1920 Influenza Levied a Heavy Toll in Kansas
by Donna Casement
(full newspaper articles cited here can be read by clicking on the link below)
The United States looked to the year 1920 as a time to recover from the emotional and economic toll of the 1918-1919 influenza epidemic. One quarter of the population of the United States had been infected and fatalities numbered more than 675,000. Worldwide estimates range form 17 to 50 million deaths.
Holidays were celebrated by family and friends, and there was hope for the future. However, waking up on Thursday, January 22, 1920, Topekans would read the headline, “Influenza Hits Kansas: 124 New Cases Reported, Epidemic Makes Its Appearance in Various Parts of the State-Two Deaths are Reported in Lawrence”. The secretary of the board of health, Dr. S. J. Crumbine, is quoted as saying, “Though there have been isolated cases in various parts of the state since last fall, this is the first report of influenza in the form of an epidemic this year.” (#1-The Topeka Daily Capital, January 22, 1920)
Lawrence’s first influenza death was a young woman named Josie Cooper, aged 23. She died on Tuesday, January 20 at the home of her aunt. She would be one of 9,037 Kansans who would die of influenza at the beginning of the 1920 epidemic. (#2-Lawrence Daily Journal-World, January 21, 1920)
After noting that Lawrence had its first influenza death, the Lawrence Daily Journal-World recommended that its readers follow the health service bulletin published by the Public Health Nursing Association. The bulletin asked people to avoid crowds as much as possible, keep their hands away from their mouth and nose, and to cough or sneeze into a handkerchief. It went on to ask people to wash hands before eating, get plenty of sleep, possibly on a sleeping porch or well-ventilated bedroom, and finally, to avoid excesses of all kinds that might lead to undue fatigue either mental or physical. (#3-Lawrence Daily Journal-World, January 21, 1920)
“More than one hundred cases of the flu are reported in and around Olpe, with the epidemic rapidly spreading over the south part of the county. There are only a few cases in Emporia. According to Dr. J. H Patton, the flu is of the same character as last year and of no milder form. This year he said many infants have been taken sick, while they seemed practically immune last winter.” (#4-The Lyon County News and the Emporia Times, January 22, 1920)
Newspapers first reported influenza cases in Kansas beginning the third week of January. The Kansas Board of Health sent letters to city health officers giving guidance on case reports, quarantine provisions and the sterilization of public food and drinking utensils. “Whereas: It is known that certain dangerous communicable diseases are transmitted through and by the secretions of the upper respiratory tract; therefore, be it Resolved, that all glasses, cups, spoons, forks, knives or other utensils used in serving food or drink to the public that come in contact with the lips or mouth shall be sterilized and adequately protected from contamination before each service.” (#5-Fort Scott Tribune and the Fort Scott Monitor, January 29, 1920)
On January 30, The Topeka Daily Capital reported 1,424 new Kansas cases of influenza. “There is no question about it being a general epidemic. Whether or not a state-wide quarantine will be ordered depends upon whether the disease assumes a virulent type,” said Dr. S. J. Crumbine. He went on to say that so far, the influenza was a mild type, but the tendency is for more severe cases as the epidemic increases in force. He said rural districts had been more heavily hit than cities. (#6-The Topeka Daily Capital, January 30, 1920)
On the same day, January 30, Topeka reported to the state health department that a period covering an 18-hour span, showed 673 new cases, as compared with 1,424 new cases for a 24-hour period reported the day before. (#7-The Wichita Beacon, January 30, 1920)
“We are not trying to alarm the people-only to warn them of the seriousness of the epidemic,” announced Dr. S. J. Crumbine, secretary of the state board of health. “The danger of greater spread of the disease should be apparent to all. The figures we are giving out every day speak for themselves. The state is again in the throes of a great influenza epidemic. The pleasant weather of the past few days will help relieve the situation some, as people have been airing their houses and have been out of doors more. Still, the epidemic of 1918 started in Boston in August. Influenza is no respecter of seasons.” (#8-The Topeka Daily Capital, January 31, 1920)
The first day of February brought headlines that read, “Influenza Cases Increasing Hourly Throughout Kansas, Total Number Reported 7,562, Epidemic More Severe As Time Passes”. “Influenza has taken a most alarming hold on the entire state,” said Dr. Crumbine. There were 36 reported cases of pneumonia and seven deaths in the state. The largest number of influenza cases were in the following places: Edwards County, 157; Kansas City 90; Wabaunsee County, 97; Pottawatomi,e and Ford Counties, 89 each. (#9-The Topeka Daily Capital, February 1, 1920)
On February 4, the Wichita Daily Stockman reported more than 11,870 cases of influenza in Kansas, with 3,619 new cases reported that day, including 21 deaths. Towns and cities throughout the state were being urged to restrict public meetings as much as possible and to enforce strict quarantine of individual cases. “The state board of health contemplated issuing a state-wide closing order which would prohibit public gathering of all kinds, due to the rapid spread of the influenza epidemic,” Dr. S. J. Crumbine, secretary announced this afternoon. He said the statewide edict would be issued unless cities, in which the disease is prevalent, take immediate steps to restrict public gatherings. He said the situation is growing more serious rapidly. Three thousand six hundred and nineteen new cases of influenza in Kansas reported to the state board of health up until 4 o’clock this afternoon, indicating a rapid development of the epidemic in all parts of the state.” (#10-Wichita Daily Stockman, February 4, 1920)
“With 3,440 new cases of influenza reported to the state board of health up to noon today, officials said the indications were that the epidemic is increasing daily. Yesterday the total was 4,101 and the total to date is 36,043. The day’s deaths at noon had reached 52.” (#11-The Evening Kansan-Republican, Newton, February 10, 1920)
The state health department gave daily updates on new influenza and pneumonia cases, and deaths. The department also released to newspapers across the state, guidelines on staying healthy and dealing with the disease. They listed the “don’ts” which included avoiding sprays and gargles as a means of preventing influenza because they were useless and generally harmful. They asked people to steer clear of quack medicines, self-medications and “gads” generally and avoid alcohol in any form for prevention or a cure. The “dos” included keep away from crowds, forget the handshaking habit and don’t “fight off” the disease by keeping at work after it gets you. (#12-The Topeka Daily Capital, February 12, 1920
“Kansas Leads All States”-A report from the surgeon general of the United States received by Dr. Crumbine showed that Kansas led all states in the union in the number of influenza cases in proportion to her population, and all except Pennsylvania, five times greater in population than Kansas, for the period February 3 to 7. During this period influenza cases in Kansas totaled 9,287, the report stated. Dr. Crumbine’s alibi is that perhaps the records are kept better in Kansas than those other states.” (#13-Baxter Daily Citizen, Baxter Springs, February 13, 1920)
“Flu Deaths Run High”-The state board of health epidemiologist Dr. T. D. Tuttle gave an overview of the influenza situation in Kansas. He said, “In 1918, the epidemic extended over a period of three months, October, November and December and lapped over into 1919. In the three months of 1918, the state board was notified of 133,773 cases of influenza and influenza-pneumonia. For the same period, 2,639 influenza deaths were reported. The number of deaths directly traceable to the influenza plague totaled 8,688-the additional 6,049 deaths being attributed to influenza-pneumonia in one form or another.”
