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Flu Epidemic of 1918 Hit El Paso Hard
Article first published in Vol. 19, 2000.
By Valerie Garnica and Armando Resendiz
In 1918, a flu pandemic spread in three principal waves. For 17 weeks, from September 1918 to January 1919, the virus killed 20 to 40 million people worldwide, with unusually high death rates among young, healthy adults. The virus became known as the "Spanish Flu," not because it originated in Spain but because so many Spaniards caught the disease - an estimated eight million.
Such a vaccine was not available 82 years ago.
In 1918, the severity of the disease became apparent when it targeted so many different ages and types of people. Rural and city dwellers alike, soldiers, and most surprisingly, those in the prime of life became victims. The second wave of the flu attacked mostly young people between the ages of 20-40, unusual because influenza historically had affected the elderly and the very young.
Europe recorded over two million deaths compared to almost 16 million deaths in Asia, about five million in India alone. Fatalities in the United States numbered over 500,000. Even isolated areas such as Eskimo villages in Alaska were wiped out. In 1918, El Paso was a dominant railroad center and a rapidly growing city, with a population of about 75,000. Fort Bliss had become a major military base. The Spanish flu epidemic made El Paso work together as a community.
On October 3, 1918, Mayor Charles Davis closed all schools, churches, theaters and other public places. Even funerals could not be held in churches. Health officials denied all requests to reopen them. Dr. J. W. Tappan, Director of the El Paso City-County Health Unit, declared on October 26, "The epidemic is abating, but has not abated sufficiently to allow reopening. If we reopened now, it would start out again with a whoop."
One reason this flu epidemic became so deadly was the rapid course of the disease. Some victims died within hours of contracting this flu. The El Paso Herald-Post published four directives to help prevent the flu from spreading. Residents were told not to cough or sneeze without covering the mouth; not to sleep in the same room with an infected person; not to kiss; and not to wait until the symptoms pass before calling a doctor.
Local health officials enacted an ordinance making it mandatory for residents to wear face masks in public. El Pasoans were told to avoid crowds and packed cars. Because the city was not prepared for an epidemic, existing hospitals became overcrowded and physicians were in great demand. Various buildings were converted into makeshift hospitals.
Fort Bliss soldiers could not leave the base without permission and were subject to arrest if they did. When they entered El Paso, soldiers could not go south of Overland Street. By October 15, Fort Bliss had 1,309 cases. Many of these patients were soldiers who had returned from Europe, where the flu was raging. The commander of Fort Bliss volunteered the services of his medical officers to help the city with the epidemic.
Mexican-Americans in the south part of the town suffered most. The virus ripped through the section named Chihuahuita because no hospital existed in the area, and other health services were not provided. Residents of the area died by the dozen. On October 15, officials recorded 37 deaths in south El Paso, and 22 sick people were found in one house.
Fred M. Morales, writing about the neighborhood, said that ambulances would pick up the seriously ill from Chihuahuita four to five times a day and transport them to the Santa Fe Street tenement buildings that were converted into hospitals. Residents often avoided hospitals because they could not speak English and were frightened of dying there.
On October 16, 1918, city and health officials decided to convert the 28 rooms of Aoy School into an emergency hospital for influenza patients. Historian Bradford Luckingham writes that the city furnished utilities; the school board provided the building; the United States Public Health Service supplied the physicians; the Red Cross contributed the beds, medicines and nurses; and the Associated Charities provided food, clothes and money for families in need. Aoy teachers assisted Red Cross workers, speaking Spanish to the patients.
Volunteers from all over the city donated food and clothing to the sick in hospitals, while others used their vehicles as ambulances. These volunteers also taught family members of flu patients rules to prevent reinfecting the patient or spreading the disease to others.
The epidemic took its toll on El Paso. In late October, nearly 5,000 Spanish influenza cases had been reported, and at least 400 people had died. During the week ending October 23, 229 deaths occurred in the city. Of the dead, 144 were from the Southside, an increase of 42 over the previous week. Dr. Tappan explained that the high death toll among Chihuahuita residents resulted largely from the fact that a whooping cough epidemic already existed and served to further weaken children who then contracted influenza.
The economic loss in El Paso was drastic. The board of health decided that no new businesses should be opened and ordered that "no stores or public gathering places of any kind, shall allow more than twenty-five persons other than employees, to congregate on one floor." The board also authorized special officers to help enforce the regulations. They cited several stores and restaurants for unnecessary crowding.
The city removed the prohibition of public gatherings on November 9, allowing more than 8,000 people to view the Armistice Day parade on November 11. Fort Bliss lifted its quarantine. By this time, El Paso had recorded 600 fatalities. Cases of the Spanish flu continued to occur, but by January 1919, the flu scare was over.
Today, researchers are trying to figure out where this virus came from, why it did so much damage and if and when it will occur again. Determining the origin of the virus can help doctors understand how best to fight the disease. One research team has noted that there had been an outbreak in spring 1918 of a mild flu, followed by an outbreak in the autumn among pigs, and then the killer epidemic in people. This sequence of events supports the theory that the 1918 influenza spread from humans to swine and then back to humans.
Scientists investigating the 1918 flu were stymied in part by the difficulty of finding viable tissue samples from people who had been dead for more than eight decades. In 1999, the Armed Forces Institute of Pathology team used samples from the body of an Alaskan Inuit who was buried in permafrost on the Seward Peninsula, a 21-year-old soldier who died in South Carolina and a 30-year-old who died in New York. The team managed to compose the entire gene for hemagglutinin, a protein the influenza virus uses to infect the cells scientists look at first to determine a flu strain.
Dr. Rod Daniels, of the National Institute for Medical Research in London, England, says, "Ultimately when we have the genetic information and we have pinned down the pathogenic determinants, then we can monitor for those things through our existing surveillance system. We could probably spot a virus that is evolving down a particular route and prepare a vaccine ahead of time and maybe stop that virus in its tracks."
Regardless of technology, an influenza epidemic is still possible in our time. Paul M. Rowe writing in the British medical journal Lancet, says, "Influenza pandemics are not new, but rapid international travel combined with complications caused by emerging drug-resistant bacteria and the deterioration of the public health service infrastructure in many places may make the next one very severe." No cure exists for the flu, but the yearly vaccines minimize the symptoms. Doctors can identify various strains and treat patients immediately.
Even with a new vaccine every year, El Pasoans fall victim to various strains of influenza. Epidemiology units monitor hospitals and schools here in El Paso daily from September through April for high numbers of people with flu-like symptoms. If the number of flu cases rises 10 percent above normal, the city will react with emergency measures.
The two main medical interventions available are vaccinations and antiviral drugs, neither of which is 100 percent effective. Bertha Holguin, a nurse at Texas Tech Medical Center, who concentrates on flu cases, says the most important step to preventing flu is still to wash hands thoroughly and frequently.
The Spanish Flu, coming at the end of World War I, killed more people than the war did. Because the city's health agencies and volunteers worked relentlessly to stop the spread of the virus, El Paso had a relatively low mortality rate. Nevertheless, the flu remains a potentially fatal disease 100 years later. The world must be better prepared for another catastrophic outbreak than it was in 1918.
Bacteria Fingered as Killer in 1918 Flu Pandemic (NPR piece)