One-hundred years ago, headlines in the Daily Inter Lake had a recurring theme — the influenza epidemic.

“Records Indicate Epidemic Increasing,” one Inter Lake headline declared. Other 1918 articles noted “Whitefish Battling with Influenza Epidemic,” and “Influenza Spread by Carelessness.”

The deadly Spanish influenza, largely considered to be the “most devastating epidemic of the 20th century,” had crept its way to Montana a century ago.

On Jan. 16, 1918, the disease claimed the life of Silva Whitmore of Red Lodge — the first of thousands of Montana residents who would die in the pandemic. She was followed shortly thereafter by Three Bear of Browning, Fusaye Sato of Geraldine and John Woods of Anaconda.

Within about a 12-month period, the Spanish influenza infected an estimated 500 million people worldwide and claimed the lives of more than 50 million men, women and children, according to state public-health officials who authored a recent overview of the 1918-19 flu epidemic.

Three Montana public-health experts, Todd Harwell, Dr. Greg Holzman and Dr. Steven Helgerson, recently released an overview article titled “No More War, No More Plague,” detailing the impact of the 1918 pandemic in Montana. The piece was published in The Magazine of Western History this summer, noting the 100-year anniversary since the deadly outbreak.

According to the article, when the U.S. joined World War I efforts in April 1917, attention from country leaders diverted from issues looming on home soil to those happening overseas. And as soldiers from Montana and elsewhere joined the forces one after another, so did medical personnel, leaving a limited number of professionals to assist with the emerging influenza outbreak.

“People were so distracted by World War I they weren't prepared for what was coming at them,” said Todd Harwell, administrator of Public Health and Safety Division of the Montana Department of Health and Human Services. “This all started at an unusual time and there was a lot they were up against.”

In Montana, the southwest region of the state experienced the crux of the pandemic, with Cascade, Meagher, Lewis and Clark, Gallatin, Missoula and Silver Bow counties getting hit the hardest.

Numbers show that a little more than 100 residents per thousand cases died from influenza from 1918 to 1919 here in Flathead County, which pales in comparison to the 780 per 1,000 cases in Silver Bow County. By the time the first known case of influenza in Flathead County claimed the life of 16-year-old Helen Carrol of Columbia Falls, Butte's daily death toll was already at 18.

“Butte was one of the main population centers,” Harwell said. “Because of the war there was a lot of traffic and people moving around, troops coming and leaving.”

Butte was a booming epicenter for farming, mining and was a place where people lived relatively close to one another. Harwell estimates this is why the region was hit the hardest.

According to a 1993 True West article, “The Legend of China Basin,” written by former Inter Lake staffer Rick Hull, the worst of the epidemic hit Flathead County in November 1918, eventually peaking at 22 deaths per day.

In Kalispell and Whitefish, community buildings were transformed into makeshift treatment centers to accommodate the increasing number of flu patients.

“The valley's communities were in a near panic. Health officials closed churches, schools and movie theaters. Gathering places of every type, from pool rooms to ladies' social halls, were deserted. Signs in local ice cream parlors warned, 'Get what you want and move on,'” the article noted.

“In Kalispell the old Crescent hospital reopened to house the overflow of flu victims, while in Whitefish, rows of beds transformed the Masonic temple into a makeshift hospital,” Hull's article noted. “Soon even those filled to capacity as the flu struck one out of every three people.”

According to State Medical Officer Greg Holzman, residents statewide attempted to slow the spread by avoiding public spaces.

By the time the flu loosened its death grip on Montana, more than 4,000 residents had died. The state, along with the nation, was ill-prepared, under-equipped and somewhat blindsided.

“While public health and medicine was aware of influenza, they still did not know what the cause was and it wasn't until the 1930s until it was identified,” Harwell said. “And public health and medicine didn't have the means to cure it.”

Now, a century later, Harwell, Holzman and Jim Murphy, the chief of the state's Communicable Disease, all agree: another epidemic the size and scale of the Spanish influenza is very possible today.

“It's not a matter of if, it's a matter of when,” Harwell said.

According to the Centers for Disease Control and Prevention, the 2017 to 2018 flu season was a “high severity season” and it was the first season to be classified as such across all age groups. The center reports show that less than 40 percent of the population received flu vaccination coverage.

“There is a vaccine out there that is pretty effective, yet fewer than half of the population choose to get it,” Harwell said.

The vaccine doesn't offer complete immunity from the disease, but can protect against certain strains. However, strains continue to develop, and although researchers are working on a universal vaccine to combat all strains, the ongoing shifts sometimes make it difficult to get ahead of the disease, Harwell said.

“We have a vaccine to try and prevent it,” Holzman said. “The medical science has improved drastically and public health work to be prepared for these events.”

In addition to better medicine and public health systems, facilities nationwide often conduct emergency preparedness drills that test the communication abilities of hospitals, emergency personnel and more should an outbreak occur.

According to Holzman, global surveillance systems have also been landmarks in managing outbreaks of the flu and other diseases. By having the ability to detect diseases early and communicate with neighboring states and countries, we are able to identify more serious strains of disease sooner.

“Get out and get vaccinated,” Holzman said. “If not for yourself, get vaccinated for the sake of others who maybe for whatever reason can't get vaccinated themselves.”

Reporter Kianna Gardner may be reached at 758-4439 or kgardner@dailyinterlake.com.