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Entrance to state exhibition tightly packed with people.
A likely reservoir for influenza. Entrance to United States Government War Exhibition, September 8, 1918, one quarter of a million people in attendance. [Credit: The Library of Congress]

On September 27th, state officials reported to the PHS that several cases of influenza had appeared in Chicago and its vicinity.

On October 1st, the Illinois State Health Officer telegraphed the PHS, saying, "Situation in communities adjacent to Great Lakes Naval Station shows tendency to improve. Disease spreading along main traveled routes." The officer was overly optimistic. On that same day, 374 cases were reported in Chicago, with 14 deaths from influenza and 45 deaths from pneumonia. By October 11th, the PHS was forced to acknowledge that "five hundred to six hundred municipalities have reported cases." By that time, the disease was already epidemic in Chicago, Peoria, Kankakee, and Rockford. Rural communities had also begun to report cases.

On October 25th, state officials failed to report to the PHS, although they were required to do so. This may have been because state health officials were too overwhelmed by the pandemic to keep accurate records. A week later, the state did manage to submit a report for the state. At that time, officials believed that "the epidemic was abating in the northern" part of the state. However, the pandemic was "developing rapidly in the southern portion. Rural sections and coal-mining districts were said to have been hard hit." Chicago was still reporting over ten thousand new cases each week. The actual number of influenza cases and influenza-related deaths was probably significantly higher than reported. The epidemic most likely peaked in Illinois during the week of October 26th. Over 40,000 new cases of influenza were reported for the state during that week alone.

Black and white photo a theatre in Illinois with a sign reading, The Man of the Year.
Chicago, Ill., Illinois c. 1890-1910. [Credit: The Library of Congress]

As the nation's largest rail hub, Chicago was especially vulnerable. Influenza reached the city and, from there, spread to the rest of the country. Although Chicago should have been recognized as being especially vulnerable, public health officers there were overconfident. Even before influenza had reached the city, officials boasted that "we have the Spanish influenza situation well in hand now. Of course, they did not.

Although Chicago's officials knew that large gatherings helped spread influenza, patriotic parades remained common. Parade attendees were, however, cautioned to return home immediately after the parade. To minimize the risk of infection, attendees were told to remove all their clothing, rub their bodies dry, and take a laxative. This approach failed to prevent the spread of the disease.

Patients who contracted influenza suffered from a strange set of symptoms. Delirium was not uncommon. One Chicago nurse found a delirious eight year wandering the streets in his pajamas. When she returned him to his home, she discovered that his entire family was ill. His four siblings all had temperatures over 104 degrees. Four children, including the boy, had temperatures over 104 degrees. His father, whose temperature was over 101 degrees, had just given his wife a spoonful of camphorated oil instead of castor oil as he intended. Camphorated oil was banned by the FDA in 1980 as it is poisonous.

There was no comfort for the dying. The city ran out of hearses. City officials proclaimed that "there shall be no public funerals held in Chicago over any body dead from any disease or cause whatsoever. No wakes or public gatherings of any kind shall be held in connection with these bodies. No one except adult relatives and friends not to exceed ten persons in addition to the undertaker, undertaker's assistants, minister and necessary drivers shall be permitted to attend any funeral. No dead body shall be taken into any church or chapel for funeral services in connection with such body.

Concerned that spitters and sneezers might spread the disease, the Chicago Health Commissioner, John Dill Robertson ordered the police to "arrest thousands, if necessary, to stop sneezing in public!" Crime took a backseat to concerns about influenza. Fortunately, crime rates remained low; most of the city's criminals were too ill to take advantage of this lapse in policing.

Crowds of spectators seated in an outdoor arena for a show.
The Battle, U.S. Government War Exposition, Chicago took place on Sept. 3rd, 1918, just a few weeks before the first case was reported to the PHS. [Credit: The Library of Congress]

On November 6, as the number of new influenza cases began to decline, PHS Officer J.O. Cobb wrote a latter to PHS Officer W.G. Stimpson. Cobb pointed out that many doctors and nurses in the Chicago area had become ill because they had failed to wear their masks properly. The truth was, however, that many of these poeple became ill because masks did little to prevent the spread of influenza. Cobb also complained that the PHS hospital in Chicago was in such dire need of repair that caring for patients was difficult. Noting that the hospital "beds were filled as fast as emptied," Cobb explained to his superiors back in Washington that he had exceeded his budget. In his defense, he said "We were driving under great pressure and I did not let matters of expense stand in the way." Cobb was especially concerned about caring for soldiers who came from the upper class: "We had sons of wealthy people scattered all over the country. Mothers and fathers came here from all over and so far as I know there has not been one word of complaint and on the contrary, many letters and expressions of gratitude."

Outside Chicago, the situation was equally serious. Navy nurse Josie Brown, took a Pullman from St. Louis to the Naval Hospital in Great Lakes. Upon her arrival, she was horrified by what she discovered. In every ward, all of the beds were occupied by dying soldiers, whom also lay dying on stretchers next to the beds. Brown, along with other hospital personnel, found herself working 18 hour days.

Looking back on the situation , Brown said "The morgues were packed almost to the ceiling with bodies stacked one on top of another. The morticians worked day and night. You could never turn around without seeing a big red truck loaded with caskets for the train station so bodies could be sent home. We didn't have the time to treat them. We didn't take temperatures; we didn't even have time to take blood pressure. We would give them a little hot whisky toddy; that's about all we had time to do. They would have terrific nosebleeds with it. Sometimes the blood would just shoot across the room. You had to get out of the way or someone's nose would bleed all over you. Brown was especially horrified by the suffering, saying Awhen their lungs collapsed, air was trapped beneath their skin. As we rolled the dead in winding sheets, their bodies crackledB-an awful crackling noise which sounded like Rice Crispies when you pour milk over them.

Influenza remained prevalent throughout the state during the winter and spring of 1919. By the summer, the disease had begun to fade in Illinois.

Population in 1920:
6.48 million. Chicago was the state's largest city, with a population of 2,701,705. Peoria was the state's second largest city, with a population of 76,121.

Most of the state's residents lived in urban areas.

First Official Report of Influenza:
The Public Health did not require states to report influenza before September 27. Illinois first reported cases of the disease on October 1st.

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