State officials first reported on the presence of influenza in Missouri on October 11, 1918. However, influenza had appeared in the state long before that date. By the third week of October, 3,765 influenza cases and 90 deaths had been reported from St. Louis, with 558 cases and 13 deaths being reported for October 16th alone. State officials, however, rarely had acdcess to accurate figures and the actual number of cases and deaths was probably higher than that. On October 25th, state officials maintained that "conditions are either stationary or improving" in the state. But on October 24th, the situation took a turn for the worse. Influenza began spreading into rural districts. Between October 26th and 28th, the situation continued to be dire, with rural and urban areas across the state reporting high numbers of cases and deaths.

Quiet residential streets such as this one in Kansas City, Missouri were not exempt from the ban on public gatherings during the epidemic. c. 1914. [Credit: The Library of Congress]

On October 17th, The Kanses City Star announced that "A DRASTIC BAN IS ON." All theaters, schools, and churches were closed. Public gatherings of twenty or more persons, including dances, parties, weddings, and funerals were banned. Entertainment in hotels, bars, and restaurants were banned as well. Only twenty-five people were to be allowed in a store at any one time. Street cars were forbidden to carry more than twenty standing passengers. City officials also insisted that all elevators and streetcars be sterilized daily; telephone booths were to be sterilized twice a day. In an attempt to keep city streets clean, streets were deluged in water.

Officials were optimistic that these tactics would help contain the pandemic. But despite these efforts, Kansas City was struck especially hard by the pandemic, becoming one of the worst hit areas in the country. The situation was especially bad during the fall. By the early winter, officials saw some improvement. However, more than a hundred influenza or pneumonia patients remained in the isolation ward of General Hospital and preparation were being made to use the fourth floor of the hospital for additional patients.

Students at the American School of Osteopathy in Kirksville, Missouri graduated early so that they could join the fight against influenza.

In St. Louis, the mayor, Henry Keil, announced on October 7th that "Spanish influenza is now present" in the city. It will, he continued, "become epidemic." Following this announcement, he ordered all theaters, schools, pool halls, cabarets, lodges, and dance halls to be closed and discontinued until further notice. Public funerals, Sunday schools, and conventions were also banned.

No. 32 Fourth Street north from Market Street in St. Louis, Missouri was a likely area to contract the flu during the epidemic. [Credit: The Library of Congress]

In late September, Missouri University students were asked to refrain from leaving Columbia on visits, and the public was asked to avoid crowded areas. A local physician announced that "everyone with a cold should be regarded and should regard himself with suspicion." between September 26th and December 6th, over a thousand students at the university contracted influenza. Looking back on the pandemic and its impact on the university, a local doctor said "I saw one patient die within 18 hours of this disease and 12 hours after being put to bed. I have seen a number of others menaced with death during the first 48 hours of the disease." He concluded that "the statement that influenza is uncomplicated is, I believe, erroneous."

On October 7, 1918: Mayor James Boggs prohibited Columbians from meeting in places of amusement, schools, churches. The city and the university were quarantined. Only members of the Students' Army Training Corps were allowed access to the campus for military training purposes. Influenza was widespread among the students and two new hospitals were opened to care for influenza patients; nurses came from St. Louis and Centralia to ease the load.

Cures and preventatives were eagerly sought. From Missouri, a physician wrote to the Public Health Service offering to make his remedy for influenza available to public officials. Concerned that the PHS might unfairly steal his remedy, he refused to describe the remedy in any detail. He did, however, say that he would "furnish the remedy for the nominal price of $4.50 for each patient." If the federal government was unwilling to provide this money, he was prepared to accept a surgeon's commission and pay in the Army medical department. He claimed to have tested his remedy "on the most Desperate caises [sic]." Another Missourian also claimed to have found a sure cure for influenza. She was more willing to describe this remedy, which consisted of water, salt, and coal oil. her remedy was available to the government but she did ask federal officials to provide her with a financial reward. Needless to say, these remedies were ineffective and the PHS refused to pay for them.

The disease peaked in the fall of 1918. It continued to be prevalent throughout the state during the winter and spring. It gradually disappeared during the summer.