The 1918-1919 influenza — "Spanish Flu" — pandemic ranks as one of the deadliest global disease outbreaks in recorded history with an estimated 50 million to 100 million deaths worldwide. Nearly 700,000 people are estimated to have died in the United States alone.
In Arkansas, about 7,000 residents were estimated to have died due to the flu.
The term Spanish Flu was a misnomer, as the disease did not begin in Spain. Remaining neutral during World War I, Spain was the first country to report to the world the fast-acting disease's ferocity, while government officials in other countries, especially those involved in the hostilities, censored the information.
The flu reached pandemic proportions in different parts of the United States at different times in late 1918. The appearance of the flu in the fall of 1918 is considered a second wave of the pandemic. The first wave, in early spring of that year, was minor compared to what happened in the fall, and yet another wave struck in the early months of 1919.
Urban areas were infected sooner than the rural areas, most likely because of population density and the high volume traffic. Arkansas' population was about 1.5 million in 1918, and Little Rock was the state's most populated city at more than 60,000. The Central Arkansas area, as a result, was the first in the state to be hit by the pandemic.
Central Arkansas was also hardest hit in terms of ultimate fatalities, followed by the northwestern corner. The Delta counties reported the lowest mortality rates during the pandemic, even though the majority of the state's Black population lived in that area. Poor access to medical care resulted in the Black communities in the United States being affected disproportionately.
Lackluster record keeping most likely resulted in some deaths not being accurately recorded as influenza-related or not reported at all, so the death rate is most likely higher than reported.
GRADUAL AWARENESS
Astute Arkansans would have followed the global progression of the 1918 influenza season through newspaper articles. Seasonal flu had roused concern for years, because of earlier pandemics. But seasonal flu came and went. Newspapers began reporting disease outbreaks including influenza in military camps and the health status of training camps in 1916, but the focus was not on flu.
Articles began to sporadically appear in the Arkansas Democrat and Arkansas Gazette beginning in early April 1918 reporting cases of influenza around the world. The June 17 issue of the Gazette carried a two-paragraph mention of an outbreak in Berlin, while the July 10 issue of the Democrat announced that German Emperor William II was afflicted.
By mid-September 1918, cases were appearing in the civilian population in larger cities of the northeastern United States, before any reported cases were on military bases. It is likely that soldiers returning from the war in Europe brought the influenza back to American shores.
While the front pages of the two statewide newspapers brought news from the war front, on Page 8 of the Sept. 18 issue of the Democrat, readers were alerted to the new presence of influenza in Little Rock: "Influenza Epidemic Is Sweeping the Country," proclaimed the headline. One case of the "Spanish influenza — the real thing and as Spanish as a bullfight or a fandango ..." was diagnosed in the city according to Dr. J.C. Geiger, the United States Public Health Service official stationed in the capital city.
Geiger noted that there was no immunity for influenza and warned that there would be additional cases.
In the next five months, the influenza pandemic would become front-page news as it ravaged the state.
Two days after the Democrat's announcement that the Spanish flu had made its entrada into Little Rock, the Gazette proclaimed, on Page 12 nonetheless, that the disease, according to Geiger, was just the old-fashioned garden variety of the flu, the plain old "La Grippe" as the disease was often called because of the grip the disease got on its victims.
RAPID SPREAD
By Sept. 24, more than 100 cases of the flu had been identified at Carlisle in Lonoke County. Geiger placed the town under quarantine, the schools were closed, and no one was allowed to enter or leave the town without having a certificate from health authorities. This quarantine early in the Arkansas spread was a harbinger of darker times.
The Sept. 26 edition of the Gazette noted that Camp Pike (today's Camp Robinson) in the northern part of Pulaski County had started to take precautionary measures to prevent the spreading of what camp officials called "bad colds." Individual units had already been quarantined on the military base. With more than 50,000 soldiers and employees in Camp Pike, the base could easily have qualified as Arkansas' second-largest city, behind Little Rock. Because of the cramped quarters found in military camps, an outbreak of the flu at Camp Pike could potentially spread very quickly. Indeed, the situation grew more serious daily, although camp officials downplayed the severity of the outbreak, calling reports of the camp as a "hotbed of influenza infection" German propaganda.
Although camp officials did not anticipate a general quarantine of the camp initially, as the number of cases increased, stricter measures were implemented. Congregation in previously quarantined areas was prohibited; moving-picture shows were canceled and visitors were discouraged from visiting the camp. Cases grew exponentially over the following days, though, totaling about 7,600 by the first of October.
The Oct. 1 issue of the Gazette ran two significant articles regarding the flu. One noted that influenza had claimed its first victim at Eberts Field, the recently built training airfield in Lonoke. That base had more than 100 reported cases of the flu among its nearly 1,000 population.
The Gazette also quoted Geiger about the situation in Little Rock under the headline "Influenza Epidemic Threatens the City":
"It is apparent that Little Rock is about to enter the Spanish influenza zone," Geiger noted. He reported that 67 cases of the disease had been reported in the capital city in the last two days, but he still did not consider the situation serious.
Despite the number of flu cases increasing dramatically day by day, including a total of 131 new cases on Oct. 2. Geiger reassured the public that the situation was under control. But he cautioned people with colds or other symptoms of the disease to stay at home. "Visiting should be curtailed," he warned.
