During the influenza pandemic, the Surgeon General of the Public Health Service was Rupert Blue. A southerner, Blue was born in 1868 and grew up in South Carolina.
In 1892, he received his medical degree from the University of Maryland and entered the Public Health Service. Blue's early years in the service were spent performing medical inspections of immigrants to ensure that epidemic diseases were not imported into the United States. When bubonic plague struck San Francisco in 1902 and then again in 1907, Blue oversaw rat eradication and urban sanitation programs there. A skilled diplomat, Blue worked with state and local officials to sponsor public education programs. These campaigns proved to be highly successful and they ultimately allowed federal authorities to avoid imposing a quarantine on the city and state.
In 1912, President William Howard Taft nominated Blue to serve as Surgeon General, a position Blue held until 1919. Under Blue's leadership, researchers at the PHS discovered the root causes of diseases ranging from tularemia, pellagra and trachoma. The PHS also reduced the prevalence of typhoid, hookworm, malaria and trachoma within the United States. Blue also oversaw the creation and implementation of the Service's earliest sex education programs.
Retaining and recruiting physicians for the Public Health Service was especially difficult during World War I. In 1917, President Woodrow Wilson issued an order making the Public Health Service an arm of the military. This enabled the Service to increase officer's pay and benefits so that they were on a par with those of the military. Staffing shortages remained a problem, however. In the midst of the pandemic, Congress passed an act creating a Reserve Corps for the Public Health Service. Theoretically, this Reserve Corps could be called upon during a national emergency---but as Blue discovered, the Act which was passed in October of 1918 came too late to provide much assistance.
Events during Blue's tenure as Surgeon General made him an advocate for national health insurance, or universal sickness insurance as it was known in 1918. During the latter part of his tenure, Blue repeatedly spoke on this subject not only in his role as Surgeon General but also in his position as president of the American Medical Association (AMA).
On March 9, 1920, Blue stepped down from his position as Surgeon General. During the next twelve years, he remained within the Public Health Service, representing the PHS at a series of international conventions as well as the League of Nations.
Blue died on April 12, 1948 in Charleston, South Carolina.