Produced by the University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan Library

Influenza Encyclopedia

The American Influenza Epidemic of 1918-1919:

A Digital Encyclopedia

Louisville, Kentucky

50 U.S. Cities & Their Stories

In the late summer and early fall of 1918, the many military installations across the United States tended to be hit first and hardest with epidemic influenza. Soldiers, sailors, and Marines on liberty, leave, or official business traveled to cities, often bringing influenza with them. This had been the case in Boston, for example, a city ringed with numerous military bases and training facilities.

Just a few streetcar stops down the line from Louisville was Camp Zachary Taylor. The camp was enormous, encompassing 1,530 buildings sprawled across 3,376 acres and accommodating over 45,000 enlistees and officers. At the time, it was the largest World War I Army training camp in North America. On September 24, local Louisville newspapers reported over one hundred soldiers at the camp were ill with influenza. Just a day later, that number had more than doubled to 262. By the end of the month, the camp hospital was caring for more than 2,100 cases of influenza. The hospital was so overcrowded that 15 barracks of the “C” Section – a section of camp located east of the Lincoln Avenue overpass – had to be converted to temporary hospital wards.1

Camp officials acted as quickly as they could to contain the disease. On September 27, they enacted a partial quarantine of the camp, prohibiting the soldiers from entering theaters, movie houses, restaurants, and other public places in town. They also prohibited the soldiers from congregating within the camp. Only a dozen soldiers were allowed in the canteen at a time.2 A few days later, military officials posted provost guards at strategic Louisville locations to prevent soldiers from entering public areas of the city.3

To further protect Louisville, officials from the Army, the United States Public Health Service, and city health officer Dr. T. H. Baker met on September 26 to develop a plan of action. All agreed that the main problem was that of soldiers spreading the disease to the civilian population. That issue was already addressed by the quarantine at Camp Taylor. To further keep civilians safe, the men agreed to try to prevent overcrowding and poor ventilation in Louisville’s streetcars and public places. Health Officer Baker and USPHS officer Lieutenant R. B. Norment asked movie house managers to prevent congestion and to ventilate thoroughly their theaters between films, and asked the Street Railway Company to keep the windows in their streetcars wide open at all times. Further, Baker issued a prohibition against public funerals in order to prevent an assembly of people, several of which would likely have had contact with the disease.4 The next day, Baker and Norment advised residents to walk rather then take streetcars, to stay home if they felt ill, and to avoid crowds. Physicians were told to report cases of influenza to the Louisville health department.5 On October 2, Dr. Joseph N. McCormack, Secretary of the state Board of Health, made influenza a reportable disease across Kentucky and ordered local boards of health to placard and quarantine any infected households for a minimum of ten days.6

Influenza was already circulating amongst Louisville residents. By September 20, a week before these measures were put into effect, some 50 civilian cases had been reported to the health department, although health officials would only confirm that three of them were actually “Spanish” influenza.7

By October 7 it was clear that Louisville’s nascent influenza epidemic was spreading. Norment, now Acting City Health Officer while Baker was on medical leave, directed the city’s district, tuberculosis, and health department nurses to begin preparations for the likelihood of a more widespread civilian epidemic. The most immediate need was for automobiles to help visiting nurses make speedy responses to those in need. The Motor Service League turned to the women of Louisville, who responded generously with their automobiles; on weekends, nurses used municipal vehicles.8

Louisville’s charitable nursing associations organized home care for the city. On the morning of October 7, the Babies’ Milk Fund Association and the King’s Daughters’ District Nurse Association (which would merge in 1919 to become the Public Health Nurses’ Association), and the Board of Tuberculosis agreed to coordinate nursing care through the District Nurse Association. Starting the next day, supplemental nurses worked alongside Louisville’s regular district nurses to care for influenza victims in their homes. Until the number of new cases became overwhelming, nurses conducted all investigations and placarded homes. As the number of emerging cases accelerated, the police stepped in to do the placarding.9 The Red Cross Home Service, Associated Charities and, eventually, the Emergency Hospital, worked effectively to supply meals for the sick. Writing in Public Health Nurse, a Louisville visiting nurse superintendent later praised the cooperation that took place among the city’s private and public health agencies – it occurred “without one hour lost in friction or needless argument.”10

