100 Years Ago, the Spanish Flu Tore through New Orleans in Three Terrifying Weeks

“Spanish” is a misnomer: There’s insufficient evidence of a defined origin, but the first identified cases in the US appeared at Fort Funston, Kansas, in the spring of 1918. (According to a recent deep dive by USA TodayOpens in new tab, Spain stood alone in reacting quickly to the outbreak, which unduly linked the country with the virus in the public imagination.) The initial outbreak was mild, but by summer the influenza was raging in Europe and returned to the United States with a vengeance in late August.  

The latter visitation attacked military bases and northeastern cities before spreading westward across the United States like a wave. At first the Spanish flu seemed a long way from New Orleans. The Daily States referred to it as the “sneeze malady” or the “sneeze plague.”

On October 1, the Times-Picayune carried a statement from Dr. William H. Robin, president of the New Orleans Board of Health: “Influenza does not spread, or become severe in warm, sunny weather, such as prevails during the greater part of the year in New Orleans.” Nonetheless, the newspaper warned that the disease could leave a “trail of death.”

Virtually nothing was known about the viruses that cause influenza, although Spanish flu was recognized as more virulent than the common grippe—and it was often trailed by secondary pneumonia. Pneumonia was the most common killer in the United States before the use of antibiotics, which were about a decade away from being invented.  

With Spanish flu, the onset was rapid, and death could come within hours: Luis A. Caro, Colombian consul general in New Orleans, left his office on a Friday and was found dead in his rooms at the Lafayette Hotel the following Monday. 

The flu was spreading around Boston’s Commonwealth Pier when the oil tanker Harold Walker set sail for New Orleans on September 5. On board were 15 sick crew members, three of whom would die. One of the dead, who was from New Orleans, was reported by the Times-Picayune to be the first New Orleanian to die of the new influenza.  

It’s possible that the Harold Walker brought the Spanish flu to the city. Sometime between September 21 and 28 the “sneeze malady” silently began its onslaught. Louisiana’s military bases, crowded with World War I troops, fell victim first. On September 28 Camp Beauregard near Alexandria was under rigid quarantine, with quarantine restrictions to follow at Camp Martin on the Tulane University campus—where one of the first outbreaks in New Orleans occurred—and at the Algiers Naval Station. 

By October 5 the epidemic was spreading rapidly throughout the South, and by mid-October the illness raged in New Orleans. 

Because overcrowding was deemed the major cause of contagion, health officials proposed every manner of keeping people separated. Doctors and media warned people to stay home from the planned parade on Canal Street for the Fourth Liberty Loan on September 28—an attempt at what we would call social distancing—even though Americans were generally encouraged to attend such war-relief efforts. People did not heed these warnings and crowded Canal Street and the parade route. On October 5, a war rally in Lafayette Square attracted 50,000 people, and a few days later thousands packed the Orpheum–St Charles Theater to buy Liberty bonds. 

Within days the city was awash in influenza cases.

By the second week of October, most war rallies were canceled throughout New Orleans, as the city and state boards of health began to impose stringent safeguards against crowding. Schools, movie houses, theaters, dance halls, and churches were closed, while public meetings, concerts, sports events, street gatherings, public weddings, and public funerals were prohibited. Influenza victims had to be buried quickly without church services (and in the presence of a health official), rigid anti-expectoration laws were enforced, and stores agreed to stop advertising special sales.  

Saloons, pool halls, ice cream parlors, and restaurants were allowed to remain open but faced closure if they became overcrowded or neglected to follow strict sanitary regulations. Streetcar crowding was an ongoing issue. Union regulations prohibited drivers from operating extra trips, but the issue was moot as 175 drivers were out sick. Most families had at least one sick member. Several temporary influenza hospitals opened to look after the seriously ill. 

The epidemic took an economic toll as well. Merchants reported decreased sales, businesses operated with reduced staffs, and restaurants served fewer customers—similar to but less severe than the disruptions we’re experiencing as part of the current crisis. Tulane University called off all classes; Newcomb College was closed. The new Cumberland Telephone Company was unable to open its lines on schedule because so many operators were out sick.

As with much of the coronavirus coverage today, newspapers and officials aimed to strike a balance between addressing public concern and discouraging panic. Newspaper advertisements told readers how to avoid the flu and its complications but added, “Don't Get Scared,” and “Don’t Be Alarmed—Be Careful!” Dr. Oscar Dowling, head of the state board of health, however, feared that New Orleanians were still congregating too much. If crowding did not cease, Dr. Dowling warned, “there is the greatest sort of danger that we will find ourselves in a most appalling situation.”  

With so little knowledge of the flu virus, doctors could only offer advice, such as to eat foods containing milk—which caused a milk shortage. Nurses were essential, but their services were stretched to the limit.  

By October 9, only 24 of the city’s 646 doctors had made reports to the board of health. At this time, according to one estimate, there were 58,000 cases, although only 8,000 had been reported. The numbers began climbing soon, however, as doctors learned they could be prosecuted if cases went unreported. By October 16, the number of reported cases rose to more than 4,000 for that one day—and new cases per day exceeded 2,000 through October 24. Not until October 29 did the daily influenza count fall below 1,000.  

As the new cases subsided, pneumonia deaths related to influenza increased dramatically. On one day alone 147 people died, and in a two-week period, there were 1,306 deaths reported. 

Following its own course, the epidemic began subsiding rapidly in November. Activities on All Saints Day were allowed to take place, and church services resumed on November 3. Schools and other businesses opened soon afterward. Even with huge crowds pouring into the streets on November 11 for Armistice Day, celebrating the end of World War I, there was no immediate recurrence of the epidemic.  

In January, the Spanish flu returned to take 763 more lives. But with the arrival of spring, the misnamed flu was gone, and New Orleanians could look forward to happier—and healthier—times.