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South Dakota
On the left side of the photo, a man walks behind a horse.  A haystack is behind him.  Another horse is harnessed to a wagon in the center of the photo.  A machine to stack hay is on the right side of the photo.
Farm work was neglected across the state as entire families fell ill. [Credit: The Library of Congress]
The first official cases in the state were reported on September 23rd when the state noted "a few scattered cases." By October 4th, the state was reporting that "cases have appeared in a number of places.” By October 11th, influenza was widespread, with cases reported from "many points in the State." The situation continued to worsen. During the week of November 2nd, there were 218 deaths from influenza across the state. This week may have been the high point of the disease in the state.

Among the many victims of the disease were some of the state’s most prominent citizens. Peter Norbeck, the governor of South Dakota, became ill with influenza and was admitted to St. Joseph's Hospital in Deadwood. He had contracted the flu on a business trip to Lusk, Wyoming. Like most influenza patients, he developed a very high fever. However, his case was not regarded as critical and he was released from the hospital after a few days.

A newspaper article is titled “Norbeck Ill.”  The article goes on to discuss the governor’s illness and his treatment at a hospital in Deadwood.

Even high-ranking politicians were not immune from the pandemic. [Credit: The Library of Congress]

Concerns focused on prevention and sanitary ordinances were put into effect. In Rapid City, people who spit on the sidewalks were arrested and fined. A Rapid City police officer was arrested under the ordinance and fined $6, a considerable sum at the time. All funerals were held out doors to prevent the spread of influenza and, in some cities and towns, pedestrians were required to present a doctor's note stating that they had recovered from the flu and were no longer contagious. Public gatherings were banned leading to the indefinite closings of churches, theatres, schools, pool halls. The University of South Dakota shut down to prevent the spread of the flu.

Newspapers provided advice: "When talking to another person stand at least two or three feet away"; "Keep yourself comfortably dressed and eat plenty of wholesome foods"; "Keep your home well ventilated and have plenty of fresh air in it at all times"; "When you get a severe cold and think you have Spanish influenza go home and go to bed." The Public Health Service, in conjunction with the Red Cross, supplied nursing personnel and supplies. Recommended cures included Hood's Sarsaparilla, Hood's Pills, Pepitron and Foley's Honey and Tar. None of these cures proved effective and the advice given to those hoping to avoid contracting influenza had no real impact.

The disease slowly began to decline in the state during the latter part of November. Influenza did not disappear from the state until the late spring of 1919.

Population in 1920:
636,547

Demographics:
Most of the state's residents lived in rural areas. There were no cities with a population above 70,000.

First Official Report of Influenza:
The Public Health Service did not require states to report influenza before September 27th. South Dakota first reported the presence of influenza on September 23rd but the disease may have been present earlier.

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