The disease was first reported as being present in Indiana on September 20th. Influenza swept across the state from north to south in two separate waves. The first and most lethal of these waves began in October 1918 and lasted into February 1919.

Crowds such as this political rally would have been suspended during the epidemic. c. 1912 [Credit: The Library of Congress]

The first official report from the state appeared in The Public Health Reports during October. State officials reported that an epidemic had developed in Evansville beginning in the last week of September. By October 11th, state officials were forced to admit that "the disease has been reported from a number of places" in the state. On October 25th, state officials believed that the situation had begun to improve, although they admitted that the number of pneumonia cases was increasing. Officially, the state reported 154,600 cases between September and February. Today, historians and epidemiologists believe that the actual number of influenza cases in the state was about 350,000. Approximately 10,000 deaths from influenza occurred in Indiana during this period.

Overall, the epidemic in Indiana was slightly less severe than it was elsewhere in the United States.

On September 27th, in response to a request from the PHS, the Indiana State Board of Health issued an order to all county and city health officers warning them of a pandemic and suggesting preventive measures. Among their recommendations was a suggestion that authorities tell people who are " compelled to cough or sneeze to hold cloth or paper handkerchiefs over their nose." Officials were also told that "persons with colds must be excluded from public gatherings."

On October 6th, the Indiana Board of Health, in compliance with orders from the PHS, banned all public gatherings. The order was rescinded, however, soon after it had been imposed. The Secretary of the Board of Health had been out of town when the order was imposed. Insisting that "the [federal] government cannot prescribe what a state board of health can do," the Secretary was prepared to defy the federal authorities---even at the cost of a few lives. On October 9th, the State Board of Health re-imposed the ban on all public gatherings. Churches could be open for prayer and meditation but not for large services. Public funerals were banned.

The ban was scheduled to be lifted on midnight of October 26th. It would have been lifted sooner, but following reports of continued cases from 43 counties, the Board decided to keep the ban in place.

As elsewhere, doctors stepped in to fill the breach, providing money and support for patients, sometimes from their own pockets. A letter from a PHS Officer to the Surgeon General of PHS dated February 25th, 1919 details how some physicians were overwhelmed and unable to keep accurate records: ADr. C.R. Applegate, Acting Assistant Surgeon for influenza control in Indiana, was assigned from this station for service at Clinton, Universal, Jacksonville, Shirkeyville, and New Goshen, all of them mining towns in the Clinton District. Dr. Applegate found it necessary to attend cases of influenza because of the great lack of physicians. He also found it necessary to expend his own money for drugs used in treating these cases. He endeavored to keep an account of these drugs, but, as stated in his affidavit, lost the book in which these accounts were kept, and found it impossible to secure any sort of statement from the drug store in Clinton where most of these drugs were purchasedYI am very certain the statement as submitted by Dr. Applegate is an accurate statement of the amount of money he advanced personally for these drugs and for which he should be reimbursed."

On North Delaware Street in Indianapolis placards identifying flu cases would have been one of the preventive measures taken by state health authorities. c.1904. [Credit: The Library of Congress]

The first four civilian cases of influenza were reported in Indianapolis on September 30th. By October 2nd, there were 200 cases and four deaths. On that day, the city health board imposed a ban on all public gatherings. The schools closed in response (the last time that they had been closed in response to an epidemic was in 1910 when a diphtheria epidemic had swept through the city).

The city's ban on Halloween parties and gatherings was credited with saving Indianapolis from a worse epidemic. The epidemic waxed and waned in Indianapolis and the city=s health officer proposed lifting the ban on gatherings etc. on October 31st. But by November 16th, a return of the flu caused the city health board to require everyone to wear masks and to re-close the schools. During the height of the pandemic, the local paper, The Star, urged women to enroll in Red Cross classes. Nursing care was deemed more important than Agood doctoring@ since treatments were so limited.

In Muncie, The third floor of the Commercial Club became a temporary hospital. City officials in Muncie also cancelled Halloween, saying that the practice of wearing masks during the holiday was dangerous as people tried on the masks before buying them and officials were concerned that the masks retained "flu germs."

In Gary, the building owned by The Knights of Columbus was turned intoa hospital as was the Masonic home.

In Evansville, the Elks Home became a temporary hospital. Evansville had an anti-spitting ordinance but public health officials saw no value in forcing citizens to wear masks. Remedies advertised in the local paper included Halls Superior Compound, Dr. Jones' Liniment, Horlick's Malted, Mendenhall's Chill and Fever Tonic, Dr. Chase's Blood and Nerve Tablets, Father John's Medicine, Red Devil Grippe Tablets, Hills' Bromide, and Cascara Quinine. A dairy recommended drinking milk and a chiropractor argued that sessions with a chiropractor could prevent influenza. None of these treatments were effective.

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.