Spanish Influenza in Idaho: Hidden and Forgotten

Frank Gardner Patterson's life ended in Quantico, Virginia, on September 26, 1918.1 He was the first reported Idaho victim of the Spanish influenza pandemic that swept the world during World War I. He was just twenty-two years old. Sixteen months earlier, Frank had joined the first of three waves of men in the United States to register for the draft. America was going to war: the Great War to end all wars.More than a year after registering for the draft, Patterson traveled to the bustling Navy Yard at Mare Island, California, a crowded and regimented place worlds apart from Idaho. There he became a part of the enormous mélange of four million American soldiers, sailors, and marines traveling to and from training camps and permanent posts, to Europe and back again on ships holding thousands of men, and sharing battlefields with French and British soldiers. It was a perfect storm for transmitting Spanish influenza.Less than three months after having answered the call to duty, and four months before the war ended, Patterson died. He had not yet had the chance to defend his country's citizens or to play his small part in bringing peace to the world. Spanish influenza ravaged worldwide in three main waves from the spring of 1918 through the winter of early 1919, with an additional, fourth wave in the spring of 1920. In 2002, a paper placed the number of Spanish influenza deaths globally at 50 to 100 million.2 Researchers estimate more than a quarter of the population of the United States had been infected, resulting in 675,000 deaths—2.5 percent of all of those who became ill, twenty-five times more individuals than were usually seen in an influenza epidemic.3Spanish influenza did not originate in Spain. It was so named because Spain was first to report the disease. Other countries did not report it because they were censoring the news in order to deflect any thoughts that their armies were becoming weak. It is likely that Dr. Loring Miner, a physician practicing in Haskell County, Kansas, may have first identified the onset of the pandemic. Miner reported an epidemic of influenza that, in late January and early February of 1918, occurred among dozens of his strongest and healthiest patients. In some cases, the instances of influenza were followed by pneumonia resulting in death. Weeks later, the epidemic among Miner's patients disappeared as suddenly as it had appeared.Although Idaho was not a populous state, and vast areas were isolated by mountain ranges, it was not immune to the epidemic. The railroad hub of Spokane, Washington, was thirty-five miles west of Coeur d'Alene in northern Idaho, and Pocatello in the southeast was 165 miles north of Fort Douglas, near Salt Lake City, Utah.In Idaho, Spanish influenza was not just the forgotten epidemic, as it is universally known, but it was also hidden for almost one hundred years. The death of twenty-one-year-old Miguel Quintana was lost to history4—as were those of twenty-four-year-old Frank Jones,5 thirty-two-year-old May Keele,6 thirty-six-year-old Ernest Dixon,7 and more than two thousand others.Idahoans had watched, feared, and mourned as husbands and wives, parents and grandparents, children, friends, and neighbors were lost to the epidemic. Thousands who became ill and delirious with fever must have wondered whether they would live or die. By 1921, the time had come to turn the corner on that dreadful chapter of Idaho's history. We will never know if the epidemic was purposefully forgotten or just too painful to remember. But we do know that it was hidden, in large part, by Idaho's weak public health structure.The United States Public Health Service had emphasized the need for a strong public health infrastructure at the state level if communicable disease was to be contained, and Idaho's was far from strong. Several groups settled in Idaho Territory: Mormons built communities in the southeast part of the territory after moving from the midwestern United States to escape religious persecution; Copperhead Democrats gathered in the northern part of the territory after relocating to escape conscription into the Civil War, which they were against; and individualists looking to escape government constraints established settlements in other parts of the region. Idahoans did not want the federal government meddling in their affairs, even if it was to their advantage. Moreover, Idaho government officials did not recognize the need to fund public health interventions, let alone public health infrastructure.The public health structure in Idaho evolved slowly from just having county health boards to including a state board of health, and then it changed dramatically in 1919 when the state board was disbanded and a public health advisor was hired and assigned to the newly formed Department of Public Welfare.8 The brunt of the Spanish influenza epidemic took place just before and during the transition period.The Idaho State Board of Health consisted of five members; three were experienced and licensed physicians from different parts of the state. One was appointed secretary. The state attorney general and the state engineer were ex-officio members. The state board was charged with establishing local boards of health and defining their duties. Since county boards had already been given the authority to define the duties of local boards, conflict was guaranteed.9 While county boards retained their right to declare quarantines, the state board was responsible for determining which diseases county and local boards would report. Neither influenza nor pneumonia was required reporting at the time Spanish influenza erupted. Although the state board had the authority to take action when it believed a dangerous disease might be “invading” Idaho, this proved fruitless when Spanish influenza arrived early in October 1918.One of the most daunting tasks of the state board, one left solely to the board secretary