Alabama Epidemic History



YELLOW FEVER


Alabama was first visited by this dread scourge in 1704, when a vessel from Santo Domingo brought the disease to Fort Louis de la Mobile, then the chief town of French Louisiana, and barely two years following settlement. The trouble assumed epidemic proportions, and among those who succumbed was Henri de Tonti. Since that date there have been many visitations to this and other towns in the State. In 1873, the disease reached the town of Huntsville in the Tennessee Valley.

Yellow fever has never been known to originate in the United States, and all epidemics have been traceable to the West Indies where, up to a few years since, it existed throughout the year. The first recorded epidemic in the history of the world occurred in December, 1493, in Santo Domingo, at the town of Ysabella, which had been only that month founded by Columbus, during his second voyage to America.

Since the occupation of Cuba in 1899 by the United States, when the cause of the spread of the disease was ascertained, and Havana and other towns were cleaned up, there has been no recurrence of yellow fever in Alabama except in sporadic cases. The last reported cases were in 1905, when it manifested itself at Castleberry, at Montgomery and on board a vessel in Mobile Harbor. The subjects at Castleberry and Montgomery were refugees from Mobile.

Effective quarantine regulations have in a large measure been responsible for the arrest of the trouble in recent years, the United States Public Health Service having been very strict in its enforcement.

A survey shows the mortality rate at Mobile in all epidemics to be high. This is accounted for principally from the fact of laxity by municipal authorities in the enforcement of preventive measures and quarantines during the early days of the epidemics. The suppression of facts in reference to the prevalence of the disease has also contributed to its spread. Even as late as 1899 the State health authorities were severely criticised for reporting the disease immediately after it manifested itself, it being felt that injury in a financial way was done by circulating the information. Prevalence of the disease in other towns in the State is traceable to refugees from Mobile, New Orleans, or Pensacola in all cases. Prior to the discovery of the mosquito theory in 1899, no cleanup campaign had ever been waged, and practically no preventative efforts were used except disinfectants, the popular theory being that the coming of the first frost was the only means of arresting the trouble. Statistics show that the large per cent of deaths was among refugees who returned to the infected districts after the first frost, contracted the fever and died. Many cases among negroes have been reported, but the percentage of deaths among them has always been small.

Statistics.

Below will be found statistics of recurrence, cases, deaths, periods covered and other items of importance. For early years but few facts are available, although there can be hardly any doubt that the mortality of the early colonists in the eighteenth century is to be traced to the scourge of yellow fever.

1704. Severe epidemic among the then small colony at Mobile, introduced from Santo Domingo. Many deaths, but no available statistics.

1765, 1766. In each year severe epidemics at Mobile, introduced from Jamaica. The fatalities were largely among newcomers, or late arrivals.

1805. Few deaths at Mobile. Disease introduced from Havana.

1819. Severe epidemic at Mobile from August 19 to November 30, with 274 deaths. Many cases occurred after frost. Epidemic at Fort St. Stephens from July 4 to December 1; and at Fort Claiborne July 4 to December 1. Introduced from Havana.

1821. Sporadic cases; and seven deaths in Mobile during October. Other points not affected.

1822. Severe epidemic at Blakely. "Only four or five cases" reported at Mobile.

1824. Six deaths in Mobile, the last September 25, more than a month before frost.

1825. Severe epidemic at Mobile. The board of health concealed the true conditions, and although the disease made its appearance as early as July, no official report was given out until September 2, when only one case was announced. It was not until September 11 that official admission of epidemic conditions was made. Many deaths reported.

1826-27. Sporadic cases in Mobile in September.

1828. Mild epidemic in Mobile, but no statistics available.

1829. Epidemic in Mobile; 130 deaths. First case August 14.

1837. Four cases appeared September 20 at Mobile, but no more at that time. On October 2 a frost fell and those who had left the city returned. On October 10, cases broke out in every section of the city, and the disease was soon epidemic, running to the end of November, 350 deaths reported.

1838. Few sporadic cases at Mobile.

1839. Severe epidemic at Mobile among the new inhabitants. The first case occurred August 11, and the last case October 20. Deaths, 450.

1841. A few scattering cases among inhabitants of the interior, then visiting in Mobile.

1842. Slight epidemic in the southern section of Mobile; 160 cases, and 70 deaths.

1843. Severe epidemic at Mobile. First case reported August 24, and the last, November 5. The public was kept in ignorance, the disease became widespread. Cases 1,350, with 750 deaths. The infection was traced to New Orleans. 1844. Epidemic at Mobile. The first case reported August 14. Deaths, 40.

