Throughout the world, at least 21 million people died, including some 700,000 in the United States.
Influenza, characterized by rapid onset and high fever, arrived in Boston on August 31, 1918, and made its way to Puget Sound the following month on a trainload of sick Navy draftees from Philadelphia. Fatalities result from pulmonary edema (the collection of fluid in the lungs) or from secondary infections from bacterial pneumonia. Persons between the age of 20 and 35 experienced the greatest risk. The massive movements and concentrations of populations during World War I contributed to the rapid spread of the disease. Seattle's population swelled to more than 400,000 because of military facilities and shipbuilding.
No Dancing, No Spitting, No Gathering
At first, Seattle authorities acted by banning dances and ordering street cars and theaters to ventilate to the fullest extent, and police enforced the anti-spitting ordinance. The Old City Hall and the Women's Dormitory (now Clark Hall) at the University of Washington were pressed into service as hospitals to handle the mass of cases. When ministers complained about the ban on religious gatherings, Mayor Ole Hanson remarked, "Religion which won't keep for two weeks is not worth having." All but close relatives were barred from funeral services.
Because the disease appeared in Seattle six weeks after it was first seen in Eastern cities, local officials had a chance to plan. The Seattle Department of Health and Sanitation and doctors at the Puget Sound Naval Shipyard developed a vaccine and ordered that all shipyard workers be vaccinated. Of the 10,000 persons vaccinated, none developed influenza.
On October 29, 1918, six-ply gauze masks became mandatory in Seattle. The next day they were required throughout the state. But public health discipline fell apart when the Armistice was announced on November 11, 1918. Thousands of joyous people celebrated in Seattle's streets, but "not a mask in sight." The mask rule was lifted the next day and theaters and public places reopened. Illness and deaths climbed again and peaked on December 9, 1918, before dropping off. Schools were reopened in January 1919 and in March 1919 no deaths from influenza were reported. Seattle suffered a death rate from the disease approximately half that of San Francisco and a third that of Philadelphia and Baltimore.
The disease disappeared from around the world almost as fast as it appeared and it has not reappeared since.