Geiger, for the first time, raised the possibility of placing Little Rock under a quarantine.
CAMP PIKE
Little Rock, though, wasn't the only city on the verge of an outbreak. Dr. Charles W. Garrison, the state health officer, reported that the pandemic was spreading around the state and had reached Hot Springs, Stuttgart and El Dorado. Hot Springs closed its schools as a precautionary measure, and other towns followed suit, even though Geiger insisted closure was unnecessary. The Oct. 5 issue of the Gazette noted that 400 cases were spread throughout the state, excluding Little Rock.
While Little Rock was beginning to see an increase in cases, Camp Pike was being ravaged by the disease. The number of cases reported at the camp jumped exponentially. The rate of infection alarmed camp officials so much that a general quarantine on the entire camp was issued.
While the quarantine — reported in the Gazette on Oct. 3 — provided some defense against the disease, the flu still advanced through the camp. Also Oct. 3, the Gazette quoted undertakers as saying that 25 soldiers and one nurse had died at Camp Pike. The story noted that the death toll was likely higher because soldiers who died of pneumonia secondary to the flu were not included in the count.
The mortality rate from influenza at Camp Pike was so high that Owens & Company, the undertakers in North Little Rock that had the government contract for the camp, was overwhelmed. The funeral home worked night and day shifts, and the Army assigned nine government embalmers to Owens to keep up with the deaths.
The Democrat and Gazette, as well as other newspapers across the state, were filled with obituaries of soldiers who had died from the flu at Camp Pike — until the camp commandant instructed the staff at Owens & Company not to supply the newspapers with the obituaries for soldiers because the string of deaths at the camp was hurting morale.
STATEWIDE LOCKDOWN
The situation in Little Rock continued to deteriorate as October progressed. Geiger, though, in his usual manner, continued to declare the influenza pandemic was not alarming. He declared that a quarantine in Little Rock was unnecessary despite the number of cases doubling daily. The Oct. 6 Gazette quoted a telegram Geiger sent to the U.S. surgeon general, stating, "A general quarantine is both unwise and unnecessary."
The Gazette was a morning newspaper; the Democrat appeared in the afternoon. The morning of Oct. 7, the Gazette reported Geiger had advised boarding schools with outbreaks to segregate sick students, quarantine themselves and not to send their students home. That afternoon's issue of the Democrat reported on its front page the imposition of a statewide quarantine.
The headline read: "Drastic Statewide Quarantine Order to Check Influenza."
By this time, Little Rock cases of the flu had reached 1,800. The quarantine affected every aspect of life. Schools, churches, fairs and other places of amusement — and any public gathering — were ordered closed by Geiger. Furthermore, the order prohibited children under 18 years of age from boarding a streetcar or being on the streets except as an absolute necessity.
Across the state, towns shut down as the quarantine went into effect. Venerable institutions such as the University of Arkansas shuttered their doors as the flu continued its march there, but the tuberculosis sanatorium at Booneville went on lockdown and remained influenza-free for the duration of the pandemic.
FAMILY TRAGEDIES
Stories about multiple members of families succumbing to influenza became a regular feature in the papers. One such story in the Gazette (Oct. 11, Page 2) was about the Barrett family from Helena. Emma Barrett and her two sons, Robert and Charles, died within hours of one another, all from complications from the flu. Their deaths left Mr. Barrett and his one remaining son alone.
This scene, unfortunately, was repeated around the state throughout the duration of the pandemic.
The pandemic raged on in Little Rock. By Oct. 10, there were reported another 951 cases of the flu, bringing the total reported cases to more than 3,100. Geiger, who up to this point was still assuring the public that the pandemic was not bad, finally admitted in an interview that the situation was "unquestionably bad." Yet, he stated it was well under control and not as serious as it was sometimes rumored to be. He urged people not to congregate or spit on the sidewalk, which could spread the disease.
On Oct. 17, the Democrat announced that the pandemic at Camp Pike was virtually over. The camp had been on quarantine since early October. Much praise was heaped on Col. Charles Miller, the camp's commanding officer. Editorials praised him for his prompt measures in handling the disease. His efforts to keep morale up at the camp were also commended. Of special note were the "cheer-up wagons" that went through camp to lift the men's spirits. These wagons furnished music and vaudeville shows.
The statewide quarantine was modified Oct. 24 to allow the reopening of colleges, universities and boarding schools. Churches were allowed one service each on Sundays, and the Little Rock Public Library was also allowed to reopen. Public schools, though, remained shuttered until early November.
On Oct. 26, Camp Pike officials announced the quarantine there was lifted. In all, it was estimated more than 10,000 camp personnel had been infected with influenza and more than 700 had died.
On Nov. 2, the quarantine for Little Rock and North Little Rock was lifted.
Dr. C.W. Garrison, the state health officer, declared in early December that the flu was leaving Little Rock. In mid-December, though, Garrison issued a warning to local officials that cases of influenza were on the rise, a situation that continued into January.
In fact, so many reinfections were occurring that Geiger warned in the Jan. 17 Democrat that a second quarantine might be necessary.
The second quarantine never materialized, though, as the influenza cases declined.
While the flu is an annual occurrence and remains deadly, Arkansans of 2020 have vaccines and other advances in science to combat the disease.
Timothy G. Nutt is an Arkansas historian and archivist.