEPID7 at time of making influenza notifiable

0.21

P = 0.41

0.12

P = 0.64

0.24

P = 0.35

CEPID7 at time of bans on public gatherings

0.54

P = 0.03

0.67

P = 0.003

0.28

P = 0.28

CEPID7 at time of imposing case isolation

0.28

P = 0.28

0.26

P = 0.31

0.22

P = 0.40

CEPID7 at time of bans on public funerals

-0.03

P = 0.90

0.15

P = 0.56

-0.37

P = 0.14

Outcome: Excess weekly P&I deaths

Measure of interventions

(a) Peak

(b) Normalized peak

(c) 1918 total

(i)

Number of interventions before 50/100,000 CEPID10

-0.51

P = 0.04

-0.52

P = 0.03

-0.35

P = 0.17

Number of interventions before 100/100,000 CEPID10

-0.77

P = 0.0003

-0.77

P = 0.0003

-0.48

P = 0.0499

Number of interventions before 150/100,000 CEPID10

-0.74

P = 0.0007

-0.78

P = 0.0002

-0.44

P = 0.08

Number of interventions before 200/100,000 CEPID10

-0.77

P = 0.0003

-0.86

P<0.0001

-0.48

P = 0.049

Number of interventions before 250/100,000 CEPID10

-0.52

P = 0.03

-0.56

P = 0.02

-0.31

P = 0.23

Number of interventions before 300/100,000 CEPID10

-0.52

P = 0.03

-0.57

P = 0.02

-0.32

P = 0.20

(ii)

CEPID10 at time of first intervention

0.29

P = 0.26

0.24

P = 0.36

0.25

P = 0.33

CEPID10 at time of second intervention

0.70

P = 0.002

0.64

P = 0.005

0.52

P = 0.03

CEPID10 at time of third intervention

0.74

P = 0.0008

0.70

P = 0.002

0.52

P = 0.03

CEPID10 at time of fourth intervention

0.82 P = 0.0001

0.85

P<0.0001

0.53

P = 0.03

CEPID10 at time of fifth intervention

0.73

P = 0.0009

0.84

P <0.0001

0.43

P = 0.08

CEPID10 at time of sixth intervention

0.62

P = 0.009

0.73

P = 0.001

0.40

P = 0.11

CEPID10 at time of seventh intervention

0.66

P = 0.004

0.69

P = 0.002

0.49

P = 0.045

(iii)

CEPID10 at time of closing schools

0.67

P = 0.003

0.75

P = 0.0005

0.39

P = 0.13

CEPID10 at time of closing theaters

0.72

P = 0.001

0.85

P<0.0001

0.38

P = 0.14

CEPID10 at time of closing churches

0.66

P = 0.004

0.77

P = 0.0003

0.30

P = 0.25

CEPID10 at time of closing dance halls

0.17

P = 0.50

0.17

P = 0.50

0.30

P = 0.23

CEPID10 at time of other closures

0.48

P = 0.053

0.48

P = 0.049

0.35

P = 0.17

CEPID10 at time of making influenza notifiable

0.26

P = 0.30

0.18

P = 0.48

0.27

P = 0.30

CEPID10 at time of bans on public gatherings

0.60

P = 0.01

0.72

P = 0.001

0.36

P = 0.15

CEPID10 at time of imposing case isolation

0.29

P = 0.27

0.27

P = 0.30

0.23

P = 0.36

CEPID10 at time of bans on public funerals

-0.01

P = 0.98

0.16

P = 0.53

-0.34

P = 0.18

Intervention

Comments

No. of 17 cities implementing

Median (interquartile range) epidemic stage (CEPID) at time of implementation*

Making influenza a notifiable disease

Based on first definitive reference in available source(s)

15

5.6 (3.1, 25.9)

Emergency declarations

Official declaration of public health (or other) emergency by authorities

4

--

Isolation policies

Based on first definitive evidence of community-wide policy, beyond public exhortation alone (e.g., opening of isolation ward, designation of influenza hospital, implementation of policy of home isolation, etc.)

14

15.7 (7.6, 30.8)

Quarantine of households/

placarding of houses where infection identified

Based on first definitive reference in available source(s)

5

--

School closure

Based on date policy announced

14

30.8 (15.1, 96.3)

Church closure

Based on date policy announced

15

29.9 (12.4, 130.6)

Theater closure

Based on date policy announced

15

29.9 (10.3, 66.9)

Dance hall closure

Based on date policy announced

11

44.7 (12.4, --)

Other closure

Based on date policy announced (includes places of amusement such as billiard halls, saloons, soda fountains, etc.)

13

84.7 (29.9, 322.0)

Introduction of staggered business hours to reduce congestion in stores and on transit systems

Based on date policy announced; typically applied to retail outlets, not offices

8

--

Implementation of mask ordinances

Based on date of introduction of community-wide policy (some cities implemented mask orders for specific occupations but these were not scored as community-wide policies)

2

--

Implementation of rules forbidding crowding on streetcars

Based on implementation of community-wide policy, beyond public exhortation alone (i.e., evidence of enforcement)

6

--

Private funerals

Based on date policy announced; sometimes coupled with restrictions on weddings

11

92.1 (30.8,--)

Ban on door-to-door sales

Based on date policy announced

1

--

Interventions designed to reduce transmission in the workplace

Defined as implementation of community-wide policy to promote social distancing in workplace, beyond public exhortation alone

0

--

Protective sequestration of children

Defined as implementation of community-wide rules banning the public congregation of children or forbidding children to enter certain establishments (e.g., theaters, retail stores, etc.)

