The 1918–1920 Influenza Pandemic in Lynden, Washington

Quick programming note: Usually I write about marketing and consumer behavior. I’m taking a quick break to write about the events that happened 102 years ago in my hometown, Lynden, Washington.

The first person in Lynden to die of influenza during the 1918 pandemic—the so-called “Spanish flu”—was Cora VandenBrink. She died on Monday, October 28, 1918. She was twenty-nine. Two days later, her brother-in-law, John Hendricks died. He was twenty-seven. According to the Lynden Tribune, “the entire Vandenbrink and Hendricks families had been stricken with the influenza, and had been in serious condition for several days.”¹

Five days later, the third person to die was Cora’s newborn baby, who was only seven days old and born prematurely. There is no first name on the death certificate, just “Baby VandenBrink.” There was no funeral. Premature births, followed by the death of the mother, were a common feature of the 1918 flu. In fact, the fatality rate for pregnant women ranged from 23 percent to 71 percent, depending on which study you consult.² And, of the pregnant women who survived, more than one in four lost their child.³ Baby VandenBrink was the first of five babies in Lynden who would die. Most of the people the flu killed were in their late 20s and early 30s. Harvey Cushing, the famous neurosurgeon, called these young victims “doubly dead in that they died so young.” The flu killed an estimated 50 million people worldwide between the spring of 1918 and the summer of 1920.

This is the story of the 1918 flu epidemic in Lynden, Washington—of how it arrived in Lynden, of the community’s response, and of the people it killed.

How influenza came to Western Washington

By the time Cora died, the flu had been present in Western Washington for roughly six weeks. The first cases in the state were reported on September 21, 1918 at Camp Lewis in Tacoma (now Fort Lewis) among soldiers who had been transferred from army camps in the east.⁴ During the First World War troops were transferred between camps and across the Atlantic, taking the virus with them. The virus sickened soldiers before spreading to local populations and beyond.

Nobody knows for sure where the virus originated, but the most accepted theory is that the virus broke out in Haskell County, Kansas in early 1918 and spread to nearby Camp Funston, now Fort Riley.⁵ Troop transfers took the virus to other camps and eventually to Europe in the spring of 1918, where it mutated into a more virulent form—and where it received it’s “Spanish flu” moniker, since Spain had the only uncensored press in Europe during the war—before returning back to the United States in August, 1918, affecting the cities of New York, Boston, and Philadelphia. From Philadelphia, a troop transfer brought the virus to Washington state, where it infected soldiers at Camp Lewis, Camp Malley, and the naval camp at the University of Washington where, on October 3, 1918, the first death in the state was reported.⁶

The first cases in Lynden

Many young men from Lynden were stationed at these camps and made regular visits home. On September 21—the day the flu arrived at Camp Lewis—John Brus traveled from Camp Lewis to Lynden, although for him to have the virus he would have needed to have contracted it in the preceding days, before it had been reported.⁷

The following weekend, on September 28, Company E arrived in Lynden from Camp Murray, where they had been stationed the previous two weeks, and where the virus was circulating. Most of Whatcom County’s soldiers belonged to Company E, and they had been invited back to town to perform military drills at the Lynden fair on October 4 and 5, a Friday and Saturday.⁸ (Today, the fair is held at the end of the summer, but in 1918, the fair, which was then mostly focused on agriculture, was held in the fall after crops were harvested.)

It’s possible Company E brought influenza to Lynden. More likely, though, was that the virus spread from Camp Lewis northward during the first week of October. The first cases were reported in Bellingham on October 9, 1918. As a precaution, Lynden’s mayor, Ed Edson, closed Lynden’s schools and ordered that all “churches, prayer meetings, lodge sessions, private parties, and other gatherings” be cancelled. He also banned “card games and pool playing,” and shut down Lynden’s “moving picture theater.”⁹

Even though the threat seemed low, influenza was spreading undetected. It could take up to a week for someone who was infected to begin showing symptoms.¹⁰ During this time, they could infect others. Of those who died of the flu, an average of nine days elapsed between symptom onset and death,¹¹ and sometimes much longer.¹² This meant that if Lynden reported its first deaths starting October 28, 1918, people began displaying symptoms on October 17, and were likely infected by October 10—and probably a few days earlier.

The following week, the first cases were confirmed.¹³

What it was like to have influenza

Influenza is a respiratory disease. Infection triggers inflammation in the nose and throat, accompanied by lots of mucous. You get a headache and develop a high fever. You start coughing. You feel nauseous. You vomit. This is the kind of sickness most people are familiar with—you’re miserable for a few days and then you recover.

