Raleigh, N.C.
October 5, 1918

To County Commissioners, Mayors, Councils of Defense, Superintendents of Public and City Schools, and County Health Officers:

The rapid spread of Spanish Influenza and the serious and contagious nature of the disease require now a rapid county and town organization to fight it. Every agency in the State and counties must work together. In some counties very large numbers are stricken. You should anticipate an attack of at least 30 per cent of your people. You may be able to lower this by proper methods.

We urge you to take the following steps at once:

First, let the men to whom this letter is addressed arrange for a prompt meeting with the County Commissioners. If there is influenza in your county, lose no time. If there is not, it will be well to meet anyhow to perfect plans against its approach.

Second, list all the trained nurses in your county and ask them to be ready for public service on call.

Third, list all women who have had Red Cross training in nursing and ask them to volunteer for service, and keep a record of those who volunteer and be prepared to assign them where they are most needed.

Fourth, list all the competent women and men who will volunteer and be prepared to assign them. Appeal strongly for volunteers.

Fifth, select a competent man or woman to organize health committees in each schoole district and to manage for that district.

Sixth, select a competent man or woman to supervise the work in the county in conjunction with county health officers. Let this supervisor keep all list of volunteers and be ready to meet emergencies. Let this person also furnish lists to the local school districts, and take the active management under your supervision.

Seventh, in case you, at any time, need extra doctors or nurses, notify both the Supervisor and the Chairman of the County Board of Commissioners, and let the Chairman wire the State Board of Health. If there is need in a city, let the Mayor wire the case. It is necessary that these calls for help be systematized and come from some responsible officer.

Eight, if an outside doctor is to be sent, provide a machine or other vehicle for him by the time he arrives. A local guide should also be furnished, as this would save much time.

Ninth, a representative of the State or National Board of Health will meet you whenever it is necessary.

We ask most prompt and thorough organization. Human life is at stake.

Very truly yours,

T. W. Bickett, Governor,
J. Y. Joyner, Supt. of Public Instruction,
J. J. Kinyoun, United States Army,
D. H. Hill, Chairman State Council of Defense,
W. S. Rankin, Secretary State Board of Health.