Volume 12, Number 12—December 2006
Dispatch
Nonpharmaceutical Influenza Mitigation Strategies, US Communities, 1918–1920 Pandemic1
Howard Markel*
, Alexandra M. Stern*, J. Alexander Navarro*, Joseph R. Michalsen*, Arnold S. Monto†, and Cleto DiGiovanni‡
, Alexandra M. Stern*, J. Alexander Navarro*, Joseph R. Michalsen*, Arnold S. Monto†, and Cleto DiGiovanni‡Table
Six communities that along with Bryn Mawr College escaped influenza pandemic, 1918–1920
| Characteristics | Yerba Buena, CA | Gunnison, CO | Princeton University, NJ | WPIB, PA* | Trudeau Sanatorium, NY | Fletcher, VT | Bryn Mawr College, PA |
|---|---|---|---|---|---|---|---|
| Population | ≈6,000 | 1,329 in town, 5,590 in county | 1,142 | 179 students; faculty and staff also lived on-site | 356 patients admitted in 1918; 259 discharged; average daily patient census of 150 | 737 | 465 |
| Geographic isolation | Small island off coast of San Francisco | Small mountain community in western Colorado; commercial, educational, and transportation hub | Student body in a small college town; campus somewhat separated from the town | Located in a busy residential Pittsburgh neighborhood but somewhat isolated by standards of the day | A small institute on the outskirts of a very small mountain community in upstate New York | Very small rural community in upstate Vermont | Student body in a small college town; only 10 miles from Philadelphia |
| Ordinary or special population | Primarily a military population; ≈1,000 civilian family members and workers were present | Ordinary population composed of native-born and immigrant residents | All-male student body; 92% of students were members of a military training corps | Student body was blind and thus isolated by standards of the day | Patients and staff were tubercular and were thus isolated by standards of the day | Ordinary rural population | All-female student body |
| Period of protective sequestration | Sep 23 – Nov 21,1918 | Oct 31, 1918 – Jan 20, 1919 (countywide); public closures and imposed social distancing as of Oct 8, 1918 | Never under a full protective sequestration, as recruits and cadets continually arrived and left; restrictions on off-campus travel (with perimeter control) imposed Oct 8–Dec 21, 1918 | Early Oct – late Nov 1918 | A de facto protective sequestration existed due to its geographic and institutional isolation | Not applicable | ≈Oct 1–Nov 7, 1918 |
| Cases and deaths | 0 cases, 0 deaths during protective sequestration | 0 cases, 0 deaths in town (2 cases, 1 death in county) | 68 cases, 0 deaths in student population† | 12 cases, 0 deaths | 0 cases, 0 deaths | 2 cases, 0 deaths | 110 cases, 0 deaths
*WPIB, Western Pennsylvania Institution for the Blind. |
*WPIB, Western Pennsylvania Institution for the Blind.
†One professor died.
1Presented, in part, at the 5th CDC National Conference on Public Health Law, held in Atlanta, Georgia, USA, June 2006.
