The case for an American origin of Spanish Influenza gained prominence with the publication of John M. Barry’s The Great Influenza in 2004.* The book, a popular general history of the 1918 pandemic, attached historical significance to an alert in the U.S. government’s weekly Public Health Reports of April 5, 1918. An influenza alert headed “Kansas—Haskell” memorialized eighteen cases and three deaths from influenza “of the severe type.” That notice was likely, the author speculated, the first mention anywhere of a disease that was about to ravage humanity. It was certainly the first medical alert of influenza in the U.S.A.; health authorities did not require reporting of influenza cases.
* The Great Influenza: The Story of the Deadliest Pandemic in History by John M. Barry (Viking-Penguin, 2004; Penguin Books, 2005).
The Great Influenza was the first study of the pandemic to attach global significance to the alert. As Barry put it in a scholarly article, “It remains the first recorded instance suggesting that a new virus was adapting, violently, to man.”*
* “The site of origin of the 1918 influenza pandemic and its public health implications” by John M. Barry, Journal of Translational Medicine, 2:3, 2004. Downloaded from US National Library of Medicine.
Not content, I guess, to rest on his significant “find,” the writer tracked the notice to its source. “Haskell” was taken to mean Haskell County, in the southwestern part of Kansas, and Barry made a case that the first outbreak of deadly influenza occurred there in January and February 1918.
In that narrative, county health officer Dr. Loring Miner was the anonymous reporter of the outbreak to Public Health Reports. Dr. Miner “had never seen influenza like this,” the story goes. “This influenza killed. Soon dozens of his patients — the strongest, the healthiest, the most robust people in the county — were being struck down as suddenly as if they had been shot.”*
* The Great Influenza, p. 93.
The deaths so vividly described do not include any actual named persons. The dating of the Haskell County outbreak was apparently based on a pattern of newspaper snippets reporting health issues among the local citizenry:
The local paper, the Santa Fe Monitor, apparently worried about hurting morale in wartime, said little about the deaths but on inside pages reported, “Mrs. Eva Van Alstine is sick with pneumonia. Her little son Roy is now able to get up. … Ralph Lindeman is still quite sick. … Goldie Wolgehagen is working at the Beeman store during her sister Eva’s sickness. … Homer Moody has been reported quite sick. … Mertin, the young son of Ernest Elliot, is sick with pneumonia. … We are pleased to report that Pete Hesser’s children are recovering nicely. … Mrs. J. S. Cox is some better but is very weak yet. … Ralph McConnell has been quite sick this week.”*
* The Great Influenza, pp. 93-4. Quoting the Santa Fe [Kansas] Monitor, February 14, 1918.
Comparing Barry’s transcriptions with the original text, one discovers elisions that seem made to enhance the “deadly” theme: “Mertin, the young son of Ernest Elliot, is sick with pneumonia
but is getting along very nicely.”
Leaving aside such minor subtraction from a full and accurate account, Barry’s texts are fraught with issues of veracity.
1) The documentary value of gossip as evidence of a deadly influenza epidemic
Local notes in the Santa Fe Monitor — that’s the closest we get to actual cases. As far as I can tell, the narrative of deadly epidemic influenza in Haskell County boils down to a dramatized summary:
In late January and early February 1918 Miner was suddenly faced with an epidemic of influenza, but an influenza unlike any he had ever seen before. Soon dozens of his patients – the strongest, the healthiest, the most robust people in the county – were being struck down as suddenly as if they had been shot. Then one patient progressed to pneumonia. Then another. And they began to die.
“The site of origin of the 1918 influenza pandemic”
There are no names of victims, so needless to say no obituaries, and nothing resembling Dr. Miner’s actual practise. Barry listed among his sources Dr. Miner’s daughter-in-law and grand-daughter; yet what they knew or held is nowhere part of the outbreak narrative.* Instead we are told that, where the usual victims of deadly pneumonia are the very young and the old, Dr. Miner distinguished the new deadly pneumonia from all the other deadly pneumonias by its cruel habit of killing “the strongest, the healthiest, the most robust people in the county.”
* The Great Influenza, p 473.
Barry’s claim to have discovered a deadly outbreak in Haskell County in January and/or February 1918 is not supported by official records. The 1918 report of mortality from disease in Haskell County indicates eleven deaths that year. There was one death in January and one in February. In the State Board of Health’s reporting scheme, Influenza was coded 10. There were no deaths from influenza there in 1918. Pneumonia, code 92, registered one death.
Kansas Board of Health. Summary of Deaths — Haskell County. On the Kansas Memory website. Kansas Historical Society.
Three of Kansas’s one hundred five counties had fewer deaths from disease than Haskell in 1918.
2) The problematic delay of months between the outbreak and the alert
The Haskell County construction does not pass the bar of common sense. If people really died in numbers there from a new disease, would any health officer delay reporting it for two or three months? Time is of the essence, isn’t it, in bringing an outbreak under control?
Barry’s account of the April 5 alert hurries past the delay in order to frame a grand theme about the alert:
The disease did not, however, slip from Miner’s thoughts. Influenza was neither a reportable disease, nor a disease that any state or federal public health agency tracked. Yet Miner considered this incarnation of the disease so dangerous that he warned national public health officials about it. Public Health Reports (now Morbidity and Mortality Weekly Report), a weekly journal produced by the U.S. Public Health Service to alert health officials to outbreaks of communicable diseases throughout the world, published his warning. In the first six months of 1918, this would be the only reference in that journal to influenza anywhere in the world.
It has been suggested that Dr. Miner did try to post the influenza alert at the time of the outbreak, but it was ignored by the Public Health Service.* Such an explanation has circulated independent of Barry’s account.