3

--

Ban on public gatherings

Based on date policy announced

15

30.8 (12.4, 118.1)

Implementation of no-crowding rules in locations other than transit systems

Based on implementation of community-wide policy, beyond public exhortation alone (i.e., evidence of enforcement)

3

--

Implementation of community-wide business closures

Scored for declaration of general business closure, not closure of specific kinds of establishment (e.g., ice cream parlors, taverns). Similar to current concept of "snow days". Based on dates of implementation.

1

--

Events

First reported case

"177 new 'flu' cases - Health office to take drastic action against disease - 10 more deaths at Meade", Baltimore Sun, October 2, 1918, p. 16.

First reported death

"'Flu' spreading in city - Over 30 cases reported by physicians in last few days - Only one death last week - Alleged control of disease termed camouflage in respect to civilians by Health Board', Baltimore Sun, September 29, 1918, p. 9.

Amplifying Events

Liberty Loan Parades

Video clip and description of event available from United States Library of Congress, accessed online at http://memory.loc.gov/cgi-bin/query/r?ammem/papr:@filreq(@field(NUMBER+@band(trmp+4147))+@field(COLLID+roosevelt)) on November 20, 2006.

Dates of Interventions

Reportable Disease

"37 die from flu - Edgewood Arsenal reports 23 and Meade 13 - 396 new cases at Meade", Baltimore Sun, September 30, 1918, p. 14.

Isolation

"177 new 'flu' cases - Health office to take drastic action against disease - 10 more deaths at Meade", Baltimore Sun, October 2, 1918, p. 16.

Schools

"'Flu' toll big; 78 die at Meade - Seventy victims reported by the Health Department - Schools to close; 30,000 are absent - New cases, including Sunday's, 1,650 - 667 in counties", Baltimore Sun, October 8, 1918, p. 16.

Churches

"Vaccine sent to check 'flu' - Supply received here from U.S. Medical School in Washington - Churches included in closing order - 214 deaths reported in city and 2,853 new cases are heard from", Baltimore Sun, October 11, 1918, p. 14; "No church tomorrow - First time in city's history sacred edifices ordered closed - Many previous epidemics - But modern science recognizes the necessity of preventing all unnecessary gatherings", Baltimore Sun, October 12, 1918, p. 5.

Theaters

"'Flu' toll up; theatres shut - All private schools and colleges ordered to close - Regulation applies to entire state - 117 deaths in city in last 33 hours - 91 soldiers die", Baltimore Sun, October 9, 1918, p. 16.

Dance halls

"177 new 'flu' cases - Health office to take drastic action against disease - 10 more deaths at Meade", Baltimore Sun, October 2, 1918, p. 16.

Other closures

"Vaccine sent to check 'flu' - Supply received here from U.S. Medical School in Washington - Churches included in closing order - 214 deaths reported in city and 2,853 new cases are heard from", Baltimore Sun, October 11, 1918, p. 14.

Staggered business hours

"'Flu' cuts store hours - Dr. Blake orders them to open after 9:30 and close at 4:30 - 81 die in city; 1525 new cases - 75 die at Meade, with 455 new cases - 15 expire at McHenry", Baltimore Sun, October 10, 1918, p. 16.

Private funerals

10/11/1918 is date of church closure; first reference to ban on funerals "Ban still on funerals - Churches opened today for all other regular services - Dr. Blake gives his reasons - Impossible because of poor ventilation and inadequate embalming - 110 deaths reported" Baltimore Sun, October 27, 1918, p. 14.

Ban on public gatherings

"Vaccine sent to check 'flu' - Supply received here from U.S. Medical School in Washington - Churches included in closing order - 214 deaths reported in city and 2,853 new cases are heard from", Baltimore Sun, October 11, 1918, p. 14; "Saloons restricted; Laurel Track closed - 'Flu' epidemic leads to order shortening business hours for bars - Dentists required to mask - Fewer new cases are reported in city and state - Fifty deaths occur at Meade and five at Fort McHenry", Baltimore Sun, October 12, 1918, p. 14; "'Flu' epidemic believed on wane - Death rate increases but fewer new cases are reported - Baseball games are banned - thirty-two soldiers die at Meade and 120 new cases of pneumonia are reported - Six succumb at Fort McHenry", Baltimore Sun, October 13, 1918, p. 14.

Events

First reported case

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 40, citing Forty-seventh Annual Report of the Health Department of the City of Boston for the Year 1918, p. 44. Also, Barry JM. The Great Influenza: The Epic Story of the Deadliest Plague in History. New York; Viking, 2004, p. 184. No citation.

First reported death

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 40, citing Boston Evening Transcript, September 10, 1918 (no page number); and Monthly Bulletin of the Health Department of the City of Boston, vol. 7 (September 1918), p. 184.

Amplifying Events

Liberty Loan Parades

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 40, citing Boston Daily Globe, September 3, 1918.

Other

Baseball Almanac, accessed online at http://www.baseball-almanac.com/ws/yr1918ws.shtml on November 20, 1918.

Dates of Interventions

Isolation

"Vigorous action to stamp out grippe - 18 deaths from disease in Boston yesterday - City hospital closed to visitors for indefinite period", Boston Daily Globe, September 18, 1918, p. 3.

Schools

"Influenza adds 1009 to death list in day - Boston schools close - Urgent appeal made for nurses - Governor calls attention to seriousness of situation in proclamation", Boston Daily Globe, September 25, 1918, p. 1.

