The 1918 “Spanish” Influenza Pandemic

Image from University of Kentucky Training of the Fighting Mechanic records, University of Kentucky Special Collections.

Quick Facts About Kentucky and the Spanish Influenza Pandemic

Approximately 13,000-14,000 Kentuckians were casualties of the first and second waves of the pandemic.

  • October 1-3, 1918: ambulances at General Hospital (Louisville) were working 24 hours a day picking up sick and febrile patients with fevers exceeding 103 degrees Fahrenheit.
  • October 4, 1918: the isolation ward at General Hospital was so over-packed with critically ill patients that they had to begin turning people away.
  • October 6, 1918: The Kentucky State Board of Health issues a blanket-wide quarantine prohibiting public gatherings throughout the Commonwealth. Dr. John G. South, president of the State Board of Health, stipulated that all places of amusement, schools, churches, and other places of assembly be closed and that unnecessary travel was discouraged along with social visiting until the pandemic cleared. This order would remain active for more than 30 days.
  • October 7, 1918: Authorities at a hospital at Camp Taylor issued a critical call for more nurses. Nurses stepped up to bat and reported to the American Red Cross headquarters for duty.
  • October 10, 1918: The City of Paducah, by order of the Board of Health, banned public funerals from being held until influenza cleared from the area. All funerals were to be private and held from the residence.
  • November 10, 1918: The quarantine was officially lifted.

    Final Statistics

  • Kentucky influenza deaths in 1918: approximately 8,699
    Kentucky influenza deaths in 1919: approximately 4,591
  • Jefferson County had a total of 1,321 deaths in 1918-19
  • The City of Louisville would have had approximately 28,000-72,000 total cases of influenza during 1918-19.
  • Locales within Kentucky began running out of caskets because of the high number of deaths. Gravediggers fell victim to influenza and, eventually, soldiers were called in to dig graves.
  • Approximately 10-25% of the world’s population became infected with the influenza virus in 1918-19.

According to one newspaper report, “R.G. Potter of Louisville, who was a teenager at the time of the pandemic, drove a truck part-time at Camp Taylor” and recalled how the dead were hauled away in trucks and in horse-drawn vans. Potter said that, “caskets were arranged in pyramids on the flatbeds, 10 on the bottom, 9 on the next layer, until they reached the top where one lonely casket was positioned.” Caravans of trucks and horse-drawn vans would carry the dead to train stations during the middle of the night.

Spanish Flu in Kentucky


In 1918, the world was undergoing a number of transformations. A great world war heralded on in Europe. In the United States, there was a sense of safety. Many advances in technology were taking over the country and the world. There were motorized vehicles, the Wright brothers had made it to where one could look to the sky and see an airplane. Hospitals were becoming widely available to many Americans and throughout the Western world. Scientists had already developed cures and vaccines for smallpox, diphtheria, and even developed a vaccine for a condition that would cause inflammation in the meninges, known as meningitis[1]. Physicians and scientists began to realize that they could take on nearly any virus, bacteria, or bug that could afflict any human being. Physicians and scientists began feeling a bravado, unlike any other clinicians or scientists, had in previous years. It was a time to celebrate advances in technology; a time to sit back and enjoy life. That sense of comfort and confidence, however, would soon begin to erode. 

Image from The Breckenridge News (Cloverport, Kentucky), 16 October 1918.

In early March of 1918, military officials in the state of Kansas reported hundreds of cases of servicemen with a mysterious illness. The men were febrile, diaphoretic, and some became cyanotic. Nearly as soon as the reported cases came about, they disappeared and life went back to normal. Soon, however, those soldiers from Kansas would be called overseas to help fight in the war. Thought the mysterious illness that afflicted hundreds of soldiers was all but a faded memory, it would quickly become headlines across the world. One the soldiers from Kansas arrived overseas, that mystery illness began showing up. In American soldiers. In soldiers from all countries. By the time the service members began arriving back in the United States, it was clear that something was wrong. Men with hemorrhagic catarrh, several cyanosis, diaphoresis, and hemoptysis started overwhelming the military medical community. This mysterious disease’s origins were not new to the world; it was influenza yet so severe that physicians and scientists had never seen the likes before. Post-mortem examinations revealed lungs that were completely cyanotic and extremely heavy and wet with mucus and purulent materials[2].

It was the perfect storm. A time of war and infected soldiers resulted in a pandemic spread of the influenza virus throughout the world. A single cough could mean the infection of hundreds or thousands of men, women, and children. Up until September of 1918, the influenza virus had stayed mostly restricted to military personnel and military bases. A small town in Massachusetts changed all of that when three individuals died on the streets there. Within weeks, cities across the Eastern seaboard had hundreds of new cases and deaths from influenza[3]. The quiet confidence and complacency felt by citizens, physicians, and scientists became replaced with uncertainty and fear. Time had always been on their side but this time it was not. Some patients would present to physicians with influenza and die within hours. Physicians and public health officials, however, denied that there was any real concern. The focus stayed on the war efforts. Thousands of men, women, and children would congregate together and unknowingly spread the influenza virus.

