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Excerpts on the Influenza and Pneumonia Pandemic of 1918

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EXCERPTS ON

THE INFLUENZA AND PNEUMONIA PANDEMIC OF 1918

FROM

WAR DEPARTMENT ANNUAL REPORT TO THE SECRETARY OF WAR

FISCAL YEAR ENDING JUNE 30, 1919

 

REPORT OF THE SURGEON GENERAL, U.S. ARMY

IN TWO VOLUMES


INTRODUCTION

The War Department Annual Report to the Secretary of War was the annual accounting of the entire War Department to the Secretary of War. As such the reports form an incredible source of information on virtually every aspect of the operations of the War Department and U.S. Army during a given fiscal year. The annual report of The Surgeon General, usually referred to as "The Annual Report of The Surgeon General," provides a detailed overview of the health of the U.S. Army and the activities and programs of the Army Medical Department and the Office of The Surgeon General during the year. The Annual Report of The Surgeon General for 1919 consisted of two large volumes (Volume I, 1,014 pages of text with 332 pages of appended statistical tables; Volume II, 1,188 pages) for the first and only time because of its extensive coverage of the Medical Department at home and abroad, including the American Expeditionary Forces (AEF) in France, during World War I.

Significant parts of the two volumes were devoted to the preliminary appraisal and statistics of the wartime impact of influenza and pneumonia on the U.S. Army, especially during the pandemic of 1918.  The excerpts included here deal with the impact of the influenza pandemic and its often deadly by-product, pneumonia, on the Army. The seriousness of the attack of influenza and pneumonia in the fall of 1918 cannot be understated--the statistical tables tell all too graphically the huge cost in soldiers' lives that these diseases exacted in an incredibly short time. 

The Surgeon General, Major General Merritte W. Ireland, in his "Letter of Transmission" provides an introduction to the influenza pandemic within the context of the overall activities of the Medical Department and the health of the Army during the period 1 July 1918-30 June 1919. His conclusions about influenza are an important statement of the Medical Department's initial conclusions about the pandemic and how it was handled.

Excerpts from the Report of the Division of Sanitation, Office of The Surgeon General, provide a perspective on how that division tried to combat the deadly influenza and pneumonia which spread throughout the Army in the U.S. and France within 8 weeks in September and October 1918. Particularly relevant here are the Section of Communicable Diseases' report on the influenza-pneumonia pandemic and its recommendations to the War Department for controlling the epidemic.

The extended excerpt from the section on infectious diseases, "Influenza, Pneumonia, and Common Respiratory Diseases," provides a detailed but only preliminary statistical discussion of respiratory diseases and especially influenza and pneumonias (pages 618-787). The first part of the excerpt (pages 618-740), "Statistical Discussion," places the influenza pandemic into historical context within the Army going back to the Civil War and provides data on influenza and pneumonia cases and rates per 1,000 soldiers for all officers and enlisted personnel in the United States and Europe. The second part (pages 740-87), "Extracts from Reports Relative to Influenza, Pneumonia, and Respiratory Disease," provides information from camp, base, and general hospitals throughout the United States as well as from division surgeons on the impact of influenza and pneumonia on these organizations. All figures and tables from these pages are linked from the text as well as the table of contents below.

Excerpts are also furnished from the Division of Laboratories, Office of The Surgeon General, and its epidemiology section which were deeply involved in identifying and combating infectious diseases, especially influenza and pneumonia as they appeared in the fall of 1918.

CONTENTS

1.  Surgeon General Merritte W. Ireland's Letter of Transmission

2.  Annual Report of The Surgeon General for Fiscal Year 1919, Volume I

  E.  Infectious Diseases

I.   General Remarks (Page 618)

II.  Influenza, Pneumonia, and Common Respiratory Diseases.

   1. Statistical Discussion (Pages 618-739)

   2. Extracts from Reports Relative to Influenza, Pneumonia, and Respiratory Diseases (Pages 740-87)  

Influenza

Pneumonia

Pneumonia Immunization

3. Report of the Division of Sanitation (Volume II, 1021-23, 1033-41)

   Section of Communicable Diseases

Influenza-pneumonia epidemic in the fall of 1918

Recommendations to the War Department for Control of the Influenza Epidemic

4. Report of the Division of Laboratories and Infectious Diseases (Volume II, 1041-52)

Section of Epidemiology