The 1918 flu was unlike anything people had experienced before. Serious cases caused even more aches and pains, especially in the joints. People suffered chills to the point of constant shivering. Pockets of air developed beneath the skin (“subcutaneous emphysema”). Air leaked through tiny breaks in the lungs, producing a cackling sound when people coughed or tried to breathe. People developed earaches and discharged pus from their ears. Headaches worsened and vision became diminished. Organs began to fail, including the kidney and liver. People hemorrhaged from within. Violent coughing fits tore muscles.

The virus also compromised the spongy tissue in the lungs that aids in the transfer of oxygen from air into the bloodstream. The lungs became filled with dead cells and fluid—and lots of blood. Influenza slowly deprived people of their ability to breathe. It did so by tricking the body’s immune system into destroying itself, making people susceptible to secondary illnesses. Often, after a weeks-long battle with influenza and a near-recovery, people would often return to normal life only to die of other infections within just a day or two, simply because their compromised immune system couldn’t mount an effective response.¹⁴

The first deaths in Lynden

The long period between infection and death gave the community a false sense of security. Doctors downplayed it as “nothing more than severe cases of the grippe.”¹⁵ Churches and schools made plans to reopen on Sunday, October 20, just a few days after the first cases were reported and a full week before the first fatality. The movie theater would reopen that weekend, too.

That changed on Monday, October 28, 1918, when Cora VandenBrink died, followed by John Hendricks two days later, and Baby VandenBrink the following week. Their deaths “awakened the community sharply to the seriousness of the scourge.”¹⁶

Schools closed again. Churches stopped meeting. Gatherings were once again banned. Everyone was ordered to wear masks. The county board of health even instructed Jake Le Compte, Lynden’s only police officer, to enforce the mandate, and everyone complied “for a great portion of the day.”¹⁷ (For the remainder of the epidemic, people in Lynden did not wear masks.)

After those first three deaths, nobody else died, at least not yet. Had the community overreacted? Was the threat subsiding? By mid-November, people began discussing a second plan to reopen. Mayor Edson lifted the ban on gatherings on Monday, November 11—the same day as the armistice that ended the First World War. On that day, there was “a grand procession of parades and clatter,” complete with floats, a band playing patriotic music, prayers and short addresses by Lynden’s most prominent citizens, and the German Kaiser, in effigy, dragged “up and down the street behind two or three automobiles.”¹⁸

Mistaken optimism

Not everyone who got the flu died right away. Many even seem to return to full health, only to swiftly become ill again and not recover. Most people who died from the virus died of pneumonia, through a massive invasion of the lungs directly. But more typically the influenza virus worked to destroy the body’s immune response, which allowed other bacteria to enter the respiratory tract unopposed. In The Great Influenza, John M. Barry writes:

Ten days, two weeks, sometimes even longer than two weeks after the initial attack by the virus, after victims had felt better, after recovery had seemed to begin, victims were suddenly getting seriously ill again. And they were dying. The virus was stripping their lungs all but naked of their immune system; recent research suggests that the virus made it easier for some kinds of bacteria to lodge in lung tissue as well. Bacteria were taking advantage, invading the lungs, and killing. People were learning, and doctors were advising, and newspapers were warning, that even when a patient seemed to recover, seemed to feel fine, normal, well enough to go back to work, still that patient should continue to rest, continue to stay in bed. Or else that patient was risking his or her life.¹⁹

Thus, in early November, there were people in Lynden who were recovering but would later die. And there were even more people infected—and infecting others—but not yet showing symptoms. Many of these people attended the Armistice Day celebrations, and many would attend church the first Sunday they could.

The worst of the outbreak

The rush to return to normal had consequences. Three more people died the first week of December, “the first deaths since the recurrence of the disease,”²⁰ which was not really a recurrence at all—the virus had been there all along. Lynden’s health officer warned that “all of the deaths from influenza are due to neglect in the early stages of the disease.”²¹ Schools closed again and all gatherings were canceled. The next week, four more people died, including two infants. The school board met and decided to close the rest of the year.

After Christmas, Lynden tried a third time to return to normal. When schools finally re-opened, they did so with restrictions—students with ill family members could not return until a doctor “certified their health.” School buildings were “fumigated every few weeks.”²²

At the start of 1919, the worst was over. Though six people died the first week of December and seven the second week, there was only one death after December 19. Then, in January only three people died the entire month, followed by two in February, one in March, three in April, and two in May. The last person in Lynden to die of influenza that winter died on May 23, 1919. 

The second wave in 1920

People talk about influenza coming in waves.The first wave, which probably appeared in Kansas in January of 1918 and spread throughout the Midwest, didn’t make it to Lynden. If it did, it didn’t kill—there were no influenza deaths recorded the previous winter, and no excess deaths, either. What Lynden experienced during the winter of 1918–1919 was actually the second wave.

