1918: A deadly confluence of influenza and forest fire

The following historical account on the flu pandemic in 1918 comes from the Minnesota Historical Society and its MNopedia project that tracks Minnesota history online and includes the history feature the Pine Knot News publishes weekly. Reporter Mike Creger added information about how the flu hit fire-ravaged Carlton County.

The 1918 influenza pandemic, often referred to as the "Spanish flu," caused an estimated 50 million deaths worldwide. In the United States, an estimated 675,000 deaths occurred; 10,000 were in Minnesota. It's difficult to know what the actual numbers were since knowledge about the flu was limited. It was not a requirement to report flu outbreaks then, and often causes of death were attributed to other afflictions, like pneumonia.

The influenza virus that caused the worldwide pandemic originated in an outbreak in Haskell County, Kansas, in early 1918. By March, 100 soldiers at Camp Funston, now Fort Riley, near that county became ill with the flu. As the soldiers were deployed to fight in World War I, they carried the virus with them and spread it rapidly worldwide.

Soldiers went home on furloughs before being shipped out and spread the disease in their hometowns, including many in northern Minnesota.

The first flu case in Minnesota was reported in Wells in the last week of September in a soldier who had returned home on leave. Train travel led to major spreading of the virus. Additional cases were quickly reported in other areas of the state. It produced high death rates among children younger than 5 years old, adults age 65 and older, and, unusually, people between 20 and 40 years old.

The illness hit Duluth by early October. The city was the first in the state to tell people to stay home. It closed theaters and other popular gathering spots to ease the spread. The next day, what we now call the Fires of 1918 swept through Carlton County and into Duluth city limits. Residents here were caught in a tragic confluence of misery. It has been estimated that 450 people died in the fire. Hundreds more fire survivors lived only to die from influenza.

The disease appeared in people quickly. A victim could be healthy in the morning and dying by late evening. Extreme and agonizing symptoms included cough, exhaustion, general body pain, chills, fever, congestion, and bleeding from body orifices. Victims could develop highly unusual, devastating lung damage resulting in pneumonia, cyanosis (blue skin), and quick death, or secondary bacterial pneumonia. The intensity and speed of the disease stunned doctors.

The flu, also known as the grip or grippe, occurred in three waves in 1918: March to early summer; the fall; and winter extending into early 1919. The highest mortality occurred during the second wave, when troops brought the virus home. Spain was the first country to report cases since its newspapers were not under war censorship, hence the misplaced name.

The outbreak hit military installments hard in the Twin Cities area. The hospital at Fort Snelling admitted its first case of influenza on Sept. 27. Within 10 days, 850 patients had been admitted, most with the flu. Two hundred of those developed pneumonia, with 61 deaths. Most of the patients were men under the age of 20 who had enrolled in the Students' Army Training Corps at the University of Minnesota. Close contact in classrooms and barracks was likely the cause of the explosive spread. The epidemic peaked there around Oct. 15.

To reduce the spread of the flu, health officials directed Minnesotans to rest, use handkerchiefs, and go to bed and contact a doctor if symptoms arose. They discouraged standing in crowds, spitting on floors and sidewalks, and sharing drinking cups and towels. Government officials throughout the state closed public spaces in an attempt to prevent the spread of the flu. Schools, libraries, dance and pool halls, theaters, bowling alleys, churches, and lodge halls were shuttered. Public events such as parties, meetings, and funerals were banned.

Dr. Henry Bracken, the secretary of the Minnesota State Board of Health during the epidemic, expressed frustration with the shortage of nurses and doctors to care for the sick. One-third of doctors were already supporting the war effort, and others were in northern Minnesota caring for forest fire victims. Others were sick themselves, had died from the flu, or feared exposure to the disease.

In Atkinson Township southwest of Carlton, four families who had lost everything in the fire had been hit with the flu. County commissioners held a special meeting to create an isolation hospital there to care for the sick. Fire victims were susceptible to the virus because of smoke inhalation and the fact that the injured were huddled together in makeshift care centers across the region, easing the spread.

Martial law was declared in Cloquet. Anyone seen in city limits was required to wear a mask for protection and any cases of the flu had to be reported to the makeshift hospital at Garfield school.

School resumed at Garfield in early November in Cloquet, but the flu was still raging in the region. On Nov. 22, Captain F. L. Smith, medical director of the Northern Military District of the Home Guard, reported that the epidemic had ended in McGregor, but Brookston had 33 flu and 10 pneumonia cases in the hospital, with 60 people being treated at home. Eight people were in the Floodwood hospital and 160 patients had been treated in Automba: 80 with the flu and 15 with pneumonia. A good portion of the area had also been severely damaged by the fires.

In 1920, the Minnesota State Board of Health reported that there had been 257 influenza deaths in 1917 (before the new strain of the virus entered the state). That number jumped to 7,521 in 1918 and 2,579 in 1919. The majority of the deaths occurred from October 1918 through January 1919: October (2105 deaths); November (3,260); December (2,010); January (1,012). During that same period, Minneapolis, St. Paul, and Duluth reported 1,103, 944, and 327 deaths, respectively. The number of deaths due to influenza dropped dramatically by the spring of 1919.

In 1918, viruses were unknown, and the cause of influenza was incorrectly attributed to a bacterium known as Pfeiffer's bacillus. It wasn't until the 1930s that scientists proved that the flu is caused by viruses.