On the same day that Acting Health Officer Norment met with visiting nurses, state Board of Health Secretary McCormack issued a state-wide order closing all churches, schools, and places of amusement or assembly until further notice. Louisville Mayor George W. Smith issued a statement endorsing the state order and putting it in full effect in his city.11 To augment the efforts, Norment met with Louisville’s Retail Merchant’s Association to stagger the work hours of store employees as a way of relieving crowded streetcar conditions.12

On October 12, the health department reported that a total of 2,300 cases of influenza had appeared since September 28.13 Louisville’s citizens moved to help, volunteering even more automobiles to the Women’s Service League and Louisville Automobile Club, in turn permitting visiting nurses to increase their home visits.14 By the end of the month, nurses made a staggering 2,589 calls, routinely working seven days a week to ensure that all who needed it received care.15 Even Acting Health Officer Norment made use of volunteer transportation. He and his assistants drove house-to-house one Saturday, distributing pamphlets on influenza.16 The Louisville Advertising Club agreed to work with a special state committee to provide daily public education in the state’s newspapers.17 Later, when Christmas approached, merchants voluntarily restricted some of their seasonal promotions and implemented other changes to minimize crowds.18

As the epidemic gained in intensity, hospitals soon were stretched to the breaking point. The health department interceded by opening a 75-bed emergency hospital at the Hope Rescue Mission on October 13, under the direct supervision of acting health officer Norment. The emergency facility had the capacity to expand to 110 beds, which it did just days later. Volunteers, including some public school nurses, labored so tirelessly to help patients – many of whom were picked up half dying from the streets – that medical staff sometimes forced the volunteers to stop and rest for their own welfare.19

Then, suddenly, the number of new influenza cases started to drop, prompting some to surmise that the epidemic would soon come to an end. On October 18, members of the state Board of Health, the United States Public Health Service, military authorities, and a number of local Kentucky health officers – including Acting Health Officer Norment – met at the Seelbach Hotel to discuss the possibility of lifting the ban, at least in Louisville. Instead, state health authorities not only affirmed the existing closures, but also tightened and extended the restrictions. Effective the next day, the state Board of Health ordered all saloons and soft drink stands to close between 6:30 pm until 6:30 am. Only churches and synagogues had some measure of latitude – the Board permitted churches to open for individual prayer and meditation.20

Louisville’s epidemic continued to abate over the course of the rest of the month. By October 22, the city’s newspapers were happily reporting that influenza’s high mark had been reached on two weeks earlier, and that the number of new cases was on the steady decline.21 On October 30, state and local health officers as well as representatives from the Red Cross and the Louisville Board of Trade met once again at the Seelbach to discuss the lifting of the bans. Norment stated his belief that the city’s epidemic had run its course, and that there would be no danger in allowing public gathering places to reopen. Clergy argued that allowing regular religious services would lift the morale and spirit of residents, and thus stimulate their resistance to influenza. The arguments fell on deaf ears, as once again the state Board of Health voted to continue the closure orders, although this time it provided a possible timeframe for when they might be lifted – one week. The problem was not so much with Louisville as it was with the surrounding Jefferson County, which was still in the midst of a serious epidemic. If Louisville were allowed to reopen, some believed that visitors would flock to the city for amusement, thus bringing influenza with them.22 Until the situation in Jefferson County improved, the bans would remain in place.

As October turned into November, conditions in Louisville continued to improve. Finally, on November 6, the Kentucky Board of Health announced that the closure order and gathering ban would be lifted for the Louisville area effective Sunday, November 10 for churches and Monday, November 11 for all other places. The Board omitted mention of the business hour restrictions on saloons and soda fountains, as these measures were enacted in a separate order. Secretary McCormack stated that the Board would have to take up this issue at its next meeting, although he hinted that the decision might be left up to local health officials. Norment, pleased that the major closure order would soon be removed, vowed to ensure that saloons and soda fountains followed the restricted business hours for the time being.23