The third wave—Lynden’s second wave—arrived in February of 1920. During that month, influenza made a sudden return everywhere all at once. There are reports of people dying in Japan, Peru, all over the United States. In Lynden, on February 15, 1920, Charlotte Elizabeth Perry died of influenza. She was twenty-nine. In the weeks following Perry’s death, eleven more people died. Once again, the illness targeted the young: the average age of death during the third wave was 33 years and 10 months. Lynden’s second wave lasted only five weeks: on March 24, 1920, Lilda Henrietta Brunink became the last person to die of influenza during the epidemic. She was four years old.

How many people got the flu?

It’s impossible to know how many people got the flu in Lynden between October, 1918 and March, 1920, for a couple reasons.

1. First, most cases in Lynden were not documented in any kind of official way, although it’s possible to guess based on reliable data from other areas. Around the world, the attack rate ranged from 20% to 60% in isolated areas.²³ In Rio de Janeiro, it was 33%. In Buenos Aires, it was 55%. One-third of Japanese got the flu.²⁴
2. Second, it’s also impossible to know the number of asymptomatic or mild cases. One study estimated that in the British Royal Air Force, 59% of all cases were asymptomatic,²⁵ that is, people could infect others even though they never got sick themselves.

While it may not be possible to know how many people got the flu, it is possible to know is how many people died. Dying is an unmistakable, unambiguous thing to do.

The number of 1918 influenza deaths in Lynden

Between October 1918 and March 1920, the flu claimed 42 lives in and around Lynden.²⁶

This is just an estimate. It’s impossible to know for sure how many people in and around Lynden died from the flu, for four reasons:

1. First, death certificates didn’t always list the flu as the cause of death. Sometimes they listed pneumonia in addition to or instead of influenza. In some cases, mothers with the flu went into premature labor, and both the mother and baby died, even though the causes of death would be “died during childbirth” and “premature birth.”
2. Second, on many death certificates, the handwriting is illegible.
3. Third, there are many death certificates for people in and around Lynden who died during the pandemic whose place of residence was listed only as “Whatcom County” or “Washington.” These deaths aren’t counted toward Lynden’s total.
4. Fourth, many people from Lynden died while stationed at army and navy camps, or while overseas in France and Belgium. (Although Cora VandenBrink was the first person in Lynden to die, the first person from Lynden to die was Lee Alexander, who died on October 9, 1918, a full three weeks earlier.²⁷)

One other complicating problem is that it’s not possible to know exactly who lived in Lynden at the time. While the 1920 census records a population of around 1,250, many people who didn’t technically living in the city of Lynden proper still considered Lynden their home. For example, everyone acknowledged that Cora Vanden Brink was the first person to die from the flu in Lynden—the Lynden Tribune tells its readers she was “from the Lynden district,” and her death certificate lists Lynden as her hometown—but she actually lived in Clearbrook, several miles to the east. If the community of Clearbrook considered itself within the borders of Lynden, what other communities did, too? For the purposes of this post, I considered anyone from Lynden if they lived in the communities of Delta, Glendale, North Prairie, Northwood, Clearbrook, Everson, Strandell, and Laurel. Most of these residents would have self-identified as “from Lynden.”

The population within this would have included 1,250 people from within the city of Lynden itself, plus another 1,000 in the outlying communities and rural areas, making a total population of around 2,250. With an estimated 50% attack rate, approximately 1,125 people would have become infected—perhaps a little more or a little less. Forty-two of them died, which means the fatality rate in and around Lynden was around 3.7%, about 1 in 27 people.

By comparison, the fatality rate for the United States as a whole was 0.65%. In Italy, 1% died—the worst rate of any developed country.²⁸ The more developed and more urban an area, the lower the fatality rate, since denser populations were exposed to influenza viruses more frequently and built greater immunity. Lynden was neither urban nor developed; it didn’t have a population with high rates of previous exposure to influenza viruses.

The fatality rate for young adults was far worse than 3.7%: it’s likely that between 5 and 10% of all young adults worldwide died from the flu.²⁹ In Lynden, the average age of death was 29 years, 3 months. Exactly one-third of all deaths in Lynden were people between the ages of twenty-five and thirty-five.

One way to see the full effect of the pandemic is to calculate the number of excess deaths during the epidemic—the number of deaths compared to normal, using the previous three years as a baseline. Here’s a graph that compares actual deaths with excess deaths:

Since Lynden’s population was small, the data is a little noisy. If we expand the data to include all of Whatcom County, it’s easier to see the rate of excess deaths during the pandemic:

Could influenza in Lynden have been prevented?

Even though the actual number of deaths cannot be known, it is worth asking: could they have been prevented? Could the flu have been stopped?