Churches

"Saloons, billiard rooms, soda fountains closed - Order effective at 12:01 AM Sunday - Churches asked to suspend services - Gasoline ban remains - Day's deaths 183", Boston Daily Globe, October 5, 1918, p. 1; "'How dry I am' to be tune in Boston - King grippe hangs 'K.O' on drinking places - Churches and bowling alleys also closed by epidemic - Want something to do? Nothing doing", Boston Daily Globe, October 6, 1918, p. 4.

Theaters

"Public gatherings barred till Oct. 7 - Sunday church services declared optional - Better car service asked - Grippe deaths in 24 hours 156", Boston Daily Globe, September 27, 1918, p. 1.

Dance halls

"Public gatherings barred till Oct. 7 - Sunday church services declared optional - Better car service asked - Grippe deaths in 24 hours 156", Boston Daily Globe, September 27, 1918, p. 1.

Other closures

"Saloons, billiard rooms, soda fountains closed - Order effective at 12:01 AM Sunday - Churches asked to suspend services - Gasoline ban remains - Day's deaths 183", Boston Daily Globe, October 5, 1918, p. 1; "'How dry I am' to be tune in Boston - King grippe hangs 'K.O' on drinking places - Churches and bowling alleys also closed by epidemic - Want something to do? Nothing doing", Boston Daily Globe, October 6, 1918, p. 4.

Staggered business hours

"Big drop shown in influenza deaths - Day's total in Boston 149 - Reports encouraging - State-wide closing of all public meeting places urged - Day's developments in grippe situation", Boston Daily Globe, October 6, 1918, p. 1.

Private funerals

"Influenza deaths in Boston fewer - Red Cross rushing nurses and doctors here - Public funerals prohibited - Many churches to close", Boston Daily Globe, September 28, 1918, p. 1.

Ban on public gatherings

"Public gatherings barred till Oct. 7 - Sunday church services declared optional - Better car service asked - Grippe deaths in 24 hours 156", Boston Daily Globe, September 27, 1918, p. 1.

Events

First reported case

City of Cambridge, Massachusetts. Annual report of the Board of Health for the year ending December 31, 1918, Table D, p. 20.

First reported death

City of Cambridge, Massachusetts. Annual report of the Board of Health for the year ending December 31, 1918, Table D, p. 20.

Amplifying Events

Liberty Loan Parades

Cambridge Chronicle, October 19, 1918, p. 1.

Dates of Interventions

Reportable Disease

City of Cambridge, Massachusetts. Annual report of the Board of Health for the year ending December 31, 1918, p. 30.

Emergency Declaration

City of Cambridge, Massachusetts. Annual report of the Board of Health for the year ending December 31, 1918, p. 32.

Isolation

City of Cambridge, Massachusetts. Annual report of the Board of Health for the year ending December 31, 1918, p. 30.

Churches

City of Cambridge, Massachusetts. Annual report of the Board of Health for the year ending December 31, 1918, p. 32.

Other closures

City of Cambridge, Massachusetts. Annual report of the Board of Health for the year ending December 31, 1918, p. 32.

Private funerals

City of Cambridge, Massachusetts. Annual report of the Board of Health for the year ending December 31, 1918, p. 32.

Events

First reported case

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 40.

First reported death

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 40.

Amplifying Events

Liberty Loan Parades

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 106.

Dates of Interventions

Reportable Disease

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 82.

Isolation

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 104.

Quarantine

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, Chart XX, p. 81.

Theaters

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 106.

Dance halls

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 106.

Other closures

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 106.

Private funerals

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 112.

Protective Sequestration

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, Appendix E ("Letter to John Alcock, General Superintendent of Police, City of Chicago"), p. 147.

Ban on public gatherings

Robertson JD. Report and handbook of the Department of Health of the City of Chicago for the years 1911 to 1918 inclusive. Chicago, 1919, p. 106.

Events

First reported case

Sanitary Bulletin of the City of Cincinnati, October 1, 1918

First reported death

Amplifying Events

Liberty Loan Parades

Dates of Interventions

Reportable Disease

The Ohio Public Health Journal, Volume IX, Number 11, November 1918, p. 452

Isolation

Sanitary Bulletin of the City of Cincinnati, September 19, 1918

Quarantine

Sanitary Bulletin of the City of Cincinnati, September 19, 1918

Schools

Sanitary Bulletin of the City of Cincinnati, October 10, 1918

Churches

Sanitary Bulletin of the City of Cincinnati, October 10, 1918

Theaters

Sanitary Bulletin of the City of Cincinnati, October 10, 1918

Dance halls

Sanitary Bulletin of the City of Cincinnati, October 10, 1918

Other closures

Sanitary Bulletin of the City of Cincinnati, October 10, 1918

Private funerals

Sanitary Bulletin of the City of Cincinnati, October 10, 1918

Ban on public gatherings

Sanitary Bulletin of the City of Cincinnati, October 10, 1918

Events

First reported case

First reported death

Amplifying Events

Liberty Loan Parades

Dates of Interventions

Reportable Disease

The Ohio Public Health Journal, Volume IX, Number 11, November 1918, p. 452

Isolation

"1200 new cases of flu - Thirty-four more deaths are reported - Epidemic crisis near - Hospital facilities extended to meet situation", Cleveland Press, October 19, 1918.

Schools

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

Churches

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

Theaters

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

Dance halls

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

Other closures

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

Transit use discouraged

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

Private funerals

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

Ban on public gatherings

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

No crowding rule

The City Record of the Cleveland City Council, October 21, 1918, File No. 47932, citing promulgation of health regulations by Acting Commissioner of Health H.L. Rockwood.

