Armstrong – Table of Contents

The United States Public Health Service became actively involved with measures
to combat, control and study the influenza pandemic of 1918 (1). The PHS became aware
through newspaper reports in the summer of 1918 and from official reports from overseas
health departments of the prevalence of the so-called Spanish influenza in foreign
countries. The Service also recognized that, because of the widespread prevalence of the
epidemic, it would be impossible to prevent the occurrence of the disease in the United
States. The epidemic actually appeared in three waves in the United States: early spring
1918, late summer 1918 and fall-winter 1918-1919.
Medical officers of the Service, as exemplified by Armstrong aboard the Seneca,
were among the first to observe the early stages of pandemic influenza. These officers
were attached to Coast Guard vessels, based on Gibraltar, performing convoy escort duty
up the coast of Spain and across the Bay of Biscayne to England. They watched the
beginning of the epidemic in Spain and its progression to England and France. The
officers saw practically all ships of the entire British-American-Italian fleet tied up at one
time or another in the harbor of Gibraltar with many crew members ill with influenza.
This was as described by Armstrong in the previous chapter.
The medical officers, including Armstrong, found that the most effective
measures to help the sick crewmen were to take temperatures of the entire crew company
twice a day, to place at bed rest every one with even a fractional degree of temperature
elevation, and to keep them at rest until they were fever-free for a full day. Medical
quarantine officers were cautioned to be on alert for typical cases among crew,
passengers and vessels entering the United States from European ports so that cases of
influenza could be brought to the attention of local health officials.