to carry out, was collecting infectious disease reports. These reports were needed as guidance for prevention efforts. Those with the competence to stop the spread of disease needed to know when and where diseases were occurring. Reports were sent to local boards, which in turn sent them on to county boards, who, every ninety days, sent their accumulated stacks to the state board. The process was cumbersome, far from and it was an for the who was also a practicing infectious disease reports were for the spread of Spanish influenza in the state, they were not sent the Board of Health that permanent of communicable diseases be on death and had not been in County, also reported death did not even to of death was or reported as to have been from of and as to of a in and on the Spanish influenza in Idaho, Dr. secretary of the State Board of Health at the was by Public Health to be Idaho's federal of was to the public health in in order to Idaho with they needed to the epidemic. The was with a which was reported by Idaho the for of state board given federal authority not did have the of a epidemic in the of physicians having been to war with he had a federal in a state that federal to be to reporting and an Idaho's Spanish influenza epidemic was lost to because not a was it by the State Board of Health or the newly hired public health advisor to the Department of Public The state report would have 1918, during which the first and waves of the epidemic had The three state board who were practicing physicians the epidemic for at a time when of Idaho physicians had been to in the The of a report must have in to for patients. The of the report not physicians and of the but it left a in first report of the Department of Public of Public the years was just three and did not of Dr. the newly hired public health that a of of infectious diseases had been reported to his in but that was as in more than of to Spanish influenza was not in the even the wave and a fourth wave of the epidemic occurred during the years it reports from the State Board of Health and Dr. is on the of in Idaho to be from and other 1918, in and on the Idaho State of reported that and of Spanish influenza had with their war report the epidemic at the Idaho State for the in be the Department of Public first report. patients and four had ill, with four to pneumonia and of the Idaho State the health of during the of the during the two years have been with the of the when the Spanish influenza was He reported deaths from Spanish influenza in the but he all as deaths from some on the epidemic, not and deaths were reported and did not or the in which the and deaths One from October 1918, that than of influenza have been reported so far in the state. of them in Idaho, but have been reported from the than a later, the from county were reported and were in the reported to the on Spanish influenza at the Idaho State in a different of the epidemic than In 1918, Frank reported of Spanish influenza and two deaths in the by two before he was to be and were a fourth four were were and one was to were of influenza at the but not all of them were It is not were at the Spanish influenza had and it traveled through the It is also not if the into the this most be the Spanish influenza epidemic and pneumonia must be from death deaths from Spanish influenza were the of the epidemic, and the reporting of of death was far from death the most of Spanish influenza for Idaho. of almost thousand death the year to the epidemic, through 1921, the year after the epidemic, a of the number of reported Spanish influenza and pneumonia The number of Spanish influenza in with the number of death for the United States the most of the epidemic experienced a in pneumonia deaths in 1918 with the first wave of Spanish of those deaths were among and the of five that were as of one or two the state. The was Idaho. of the deaths occurred in County, with three reported as the or the of the Spanish influenza epidemic in the the end of four before Idaho Frank Patterson in Quantico, in one were reported among in and the The epidemic was reported as and Idahoans by reports that it was not and had been any it was by as Spanish influenza the than two after Patterson the first death from Spanish influenza on Idaho was reported in Idaho. of County, on October 1918, the after he was first seen by a Spanish influenza traveled to through Fort Douglas, a and training three miles Salt Lake from Salt Lake through of Spanish influenza in County, more than miles to the He first a physician for his on October the the first of Spanish influenza was reported in Spokane, Washington, a railroad hub just miles to the October 1918, the Spanish influenza death during the first was was just years He in County, than one hundred miles from where had just the Spanish influenza epidemic in Idaho, as it be One death had occurred in of three during the first of the epidemic in in northern Idaho and two in the Idaho first the reported on the One in the Idaho in Public health every but to spread of epidemic in State after state and after was into the the of the epidemic in Idaho, Spanish influenza from the first three more of Idaho's of the were in the in the and the was in the miles to the west and miles to the of the in Idaho, it is to Spanish influenza traveled to with in City, the of the state. the days, Spanish influenza deaths had more than the number of influenza deaths in all of the year before the epidemic the end of the one hundred and two deaths from Spanish influenza had in more than of all Idaho the epidemic spread into those with reported just two in the in the and the of that northern Idaho from Idaho had yet to report a the wave news and But news in Idaho reported that in at all and must be at in in in in County, in and on and the end of 1918, the wave of the Spanish influenza epidemic was in It had through Idaho with at deaths reported in By the end of the wave a of men, and were reported