Cover your sneezes. Stay home if you are sick. Wash those hands.
Sound familiar? Those warnings about how to prevent spreading the flu come from 1918 -- not 2009.
That year saw the Top of Utah reeling from the Spanish influenza, which was killing people by the millions the world over and which officially hit the Beehive State in October.
Yet if some flu precautions from the past century are the same, others were markedly different: No one was permitted in train stations except on business. Public funerals were abolished. The homes of the sick had to post placards in a "conspicuous place" bearing the word "Influenza."
"It was a fear of kind of the unknown, really, in those days. ... Medically, I don't think they understood all the ramifications of it," says Richard C. Roberts, a former Weber State University history professor who wrote about the pandemic in 1997's "A History of Weber County."
With worries about the H1N1 virus, or swine flu, dominating today's headlines, we decided to look back at how the 1918 pandemic -- deemed "a global disaster" and "the mother of all pandemics" -- played out in the Top of Utah.
Nationally, influenza swept across the country in three waves, beginning in the late spring and early summer of 1918, according to an online history compiled by the United States Department of Health and Human Services. The next waves hit in the fall of that year and the spring of 1919.
During its course, the flu killed 675,000 Americans and more than 50 million people worldwide.
Utah reported its first official case of the disease in October 1918. Ogden, with its railroad station relaying folks in and out of town, was hit hard, logging 2,628 cases of the flu from Oct. 3 to Oct. 26 -- and 73 deaths.
During the fall and into December, Ogden was reporting 50 new cases of flu per day. Double that number were occurring in Salt Lake City.
Ogden was one of a few towns that adopted a citywide quarantine, according to historian Leonard J. Arrington in a history of the Utah epidemic published in a 1990 Utah Historical Quarterly. If a resident of Ogden visited Salt Lake City -- where there was no quarantine -- he or she had to present a health certificate, signed by a doctor, to get back into Ogden.
"Highway patrolmen turned back a number of cars without certificates to the accompaniment of considerable profanity," Arrington wrote.
About 45,000 cases of influenza were reported in Utah in 1918, Arrington wrote, with 2,282 deaths. Almost 4 percent of those stricken died.
Fighting the flu meant long days for doctors like Edward Rich of Ogden, whose wife Alymira wrote about the epidemic in her diary, part of Weber State University's special collections department.
"Dr. (Rich) is still out making calls and it is now 11:30 p.m.," she wrote on Dec. 1, 1918. "Last month was the busiest month in practice he has ever had."
Alymira Rich also notes on Nov. 13 that "Dr. is home sick with the influenza. Am real worried about him."
Although her husband recovered, others didn't fare as well.
"There are so many friends dying," Alymira wrote on Dec. 5. "We sure feel sad."
The Red Cross ran regular notices in the newspapers asking for volunteers to help care for the sick.
"Any woman or girl, even of above 10 years of age, who has had the 'flu,' can be of greatest help right now if they will. There were more calls for
help yesterday than we could fill," read a Nov. 6, 1918, article.
Folks were admonished to go to bed as soon as they knew they were sick, and to isolate themselves to avoid spreading the disease.
People at that time "knew only that germs carried the disease, but they didn't know what germs were or how you got them from someone else," says Charla Haley, public information officer for the Utah Department of Health in Salt Lake City.
The limited knowledge led to ideas like sealing up keyholes in houses or outlawing spitting on the sidewalks, she says. Although alcohol was banned in Utah, doctors, nurses and pharmacists could prescribe "spirits" such as brandy or whiskey.
The sick were advised to wrap up in blankets to stay warm but also to leave windows open to breathe fresh air. Mustard plasters were a common home remedy.
For some flu patients, the "hospital" ended up being the basement of a church.
"They needed more space than the hospitals had," says retired history professor Gordon Harrington, so his church, then known as Ogden's First Congregational Church, opened a temporary hospital in its basement at 25th Street and Adams Avenue.
