The 1918 Influenza Pandemic

This site has a nice overview of the flu outbreak worldwide:

http://virus.stanford.edu/uda/

Then make sure that you read this article from the New York Times, which mentions how St. Louis’s response was much wiser than Philadelphia’s:

http://www.nytimes.com/2007/04/17/health/17flu.html

And here is the short article by Tim O-Neill from the Post-Dispatch, which I will just copy here because they never keep their links current:

ST. LOUIS – In October 1918, the meat grinder known as World War I was lurching to its exhausted conclusion in the Argonne forest. Another, even bigger, killer was just getting started.

The 1918-19 influenza pandemic, known to history as the Spanish flu, was racing across the world. Estimates of the flu’s worldwide toll range from 25 million to 50 million deaths, including 675,000 in the U.S. The numbers overwhelmed the butchery of four years of ghastly trench war, which managed to kill about 8.6 million, including 116,000 American doughboys.

In St. Louis, a strong-willed doctor moved quickly, drastically and successfully to limit the horror. He was Dr. Max C. Starkloff, then in the 15th of his 30 years as city health commissioner. He prevailed on Mayor Henry Kiel to let him order the closing of almost all public places, including churches, schools, dance halls, fraternal lodges, theaters – even open-air funerals. His proclamation said that “Spanish flu is now present and probably will become epidemic in St. Louis.”

The Liberty Loan Organization canceled its rallies. Washington University football players wore masks in practice. St. Louis police officers were told to forgo arrests on petty cases, the better to reduce court docket calls.

Starkloff issued his order on Oct. 7, 1918, only three days after the first reported case of influenza in the city. But there already had been two flu deaths among the soldiers just south of the city at Jefferson Barracks, where the hospital population was 800 and growing quickly.

Starkloff’s strategy was “social distancing,” the simple practice of keeping people away from one another. During the brief but deadly sweep of the flu that fall, the death rate in St. Louis was 2.8 per 1,000 residents, lowest among the nation’s major cities. The rate was 8.0 in Pittsburgh, 7.6 in San Francisco and 7.1 in Kansas City.

Businessmen whose sales plunged beseeched City Hall to loosen the rules. Catholic Archbishop (later Cardinal) John J. Glennon urged Starkloff to reopen the churches. But the son of a German-born doctor held firm and had the trust of Mayor Kiel, who told Starkloff, “I don’t want anyone to die. Therefore, I shall support you.”

On Nov. 11, Armistice Day, Starkloff let downtown stores sell American flags, but only outside on the sidewalks. He allowed the schools to reopen a few days later and lifted the last of his ban on Nov. 18. Near month’s end, Starkloff closed the schools again for a short time.

Deaths continued, even spiking in December. But the number of new cases fell. The virus worked quickly through its victims, then faded. It had infected 31,500 people in St. Louis and killed 1,703.

Starkloff retired in 1933 and died at home in Carondelet in 1942 at age 82. Shortly after his death, a grateful city renamed its City Hospital just south of downtown in memory of him. One of his great-grandchildren is Max Starkloff, a local leader in disability services who founded Paraquad Inc. and the Starkloff Disability Institute.

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