to have from Spanish influenza and from two had a reported But that was to three of the epidemic the of wave had been the epidemic was that was in 1918, when it back to of Spanish influenza deaths was reported in 1918 and January 1919, as were of a in the of deaths in and 1919, all was a county had yet to report a Spanish influenza the winter of as a in the Spanish influenza epidemic was and will never influenza epidemic that will take a as as in wave four of the epidemic was the as not not an epidemic, But Idaho a different in reported to health of influenza State Department of Public Health epidemic of the of three January through of deaths from Spanish influenza and from pneumonia were reported in then it was The epidemic was to the the every county in Idaho had reported at one death. The to do County, in the northern and Idaho from Spanish influenza from October 1918, through 1920. percent of the population became deaths from pneumonia were most of the influenza reports from the Idaho not is the most having the Public Health for reporting deaths to their a population than percent than Idaho's a of deaths from Spanish influenza and pneumonia the two yet on Idaho's reported deaths October 1918, and February Idaho reported influenza and pneumonia deaths October 1918, and a reported of which Dr. state health was a deaths for every one hundred the Idaho would have seen cases, percent of the percent for the first wave of Spanish influenza is to have on the fourth of in 1918 when a with influenza was at three hundred miles to the of Haskell County, three hundred of the just thousand in the had been with and thousands more had been at Spanish influenza traveled with from to and into and By the end of 1918, the disease had spread to of main camps and of the in the United influenza arrived in with American during or It was not at the because patients were ill, and influenza was not But Spanish influenza in late as the of the wave of the epidemic influenza to the United States on 1918, at in with from two it had into and on to just the Spanish influenza to be and of permanent were that first that it was a disease of the and the that Spanish influenza was to an that on the disease in the and the of the disease. by the spread of a more of sent physician and of the of of and of the of at and diseases at the to to While an with a must be some of or The stop all into and of the epidemic But that did not than three after it in Spanish influenza arrived at with from who were for on the of September 1918, were to the were the and the days, men had been through the pneumonia reported having experienced at the of the of the and and at the of the that had the to but before this It was a the physicians would for life the of those who changed spread of in Public health every but to spread of action to But the Public Health Service needed the of state and local public health in order to have a chance to do September through 1918, when the wave of the epidemic to as as it had thousand of thousand were to Spanish influenza almost as as had from By then of Spanish influenza and of pneumonia had been reported among of thousands of in almost every of the United States had ill, of thousands late Public Health a of reports to by the of the and of in he the epidemic had spread in just four to five and two waves had wave of the pandemic occurred during the winter of early the of an in a of and a percent in in reported when an general in the number of was by the fourth wave was yet to the spring of a fourth wave of Spanish influenza suddenly and disappeared just as suddenly in parts of the Idaho among the wave because the public was and to all that they had lost to the Great War and to Spanish the as it into the pandemic became as the Spanish influenza epidemic of of Spanish influenza those of of influenza but were more The of patients who did not was a pneumonia to the the and to a of the disease became It was this pneumonia that the disease so influenza was also in that most of those who were the of and and not just the and the who the of of deaths also became a of the pneumonia at the in Fort Washington, and to the pneumonia that was a of Spanish physicians became at pneumonia to Spanish influenza by looking at were did not need to to or order and to was that be for Spanish influenza of and the was to fever and it was physicians patients with a or by it the Although usually not and were with of of the a yet physician who was to have hundred to hundred of the and it to be 100 percent in was a to the number of Spanish influenza It was to be in to an thousand individuals American Public Health a in the public health 1918 to Spanish The for the with the epidemic been a as as a The by the epidemic was the of a for a and the of the first local By the end of the a of and by had a on at the It every from establishing to to do the arrived and to a the was just that, a and were if it was to yet the federal was to solely to physician and who were in to the It was to the and to the to into There was that the newly to would carry the of the three of was the of in part, by and public to in part, by individuals and establishing The was which had not been and the was by health, which is was left in the of the other the to It will to disease. spread influenza and were not to other when in order not to that had just been most for the epidemic was in which ill from or as and had the of the world. ill individuals from other and was a but it the chance Spanish influenza would into the were to for the to There were just too men crowded in training on posts, traveling on ships to and from and in the Moreover, the was to from to and to Europe the United States weak to the The that be to ill was to them and their with in sailors, and marines had been when into the and deaths but they not be from Spanish were given the authority to that be to The was a of and with and Spanish influenza to of the and of the ill were needed to but those