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The first mention of influenza was reported in a weekly public health report. The report had 18 severe cases and death tally of three in Haskell, Kansas.
Armstrong played in brass bands and riverboats in New Orleans, first on an excursion boat in September 1918.
After the end of WW1, soldiers began to demobilize, this enabled a resurgence of influenza as people celebrate Armistice Day.