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Reflecting on The 1918 Spanish Flu Pandemic in Montana

Updated: Dec 12, 2022

During the influenza pandemic of 1918-1919, Montana was one of the four hardest hit states in the nation. More than 5,000 people – about one percent of the state’s population – died during the outbreak.

In 2020, as of March 30, Montana had reported 171 cases of COVID-19 with three deaths, which is a far cry from the 145,000 cases and 2,600 deaths elsewhere in the nation. By January 1, 2021, Montana reported almost 82,000 cases and 971 deaths. Across the nation, nearly 21 million cases have now been reported, and over 350,000 deaths.

It’s clear that Montana and the world today are much different places than they were during the 1918-1919 Spanish flu pandemic. Hand-sanitizing lotion, modern medicine, and technology are a few of today’s resources that were unimaginable 100 years ago. No reports of hoarding medicine and toilet paper were included in daily newspapers during the Spanish flu pandemic.

The influenza epidemic increased the need for nurses, like these with the Red Cross pictured in front of the Havre Commercial Company building in 1917. By the fall of 1918, Montana had a shortage of nurses because the war in Europe had called many overseas.

But as many people practice “social distancing” and anticipate further spread of this new coronavirus respiratory illness, we can look at the historic deadly outbreak and learn how it played out over time across the Treasure State.

Some parallels can be made between the two pandemics. In their 1987 article in Montana: The Magazine of Western History, historians Pierce C. Mullen and Michael L. Nelson wrote that Montana reacted to the 1918 influenza pandemic in a manner similar to other states. Their observations might reflect what initially appeared to play out today across the nation.

“There was confusion, conflicts between business interests and authorities, and indecision by those entrusted to safeguard public health,” Mullen and Nelson wrote. “In all fairness, however, there was little more than what was attempted at the time that could have been done.”

Montana’s Influenza Swath Broad, Swift and Devastating

In one three-month period including October, November and December 1918, at least 35,500 people in Montana alone reportedly were infected. Census figures state that in 1920, Montana’s population was about 548,900.

A.B. Kimball of Missoula, Montana, dressed to go to work during 1918 flu epidemic.

The mortality rate was particularly high in Butte, which with 91,000 residents in 1917 had the state’s largest population. About 1,000 Butte residents died during the pandemic. At its worst, Butte undertakers would leave their wagons in the street instead of putting them in a garage because calls were so frequent.

Like the COVID-19 outbreak, the 1918-1919 flu was thought to have originated in China as a virus that mutated from an animal infection to one that can be transmitted to and through humans. It also was similar in that it attacked the respiratory system with a form of pneumonia that often was the actual cause of death.

A mild form of the virus first moved through Montana in the spring of 1918 with little fanfare. However, a second, deadlier wave hit in August, followed by the third wave in late December that lasted until the spring of 1919. Most of those who died were between 18 and 40 years old.

The Montana Board of Health’s annual report stated the first deadly strain showed up in Montana in Scobey in late September 1918. Within weeks it quickly spread throughout the Treasure State. By October 1918, 38 people had died from the flu in Missoula.

Symptoms often were a “sudden chill, followed by muscular pain, headache, backache, unusual tiredness and fever,” the Helena Independent reported on Oct. 19, 1918. Area residents were told to open all their windows – unless the weather was bad – and go to bed. They were to avoid people who were coughing or sneezing, and keep the children warm and dry, away from crowded places. Despite that advice, during one week alone in October, Helena reported about 350 cases and eight deaths.

State Closed for Business

State and local leaders urged churches, restaurants, saloons, schools and other gathering places to close, but that was met with hostility. Still, the closures took place, although some food and drink sales were allowed if the items were consumed off-site. At one point, these restrictions were urged to be lifted because no one knew how the flu was transmitted, and the closures were hurting businesses.

The University of Montana in Missoula closed in the fall of 1918, but only after considerations about what the impact might be if the students returned to their homes across the state and inadvertently spread the virus.

Meanwhile, Montana State College in Bozeman allowed students to register for the fall term, then furloughed them until after Christmas. The students were credited for the full year after their work was accelerated and less important material was removed from courses.

Rural areas of Montana also were hard hit, since medical aids and caregivers, especially nurses, were scarce. For example, a family of five near Miles City starved to death after becoming too weak to feed themselves after falling ill.

Montana towns had small hospitals, such as this one run by Christine Carberry in Sidney, Montana. During the epidemic, these hospitals were filled to capacity and many victims had to remain in their homes without adequate care.

One doctor sent to the community of Ravelli in Stillwater County found an estimated 300 cases, with no doctors or nurses. He recruited women to take care of the ill, converted the school and church into hospitals, and commandeered a farm wagon to use as an ambulance. Somehow, only five people died.

No vaccines were available until an experimental one in December 1918, and most treatment was mainly palliative care. That didn’t stop the snake-oil salesmen from offering “treatments” like “Tanlac,” which stimulated the appetite and thickened the blood. Horlick’s Malted Milk was supposed to fight the flu. And the “Hyomel Inhaler” claimed it would “absolutely destroy germs of influenza.” Most of the remedies, however, were not harmful and may have actually comforted flu victims.

The pandemic subsided in Montana by mid-1919. The Board of Health report that year noted that in October 1918 about 19,980 cases were reported; that dropped to 12,177 in November and 5,410 in December, for a total of 37,567 cases. That correlated with 1,032 deaths in October 2018; 1,471 in November; and 719 in December, for a total of 3,222 Montanans dying from the flu and its complications in six weeks.

“But this does not represent the full number of cases as reports were incomplete,” the Board stated.

Montana Spirit on Display

The stories of Montanans pulling together are legendary, not just by medical providers but also by businesses. For example, a banker in Lewistown took over operations of a bank in Winnett when that bank’s staff fell ill, and ministers held services over the telephone wires.

Schools returned to classes after Christmas. When the third wave of the flu hit in 1919, it wasn’t as severe as the second wave but claimed 1,266 more Montana victims.

Looking back, Mullen and Nelson note that it’s “difficult to evaluate the overall impact of the great influenza pandemic on Montana.” While the epidemic ran its course, Montana was focused on the conclusion of World War I and the peace negotiations.

“It appears as if people saw the influenza first as a nuisance, then as a local disaster, and finally as a nagging worry,” the two history professors wrote. “But it is just possible that the influenza experience reinforced Montana’s desire after the war to isolate itself, to look inward, to find a sense of balance, to see a place from which to survey a broken world.”

This information is from a lengthier article by Pierce Mullen and Michael Nelson that ran in the Montana Historical Society’s publication Montana: The Magazine of Western History in the Spring 1987 edition as well as in the Summer 2018 edition. Both can be ordered either through the Montana Historical Society Press by calling (406) 444-2694 or online at or

View of two nurses, Esther Thorson on the left and Christine Finkelson Carberry (later Christine Carrico) on the right, in the hospital ward at Sidney.

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