Churches reopened on Sunday, November 10, the first time the pews were occupied for regular service in five weeks. To prepare for the complete reopening of the city and to help stave off a return of the epidemic, the Louisville Boards of Health and Public Safety issued a set of regulations to prevent crowding. All stores were to be fully ventilated at all times and kept at a proper temperature. All employees exhibiting symptoms of illness were to be sent home at once, returning to work only when provided with a certificate from their physician. Stores were to employ enough staff to prevent congestion. For pool halls and bowling alleys, owners and managers were to grant admittance to those actually engaged in games. Movie house and theater managers were likewise prohibited from allowing crowds to gather inside their establishments. This did not prevent crowds of eager entertainment seekers from forming long lines as people rushed to purchase tickets for the evening’s shows.24

By Thanksgiving, physicians were reporting a slight but nonetheless noticeable increase in influenza cases. Norment remained optimistic that the worst was over, and that, while Louisville would experience elevated case burdens throughout the winter, residents need not fear a return of the epidemic.25 A little over a week later, attendance at schools in the Crescent Hill neighborhood had dropped by 50% due to influenza. Physicians reported a considerable increase in cases. In fact, a group of concerned physicians petitioned McCormack and the state Board of Health to re-implement the closure order and gathering bans so that the epidemic could be brought under control. The Board refused the request because members hoped that a recently shipped supply of 100,000 doses of influenza serum would soon do the job. In the meantime, the Board asked residents to avoid crowds, cover their coughs and sneezes, and remain in bed if feeling ill.26

On December 12, Health Officer Baker – returned from his medical leave – called a meeting of the Mayor, Norment, and McCormack, as well as representatives of the medical community, churches, schools, fraternal organizations, businesses, and amusement concerns to discuss whether Louisville should implement a second round of closure orders.27 Of particular concern were schoolchildren. Reviewing the latest data, the group agreed that a second school closure order was necessary. The next day, Baker announced that schools would be closed and children under 14 banned from theaters and other public gathering places effective December 14.28 To further safeguard youngsters, the city health department stationed inspectors in stores and motion picture theaters to serve as enforcers.29 Children did not have to wait long before regaining admittance to their favorite places of amusement. Within two weeks the epidemic subsided drastically, leading Baker to reopen Louisville’s schools on December 30. A week later, he announced that children could once again attend movie houses and five-and-ten cent stores.30

Conclusion

Louisville was not quite out of the woods yet, however. In late-February 1919, the health department documented a sudden, third spike in influenza cases that lasted approximately five weeks. The cases were generally much milder this time, however, and thus neither Baker nor the state Board of Health considered issuing a third closure order. It was not until the end of spring that conditions returned to normal.

Between September 26 and November 16, 1918, Louisville physicians reported a total of 6,736 cases of influenza to the health department, of which 577 resulted in death.31 Louisville’s excess death rate for the fall and winter was 406 per 100,000 people, average for its geographic region. Cincinnati, for example, had an excess death rate of 451 per 100,000, and Dayton 410. To the south, Nashville fared much worse, with an excess death rate of 610 per 100,000.

There can be no doubt that Louisville, like nearly every city, was challenged to care for its stricken during this time. The quick and decisive action of city officials and especially the health department, however, greatly mitigated what could have been a much worse epidemic. Under the auspices of the health department, hospital and homecare was organized and coordinated, incorporating the help of the Red Cross, the Visiting Nurses, and other community charities and services. As the tempo of new cases increased, successful calls for volunteers and the creation of a well-staffed temporary emergency hospital augmented the system of care. Many other American cities had to plead for volunteers, both from within and from without. In Louisville, the situation was well enough in hand throughout the epidemic that the city was able to furnish nurses to hard stricken communities in the hardscrabble sections of eastern Kentucky.32

Notes

1 “Influenza Rampant,” Louisville Times, 24 Sept. 1918, 8; “Flu Cases Increase,” Louisville Times, 25 Sept. 1918, 1; “Steps Taken to Prevent Flu Spread,” Louisville Times, 28 Sept. 1918, 1.

2 “Sweeping Order Issued to Men at Local Camp,” Louisville Times, 27 Sept. 1918, 1.

3 “Closes shows to soldiers,” The Courier-Journal 3 Oct. 1918 1.

4 “City and U.S. Take Steps to Check Spread of Flu,” Louisville Courier-Journal, 27 Sept. 1918, 10.

5 “Join Hands in Fight on Flu,” Louisville Times, 28 Sept. 1918, 1.

6 Annual Report of the Board of Health, City of Louisville, KY, for the fiscal year ended August 31, 1919. [Louisville: 1919], 38-39.

