The Spanish Influenza of 1918 in St. Louis, Missouri

In view of current concern about a possible pandemic of virulent avian influenza, it is timely to revisit the public health response to the “Spanish” influenza of 1918. St. Louis, Missouri, was the most successful of nine largest cities in limiting the death toll from influenza and pneumonia through the use of public health measures during the first 8 weeks of the epidemic. A second wave of cases increased the final death rate, but it remained below that of other major cities. Public health officials attributed the lower death rate to the early and rigorous ban on public gatherings.