Between the fall of 1789 and the spring of 1790, influenza occurred extensively throughout the United States and North America more broadly. First reported in the southern United States in September, it spread throughout the northern states in October and November, appeared about the same time in the West Indies, and reached as far north as Nova Scotia before the end of 1789. In the spring of 1790, a renewed epidemic developed, almost as universal as the first but more often fatal.
History
Background By the late 18th century, influenza was a relatively common feature in North America. The disease was recorded on the continent for the first time in 1647. The Western Hemisphere was then involved in several pandemics during the 1700s, including one in 1761 which, notably, might have begun in North America. Before 1789, the last major influenza epidemic on the continent was in the spring of 1781.
In March 1788, influenza broke out in Saint Petersburg and in Kherson (at the time part of Russia), as well as in Warsaw, where even the King of Poland was afflicted. It then spread westward across Europe throughout the year, evidently appearing last in Geneva, in October.
Following this epidemic of 1788, influenza was generally not reported again until the latter half of 1789, though there is perhaps some evidence that the disease may have been present in some form during the intervening period. For example, Luigi Careno, an Italian doctor based in Vienna, details a "very epidemic catarrh" that prevailed in the city during the winter of 1789; William Eden, then Ambassador to Spain for George III, describes "a new influenza of colds" prevailing in March 1789 in Madrid, where his ambassadorship was at that time coming to an end; and, according to the College of Physicians of Philadelphia, influenza was epidemic in that city in April 1789. Beyond these accounts, however, the major histories of the disease on the whole make no mention of influenza during this time.
The connection between the epidemic of 1788 and that of 1789–1790, if any, is not entirely clear. Historically, the two were often considered separately, though some authors have considered them together as a single epidemic period, both in older and more modern sources.
First epidemic According to Noah Webster, some accounts place the earliest outbreaks of the disease in Canada, though there is very little, if any, evidence of this, beyond Webster's reporting. Influenza was present in Georgia in September, and at least one report suggests that it was also prevalent in South Carolina (Charleston) by the end of the month and soon after. It appeared in Virginia at the end of September.
The flu broke out sometime in September in New York City, then the capital of the young nation, where it quickly assumed epidemic proportions. John Fenno, publisher of the influential Gazette of the United States, contracted the disease in early October. On the 9th, he wrote of "an almost universal Complaint here of a severe Cold"; the next day, he came to the conclusion that the city was "afflicted with the Influenza—I can call it by no other name." In a letter to his sister, dated 12 October, George Washington describes "[a] sort of epidemical cold" that had pervaded the city but which he had thus far been able to avoid. This "Epidemick cold", as Abigail Adams called it, soon invaded the household of Richmond Hill, on Manhattan Island, afflicting the whole Adams family (except for John Quincy and the vice president, who had departed for Braintree (now Quincy), Massachusetts, on the 5th and the 12th, respectively). On 15 October, the president set out on his tour of the New England states.
Philadelphia was stricken at the beginning of October, or perhaps even as early as late September; the outbreak there, in any case, developed subsequently to the one in New York. William Currie, a notable physician in the city, speculated that the disease could have been brought, at least in part, by some Friends of Philadelphia Yearly Meeting that had come from New York for the body's annual meeting, which that year was held from 28 September to 3 October. On the other hand, Benjamin Rush, another eminent doctor of Philadelphia, suggested that members of the 1st Congress, arriving in the city from New York after the close of the first session on 29 September, might have played a part in introducing the disease. They were, perhaps not surprisingly, "much indisposed with colds", and though they attributed their general sickness "to... fatigue and the night air", the immense and rapid spread of the disease shortly thereafter made it clear that it must have been the one "so well known of late years, by the name of the Influenza."
To observers such as Rush, the disease was considered to have spread from these cities "in all directions". It was general in Fairfield County, Connecticut, at the beginning of October. On the 12th or 15th, it broke out in Hartford, where Webster lived at that time. On the 19th, he left the town for Boston and arrived there the next day. By the last week of October, the disease was prevalent in the interior of Pennsylvania, as well as in New Jersey, Delaware, and Maryland; by the first week of November, it was prevalent in all the states of New England (Connecticut, Rhode Island, Massachusetts, and New Hampshire).
On 24 October, Washington arrived in Boston, escorted by Lieutenant Governor Samuel Adams and the Executive Council, amid much fanfare. A massive crowd had gathered in a procession to welcome him. According to Webster, who began to develop symptoms the day of his own arrival in the city, influenza was not yet present among the inhabitants at this time. Nonetheless, by the 26th, Washington had contracted it, and soon thereafter it broke out more noticeably throughout the city. This timing was not lost on the people, who quickly took to calling the prevailing ailment by such names as the "Washington influenza", the "Washington cold", and the "President's cough", suspecting they had caught it during the celebrations. By the start of November, the city of Boston was "universally seized" by the flu, such that, according to at least one report, nine-tenths of its inhabitants had already fallen ill.