7 “Spanish Flu Is Discovered Here; Three Infected,” Louisville Courier-Journal, 20 Sept. 1918, 1.

8 “Women Asked to Loan Cars to ‘Flu’ Workers,” Louisville Times, 3 Oct. 1918, 12; Louisville, Ky. Board of Health. Annual Report of the Board of Health, City of Louisville, KY, for the fiscal year ended August 31, 1919 (Louisville, 1919), 53.

9 Annual Report of the Board of Health, City of Louisville, KY, for the fiscal year ended August 31, 1919 (Louisville, 1919), 53.

10 Helen B. Lupton, “Influenza in Louisville, Ky.” Public Health Nurse vol. 9, no. 1 (1919): 48.

11 “Schools to Close while Flu Rages,” Louisville Courier-Journal, 7 Oct. 1918, 1.

12 “Closing Order Hits Churches,” The Courier-Journal, 8 Oct. 1918, 4.

13 “No Rest for City Health Officials,” Louisville Times, 12 Oct. 1918, 3.

14 “State board to enlarge rules for quarantine,” Louisville Times, 9 Oct. 1918, 1, 11.

15 Helen B. Lupton, “Influenza in Louisville, Ky.” Public Health Nurse vol.9, no. 1 (1919): 48; “No Rest for City Health Officials,” Louisville Times, 12 Oct. 1918, 3.

16 “No Rest for City Health Officials,” Louisville Times, 12 Oct. 1918, 3.

17 “Will Help Educate Public as to Flu,” Louisville Courier-Journal, 20 Oct. 1918, 8.

18 “Health Edict Banishes Santa,” Louisville Courier-Journal, 9 Nov. 1918, 1, 2.

19 Louisville, Ky. Board of Health. Annual report of the Board of Health, City of Louisville, KY, for the fiscal year ended August 31, 1919 (Louisville, 1919), 53.

20 “Ban Tightened to Check ‘Flu,’” Louisville Courier-Journal, 19 Oct. 1918, 1,2.

21 “City Gains in Fight on Flu,” Louisville Courier-Journal, 22 Oct. 1918, 1.

22 “Flu Lid Still Clamped Down,” Louisville Courier-Journal, 31 Oct. 1918, 1.

23 “’Flu’ Quarantine is Modified Here; Effective Sunday,” Louisville Courier-Journal, 7 Nov. 1918, 1; “Flu’ Ban Lifted, Subject to Rule of Local Board,” Louisville Times, 7 Nov. 1918, 7.

24 “’Flu’ Lid is Off; Churches Open,” Louisville Courier-Journal, 10 Nov. 1918, 1; “Schools Open this Morning,” Louisville Courier-Journal, 11 Nov. 1918, 2.

25 “Flu Showing Increase; Norment is Optimistic,” Louisville Courier-Journal, 26 Nov. 1918, 1; “Flu Cases Take Spurt,” Louisville Times, 30 Nov. 1918, 12.

26 “Seventy Cases Now,” Louisville Courier-Journal, 3 Dec. 1918, 9; “Hold Quarantine to See Results Serum May Give,” Louisville Courier-Journal, 7 Dec. 1918, 8.

27 “Flu Ban May Be Clamped Down,” Louisville Courier-Journal, 13 Dec. 1918, 1, 2.

28 “Tots Barred from Crowds,” Louisville Courier-Journal, 14 Dec. 1918, 1,2.

29 “Influenza on Wane; May Lift Ban Jan. 1,” Louisville Courier-Journal, 27 Dec. 1918, 5.

30 “Modified Ban on Influenza off Dec. 30,” Louisville Times, 28 Dec. 1918, 1; “Influenza Ban is Entirely Lifted,” Louisville Times, 6 Jan. 1919, 1.

31 Annual report of the Board of Health, City of Louisville, KY, for the fiscal year ended August 31, 1919 (Louisville, 1919), 38.

32 “East Kentucky in Dire Straits,” Louisville Courier-Journal, 2 Nov. 1918, 1.

