Armstrong – Table of Contents

February 19, 1920 and the investigators carried it to completion as rapidly as they could
visit the families and secure the desired information.
Upon arrival at the island, Armstrong told the assembled inhabitants the purpose of the
visit, and he requested the islanders to remember, or to mark upon their calendars, the
dates on which various members of their households became ill. The dates of onset as
secured in the household canvas were checked, as far as possible, against the school
records and the time sheets of the Kelley Island Lime and Transport Company; these
records were kindly placed at the disposal of Armstrong and Hopkins for this purpose.
These checks together with the cross checks secured through contact, histories, and other
sources between individuals rendered Armstrong and Hopkins quite confident of the
accuracy of their data.
The authors, wholly conducting the house-to-house survey by themselves, began on
February 19, completed the survey on March 7, and secured (obtained) a record of every
person on the island. They completed in 7 days a re-survey, begun on March 21, for the
purpose of locating new or recurrent cases. Following the recent conference with
epidemiological aides from several states, referred to previously, Surgeon W.H. Frost, of
the USPHS, had prepared special forms for use in recording epidemiological data.
Armstrong and Hopkins used these new forms in gathering the information during their
survey. They used Form I to collect the household record, general sanitary conditions and
similar information; they used Form II to obtain an individual record of contact and
symptoms of illness for each member of the household. In the 1920 epidemic on Kelleys
Island, they based the diagnosis of influenza in individuals primarily on clinical illness,
exposure to known cases and the realization that epidemics were occurring throughout