Hawaii’s experience of the influenza pandemic differed from that of the rest of the United States. In the summer of 1918, an early and less destructive wave of influenza arrived in Oahu. While a second and more lethal wave of influenza reached most communities on the mainland by early October, this second wave of influenza did not hit Hawaii until December.

Workers on rural and isolated plantations suffered as influenza attacked all of the islands. c. 1910-1925. [Credit: The Library of Congress]

When the Hawaiian Territorial Medical Society met in November, members viewed the pandemic as a problem limited to the mainland. Papers read at this meeting focused on topics such as “Influenza with Special Emphasis on the Recent Epidemic on the Mainland.” There was no discussion of influenza as an issue in Hawaii itself.

But by December, the Society’s medical officers were forced to reassess their views as a lethal wave of influenza now hit all of the islands. By the end of the year, the number of cases of contagious diseases reported to the Hawaiian Board of Health was 12,000 more than in the previous year with this increase being almost all due to influenza.

While mortality and morbidity rates are often impossible to calculate, Hawaii does not appear to have suffered tremendously from the pandemic. In Honolulu, reports sent to the PHS indicate that thirty-two people had died in the city from influenza and sixteen of the city’s residents had died of pneumonia, a related complication, during January. On March 12, 1919, a letter from Chief Quarantine Officer to the Surgeon General stated “that for the week ended March 1st, there were 125 cases of influenza and 20 deaths in the City and County of Honolulu. Influenza was the cause of death in seven of the cases, while the remaining 13 were due to a complicating pneumonia.”

Influenza remained a problem in the islands until the late spring when it began to slowly disappear.