By Sept. 27, 1918, influenza cases had arrived in the city of Dallas, prompting Dallas Health Officer Dr. A.W. Carnes to urge physicians to report cases promptly and to try and treat patients at their homes.

It is difficult to ascertain the severity of Dallas’s epidemic. Beginning on September 27, Carnes requested that physicians report influenza cases, but the ensuing ordinance did not become law until October 12, leaving a significant gap for which case reporting was not mandatory.

In fact, health officers were immensely more interested in smallpox, malaria, typhoid fever, and impure food and milk than they were with influenza and the destruction it wrought.

The only information provided is the total number of lobar pneumonia and influenza deaths for the period between May 1918 and May 1919: 813 in all, equaling a death rate for those diseases of 511 per 100,000.