* For example: “Kansas’ role in 1918 influenza pandemic subject of discussion at Red Rocks,” b
… [T]he disease was first observed in Haskell County Kansas in January and February 1918. Disturbed by what he was seeing, Dr. Loring Miner contacted colleagues within the state as well as the U.S. Public Health Service warning of a possible outbreak.
“But he was ignored,” Johnson said. “No one really paid attention to him until it was too late.”
3) The existence of a more convincing source of the reported outbreak
The case for a Haskell County origin may seem strained because there were in fact two “Haskells” in Kansas — one was Haskell County, the other, Haskell Institute in Lawrence — and The Great Influenza reported on the wrong “Haskell.” It is unfortunate that the wording of the alert created that ambiguity, but the notice of epidemic deadly influenza on April 5, 1918 emanated from Haskell Institute and not from Haskell County. The proof is in the nearly identical wording of the April 5, 1918 notice in Public Health Reports and the report of Charles E. Banks, Senior Surgeon, U.S. Public Health Service, on the Haskell Institute outbreak, dated March 30 and published in the April 12 Indian Leader, the weekly newsletter of the institute.
The Haskell Institute outbreak occurred the same week as the monster outbreak at Camp Funston, 160 km/100 mi west of Lawrence. Major Banks was one of nine physicians called in to Haskell for consultation with the school. Banks identified the disease as “epidemic influenza, similar in all respects that which recently attacked the troops at Camp Funston.” The weather pattern in Lawrence — “a long, dry spell followed by high winds, creating dust storms” — was, Dr. Banks wrote, “markedly similar” to that prevailing at Camp Funston just before the epidemic. In both places the result was widespread “infection of the respiratory membrane.”
“As at Camp Funston,” Maj. Banks wrote in his March 30 report, “where a certain proportion developed inflammation of the lungs, so at your institute, a like condition ensued with 18 cases of this severe type. The three deaths directly attributable to severe lung involvement is not a large proportion, less than 20 per cent mortality.”
Compare the italicized text above with the alert:
On March 30, 1918, the occurrence of 18 cases of influenza of severe type, from which 3 deaths resulted, was reported at Haskell, Kans.*
* Public Health Reports, 33:14, April 5, 1918, p 502. Downloaded from US National Library of Medicine.
Same date; same case and mortality data; same words “severe type.”
Can anyone doubt that “Haskell” meant Haskell Institute?
Without the April 5 alert to anchor the Haskell County narrative, and wreathe it with historical significance, the narrative is thin gruel indeed — a shadowy physician and some seen-in-passing notes in a weekly newspaper.
The idea that Haskell County was the subject of the April 5 alert was, I believe, the mistaken beginning of a cascade of deductions leading to the inescapable, but likely false, conclusion that the virus originated in America’s isolated, sparsely-populated heartland on the central plains.
Today the origin story in The Great Influenza is widely accepted. The Haskell County narrative appears in a guidebook to overlooked historic places in the U.S. A chapter is devoted to Dr. Loring Miner, his home and his flamekeepers in Sublette.(1) The Haskell County origin story appears in several recent histories of the great pandemic,(2) in a recent article by Barry, “How the Horrific 1918 Flu Spread Across America,”(3) and a local interest feature in The Wichita Eagle.(4) The Kansas Historical Society embraces the Haskell County origin narrative.(5) It has crept into the scientific literature(6) and the realm of medical history.(7)
1. Here Is Where, Discovering America’s Great Forgotten History by Andrew Carroll (New York: Crown Archetype/Random House, 2013), pp. 337-349, location 514 on GooglePlay ebook. ❡ 2. Pale Rider: The Spanish Flu of 1918 and How it Changed the World by Laura Spinney (Random House, 2017), Kindle edition location 2303-4. ❡ 3. “How the Horrific 1918 Flu Spread Across America” by John M. Barry, Smithsonian magazine, November 2017. ❡ 4. “How a killer flu spread from western Kansas to the world,” by Beccy Tanner, The Wichita Eagle, February 19, 2018. Accessed online at https://www.kansas.com/news/local/article200880539.html. ❡ 5. “Flu Epidemic of 1918,” online at https://www.kshs.org/kansapedia/flu-epidemic-of-1918/17805. ❡ 6. See The origins of the great pandemic by Michael Worobey, Jim Cox and Douglas Gill, in Evolution, Medicine, and Public Health (2019), pp. 19, 20. Accessed via https://academic.oup.com/emph/article/2019/1/18/5298310. ❡ 7. “The Influenza Pandemic and the War” by Frederick Holmes, M.D., Professor of Medicine Emeritus at the University of Kansas School of Medicine, published on the KU Medical Center website at http://www.kumc.edu/wwi/medicine/influenza.html; dated April 8, 2019.
The cited essay on Spanish Flu by Frederick Holmes, M.D., professor emeritus at the University of Kansas School of Medicine, endorses the Haskell County narrative thus: “It is virtually certain that young men leaving Haskell County for military service at Camp Funston in eastern Kansas carried the virus with them.”(1) Interviewed by a reporter with The Wichita Eagle in 2018, however, Holmes seemed to say the opposite about the virus’s supposed origin in Haskell County: “It’s unthinkable that it would be in Kansas. … But if you think of Dodge City as fairly remote — and this occurred west of Dodge City, west of there … well, good gravy, that’s at the end of the world.”(2)
1. Frederick Holmes, M.D., op. cit. ❡ 2. Beccy Tanner, op. cit.
In the interest of historiography, a compilation of Haskell County outbreak narratives is forthcoming.
Published September 13, 2018. Latest edit June 17, 2020.