Influenza began to appear in the West Indies around the same time as it did in the northern United States, in October and November. It broke out in Westmoreland Parish, Jamaica, around 20 October and in Nassau, on the island of New Providence, in the last week of October. The disease "raged universally" on the islands of Sint Eustatius, Saint Kitts, and Dominica at this time as well.
In early November, some trade vessels arrived at the ports of St. George's and Grenville Bay in Grenada from these afflicted islands. These ships, it was believed, introduced the flu into the island, as they were navigated by enslaved sailors who were "very much afflicted with it". These sailors, returning to the homes of their respective enslavers, were lodged alongside others of their station, who at that time were "in a perfect state of health". In less than a week, however, all were stricken; and, over the course of a fortnight, influenza became universally prevalent in St. George's. This same month, it was similarly universal in Saint Croix and in Kingston.
In these parts, similar to on the mainland, great numbers were afflicted, but the illness was mostly not very fatal. In Kingston, it struck "all classes of people, and few escaped it"; generally mild, it occasioned few or no fatalities. Similarly, in St. George's, it "indiscriminately" infected both whites and blacks, with "very few" escaping it; and, in Westmoreland Parish, it "seized great numbers of all ages, colours, and sexes", even among the young and healthy. Nonetheless, it did still have the potential to be severe during this initial epidemic. In the parish, the disease indeed "visited successively, less or more, every estate and settlement", but it could vary from place to place: Some were affected very severely, while others experienced milder outbreaks, even a few hardly perceiving its presence at all.
The epidemic continued to rage throughout the United States in November, by which time the whole country was in its grip. As The Vermont Gazette reported for 9 November, "So universal a complaint of bad colds perhaps never prevailed in America before, as at present." Its publishers, in the same report, express their apologies for the abbreviated edition that day, as the flu had afflicted their own families, as it had so many already. In Boston, where the disease "rag'd universally", felling entire families, normal business faltered in the middle of the month on account of the outbreak; bread production, for example, declined to less than a quarter of its typical output.
On 1 November, John Adams wrote to his wife Abigail from Braintree that "[t]he Influenza is here as general as it was at N. York", informing her that their youngest son, Thomas, had come down with it there but was improving. Abigail would later receive word from her sister, Mary Smith Cranch (with whom Thomas was staying at this time), that the whole household was "much indisposed with colds but nobody quite sick". On the 22nd, Abigail wrote to her eldest son, John Quincy, admonishing him for not writing at all after leaving New York the month before. As it turned out, John had contracted "a severe cold" upon his arrival in Braintree on 9 October, which confined him for 2 or 3 days; only later did he conclude that it had likely been the influenza. Writing to his mother on 5 December, he describes the sickness as "almost universal in this State", as it had been since his own infection. He recounts having been scolded for singularly maintaining relatively good health during this time, "while all the world were more or less diseased".
In December, the flu prevailed in Nova Scotia and, near the end of the month, appeared in Saint Lucia. It appeared among the Spanish settlements in South America that winter. In the United States, it persisted into December. The epidemic in Philadelphia lasted about six or seven weeks. On the whole, it took six to eight weeks for the disease to spread across the whole country.
The epidemic reportedly afflicted Native Americans with some severity. According to the land surveyor Andrew Ellicott, influenza struck those in the Niagara region "with peculiar force"; they apparently considered the attendant cough of the illness to be "so new and so irritating" that they attributed it to "witchcraft".
Second epidemic In Grenada, a shift in the presentation of the disease began to be observed in the middle of December. While earlier in the fall it had been a more catarrhal (i.e., coldlike) affliction, it soon took on a more inflammatory character, marked "by the violence, obscurity, and insidious nature of its symptoms" when it first appeared on some estates. This change "increased to a most alarming degree, and rendered the disorder... extremely dangerous and fatal." By mid-January 1790, the disease was ubiquitous on the island again.
A similar shift was noted around this time in Virginia, where over the winter an inflammatory ailment began to appear, associated with symptoms so much more severe that there was some uncertainty whether it was influenza at all. The disease "was much more fatal" and often resistant to treatment. In the north, influenza evidently reappeared first along the Hudson River the last week of March, in Albany and in Vermont, where it laid entire families low for weeks. In early April it appeared along the Connecticut River, to the east, and from there in the northeast apparently spread in a southwest direction.