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The director of The Centers for Disease Control and Prevention said a pandemic flu is very possible. Veuer’s Sam Berman has the full story.
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Influenza patients at a makeshift hospital near Fort Riley, Kansas, in 1918. Kansas saw the first wave of flu to hit America; the second, months later, made its way to Tennessee.(Photo: Associated Press)

For four weeks in the fall of 1918, Knoxville fought the Spanish flu. The contagious illness killed an estimated 132 people and closed schools, churches, theaters and pool rooms for almost a month.

Doctors first called the illness the “old-fashioned gripe,” but there was nothing familiar about this strain of fast, often fatal, influenza. While it often started as a cold accompanied by a headache and joint pain, patients developed fever, hallucinations and bleeding from the nose, stomach, intestine and sometimes ears. They coughed up blood as their skin turned blue, then black.

People who survived could develop a lingering “hacking cough” that could turn into sometimes fatal pneumonia. During autopsies, doctors found people died with fluid-filled lungs.

Another difference was who got sick. Rather than prey on babies, the elderly and the very weak — as most strains of flu do — this one hit young, previously healthy people in their prime. Most patients were between 21 and 40 years old. More than 90 percent of victims across the United States were younger than 65. All told, the epidemic dropped America’s average life expectancy by 12 years.

“Spanish flu” was a misnomer, as the flu took its toll on many countries. But since the flu outbreaks happened during World War I, they were among the “bad news” many countries’ newspapers — including the United States’ — suppressed. Spain was a neutral party in World War I with no strategic need to hide its vulnerabilities. So most flu news came from wire services in Spain and therefore tagged the flu with the country’s name too.

In a way it was the war that brought the pandemic to East Tennessee. Soldiers, many of whom arrived here on trains from other parts of the country, trained at the University of Tennessee and at Chilhowee Park. Soldiers who got sick likely spread the disease in their barracks and in town.

The flu comes to town

“Many soldiers” were so sick, the Knoxville Sentinel reported on Oct. 5, that makeshift hospitals were set up at Chilhowee and in UT’s Reese Hall. Red Cross nurses were called in to tend to the unreported number of quarantined soldiers. The military also inoculated soldiers with a “serum” it hoped would prevent them from getting ill.

Initially, authorities didn’t seem overly concerned. Only about 350 civilians, in a city of about 75,000, were sick in early October, and they didn’t seem very ill.

Dr. W.R. Cochrane, secretary of Knoxville’s board of health, told reporters the illness “will not be likely to get any worse if due precautions are taken.” Doctors warned everyone to stay out of crowds but get plenty of fresh air and keep spaces ventilated.

But more people did get sick. On Oct. 9, three people had died. That day, 197 soldiers and 604 civilians were ill. Soon, Knoxville General, the city’s only permanent hospital, would be overwhelmed — not only by patients, but also from lack of doctors and nurses as many themselves fell ill.

Patients also crowded the 40-bed Riverside Hospital, operating in an old home, and a small black-only hospital at Knoxville College. The inadequacy of the hospitals to accommodate the flu patients hastened the construction of Fort Sanders Hospital in 1920. 

Six thousand people marched in Knoxville's Great Liberty Parade on Gay Street on April 7, 1918. Some 25,000 people crowded the streets to watch a parade that was 40 blocks long and included 150 banners and floats to mark America's one-year entry into World War I.
A company of the 117th Infantry marches in the April 5, 1919 homecoming parade.  (McClung Historical Collection)
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An American Red Cross Canteen group poses for a photo at the Southern Railway tracks near the organization's World War I canteen for soldiers.
Returning World War I soldiers crowd Walnut Street on April 5, 1919. St. John's Cathedral is at right. (McClung Historical Collection)
World War I soldiers visit a Red Cross canteen at the Southern Railway station. (McClung Historical Collection)
The Third Tennessee Infantry departs for Camp Sevier, Greenville, S.C., Sept. 7, 1917 on the first leg of their journey to the World War I battlefields in France. The view is looking south on the 100 block of Gay Street. (McClung Historical Collection)
This is a 1919 photo of Sgt. Alvin York of the U.S. Army in an unknown location. Two Tennessee researchers who think they pinpointed the World War I battlefield where Sgt. Alvin C. York's valor earned him a Medal of Honor.  (AP Photo/Department of U.S. Army)
Charles McGhee Tyson

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J.E.
Calvin John Ward, World War I Medal of Honor recipient from East Tennessee

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Kiffin Rockwell prepares to take to the skies of France
Kiffin Rockwell, in a photo courtesy of the Virginia
Kiffin Rockwell
Kiffin Rockwell, here at the airfield in France, was
The Sept. 7, 1917 Knoxville Sentinel reports the departure of local soldiers for World War I. (KNS Archive)
The Dough Boy, a memorial to veterans of World War

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The East Tennessee Veterans Memorial located in downtown Knoxville on Thursday, November 1, 2018.

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The East Tennessee Veterans Memorial located in downtown Knoxville on Thursday, November 1, 2018.

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The East Tennessee Veterans Memorial located in downtown Knoxville on Thursday, November 1, 2018.

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The East Tennessee Veterans Memorial located in downtown Knoxville on Thursday, November 1, 2018.

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The East Tennessee Veterans Memorial located in downtown Knoxville on Thursday, November 1, 2018.

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The East Tennessee Veterans Memorial is in downtown Knoxville.

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The East Tennessee Veterans Memorial located in downtown Knoxville on Thursday, November 1, 2018.

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Pandemic Influenza Storybook, a project by the agency at the pandemic’s 90th anniversary in 2008, Robert Lynn Davis told of how his father, a disabled logger named Arthur Duery Davis, was put to work digging graves in Blount County.

“There was no time to build coffins, since the bodies were put in the ground as soon as possible,” Davis said. “My father always referred to the funerals as ‘the plantings.’ One story in particular he re-told many times is as follows: ‘One morning at 6 a.m., I was set to work digging three graves for a family of six that lived down the road from my home. Around 9 a.m., the doctor sent word to dig yet another grave. Then around lunchtime, I got word to dig yet another grave, and by 4 p.m., I was instructed to dig the final grave for that entire family.’ ” 

In the 2008 state summit on pandemic flu, Secretary of Health and Human Services Mike Leavitt read from one Tennessee doctor’s medical journal:

“The man who dug his neighbor’s grave today might head the funeral procession next week. No telling who will be next.”

As October ended, the epidemic waned. More than 9,500 Knoxvillians were reported ill; 132 died — nearly as many as died in combat during the war. Statewide, however, more than twice as many people died from the flu than in the war.

1918 tips for Spanish flu prevention

  • Remain at home, don’t get in crowds. “Influenza is a crowd disease,” according to an Oct. 5, 1918, Knoxville Sentinel story.
  • Smother your coughs and sneezes — “others do not want the germs which you would throw away.”
  • Breathe through your nose, not your mouth.
  • “Remember the three Cs — a clean mouth, clean skin and clean clothes.”
  • “Try to keep cool when you walk, and warm when you ride and sleep.”
  • Open the windows, particularly at home at night.
  • Wash hands before eating.
  • “Don’t let the waste product of digestion accumulate — drink a glbad or two of water on getting up.”
  • “Avoid tight clothing, tight shoes, tight gloves.”

 

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