Get the Anti 'Flu' habit

Americans in the early 20th century were no stranger to public health measures like isolation and quarantine. This 1920s-era placard from the Topeka Heath Service was part of a public health campaign to encourage sanitary practices preventing the spread of influenza.

There are many parallels to see when looking at the past for lessons from the 1918 influenza epidemic. While scanning schoolbooks for a digital exhibit recently, I came across a passage in a 1915 junior high science textbook that reminded me of one profound difference between 1918 and today: Americans in the past were better prepared psychologically for mass isolation and quarantine measures. As this textbook shows, students in the time of the “Spanish flu” were taught about the necessity of such measures.

An entire chapter in The First Year of Science teaches about sanitation and the prevention of contagious diseases like tuberculosis or consumption, diphtheria, smallpox, measles, and scarlet fever. Two pages cover the topic of quarantine, “the isolation, or setting apart, of a person having an infectious disease, so that the disease may not spread to the community.” The textbook asks us, the reader, to reflect on whether we really understand what they have learned about germs and the spread of disease. “If we do,” the passage reads, “we shall see at once how valuable and how necessary it is for a city to be able to quarantine persons suffering from dangerous diseases.”

“We shall also be able to see the value of isolation even when it causes us personally great inconvenience,” the book continues. “Suppose that we have smallpox, or that a member of our family has it; we ought still to realize that the community has a right to demand of us that we prevent the disease, by all the means in our power, from spreading to those about us. If we are recovering from scarlet fever, we know we ought not to go to school, nor to mingle with other people, until we are absolutely certain that the last of the ‘scaling’ [symptom] is over.”

The section in the 1915 textbook on quarantine concludes with the observation that “the real value of isolation, like that of other sanitary measures, depends on how it is carried out. If we elect officers to provide a good quarantine, we must support them when they are obliged to use force with some persons who refuse to observe quarantine. Further, we ourselves must obey the regulations of our health department, not merely in the letter, so that we may just escape punishment, but in the spirit, because we recognize the fact that they are for the greatest good of all the people.”

Medical professionals and government officials worked together in the early 20th century on public health campaigns designed to help cultivate healthy habits with pithy slogans like “Swat the fly” and “Don’t spit on the sidewalk.” Kansas’s Dr. Samuel Crumbine, who worked on such campaigns for the state and later for national health associations, had a tremendous impact on public health during his long tenure on the Kansas Board of Health.

Crumbine was among those leading Kansas’s response to the influenza epidemic. In December 1918, 9 months after the first cases of the Spanish flu were thought to have spread, the Kansas Board of Health determined that the flu was more contagious than first thought. As the Daily Union reported Dec. 5, 1918, “The Topeka board of health has decided to take no more chances than necessary with the ‘flu’ germs. It has discarded the theory that influenza is infectious only, but not contagious ... henceforth the homes of influenza victims must be quarantined rather than merely decorated with ‘isolation’ signs which did not bar visitors or prevent occupants of the home from leaving the house. Under the new ruling no one except the physician and nurse will be permitted to enter or leave the homes .... The new quarantine cards bearing the full regulations, state: ‘Influenza killed 250,000 persons in the United States in two months. BE CAREFUL.’”

The greatest impact of these campaigns was on common society-wide habits. The use of common drinking cups and roller towels was phased out over the course of Crumbine’s career, which spanned the 1890s to his death in 1954. Campaigns educated the public about the role of houseflies and other insects in spreading disease and contaminating food, leading to the widespread use of window and door screens and what we now know as the “fly swatter,” a term coined by Crumbine. No doubt spitting on the sidewalk was seen as a ruder gesture thanks to these campaigns and, of course, the bricks underfoot stamped with “Don’t spit on the sidewalk.”

At the outbreak of World War I, it was understood that contagious diseases were inevitable and that society would have to take steps en masse to prevent their spread. The COVID-19 epidemic is a reminder that despite today’s advancements in medical technology, contagious diseases still require all of us to work together, as we did in 1918.

KATIE GOERL is the Executive Director of the Geary County Historical Society in Junction City.

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