Even healthy individuals could spread the influenza virus[4] making things that much more complicated. A simple cough and breathing are how the virus managed to spread so quickly and deadly. As each day brought news of hundreds or thousands of new deaths, it was clear something had to be done. A great number of physicians and nurses were sent overseas for the war efforts. This left little preparation back at home. The few remaining physicians and nurses were finally redirected across the country to take care of the sick and the dying. The number of sick became so rapid that hospitals were unable to hold any more patients. Temporary hospitals were set up in schools, gymnasiums, and even parks and outdoor locations using tents[5]. Patients would lie on cots on the floor for days waiting for someone to die so they could have a bed to lie in. Politicians and government officials began passing requirements to wear masks and other preventative measures. These measures, however, did little to prevent the spread of the influenza virus[6].

Physicians and public health officials began discussing the need for what else could be done. Quarantines and travel bans were instituted. The government began providing money to states and public health officials to attack the spread of the virus. Scientists were working around the clock to find a cure. Although hundreds of vaccines were developed, physicians and scientists were not looking at influenza as a virus. They were approaching influenza as if it were bacteria[7]. The public began losing hope and trust in the medical community. There were no medications to treat influenza so individuals began relying on old remedies and developing their own concoctions. Uncertainty and fear turned into desperation. Physicians and scientists had made no impact. Undertakers soon became overwhelmed. Coffins were being stacked on sidewalks. Native American tribes were also not immune from the devastation[8]. Literally, no one was safe. Young adults were the most frequent age group that died from the influenza virus leading to yet more confusion. The healthiest individuals in society were dying at a rapid pace. Nearly as quickly as it came, the influenza pandemic began its decline. Fewer cases and deaths were being reported. The war was over. In simple terms, the influenza virus had infected nearly as many people as it could. Those survivors were believed to have developed an immunity. That offered little consolation to those who survived, however. Mothers, fathers, brothers, sisters, and friends were suddenly gone. Like a flash flood, the virus had made its sweep and moved on. Physicians and scientists took a step back to look at how things went wrong. The bravado that was there only earlier that year was now long gone. Scientists would go on to discover that influenza is a virus and that approaching it as a bacterium was grossly inappropriate. It was a reminder of the human condition and how infallible we really are. Over time, societies build social constructs. Yet, thankfully, scientists have taken steps to make sure that complacency is never a part of science and that the fight for cures will always supersede ego.

Definition of Terms

  • Abscess: Collections of pockets of purulent matter that collect in the dermal and subcutaneous tissues.
  • Anodyne: A pain reliever or analgesic.
  • Antifebrile: A drug used abate fever.
  • Cacopathy: A severe disease or medical disorder.
  • Catarrh: Buildup of mucus; sometimes referred to as epidemic influenza or whooping cough.
  • Cyanosis: A lack of blood oxygenation resulting in a bluish hue of the skin.
  • Diaphoresis: Intense sweating.
  • Edema: Swelling of tissues.
  • Febrile: Having a fever/high body temperature.
  • Grippe: Influenza.
  • Hemoptysis: Coughing up blood from the lower and/or upper respiratory tracts.
  • Hydrothorax: Fluid in the pleural cavities.
  • Lung Fever: Pneumonia.
  • Peripneumonia: Lung inflammation.

Contributed by Shawn Logan |

⁘ Works Cited ⁘

  1. The Lexington Leader, 9 December 1949
  2. The Lexington Leader, 12 December 1952
  1. Taubenberger, J. K. “The Origin and Virulence of the 1918 ‘Spanish’ Influenza Virus.” Proceedings of the American Philosophical Society 150, no. 1 (2006): 86–112.
  2. Barry, J. M. The Great Influenza: The Epic Story of the Deadliest Plague in History. New York: Viking Books, 2004. 246 pp.
  3. Chandra, S., and J. Christensen. “Preparing for Pandemic Influenza: The Global 1918 Influenza Pandemic and the Role of World Historical Information.” Journal of World-Historical Information 3, no. 4 (2016): 20–30.
  4. Mills, C. E., J. M. Robins, and M. Lipsitch. “Transmissibility of 1918 Pandemic Influenza.” Nature 432 (2004): 901–904
  5. Oxford, J. S., and D. Gill. “Unanswered Questions About the 1918 Influenza Pandemic: Origin, Pathology, and the Virus Itself.” The Lancet Infectious Diseases 18, no. 11 (2018): 348–354.
  6. Shanks, G. D. “Insights From Unusual Aspects of the 1918 Influenza Pandemic.” Travel Medicine and Infectious Disease 13, no. 3 (2015): 217–222.
  7. Kash, J. C., Tumpey, T. M., Proll, S. C., Carter, V., Perwitasari, O., Thomas, M. J., and Katze, M. G. (2006). Genomic Analysis of Increased Host Immune and Cell Death Responses Induced by 1918 Influenza Virus. Nature, 443(7111), 578-81.
  8. The Courier-Journal (Louisville, Kentucky) 4 April 1976, p. 18.

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