"A lot of young ladies volunteered to take care of these people," says Harrington, of Ogden, author of a history about the church now known as the United Church of Christ Congregational.
Spare rooms were also opened at the Elks Club, and Dee Hospital added an annex.
American soldiers picked up influenza in U.S. Army camps in the Midwest and carried the disease to Europe -- then brought it back to the States again.
The Ogden Standard of Oct. 12, 1918, reported that five ill soldiers were taken off an eastbound train at Union Station and admitted to Dee Hospital.
In the same newspaper, the state's sanitary inspector, C. Elmer Barrett, told how another sick soldier home on furlough infected 15 Utahns with the flu in just four days -- including the family he visited, a barber who shaved him and several diners in a restaurant.
The family of Morgan County resident Forde Dickson lost loved ones to the flu, including Dickson's brother Jared, who died at Fort Logan Army Base in Colorado, according to writings provided by Linda H. Smith of the Morgan County Historical Society.
When Jared's body arrived home at the Morgan train station, Dickson recalled going aboard and finding the train full of caskets.
"I asked the soldier in charge, 'Do all these caskets contain dead soldiers?' His answer was, 'Yes, and there are seven other cars that are all full of Army boys who have died at the Fort Logan Army Base.' "
In January 1919, the 145th Field Artillery -- a Utah regiment that had served in France and lost 14 men to the flu -- returned home to a celebration that included the soldiers parading along Ogden's 25th Street, says Richard C. Roberts, co-author of "A History of Weber County."
Although there was a ban on public gatherings and people were instructed not to mingle with the soldiers, Roberts says the joy of the occasion overrode the rules as folks swarmed into the ranks to hug and kiss the men.
"The government was trying to protect the community," he says.
But: "People just didn't care. They wanted to see their loved ones."
PUNISHMENT DOLED OUT FOR BREAKING REGULATIONS
There was a war on in the fall of 1918, so the ladies of the Civic Improvement Club in Brigham City met regularly to roll bandages for the wounded.
All that changed, however, with the outbreak of influenza, which continued through the winter and caused most meetings and public gatherings to be suspended.
People rolled bandages in their homes and turned them in instead, says Sarah Yates, a Brigham City member of the club who researched the group's history.
Influenza regulations were published frequently by city and public officials in local newspapers. Failure to follow these rules could result in fines or other punishments.
Not wearing a gauze mask in a store, office or public place in Brigham City, for instance, earned violators a $5 fine, says Kathleen Bradford, author of a book about the city's mayors.
In Ogden, 16 people were arrested for gathering at a cafe for a banquet to honor the departure of a friend, according to a history of the epidemic published in a 1990 issue of the Utah Historical Quarterly.
Many schools closed in October and didn't reopen until January 1919, historian Leonard J. Arrington writes.
As the Christmas shopping season approached, city regulations stipulated, "No special sales shall be held and no such sales shall be advertised."
"Groups of three or more persons shall not be allowed to congregate on the streets, in the stores or in any public places of Ogden City," reads a notice in the Nov. 29, 1918, Ogden Standard.
BIRD FLU NEVER BECAME PANDEMIC ... YET
Before we started worrying about the H1N1 virus, or swine flu, we were wringing our hands over H5N1 -- the bird flu.
And what happened to that virus which prompted Utah leaders to plan a summit on preparing for a pandemic back in 2006?
Small numbers of people, such as poultry farmers, did catch the bird flu from being in close contact with birds, says Charla Haley, public information officer for the Utah Department of Health in Salt Lake City.
But those infected persons didn't pass the virus to other people, which is necessary for a pandemic to occur, Haley says.
"There's never been human-to-human transmission once someone got it from a bird," she says.
There are no cases of bird flu in humans in the United States, according to www.flu.gov, although there have been cases in Asia, Africa, Europe and elsewhere.
Haley says it's always possible bird flu could become more widespread; "Flu strains mutate something terrible," she says.
The 1918 flu was a type of avian flu; it was notable, in part, because it was most deadly to healthy young adults ages 15 to 34.