Kansas is often considered to be ground zero for the 1918 pandemic.

In late January and early February of 1918, a local physician in haskell County noticed a rash of severe influenza cases. Although the physician had seen many cases of influenza throughout his career, these cases were extraordinary. Influenza, usually a mild disease, had suddenly become a killer. Over the course of the next two months, influenza ran rampant through Haskell County, cutting a swath among the county's residents.

At the time, few public health experts viewed influenza as a threat and local physicians were not required to report outbreaks to the federal, or even state, authorities. However, this outbreak was so unusual that the local physician contacted the Public Health Service, sending them a report on the epidemic in his community. Back in Washington, PHS officers viewed the outbreak as unusual enough to merit a mention in the Service's weekly report on public health in the United States and abroad. But because they were preoccupied with epidemics of more severe diseases, the Public Health Service did not send any officers to Kansas to investigate the outbreak.

By mid-March, the outbreak appeared to have run its course. Certainly, it had disappeared from Haskell County.

That spring, a few medical journals published articles on the outbreak, but outside of these articles there was no real discussion of the outbreak or what it might mean.

Camp Funston, Kansas . [Credit: The Library of Congress]

Because the country was at war, farm boys from isolated communities such as Haskell County were on the move. During the spring, a soldier from Haskell County probably brought this new and virulent form of inluenza to Camp Funston, a military camp in Kansas. By mid-March, Camp Funston was in the throes of an influenza epidemic. More than eleven hundred soldiers stations there were ill with influenza; thirty-eight of these men died at Funston that spring. These deaths were highly unusual. However, the death rate in March was lower than the death rate which would characterize influenza in the fall.

Despite this early and highly severe outbreak, state officials in Kansas were not especially vigilant at monitoring influenza rates during the spring and summer of 1918.

Wehn the disease re-emerged in the fall of 1918, Kansas failed to provide the Public Health Service with a report, although they were required to do so on September 27th. On October 4th, state officials simply informed the Public Health Service that "cases have been reported from a number of places in the State." A week later, state officials provided more detail, saying that "one thousand three hundred and twenty five cases were reported" during the first week of October. As state officials were often too overwhelmed to keep accurate records, this was proabbly an under-estimate of the number of cases in the state at that time.

By mid-October, authorities noted with some concern that "cases in Kansas are increasing." By late October, over 26,800 cases of influenza had been reported since the outbreak began in September. Influenza rates continued to climb even higher while deaths mounted.

Finally, in early November, officials provided an optimistic report: "with a few exceptions in the large industrial centers, all communities...have reported an abatement, both in the severity and number of cases."

At Camp Funston, a soldier described the situation during the late fall in a letter. "We are here," he said, "held up because 'influenza' or some such a name, is in camp. It is some such a thing as pneumonia, and they seem to think it is pretty bad. It is at least bad enough to beat us out of our passes. For our commander promised us every one a very short pass home before the 15th of next month. But as there are so many cases of the disease in camp now, I expect to make my home in Funston for some time. He says that we may all go home before we leave here, for a short pass." A week later, the same soldier noted that "Lots of them go to the base hospital every day and quite a number of them are 'checking in'." He estimated that there were between 6,000 and 7,000 cases in the camp. The situation slowly improved after that.

In Topeka, as elsewhere, hospitals overflowed with influenza patients and several emergency hospitals were opened. These included hospitals at the Garfield School and the Reid Hotel. Two infirmaries linked to Washburn College were opened and the gym became "an observation hospital."

The Secretary of the Kansas State Board of Health took swift action in an attempt to contain the disease. Schools, churches and theaters were closed while homes with ill patients were quarantined. In stores, customers were to be provided with 100 square feet to limit close contact and the number of passengers allowed on streetcars was limited for the same reason.

The disease peaked in the state during the late fall. It remained prevalent thoughout the state during the winter and spring of 1919.