On October 5th, influenza cases were reported in Des Moines and Dodge City. By October 11th, the disease was reported in Des Moines, Dodge City, and Onawa. By October 11th, the PHS was reporting 8,169 cases with 72 deaths. The PHS added, somewhat ominously, that the number of cases "appears to be increasing." On October 25th, 136 localities in the state reported 2,513 new cases and 28 deaths. The disease peaked in the state during the week of October 19th, when there were a total of 21,117 cases.

Travel would have been restricted on the Chicago & North Western Railway passenger train passing over Des Moines River during the epidemic. c. 1900 [Credit: The Library of Congress]

The base hospital at Camp Dodge was quarantined on September 28th. Two days later, all of Camp Dodge was quarantined - there were 500 cases there. The first three deaths were reported Oct. 1st. At Camp Dodge, there were 245 nurses on duty on October 10th. Six days later the number of nurses had increased to 598. "I must lean heavily upon the Red Cross, and I am afraid the demands in this matter will tax your resources and endurance. Eventually the War Department will meet the requirements, but the emergency must be met by you," Major Burch, the hospital commander at Camp Dodge, told the Red Cross. Everyone at the base hospital was required to wear a gauze mask, leading to a request of 20,000 masks from the Red Cross. By early October, fourteen barrack buildings and the base hospital were being used to treat more than 3,000 ill personnel by Oct. 4.

On October 9th, Dr. Guilford Sumner, the state health commissioner, banned all indoor funerals for influenza victims. From that date forward, only outdoor funerals were permitted.

The search for a cure was constant. One newspaper report advocated an injection of a sterile solution of 1.54 grams of iodine in combination with creosote and gualacol. The treatment was ineffective but many Iowans were desperate enough to try this and other treatments.

Theatres and public places would have been closed on Locust St., Des Moines, Iowa., c. 1901. [Credit: The Library of Congress]

On October 5th, The Des Moines Tribune reported that local hospitals were unable to care for influenza patients and hospital staff had begun to refuse to admit patients with the flu. In Marshalltown, the YMCA was transformed into an emergency hospital to care for influenza patients.

The situation in Des Moines was so dire that the Surgeon General himself suggested that city officials close all of the theaters and other public places to prevent the spread of the disease. Beginning October 8th, school officials barred children from attending school if they lived in a house with anyone who had influenza. Two days later, the city issued a general quarantine, closing all schools, pool halls, theaters, and all other public places. Streetcars continued to run but conductors wore masks. Stores remained open but with shortened hours. Teachers, freed from the classroom, were encouraged to conduct "sanitary detective work:" they received full pay if they participated in a door-to-door survey to determine the number of cases in the city.

In November, the end of World War I meant victory parades in many Iowa cities and towns. In Des Moines, crowds gathered for a two hour parade; this gathering may have exacerbated the spread of influenza. In the wake of this parade, city officials required citizens to wear masks in the hopes that the masks would limit the disease; the masks failed to protect the citizens.

The Iowa State Dental Society urged people "to diligently clean their mouths, noses and throats at least twice a day. We suggest that the old excuse of 'Haven't time,' 'Never saw a toothbrush," and 'Lost mine yesterday," be discarded for the present, at least." This type of advice may seem basic to us today. In 1918, however, many Americans did not yet understand how diseases were spread, so advice of this sort was crucial.

The disease peaked in the state during the fall. However, influenza remained prevalent throughout the state during the winter and spring of 1919. By the summer, the disease had slowly begun to disappear from the state.