Timeline: Pre-hunger games
Illness spread quickly through district nine. People dropped like flies as a result of a breed of influenza. Alphonse, Winry, and Trisha contracted the disease, but luckily ended up as survivors. Pinako's office had overcrowded to the point of which the Rockbell's house had to also be used to house patients. Eventually Trisha also helped out Pinako, allowing cots to be placed in the parlor and in Hoenhiem's old study. The only people who treated patients who didn't come down with the disease were Pinako and Edward, but that could've only been because of luck.
Many contracted the disease and even worse, the chances of survival were low. For every two people that contracted the disease, one would perish due to it. The virus spread like wildfire, and Pinako was the only doctor on the eastern end of the district. She simply couldn't keep up with demand. The children watched community members they'd grown up with their entire life die, especially patronizing being the death of their friend Pitt and the death of a sweet little girl from the community named Nina.
Everyone was devastated over the deaths, and as the fifty-seventh hunger games lay only months away, children of eligible age grow weary. Due to all the deaths, this year there would be a much higher chance of actually being chosen for those still alive. The population of the district had been reduced by nearly a third.
As Winry goes to place flowers on the graves of the loved ones and friends of the family, she can't help having a sinking feeling in her gut that she may soon be joining them. Winry had to sign up for extra tesserae this year. Her grandmother wouldn't like it, but they had lost too much money treating patients of the influenza. They'd need the supplies if they planned on making it through the year.
The thought of more deaths to come only put everyone in a more depressed mood than before, hopes were low after the epidemic district nine had faced and two more unfortunate families would most probably be losing a loved one. Winry herself feared her chances. Her seven ballots might just get her in this year.