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The Seelbach Hotel, circa 1905. During the deadly influenza epidemic, city and state health officials frequently met at the stately Seelbach to plan Louisville’s public health response. It was also the site of Daisy’s wedding in the famous F. Scott Fitzgerald novel The Great Gatsby. Click on image for gallery. The Seelbach Hotel, circa 1905. During the deadly influenza epidemic, city and state health officials frequently met at the stately Seelbach to plan Louisville’s public health response. It was also the site of Daisy’s wedding in the famous F. Scott Fitzgerald novel The Great Gatsby.
City Hospital, Louisville. Click on image for gallery. City Hospital, Louisville.
Market Street in downtown Louisville, looking west from Third Street. Click on image for gallery. Market Street in downtown Louisville, looking west from Third Street.
The sprawling base hospital complex at Camp Zachary Taylor, on the outskirts of Louisville. It was the largest military camp in the United States at the time. Click on image for gallery. The sprawling base hospital complex at Camp Zachary Taylor, on the outskirts of Louisville. It was the largest military camp in the United States at the time.
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Louisville, Kentucky

Timeline of Events

Excess Death Rate (per 100,000) Daily EventsClick day to view details. Selected Event
graphNational
200Excess Death Rate (per 100,000)
180 
160 
140 
120 
100 
80 
60 
40 
20 
0 
Total Excess Death Rate 406
Total Deaths per 100,000 population over duration of epidemic (roughly 1918 September 14 through 1919 February 22).
 19181919
 AugustSeptemberOctoberNovemberDecemberJanuaryFebruaryMarchApril
Sa273101724317142128512192629162330714212841118251815221815222951219
Fr2629162330613202741118251815222961320273101724317142128714212841118
Th2518152229512192631017243171421285121926291623306132027613202731017
We243171421284111825291623306132027411182518152229512192651219262916
Tu2330613202731017241815222951219263101724317142128411182541118251815
Mo2229512192629162330714212841118252916233061320273101724310162431714
Su21284111825181522296132027310172418152229512192629162329152330613

September 20, 1918

A Louisville physician reports three cases of “true” influenza in the city under his care. Two of the patients are civilians and one is a soldier, and all recently arrived in town from the East Coast. Some fifty suspected cases of influenza have been reported in Louisville over the course of the past two weeks, but officials are doubtful that these were really influenza. Dr. T. H. Baker, City Health Officer, tells residents they can avoid infection by using antiseptic washes for the nose and throat, getting plenty of fresh air while sleeping, and avoiding crowds and places where people congregate such as churches or movie theaters.

September 25, 1918

Over 100 soldiers with mild influenza symptoms are admitted to the base hospital at Camp Zachary Taylor. Army medical officers are keeping a careful watch on the situation and are taking every precaution in the hopes of preventing a widespread outbreak of influenza at the camp.

September 26, 1918

Medical officers at Camp Zachary Taylor meet with representatives of the United States Public Health Service to discuss the influenza epidemic at the camp. The main concern is that soldiers will contract influenza while in the city, especially while visiting overcrowded places with poor ventilation. As a preventive measure, Health Officer Baker requests that the Street Railway Company keep all windows in streetcars open. Managers of motion picture houses are asked to make an effort to prevent congestion at entrances and inside the theatres and to carefully ventilate the buildings between shows.

September 28, 1918

Federal and city health officials ask Louisville residents to avoid crowds and places where people congregate, to cover their mouths and noses when sneezing and coughing, and to remain home if they feel ill. They also announce that the anti-spitting ordinance will be enforced strictly. Known cases of influenza will be isolated. At Camp Zachary Taylor, medical officers enact several epidemic control measures to prohibit gatherings of soldiers and to keep barracks properly ventilated.

September 29, 1918

Camp Zachary Taylor experiences its first influenza-related death. There are now more than 1,700 patients at the base hospital, which has become so overcrowded that 15 barracks of the “C” section are converted to hospital wards. Hospital authorities issue a call for eight additional nurses and ask for assistance from Louisville nurses. The base hospital is placed under quarantine and only immediate relatives of patients in serious condition are allowed. Visitors must wear regulation gauze masks in the hospital. All other civilian visitors are barred from entering the camp.

Health Officer Baker calls managers of movie theaters to his office to advise them on the steps they must take to avoid overcrowding and to ensure proper ventilation. The city building inspector will ensure compliance, and any managers refusing to obey the mandate will have their theater closed.