Spanish influenza were of the that were the to and and for on thousands of and in to the responsible for Spanish We in that their would be The disease was by a at the had yet to be were the and were not universally as most Spanish influenza patients who did so from were so on the of Spanish influenza that they the the for had to of pneumonia that were to as large of were to the war in and had isolated and from more than of five hundred they and had a and The had been in but had not yet been in by the time were to be to in the Great The a perfect to do that were at two camps in or September of The United States a report of the in The had been 100 percent in pneumonia during the from to when those were ended and Frank immune from patients to patients with pneumonia to Spanish might be those from immune was were not all with the of to among a Idaho, as with the of the was left to the Spanish influenza epidemic with public and a public health structure through which public be it is whether prevention all one of the most for the epidemic, was and far as public from the state, Dr. a to county boards of health and the of Spanish influenza and prevention Idahoans most likely the from physicians and patients or from as the and the also be from state board in local The to crowded be from that, with the of it was for to at all public the of the were from because were likely to the disease than and because those were the strong public and public and to the that public the spread of Spanish Dr. were he became more and and public as of public that needed to be did not take for and the to in the Idaho order of and to public the state attorney general to that the state board had authority county boards of health and from the attorney the state to to and It also a that was to the in which this order is and whether or not it will be or in order to the in to the had them The state attorney general with the state authority to do to the of that Spanish influenza reporting was so he to to of as for reporting and it had citizens to every they to the He physicians who were not to report Spanish influenza In a to to from physician all were not all physicians were to on the state authority the epidemic the were also These be at from two different In the the ill and all one is into or of their the the ill from an that is from disease. were into play during the Spanish influenza epidemic. were in the epidemic, before a of Spanish influenza had been reported in the and in the county had yet to be as Spanish influenza to the of diseases physicians were required to report to the board of was but it was by reporting Spanish influenza deaths as pneumonia patients did not have to be in was in an in the Idaho The the of the health the most health in the as the not be with Spanish influenza patients were or cases, or at more than physicians was the attorney on far the state authority the first of Spanish influenza was reported in the The was by the Dr. was not reported as Spanish The physician had been Dr. the of the state who identified Spanish influenza deaths at the but reported them to the state as after the first was the number of reported Spanish influenza in October and October in and during the first of physician was for the neighbors of three where he as as to the Board of Health that one of the physicians to any of his as influenza he had reported a number of deaths from to with the physician but public is becoming the But the public when of were the end of 1918, had been deaths in the at State reported to be the of Dr. had all but four of the pneumonia and two after the first pneumonia death was Dr. the deaths to citizens were of the and if they had the right to of physicians for deaths as The attorney general was and is that were State was just a from and on the of the Idaho Department of Health and influenza were again on the in the after in 1918, when a to whether the on of public and be the of days, had been local including and of local and the board to the Dr. a in the in Washington, reported on the influenza at the reporting it had percent of the thousand from the disease. He believed was needed to stop the epidemic and that were two to or a physician the ill, but when it was to the disease by that physician joined the other five in was the that were was of the that at one of the physicians had to the epidemic to been lost to history. By the end of wave four of the epidemic, an percent of the population of County, percent of in had ill, and had and the of in quarantines, which were to to ill with Spanish a three after the first death was reported on Idaho The to have been at as far as reported deaths from Spanish influenza Several had been reported by the time the was the first death was reported four after the was in in were Spanish influenza deaths reported in County, of them during the fourth on the number of an occurred percent of the It must be that the county was for of the of in County, was the was at the of the into to from and to them if they In 1918, a was back at the left but after to be and their for he a of to their But to the his the in of to the to his in the into but He to the for state to the which in the of was In the were were required to a that a of Spanish influenza was in their The reported Spanish influenza death in occurred during the fourth wave of the epidemic. where also reported one Spanish influenza death than a before that in all was and and the epidemic in Idaho followed the of the of the United and public had not Spanish influenza from northern and Idaho, nor did it the epidemic as it the state. We know that more than Idaho of Spanish influenza October 1918, and an percent became ill, and almost of death and infectious disease the report of the State Board of Health never and the report of of Public Health in the Department of Public not Spanish we will never know the But by death the most of we do know Spanish influenza every county in the state, of isolated the county