Probably not. Only a handful of communities around the world escaped infection, but only because they allowed nobody in or out for the duration of the pandemic. A few areas, such as American Samoa, were never infected. These few regions escaped the pandemic because they were isolated in some way—as islands, as remote areas, or as the kind of political entities that could enforce a rigorous cordon sanitaire. Lynden, on the other hand, had tight economic and social connections with the communities around it. People traveled for work or pleasure to Bellingham, Seattle, Vancouver, and beyond. Soldiers traveled home each weekend. The rural area between Lynden and its neighbors was porous. Only a strict and total cordon sanitaire enacted in advance of the first cases and a strict quarantine after the first cases would have prevented people in Lynden from dying. Even if the such measures were implemented, there was no agency to enforce it: Lynden’s only police officer couldn’t even make people wear masks for one day.

Other ways of stopping the spread would have been ineffective, too. The masks from 1918 were not as effective as the masks used in 2020 during COVID-19. They helped, but not much. Isolation would have worked but wasn’t possible in 1920. People did not understand how the virus spread—or even that it was a virus until decades later—so the community returned to normal life more quickly than it should have. The idea of asymptomatic transmission would have made little sense. (Spread from asymptomatic carriers at the Armistice Day celebrations on November 11, 1918 probably hastened the virus’s spread and caused unnecessary suffering and death.)

It’s been said that history doesn’t repeat itself, but it does rhyme. While the coronavirus of 2020 and the influenza virus of 1918 are very different viruses, they both spread and kill in the same ways and at the same rates. The 2020 response to the coronavirus resembles the 1918 response to the influenza virus. It’s difficult to foresee a different outcome.

1. The Lynden Tribune, October 31, 1918.
2. Barry, J.M. (2004), The Great Influenza: The Story of the Deadliest Pandemic in History, New York: Penguin, 240; Jordan, E.O. (1927), Epidemic Influenza: A Survey, Ann Arbor, Michigan: Michigan Publishing, University Library, University of Michigan, 273.
3. Barry, J.M. (2004), The Great Influenza: The Story of the Deadliest Pandemic in History, New York: Penguin, 240; John Harris, “Influenza Occurring in Pregnant Women: A Statistical Study of 130 Cases,” JAMA April 5, 1919, 978.
4. Denfeld, Duane Colt, “First 11 cases of deadly influenza are reported at Camp Lewis on September 21, 1918,” https://www.historylink.org/File/20317
5. Barry J. M. (2004), “The site of origin of the 1918 influenza pandemic and its public health implications,” Journal of translational medicine, 2(1), 3.
6. Wilma, David, “Flu epidemic hits Seattle on October 3, 1918,” https://www.historylink.org/File/2090
7. Lynden Tribune, September 26, 1918.
8. Lynden Tribune, October 3, 1918.
9. Lynden Tribune, October 10, 1918.
10. Cameron, I. A. (2010), “Dr Montizambert and the 1918-1919 Spanish influenza pandemic in Canada,” Canadian family physician / Medecin de famille canadien, 56(5), 453–454.
11. Brundage, J. F., & Shanks, G. (2008). “Deaths from Bacterial Pneumonia during 1918–19 Influenza Pandemic,” Emerging Infectious Diseases, 14(8), 1193-1199.
12. Nishiura, H. (2007), “Early efforts in modeling the incubation period of infectious diseases with an acute course of illness,” Emerging Themes in Epidemiology 4, 2.
13. Lynden Tribune, October 17, 1918.
14. Barry, J.M. (2004), The Great Influenza: The Story of the Deadliest Pandemic in History, New York: Penguin, 232–249.
15. Lynden Tribune, October 17, 1918.
16. Lynden Tribune, October 31, 1918.
17. Lynden Tribune, November 14, 1918.
18. Lynden Tribune, November 14, 1918.
19. Barry, J.M. (2004), The Great Influenza: The Story of the Deadliest Pandemic in History, New York: Penguin, 317.
20. Lynden Tribune, December 5, 1918.
21. Lynden Tribune, December 5, 1918.
22. Lynden Tribune, January 2, 1918.
23. Mathews, J. D., McCaw, C. T., McVernon, J., McBryde, E. S., & McCaw, J. M. (2007), “A biological model for influenza transmission: pandemic planning implications of asymptomatic infection and immunity,” PloS one, 2(11), e1220.
24. Barry, J.M. (2004), The Great Influenza: The Story of the Deadliest Pandemic in History, New York: Penguin, 363.
25. Mathews, J. D., McCaw, C. T., McVernon, J., McBryde, E. S., & McCaw, J. M. (2007). A biological model for influenza transmission: pandemic planning implications of asymptomatic infection and immunity. PloS one, 2(11), e1220.
26. I reviewed every death certificate for every person from Lynden who died between January 1, 1918 and August 31, 1920.
27. Lynden Tribune, October 10, 1918.
28. Barry, J.M. (2004), The Great Influenza: The Story of the Deadliest Pandemic in History, New York: Penguin, 397
29. Barry, J.M. (2004), The Great Influenza: The Story of the Deadliest Pandemic in History, New York: Penguin, 398.