Events

First reported case

First reported death

Amplifying Events

Liberty Loan Parades

Dates of Interventions

Reportable Disease

Richards S. 1918 Influenza pandemic: a glimpse of Indiana. Indiana State Department of Health. Accessed online at http://www.in.gov/isdh/dataandstats/epidem/2006/Feb/1918_influenza_pandemic.htm on November 12, 2006.

Emergency Declaration

"Flu pandemic state calamity - Governor calls on every county to form health commissions - Disease runs wild", Indianapolis Star, November 24, 1918.

Schools

"Influenza has reached epidemic stage in state - Tight lid is placed on all public meetings throughout Indiana - Board of Health acts", Fort Wayne News and Sentinel, October 10, 1918, p. 12. Also Richards S. 1918 Influenza pandemic: a glimpse of Indiana. Indiana State Department of Health. Accessed online at http://www.in.gov/isdh/dataandstats/epidem/2006/Feb/1918_influenza_pandemic.htm on November 12, 2006.

Churches

"Influenza has reached epidemic stage in state - Tight lid is placed on all public meetings throughout Indiana - Board of Health acts", Fort Wayne News and Sentinel, October 10, 1918, p. 12. Also Richards S. 1918 Influenza pandemic: a glimpse of Indiana. Indiana State Department of Health. Accessed online at http://www.in.gov/isdh/dataandstats/epidem/2006/Feb/1918_influenza_pandemic.htm on November 12, 2006.

Theaters

"Influenza has reached epidemic stage in state - Tight lid is placed on all public meetings throughout Indiana - Board of Health acts", Fort Wayne News and Sentinel, October 10, 1918, p. 12. Also Richards S. 1918 Influenza pandemic: a glimpse of Indiana. Indiana State Department of Health. Accessed online at http://www.in.gov/isdh/dataandstats/epidem/2006/Feb/1918_influenza_pandemic.htm on November 12, 2006.

Masks

"Board prepares to enforce flu mask wearing - Observance of order, effective today, to decide whether suspension of business is necessary - Cases drop slightly - School commissioners appeal for permission to reopen high schools, offering co-operation", Indianapolis Star, November 20, 1918, p. 1.

Ban on public gatherings

"Influenza has reached epidemic stage in state - Tight lid is placed on all public meetings throughout Indiana - Board of Health acts", Fort Wayne News and Sentinel, October 10, 1918, p. 12. Also Richards S. 1918 Influenza pandemic: a glimpse of Indiana. Indiana State Department of Health. Accessed online at http://www.in.gov/isdh/dataandstats/epidem/2006/Feb/1918_influenza_pandemic.htm on November 12, 2006.

Events

First reported case

"Stop gatherings - Schools, theaters, film shows and churches closed until influenza is checked - Health board orders it - The Board of Education will shut up the schools this afternoon - Cowgill authorized the issuance of the order to protect public health - Until further notice - the Liberty Bond Luncheons the only meetings that are excepted", Kansas City Star, October 7, 1918.

First reported death

"Ask Met. Aid in Influenza - Crowded cars a menace, health officials say - The company is asked not to let more than fifteen persons stand in a car - Many deaths and new cases", Kansas City Star, October 5, 1918.

Amplifying Events

Liberty Loan Parades

McGuinn N. Kansas City, Kansas Public School System, 1819-1961. Kansas City, Kansas; United School District 500, 1966. Accessed online at http://www.kckps.org/DISTHISTORY/dist-history/mcguinn/mcguinn_1918.htm on November 20, 2006.

Dates of Interventions

Reportable Disease

"To quarantine influenza - Missouri Health Board's orders in effect here", Kansas City Star, September 30, 1918.

Emergency Declaration

"Stop gatherings - Schools, theaters, film shows and churches closed until influenza is checked - Health board orders it - The Board of Education will shut up the schools this afternoon - Cowgill authorized the issuance of the order to protect public health - Until further notice - the Liberty Bond Luncheons the only meetings that are excepted", Kansas City Star, October 7, 1918.

Isolation

"To quarantine influenza - Missouri Health Board's orders in effect here", Kansas City Star, September 30, 1918.

Quarantine

"To quarantine influenza - Missouri Health Board's orders in effect here", Kansas City Star, September 30, 1918.

Schools

"Stop gatherings - Schools, theaters, film shows and churches closed until influenza is checked - Health board orders it - The Board of Education will shut up the schools this afternoon - Cowgill authorized the issuance of the order to protect public health - Until further notice - the Liberty Bond Luncheons the only meetings that are excepted", Kansas City Star, October 7, 1918.

Churches

"Stop gatherings - Schools, theaters, film shows and churches closed until influenza is checked - Health board orders it - The Board of Education will shut up the schools this afternoon - Cowgill authorized the issuance of the order to protect public health - Until further notice - the Liberty Bond Luncheons the only meetings that are excepted", Kansas City Star, October 7, 1918.

Theaters

"Stop gatherings - Schools, theaters, film shows and churches closed until influenza is checked - Health board orders it - The Board of Education will shut up the schools this afternoon - Cowgill authorized the issuance of the order to protect public health - Until further notice - the Liberty Bond Luncheons the only meetings that are excepted", Kansas City Star, October 7, 1918.

Other closures

"2nd hand and cleaning shops closed by city - Health officials believe influenza spread is due to old clothing", Kansas City Post, October 9, 1918.

