Influenza; Botulism
Upon reporting to the Bureau in Washington, D.C., his superiors discussed with
Armstrong his future career interests in the Public Health Service. The Service was
giving young officers returning from wartime sea duty with the Navy some choice in
picking their new assignments. The choice was clinical duty in a Marine Hospital or
participation in some of the ongoing field public health activities. At this time period the
primary field activity was the study and control of the scattered outbreaks of influenza in
the United States. Armstrong, whose prior training and experience had been oriented to
clinical medicine, changed his career aspirations. He decided that he would rather
concentrate his future professional activities in the field of public health where he could
help the many, rather than treating individual patients where he might benefit only the
few. Having made this career-determining decision, from which he did not deviate,
Charles Armstrong embarked on his initial post-war assignments.
Armstrong’s experiences during the influenza period have to be considered in the
context of the Public Health Service’s response to this devastating pandemic (1). His
initial encounter with influenza was aboard the Coast Guard Cutter Seneca. The world
wide pandemic was called the “Spanish Flu” after the area where the initial cases were
noted. The public adapted the name from the Italian sobriquet “un influenza di freddo”,
an attempt to attribute its occurrence to cold climatic conditions. It was similar to many
previous pandemics but was of extremely greater prevalence and associated with a
frightening increase in morbidity and mortality. It was estimated that world wide 20
million influenza-related deaths occurred. In the United States there were millions of