Dr. Tuttle went on to say, “In 1919 the influenza became epidemic until April. In the four months, 4,800 cases were reported in the state. The deaths for this period were 1,300. This figure increased to 3,453 deaths resulting from influenza and its pneumonia complications by the addition of 2,153 reported pneumonia fatalities.”
He concluded, “In 1920 the influenza became epidemic about January 15. Since that time, a total of 58,000 cases have been reported to the state board of health.” According to his statements, the death toll directly traceable to influenza will be larger this year and that the straight influenza toll might be smaller. Pneumonia resulting from influenza will be the outstanding cause of the increase this year. (#14-The Augusta Daily Gazette, March 1, 1920)
By the end of March, it became apparent to doctors, that the 1920 Kansas influenza epidemic developed quickly, with the month of February showing the third worst month of fatalities since the epidemic began in 1918.
“Only the two worst months of the 1918 epidemic registered more fatalities from influenza in Kansas than were reported for February this year,” according to Dr. C. H. Lerrigo, state registrar of vital statistics. With five small counties not yet heard from, total influenza and pneumonia deaths for last month are 1,572, out of a total death toll from all causes, of 3,026. “Most of the state really didn’t realize that influenza in Kansas this winter was serious,” said Dr. Lerrigo. “The communities handled the situation as a rule so as not to cause unnecessary alarm, but it was a real epidemic just the same. The reports show it was not particularly prevalent in any one section, but was general over the state.” October and December 1918, are the only months on record where the influenza death toll was heavier than last February. In October there were 2,904 influenza and pneumonia deaths reported for the state, including 950 at Camp Funston. In December 1918, 3,681 deaths were reported, of which 2,302 were charged against influenza. There are nearly three times as many influenza deaths in Kansas this February as in February a year ago, when only 613 such deaths were reported, In January 1918, there were 915 influenza deaths reported out of 1,844. (#15-The Augusta Daily Gazette, March 25, 1920)
The Kansas State Board of Health published monthly bulletins that highlighted the health concerns for the state and public information about staying healthy. Within the monthly reports, statistics on the morbidity rates of major diseases affecting the state were given. For the first time, beginning in September 1918, the bulletin released morbidity reports for influenza and pneumonia by county and cities. The reports showed the 1920 cases of influenza peaked quickly in January to 9,037, followed by 48,140 cases in February. March showed a decrease with 6,666 cases and April followed with 163 cases. May had 11 influenza cases and June had only one case. (#16-Influenza and Pneumonia Morbidity Report to the Kansas State Board of Health, September 1918 through February, 1921)
State Board of Health Epidemiologist, T. D. Tuttle summed up his observation of the 1920 outbreak in the state board’s 1920, Tenth Biennial Report. He said, “The 1920 outbreak gives us a little information with regard to the so-called “waves” of 1918-’19. There were no waves in the 1920 outbreak. The disease quickly reached its peak, declined and disappeared. But there was no armistice to celebrate in 1920, to result in a second “wave,” and there was no Christmas or other holidays, with resultant crowding of stores, parties, ect. to produce a third “wave.” The fact of the matter is that there were no true influenza waves in the 1918-’19 outbreak; they were simple recrudescences due to relaxation of reasonable precautions.” ("A Study of Influenza in Kansas from October 1918 to March 1920" by Dr. T. D. Tuttle, epidemiologist, Tenth Biennial Report of the Kansas State Board of Health, pages 99-112)
Throughout the influenza epidemic, the Kansas State Board of Health, with Dr. S. J. Crumbine at the helm as its secretary and executive officer, passed along vital information, mostly through local papers and through the state, county and city health departments, for keeping safe during a horrific public health crisis.
Dr. S. J. Crumbine is one of Kansas’ most interesting and heroic public servants. He will be the subject of future blogs.
Read newspaper articles cited here at the State Library of Kansas' KGI Online Library.
1920 Influenza Pandemic in Kansas
View Influenza and Morbidity Statistics for Kansas, 1918-1920