Staggered business hours

"A drastic ban is on - Stores employing more than 25 are restricted, also, in the new influenza edict - Open at 9, close at 4 - Not more than 20 persons may stand in a street car, the Health Board orders - Public conveyances must keep the windows open - Stops music at hotels and cafes - Effective now indefinitely - All gatherings of 20 or more persons, including parties, weddings, and funerals prohibited", Kansas City Star, October 17, 1918.

Transit use discouraged

"Stop gatherings - Schools, theaters, film shows and churches closed until influenza is checked - Health board orders it - The Board of Education will shut up the schools this afternoon - Cowgill authorized the issuance of the order to protect public health - Until further notice - the Liberty Bond Luncheons the only meetings that are excepted", Kansas City Star, October 7, 1918.

Private funerals

"To quarantine influenza - Missouri Health Board's orders in effect here", Kansas City Star, September 30, 1918.

Protective Sequestration

"Flu bans in both cities removed at noon today - Conditions so much improved as to make restrictions unnecessary - Only 2 new cases - Monday's usually big death list was reduced to only 13", Kansas City Post, December 23, 1918.

Ban on public gatherings

"Stop gatherings - Schools, theaters, film shows and churches closed until influenza is checked - Health board orders it - The Board of Education will shut up the schools this afternoon - Cowgill authorized the issuance of the order to protect public health - Until further notice - the Liberty Bond Luncheons the only meetings that are excepted", Kansas City Star, October 7, 1918.

No crowding rule

"A drastic ban is on - Stores employing more than 25 are restricted, also, in the new influenza edict - Open at 9, close at 4 - Not more than 20 persons may stand in a street car, the Health Board orders - Public conveyances must keep the windows open - Stops music at hotels and cafes - Effective now indefinitely - All gatherings of 20 or more persons, including parties, weddings, and funerals prohibited", Kansas City Star, October 17, 1918.

Events

First reported case

Galishoff S. Newark and the great influenza pandemic of 1918. Bulletin of the History of Medicine 1969;43(3):246-258. No citation.

First reported death

Amplifying Events

Liberty Loan Parades

Dates of Interventions

Isolation

Galishoff S. Newark and the great influenza pandemic of 1918. Bulletin of the History of Medicine 1969;43(3):246-258, citing Newark Evening News, September 27, 1918.

Schools

Galishoff S. Newark and the great influenza pandemic of 1918. Bulletin of the History of Medicine 1969;43(3):246-258, citing Newark Evening News, October 10, 1918.

Churches

Galishoff S. Newark and the great influenza pandemic of 1918. Bulletin of the History of Medicine 1969;43(3):246-258, citing Newark Evening News, October 10, 1918.

Theaters

Galishoff S. Newark and the great influenza pandemic of 1918. Bulletin of the History of Medicine 1969;43(3):246-258, citing Newark Evening News, October 10, 1918.

Dance halls

Galishoff S. Newark and the great influenza pandemic of 1918. Bulletin of the History of Medicine 1969;43(3):246-258, citing Newark Evening News, October 10, 1918.

Other closures

Galishoff S. Newark and the great influenza pandemic of 1918. Bulletin of the History of Medicine 1969;43(3):246-258, citing Newark Evening News, October 10, 1918.

Ban on public gatherings

Galishoff S. Newark and the great influenza pandemic of 1918. Bulletin of the History of Medicine 1969;43(3):246-258, citing Newark Evening News, October 10, 1918.

Events

First reported case

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 63, citing Annual Report of Surgeon General of Public Health Service 1919, p. 123, and Public Health Reports, vol. 33 (September 27, 1918), p. 1625.

First reported death

Amplifying Events

Liberty Loan Parades

Dates of Interventions

Reportable Disease

"Closing schools sought to stop dread epidemic - Surgeon General of Public Health Service wants meetings to stop" New Orleans Times-Picayune, October 8, 1918, p. 5.

Isolation

"Closing schools sought to stop dread epidemic - Surgeon General of Public Health Service wants meetings to stop" New Orleans Times-Picayune, October 8, 1918, p. 5. Also, "Red Cross nurses of Gulf Division are mobilizing - Spread of influenza calls for experienced workers to volunteer", New Orleans Times-Picayune, October 8, 1918, p. 14.

Schools

"Schools closed; churches also will suspend - Drastic steps taken to prevent further spread of influenza", New Orleans Times-Picayune, October 9, 1918, p. 1. Also, Parish of Orleans and City of New Orleans. Report of the Board of Health, 1919, p. 131.

Churches

Parish of Orleans and City of New Orleans. Report of the Board of Health, 1919, p. 131.

Theaters

Parish of Orleans and City of New Orleans. Report of the Board of Health, 1919, p. 131.

Dance halls

"Schools closed; churches also will suspend - Drastic steps taken to prevent further spread of influenza", New Orleans Times-Picayune, October 9, 1918, p. 1. Also, Parish of Orleans and City of New Orleans. Report of the Board of Health, 1919, p. 131.

Other closures

"Schools closed; churches also will suspend - Drastic steps taken to prevent further spread of influenza", New Orleans Times-Picayune, October 9, 1918, p. 1. Also, Parish of Orleans and City of New Orleans. Report of the Board of Health, 1919, p. 131.

Staggered business hours

"All shows, churches are ordered closed to fight epidemic", New Orleans Times-Picayune, October 10, 1918, p. 1.

Transit use discouraged

"All shows, churches are ordered closed to fight epidemic", New Orleans Times-Picayune, October 10, 1918, p. 1. Also, Parish of Orleans and City of New Orleans. Report of the Board of Health, 1919, p. 131.