October 1 , 1918

Motion picture houses are warned to prevent congregation or they will be closed.

October 3, 1918

Army officials at Camp Zachary Taylor issue an order prohibiting all officers and enlisted men from attending theaters, moving picture shows, dance halls, and from loitering in hotel lobbies or stores or visiting any places where crowds can be found. Provost guards are stationed on the streets of Louisville to ensure compliance.

October 4, 1918

Some 7,000 soldiers have now been admitted to the Camp Zachary Taylor hospital with influenza. The 159th Depot Brigade has lost more soldiers than any other organization at the local camp, with the Field Artillery Replacement Depot as a close second.

October 6, 1918

Late in the day, the Kentucky State Board of Health orders all churches, schools, and places of amusement throughout the state closed. Louisville Mayor George W. Smith issues a notice that the orders will be rigidly enforced in the city. The Louisville Board of Health advises residents against all unnecessary travel and social visiting until the epidemic has passed.

October 7, 1918

The statewide closure order goes into effect. All schools, churches, and places of public amusement and gathering across Kentucky are closed for the duration of the epidemic. The Jefferson County Board of Health directs the County Superintendent of Schools to close all rural schools and suspend all meetings pertaining to schoolwork until further notice.

October 8 , 1918

Despite the 25 influenza-related deaths that have occurred at Camp Zachary Taylor, military officials feel considerably encouraged that the epidemic there is noticeably improved. They believe that the mortality rate will not be as high as at other military camps, even though the population and the case rate are higher than at other installations. Since the start of the epidemic fifteen days ago, nearly 10,000 soldiers have been taken to the hospital and 1,310 have been released as cured. Camp officials ask the Pennsylvania and Delaware Division of the American Red Cross to send twenty nurses from Mercy Hospital in Pittsburgh.

In Louisville, Acting City Health Officer R. B. Norment meets with the secretary of the Retail Merchants Association to discuss staggering the shifts of department store employees to prevent overcrowding on streetcars. Residents are advised to shop from 10:00 am-noon and 1:00 pm-4:00 pm to avoid congestion.

At the request of the State Board of Health, the University of Louisville temporarily suspends all lectures. As of yet, there have been no cases among cadets of the Student Army Training Corps, but there have been several reported cases among medical students.

October 9, 1918

The State Board of Health meets to assess the epidemic in Kentucky and devise ways to improve the situation. Board members decide that shops and stores, while a greater factor in the spread of influenza than amusement venues, are vital to the economy and therefore will remain open. They do, however issue an order prohibiting special sales as a way to keep crowding to a minimum. The Board concludes that it is impossible to remedy the issue of crowding on streetcars, but that maintaining proper ventilation can mitigate some of the problem.

October 14, 1918

The Hope Rescue Mission opens as an emergency influenza hospital, with twenty patients occupying beds. Acting Health Officer R. B. Norment says that with proper reporting of cases by physicians and the exercise of caution by the public, the disease will soon be eradicated.

Medical officers at Camp Zachary Taylor believe the epidemic there has reached its crest. They expect the number of new cases to decline in the coming days. Restrictions on soldiers leaving or civilians entering the camp will remain in effect until all danger has passed.

October 15, 1918

Acting Health Officer R. B. Norment announces that the Health Department will begin placarding all homes of influenza patients and that people should not visit the ill. He explains that all cases will be rigidly isolated for a period of ten days from the onset of the disease, or until such time as the patient has entirely recovered from any complication of the disease. Household members will be placed under quarantine, but wage earners may continue to work provided they have no contact with the patient.

October 18, 1918

The State Board of Health meets to consider whether or not to raise the ban on public meetings in counties where influenza has not made an appearance or where there are only a few cases and the danger of the disease spreading is slight. The Board decides to tighten and extend restrictions by ordering all saloons and soft drink stands to close from 6:30pm. until 6:30am. All meetings, no matter what the cause, are prohibited. Churches are allowed to open for individual prayer, but health officials hope that people will be careful not to congregate. This ruling goes into effect tonight.

October 18, 1918

The Louisville chapter of the Red Cross urges every woman in capable of nursing to volunteer for service. The head of the recruitment effort said that efforts have been hindered by a prevailing impression that registration is to be followed by a draft, with volunteers sent to other cities. She indicated that this is not correct: all service is voluntary, and whether the service is performed in Louisville or in some other city is up to the registrant.

