On Sept. 27, 1918, local Nashville newspapers reported that there were at least a handful of cases within the city, but that authorities could not be certain since influenza was not a mandatory reportable disease in either Nashville or Tennessee. 

Two days later, city health officials as well as Captain Dr. Robert C. Derivaux, the local representative of the United States Public Health Service, reiterated that influenza was in Nashville. 

Dr. W. F. Fessey, Superintendent of City Hospital, reported that thirty cases of influenza had been admitted to his hospital and that 75 cases had to be turned away due to lack of space.