Ban on public gatherings

Parish of Orleans and City of New Orleans. Report of the Board of Health, 1919, p. 131.

No crowding rule

Parish of Orleans and City of New Orleans. Report of the Board of Health, 1919, p. 131.

Events

First reported case

"To fight Spanish grip. - Health officials discuss an educational campaign on the disease", New York Times, September 16, 1918, p. 10.

First reported death

Barry JM. The Great Influenza: The Epic Story of the Deadliest Plague in History. New York; Viking, 2004, p. 270. No citation. See also, "Find 114 new cases of influenza here - Health Commissioner says heeding of warnings will prevent spread of illness - No need for isolation - Hospitals to observe a "modified quarantine" - 10,000 placards forbid coughing and sneezing", New York Times, September 24, 1918, p. 9.

Amplifying Events

Liberty Loan Parades

"Acclaim Wilson as he marches in big Loan parade - President walks the entire route, smiling and bowing to city's tribute - Enthusiast tries to reach him to shake his hand and is beaten by crowd - Roars for war veterans - Allied fighters get rousing reception in their march down Fifth Avenue", New York Times, October 13, 1918, p. 1.

Dates of Interventions

Reportable Disease

"Must report all Spanish influenza - Pneumonia, its sequel, is now listed by Health Board to check spread here - 30 new cases at Upton - Three also stricken in family of Jersey City soldier home on leave from Camp Dix", New York Times, September 18, 1918, p. 24.

Isolation

"Find 114 new cases of influenza here - Health Commissioner says heeding of warnings will prevent spread of illness - No need for isolation - Hospitals to observe a "modified quarantine" - 10,000 placards forbid coughing and sneezing", New York Times, September 24, 1918, p. 9.

Staggered business hours

"Drastic steps taken to fight influenza here - Health Board issues 4 P.M. closing orders for all stores except food and drug stores - Hours for factories are fixed - Plan, in effect today, to reduce crowding on transportation lines in rush periods. - Time table for theatres - Radical regulations necessary to prevent shutting city up tight, says Dr. Copeland", New York Times, October 5, 1918, p. 1.

Transit use discouraged

"New cases reach higher total here; 352 of influenza in yesterday's report, Brooklyn leading - 22 deaths, including pneumonia", New York Times, September 29, 1918, p. 15.

Events

First reported case

First reported death

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 38, citing Omaha World-Herald, October 3, 1918 (no page number).

Amplifying Events

Liberty Loan Parades

Other

Gernhart G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 41, citing Omaha Daily Bee, October 5, 1918 (no page number).

Dates of Interventions

Reportable Disease

Gernhart G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 40, citing Omaha Daily News, October 10, 1918 (no page number).

Quarantine

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 66, citing Omaha World-Herald, December 20, 1918 (no page number).

Schools

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 38, citing Omaha World-Herald, October 4, 1918 (no page number).

Churches

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 38, citing Omaha World-Herald, October 4, 1918 (no page number).

Theaters

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 38, citing Omaha World-Herald, October 4, 1918 (no page number).

Other closures

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 49, citing Omaha World-Herald, October 22, 1918 (no page number).

Staggered business hours

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 49, citing Omaha World-Herald, October 22, 1918 (no page number).

Transit use discouraged

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 61, citing Omaha World-Herald, December 12, 1918 (no page number).

Private funerals

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 47, citing Omaha Daily Bee, October 12, 1918 (no page number).

Ban on public gatherings

Gernhart, G. A forgotten enemy: Omaha encounters the 1918 influenza pandemic. MA Thesis, Department of History, University of Nebraska, December 1998, p. 49, citing Omaha World-Herald, October 22, 1918 (no page number).

Events

First reported case

Barry JM. The Great Influenza: The Epic Story of the Deadliest Plague in History. New York; Viking, 2004, p. 201. No citation. Also Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 71, citing Philadelphia Inquirer, September 19, 1918 (no page number).

First reported death

Barry JM. The Great Influenza: The Epic Story of the Deadliest Plague in History. New York; Viking, 2004, p. 201. No citation.

Amplifying Events

Liberty Loan Parades

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 72, citing Philadelphia Inquirer, September 29, 1918 (no page number).

Dates of Interventions

Reportable Disease

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 71, citing Johnston JI, "History and Epidemiology of Epidemic Influenza," Studies on Epidemic Influenza. Publications from the University of Pittsburgh School of Medicine (1919) (n.p., n.d.), p. 20.

Isolation

Barry JM. The Great Influenza: The Epic Story of the Deadliest Plague in History. New York; Viking, 2004, p. 221. No citation.

Schools

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 74, citing Philadelphia Inquirer, October 4, 1918 (no page number). Also, "Pennsylvania closes all meeting places - Philadelphia appeals for physicians to check rapid spread of influenza there", New York Times, October 4, 1918, p. 24; "Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006.

Churches

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 74, citing Philadelphia Inquirer, October 4, 1918 (no page number). Also, "Pennsylvania closes all meeting places - Philadelphia appeals for physicians to check rapid spread of influenza there", New York Times, October 4, 1918, p. 24; "Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006.

Theaters

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 74, citing Philadelphia Inquirer, October 4, 1918 (no page number). Also, "Pennsylvania closes all meeting places - Philadelphia appeals for physicians to check rapid spread of influenza there", New York Times, October 4, 1918, p. 24; "Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006.

Dance halls

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 74, citing Philadelphia Inquirer, October 4, 1918 (no page number). Also, "Pennsylvania closes all meeting places - Philadelphia appeals for physicians to check rapid spread of influenza there", New York Times, October 4, 1918, p. 24; "Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006.

