Surgeon General, on his campaign to recruit physicians for the influenza effort: вЂњA number who we have called for have made excuses and have not come at all.вЂќ 8 Other physicians who were recruited by Dr. Bracken, Secretary of the Minnesota State Board of Health, reported to Dr. At one point, Minneapolis's City Hospital reported that вЂњnearly half of the nursing staff has been ill with influenza in the last three weeks.вЂќ 7 This bleak situation discouraged some clinicians from providing their services. Many health-care providers fell ill, and some died. Methods to keep them healthy while caring for influenza patients were ineffective. The war's considerable drain on the medical profession was compounded by other factors that hindered nurse and physician mobilization. The number of influenza patients that needed the attention of physicians and nurses overwhelmed St. So many physicians and surgeons have gone to Europe or to training that those at home have more than they can attend to comfortably and to good advantage.вЂќ 6 An editorial in the Minneapolis Tribune daily newspaper described the lack of physicians and nurses: вЂњThe medical fraternity is severely taxed already. 2 Although World War I was coming to an end, more than four million Americans were mobilized and the nation's resources were directed to supporting the war effort. When influenza first appeared in Minnesota on September 27, the state was ill equipped for a health crisis. While this lack of knowledge did not negatively impact infection control actions, effective treatment and prevention methods were not fully utilized. In 1918, little was known about influenza. World War I was not only costly, it required much of the medical community to be stationed overseas. Two major issues contributed to the gravity of the pandemic: the war effort and limited scientific knowledge. We focus on medical resources, community disease containment measures, public response to community containment, infection control and vaccination, and communications. Coordination between different levels and branches of government, improved communications regarding the spread of influenza, hospital surge capacity, mass dispensing of vaccines, guidelines for infection control, containment measures including case isolation and closures of public places, and disease surveillance were all employed with varying degrees of success. Many of the components of current pandemic influenza plans were utilized to some degree in Minneapolis and St. We reviewed the responses of two neighboring Minnesota cities during the 1918вЂ“1919 pandemic to gain insight that might inform planning efforts today. Due to the high likelihood of an influenza pandemic, planning is underway in many U.S. Today, influenza experts consider the possibility of another influenza pandemic, not in terms of if but when. Influenza pandemics have occurred regularly every 30 to 40 years since the 16th century. However, historical research has shown that Spain was an unlikely candidate as the initial source and some suggest that it originated in Kansas in the spring of 1918. 1 Thus, Spanish Influenza became a popular term.

During World War I, propaganda in war-engaged countries only permitted encouraging news, so as a neutral party, Spain was the first country to publicly report on the health crisis. 1 The true origin of the 1918 influenza pandemic is unknown.

Spanish Influenza of 1918вЂ“1919 killed more than 50 million people worldwide over the course of two years.

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