October 19, 1918

At Camp Zachary Taylor, nearly 8,000 of the 11,311 influenza patients have recovered from the disease. So far, 699 soldiers there have died of influenza or pneumonia since the start of the epidemic.

In Louisville, the Louisville Railway Company, operator of the city’s streetcar service, in conjunction with the Board of Health, enacts measures to reduce crowding on streetcars. Until there is an abatement of the flu epidemic, only 65 persons may ride aboard a double-truck streetcar and only 55 may ride aboard a single-truck car.

October 20, 1918

The State Board of Health creates a special committee that will work with daily newspapers to disseminate vital facts and information relevant to the efforts to combat the influenza epidemic.

October 21, 1918

The reopening of the Louisville Free Public Library will be one of the subjects brought up for consideration by the Board of Health this week

As the Board of Health considers reopening the Louisville public library, some have called for destroying those books that have been in the homes of influenza patients. Acting Health Officer Norment considers such a course “absolutely unnecessary,” as a sterilizer for the books would cost far less than the value of the books in circulation in such homes.

October 22, 1918

City health officials declare that the epidemic has reached its crest, with a high mark of 530 new influenza cases for the day.

October 27, 1918

The State Board of Health issues a public notice recommending that all residents stay out of crowded places, get proper rest, eat good food, walk to work if possible, wash hands before eating, sneeze and cough into a handkerchief, avoid those who have symptoms of influenza, and call a physicians immediately if sick.

October 30, 1918

The State Board of Health meets with representatives of the clergy, the Red Cross, the state Council of Defense, and the Louisville Board of Trade to determine the advisability of lifting the ban on public meetings. Members of the clergy argued that opening churches would lift the morale of the city’s residents and would help stimulate their resistance to influenza. Major L. D. Fricks, United States Public Health Service representative, and Acting Health Officer Norment advocate a modification of the regulations, arguing that the epidemic has run its course. The Board is not swayed, however, and by unanimous decision decides to keep the ban in place until at least next Wednesday, November 6. The Board will meet again then and reconsider the issue.

October 31, 1918

The witches’ annual Halloween carnival is held, despite Louisville’s influenza epidemic.

November 1, 1918

Because the influenza situation in Louisville is much improved, city officials have been asked to send aid to more stricken districts in the state. State health officials say that eastern Kentucky is especially hard-hit, with conditions there rivaling the worst in the country.

November 2, 1918

Upon the advice of his medical officers, Brigadier General Fred T. Austin, commanding officer at Camp Zachary Taylor, orders that the quarantine restrictions at the camp not be lifted before November 10. The epidemic is rapidly disappearing and conditions have generally cleared, but medical officers want to take every precaution to ensure that influenza is stamped out and that it will not reappear. Medical officers will convene again on November 10 to reassess the situation.

November 3, 1918

Representatives of state charitable organizations meet to discuss their roles in the aftermath of the influenza epidemic and how to best delegate the relief work. They decide that the Conference of Social Workers will act as a clearinghouse for information. It is estimated that hundreds of children will be orphaned and that whole families will need assistance for some time to come. They propose that each county care for its own residents wherever possible, with wealthier communities aiding poorer ones when needed.

November 5, 1918

Louisville has experienced 6,415 influenza cases since the start of the epidemic. It is estimated that fully one-half of the hospital admittances have been discharged as cured.

November 6, 1918

The State Board of Health meets to discuss the influenza situation in Kentucky and decides to modify its previous orders. Churches in Warren and Jefferson County (Louisville) are permitted to hold regular services. Theaters in these two counties are allowed to reopen beginning tomorrow. Schools will reopen on Monday, November 11.

November 9 , 1918

M. H. Thatcher of the Board of Public Safety meets with representatives of the Retail Merchants’ Association and asks them to avoid crowding in their stores by not allowing the public to loiter in stores longer than is necessary to make a purchase. The merchants agree.

Brigadier General Fred T. Austin, Commander of Camp Zachary Taylor, removes the quarantine regulations at camp. Beginning tomorrow, the Liberty theater will open and visitors will be allowed to enter the camp.