Other closures

Crosby AW. America's Forgotten Pandemic: The Influenza of 1918 (2nd Edition). New York; Cambridge University Press, 2003, p. 74, citing Philadelphia Inquirer, October 4, 1918 (no page number). Also, "Pennsylvania closes all meeting places - Philadelphia appeals for physicians to check rapid spread of influenza there", New York Times, October 4, 1918, p. 24; "Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http//www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006.

Private funerals

"Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Ban on public gatherings

"Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Events

First reported case

"Physicians order to report cases", Pittsburgh Sun, October 4, 1918, accessed online (ps03) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 12, 2006

First reported death

Amplifying Events

Liberty Loan Parades

"Liberty Day program", Pittsburgh Sun, October 11, 1918, accessed online (ps20) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 20, 2006.

Dates of Interventions

Reportable Disease

"Influenza sweeping nation; Pittsburgh under quarantine - Measures taken in many directions by health authorities to check disease - Saloons are closed - Also all places of amusement - Church and school attendance to be limited - Protect hospitals", Pittsburgh Gazette Times, October 5, 1918, accessed online (pgt07) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Isolation

"Influenza sweeping nation; Pittsburgh under quarantine - Measures taken in many directions by health authorities to check disease - Saloons are closed - Also all places of amusement - Church and school attendance to be limited - Protect hospitals", Pittsburgh Gazette Times, October 5, 1918, accessed online (pgt07) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Schools

"Schools close as deaths from epidemic grow - Decrease in number of new cases, however, is reported this morning - Nurses are mobilized", Pittsburgh Sun, October 24, 1918, accessed online (ps35) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Churches

"Churches are closed under health order - Sale of liquor in clubs as well as on hotel tables stopped to thwart influenza - Health inspector dies", Pittsburgh Sun, October 7, 1918, accessed online (ps13) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Theaters

"Closing order will be obeyed in Pittsburgh - Managers of theaters act promptly - No performances today - Nurses called for", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Private funerals

"Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Ban on public gatherings

"Growth of epidemic prompts drastic order by Dr. Royer - Health officials throughout Pennsylvania told to enforce edict to letter - All amusements hit - Closing of schools and churches left to discretion of local boards - Other cities act", Pittsburgh Gazette Times, October 4, 1918, accessed online (pgt06) at http://www.med.umich.edu/medschool/chm/influenza/wpib.htm on November 10, 2006

Events

First reported case

"Pneumonia increases", Seattle Post-Intelligencer, September 26, 1918, p. 5.

First reported death

Communication from the Mayor to the Seattle City Council, October 7, 1918. Seattle City Clerk's Office, Comptroller File 71547.

Amplifying Events

Liberty Loan Parades

Dates of Interventions

Reportable Disease

"Epidemic takes 23 as new serum is offered here", Seattle Daily Times, October 6, 1918, p. 1.

Emergency Declaration

Ordinance No. 38799 of the Seattle City Council, signed by Mayor Hanson October 9, 1918.

Isolation

Ordinance No. 38799 of the Seattle City Council, signed by Mayor Hanson October 9, 1918. Also, "504 more cases of influenza - Number of sufferers from malady reported since Saturday now reaches 806. - Thousands are being inoculated with new serum with good results, say officers", Seattle Daily Times, October 9, 1918, p. 1.

Quarantine

Ordinance No. 38971 of the Seattle City Council, signed by Mayor Hanson December 5, 1918.

Schools

"Churches, schools, shows close - Epidemic puts ban on all public assembly", Seattle Daily Times, October 5, 1918, p. 1.

Churches

"Churches, schools, shows close - Epidemic puts ban on all public assembly", Seattle Daily Times, October 5, 1918, p. 1.

Theaters

"Churches, schools, shows close - Epidemic puts ban on all public assembly", Seattle Daily Times, October 5, 1918, p. 1.

Dance halls

"Churches, schools, shows close - Epidemic puts ban on all public assembly", Seattle Daily Times, October 5, 1918, p. 1.

Other closures

"Churches, schools, shows close - Epidemic puts ban on all public assembly", Seattle Daily Times, October 5, 1918, p. 1.

Masks

"Seattle ordered to wear masks to prevent malady", Seattle Daily Times, October 28, 1918, p. 1. Also, "Wear influenza masks or walk, mayor orders - No excuses for not obeying rule will be accepted tomorrow, declares Hanson", Seattle Daily Times, October 28, 1918, p. 1.

Ban on public gatherings

"Churches, schools, shows close - Epidemic puts ban on all public assembly", Seattle Daily Times, October 5, 1918, p. 1.

Events

First reported case

"Family of seven here ill with influenza", St. Louis Post-Dispatch, October 5, 1918.

First reported death

Alfred A. Jost, d. 10/3/1918, as reported in St. Louis Obituary Index, at http://www.slpl.lib.mo.us/libsrc/obit18b.htm, accessed on November 12, 2006.

Amplifying Events

Liberty Loan Parades

"Thousands view big military parade in downtown streets - Cost of war brought home to public in huge spectacle in which all branches of the service were represented." St. Louis Globe-Democrat, September 28, 1918, Part II, p. 1.

Dates of Interventions

Reportable Disease

"Fifty show symptoms of influenza in city", St. Louis Post-Dispatch, October 6, 1918, p. 7B.

Isolation

"Influenza closing order extended to all churches - Dancing in hotels and cafes banned", St. Louis Post-Dispatch, October 8, 1918, p. 1.

