By Oct. 1, 1918, twenty percent of Kansas City’s army training schools had contracted influenza. Forty-three civilian cases had appeared, with 33 of them under isolation.

Kansas City Health Director Dr. E. H. Bullock now acknowledged that his city was on the cusp of an epidemic, but noted that it was not yet dangerous.

A week later, as more cases developed, Kansas City Mayor James Cowgill declared influenza a public emergency under the city charter, granting the Board of Health the authority to open hospitals, enforce health regulations, and make necessary expenditures.