The most serious outbreak of influenza (also known as grippe, grip, or flu) in Tennessee history, with 7,721 recorded deaths from the disease, was the influenza pandemic of 1918-19. What happened in Tennessee was part of an international pandemic, or worldwide epidemic, multiplied in its effect by the dislocation and home-front demands of World War I. Two great waves of influenza occurred. The first was relatively mild, but the second literally covered the globe within a period of two months. This second wave, called “Spanish flu,” appeared in the United States in August 1918. The name “Spanish flu” was a misnomer since no evidence existed that the disease either arose in Spain or was any worse there than in other parts of the world. It is possible that it was called Spanish flu because the first influenza epidemic in the Americas came from Valencia, Spain, in 1647. In addition, more information about the epidemic came from Spain, a neutral country, with no need to hide its vulnerability, unlike other European nations at war in 1918.
The disease, it is now believed, entered the United States through sailors disembarking at the port of Boston. From there, it quickly spread to populated areas along the east coast. By the fall of 1918 it had reached burgeoning army training camps and other densely populated areas throughout the country, infecting military personnel and civilians alike.
Wherever the disease occurred, it would strike hard, spread for a week or two, cause much suffering and death, and then quickly subside. It is estimated to have killed 20 to 40 million people worldwide, two to four times the number killed in World War I. Not since the bubonic plague (Black Death) that killed an estimated 62 million Europeans from 1347 to 1350 had there been such a pandemic. Never had a disease spread so rapidly or invaded practically every corner of the world. Even isolated South Pacific islands were affected, and some native Alaskan settlements were completely wiped out. There were about 20 million cases of flu in the United States in 1918-19, and 548,452 were fatal.
In Tennessee, small towns were infected as severely as larger cities; the DuPont company town of Old Hickory, near Nashville, was hardest hit. On September 28, 1918, influenza struck many workers at the E. I. DuPont Munitions Plant. This plant was particularly vulnerable due to its large labor force (over 7,500 people) and their close proximity during working hours. Since flu was easily transmitted to others through airborne droplets from sneezes and coughs, it spread rapidly through the plant and out into the community. As one in four citizens contracted the flu, public gatherings, including religious services, civic events, movies, school classes, and court sessions, had to be canceled. Temporary hospitals were established wherever space could be found, and doctors and nurses were recruited from Nashville and surrounding areas to deal with the crisis. More than 1,300 Nashvillians (most from Old Hickory) died of the flu in 1918-19. In fact, so many died that the basement of the Nashville YMCA, converted to a temporary morgue, literally overflowed with bodies.