Schools

"To close schools and theaters to check influenza", St. Louis Post-Dispatch, October 7, 1918, p. 1.

Churches

"Influenza closing order extended to all churches - Dancing in hotels and cafes banned", St. Louis Post-Dispatch, October 8, 1918, p. 1.

Theaters

"To close schools and theaters to check influenza", St. Louis Post-Dispatch, October 7, 1918, p. 1.

Dance halls

"Influenza closing order extended to all churches - Dancing in hotels and cafes banned", St. Louis Post-Dispatch, October 8, 1918, p. 1.

Other closures

"Influenza closing order extended to all churches - Dancing in hotels and cafes banned", St. Louis Post-Dispatch, October 8, 1918, p. 1.

Staggered business hours

"Big stores to close at 4 p.m. next week", St. Louis Post-Dispatch, October 19, 1918. Also, "New saloon hours for downtown zone", St. Louis Post-Dispatch, October 22, 1918, p. 6.

Transit use discouraged

"City takes action to check influenza - Street cars, by this order, will not carry any straphangers", St. Louis Post-Dispatch, November 8, 1918, p. 8.

Door-to-door sales

"559 new influenza cases and 32 deaths - Mortality for 24 hours largest yet, but the percentage is small", St. Louis Post-Dispatch, October 18, 1918, p. 3.

Protective Sequestration

"Schools closed, children banned from theaters - 707 more cases up to noon today", St. Louis Post-Dispatch, November 28, 1918, p. 1.

Ban on public gatherings

"Governor forbids all public gatherings in state", St. Louis Post-Dispatch, October 9, 1918, p. 2.

Snow Days

"City takes action to check influenza - Street cars, by this order, will not carry any straphangers", St. Louis Post-Dispatch, November 8, 1918, p. 8. Also "Closing order in force, and is generally obeyed", St. Louis Post-Dispatch, November 9, 1918, p. 1.

Events

First reported case

"Influenza kills here - One death and two new cases reported in District - Thousands ill at camps - Eighteen fatal cases in day at Camp Devens and fourteen at Camp Dix - Army nurse dead at Bridgeport, Conn. - Fewer cases at New York and Boston", Washington Post, September 22, 1918, p. 3.

First reported death

"Influenza kills here - One death and two new cases reported in District - Thousands ill at camps - Eighteen fatal cases in day at Camp Devens and fourteen at Camp Dix - Army nurse dead at Bridgeport, Conn. - Fewer cases at New York and Boston", Washington Post, September 22, 1918, p. 3.

Amplifying Events

Liberty Loan Parades

"Sousa to help Loan - Band of 300 pieces here today for parade and concerts - At Liberty Hut tonight - Saturday's subscriptions in District estimated at $3,000,000. - Banks will remain open tonight and tomorrow night until 9 o'clock to encourage early pledges - Part payments of $5 and $10 monthly on $50 and $100 bonds will be taken by banks", Washington Post, September 30, 1918, p. 1.

Dates of Interventions

Reportable Disease

"Seven die of epidemic - Day's report on Spanish influenza lists 57 new cases - 30 victims in District jail - Conference of Potomac Division of American Red Cross planned for today at Roanoke abandoned. Teachers sending home children suspected of having disease", Washington Post, October 1, 1918, p. 1.

Schools

"City fights grippe with severe steps - All schools are closed; theaters may follow - Store opening at 10 A.M. - Cigar stands and news dealers exempt from order - 11 deaths in city yesterday", Washington Post, October 3, 1918, p. 1.

Churches

"47 more die of 'flu' - Number greatest since malady swept city; 1,466 new cases - Stop all public meetings - Brownlow and Fowler also fix status of church services - Health officer denounces landlords who fail to heat apartments. Marked increase in new cases and deaths at Army camps. Total Army cases 198,799. Pneumonia also is spreading", Washington Post, October 10, 1918, p. 1.

Theaters

"Theaters closed to stay influenza - Movies and public dance halls also in order - Churches next likely - Crest of epidemic has not yet reached city; 11 deaths - Doctors too busy to report - Commissioners active directing measures - Private schools asked to close - Hospital established for girl war workers - Staggered hours in effect - Washington is made sanitary zone with Dr. Mustard in command", Washington Post, October 4, 1918, p. 1.

Dance halls

"Theaters closed to stay influenza - Movies and public dance halls also in order - Churches next likely - Crest of epidemic has not yet reached city; 11 deaths - Doctors too busy to report - Commissioners active directing measures - Private schools asked to close - Hospital established for girl war workers - Staggered hours in effect - Washington is made sanitary zone with Dr. Mustard in command", Washington Post, October 4, 1918, p. 1.

Staggered business hours

"City fights grippe with severe steps - All schools are closed; theaters may follow - Store opening at 10 A.M. - Cigar stands and news dealers exempt from order - 11 deaths in city yesterday", Washington Post, October 3, 1918, p. 1.

Private funerals

"'Flu' kills 24 more - 279 new cases in District, making total about 10,000 - Ban on public funerals - Dr. Fowler also warns people not to come to Washington - Hospitals so crowded no facilities are left patients from out of town - Declares relatives of stricken should remain away. Health officer warns of danger in attending meetings", Washington Post, October 7, 1918, p. 1.

Ban on public gatherings

"City fights grippe with severe steps - All schools are closed; theaters may follow - Store opening at 10 A.M. - Cigar stands and news dealers exempt from order - 11 deaths in city yesterday", Washington Post, October 3, 1918, p. 1.