November 10, 1918

Churches open their doors for services for the first time in five weeks. All stores in Louisville must be fully ventilated, must not be allowed to be heated past 65 degrees Fahrenheit, and must prohibit crowding. Employees feeling ill or displaying symptoms of influenza must stay at home until fully recovered. Managers and owners of theaters, poolrooms, bowling alleys, saloons, and soda fountains must keep their establishments free of crowing as well.

November 11, 1918

Louisville schools reopen, along with the University of Lousiville.

November 16, 1918

The State Board of Health lifts the influenza ban in twenty additional counties, but refuses the application of thirteen others seeking to have restrictions removed. The Board also adopts a resolution that commissions every physician in the state as a sanitary inspector with authority to isolate patients having influenza symptoms. Now, all physicians have 24 hours to report cases to their city or county board of health and must isolate all patients for a period of ten days. Failure or refusal to comply will result in the offending physician being called before the Board to show reason why his license should not be revoked.

November 19, 1918

The number of new influenza cases begins to rise once again. Acting Health Officer Norment sees no reason to fear a recurrence of the epidemic in the city. He says that there will continue to be small numbers of cases during the holiday shopping season, as people come into contact with each other in stores, but that there is no cause for alarm. He adds, however, that if the number of new cases increases significantly over the course of the next several days, a ban on public gatherings will once again be enacted.

November 30, 1918

Acting Health Officer Norment informs the Louisville Railway Company that the open window policy for all streetcars is over, and that all cars must be heated. The Railway Company had argued that it was impossible to both heat the streetcars effectively and keep the ventilators and windows open at the same time.

December 6 , 1918

The Red Cross Department of Civilian Relief announces is will make an extensive survey of Kentucky, especially those districts most seriously affected by the epidemic, to determine the after-effects of the epidemic and the needs of the populace. The Red Cross will cooperate with the Public Health Service, State Health Department and the National Council of Defense in this mission.

December 12, 1918

City Health Officer Dr. T. H. Baker is back in his office and is considering the advisability of taking stringent precautions to prevent influenza from becoming epidemic again. He calls a meeting of city officials, local United States Public Health Service officers, physicians, church leaders, businessmen, and representatives of fraternal organizations to consider taking action against the epidemic. Because the number of new influenza cases is greatest among children, officials decide to close public schools effective Monday, December 16, and to ban children under 14 from stores and other public gathering places. Attendance at movie houses and theaters is to be limited to the actual capacity of the building. Lastly, the number of passengers on streetcars is limited in order to prevent crowding.

December 17, 1918

An influenza vaccine has now been administered to members of the police department, fire department, and thousands of persons who have volunteered for inoculation.

December 18, 1918

Health Officer Dr. T. H. Baker calls streetcars the most prolific agencies in the spread of influenza, and says that the Louisville Railway Company is the only group so far to ignore the recent Board of Health order. Health Department inspectors have found cars crowded beyond the limit allowed by the order, and officials have made it clear that if the situation is not remedied immediately warrants will be issued today.

December 20, 1918

Health Officer T. H. Baker declares a ban on all church and other large Christmas entertainments. The large Christmas tree usually erected at the armory is called off due to the large crowds it attracts each year.

The Louisville Railway Company is reported to be in compliance with Board of Health orders now.

December 23, 1918

Health Officer Baker declares that influenza has been effectively placed under control in Louisville. He says that conditions have become so favorable that there is a strong possibility that all restrictions imposed by state and local authorities will be removed on January 1.

December 26, 1918

The Health Department removes all its inspectors from the large stores downtown at the request of merchants, who agree to continue to observe the order barring children under 14 from entering stores. Inspectors will be kept on duty at the motion picture theaters until the modified ban is lifted.

December 30, 1918

Public and parochial schools reopen. Children are now allowed to enter department stores, but those under 14 are still not permitted to enter movie houses, theaters, or five-and-dime stores.

January 1, 1919

Health Officer Baker announces that the influenza situation in Louisville is much improved, and that the remaining public health edicts will likely be removed by week’s end.

January 6, 1919

Health Officer Baker removes the ban on children entering places of public amusement and gathering. He tells the public that the epidemic is under control, and that keeping the measures in place any longer would be an unfair burden on the city’s youngest residents. The streetcar company no longer has to limit the number of passengers aboard its cars.