1845. Few cases at Mobile, though it did not manifest itself until November 9. Only 1 death.

1846. Four deaths at Mobile. The first case appeared September 11.

1847. Epidemic at Mobile. The first case, August 2. Deaths, 78.

1848. Mild epidemic at Mobile. The first case August 18. Deaths, 24.

1849. Mild epidemic, the first manifestation, July 3. Deaths, 21.

1851. Mild epidemic at Mobile. No records kept.

1852. Epidemic in Selma, now known to have been infected by steamboat from Mobile, although there is no reported occurrence of the disease for that year in the latter. First reported case and death, September 1, and the last death, November 13. Deaths, 53.

1853. Epidemics in Mobile, Montgomery, Demopolis, Cahawba, Fulton, Hollywood, Porterville, St. Stephens Road, Bladen Springs, Spring Hill, Dog River Factory and Citronelle. Mobile was infected from the bark Milliades, from New Orleans; and other points by refugees from Mobile, except Hollywood which was infected from New Orleans. Of the 25,000 population in Mobile, 8,000 left the city. First case and death July 11, the last case December 16. Total deaths, 1,191. A large number of cases among negroes, but only 50 died. In Montgomery the first case appeared in September, and last in November. Deaths, 35. The epidemic at Spring Hill was largely among refugees; 50 out of a group of 60 were attacked, the death rate being 5 whites, 2 mulattoes and 1 negro. No record was kept of the cases and deaths at Cahawba, Citronelle, Demopolis, Fulton and St. Stephen's Road. At Porterville, there were no cases among the inhabitants, but 5 cases with 2 deaths among refugees. At Hollywood the first case developed, August 15, and the last September 20, with 10 cases and 6 deaths. Infection from New Orleans. At Dog River out of a population of 300, there were 69 cases with 23 deaths; the first case, August 18. This epidemic was the most widespread which had occurred up to that time, not only in Alabama, but over the entire country.

1854. Epidemic at Montgomery, with a few sporadic cases at Mobile. Deaths in Montgomery, 45, the disease running from September to November.

1855. Epidemic at Montgomery, September to November. 30 deaths.

1858. Epidemic at Mobile. Deaths, 70; the first case, August 3. 1863,

1864. Few sporadic cases at Mobile during these years, brought in by blockade runners from Key West and from the West Indies. In 1863, 2 deaths reported with 6 in 1864.

1867. Epidemic in Mobile, with a few sporadic cases in Montgomery, and also at Fort Morgan. The disease appeared at all three places August 13. No statistics are available; but infection from New Orleans. 1870. Sporadic cases at Montgomery and Whiting, with a mild epidemic at Mobile. Cases at Montgomery, August 22 to November 19; at Mobile, August 27 to November 19; and among refugees at Whiting about the same period. Infection was from Havana.

1873. Severe epidemics occurred throughout the entire Gulf States. Mobile, Montgomery, Junction, Huntsville, Oakfield and Pollard were visited. At Mobile infection was traced to New Orleans; occurrence from August 21 to November 29. Total of 210 cases, with 35 deaths. Montgomery was infected from Pensacola, the first case reported, August 27. The whole population of the city, except about 1,800 fled. There were 500 cases, with 108 deaths. The last case appeared November 10. The first case at Oakfield reported September 22. Total of 7 cases, with 1 death. Sporadic cases at Pollard, but no statistics available. In a population of 35 at Junction, there were 22 cases, with 14 deaths. At Huntsville there were 3 cases, with 1 death. While Memphis and Shreveport had many more cases than New Orleans and Mobile in this epidemic, the mortality rate in the latter was much greater.

1874. Epidemic at Pollard. Infection brought from Pensacola. No statistics.

1875. Mild epidemic at Mobile; the first case reported September 1, the last October 20. Cases 16, with 8 deaths. Some cases occurred among refugees from Mobile to Whiting.

1876. Two cases, one a refugee from New Orleans, the other a refugee from Savannah, developed in the Battle House. The one from New Orleans died.

1878. Severe epidemics in the Tennessee valley, with infection in most cases from Memphis. There were cases at Athens, Courtland, Decatur, Florence, Huntsville, Leighton, Stevenson, Town Creek, Tuscumbia and Tuscaloosa. Spring Hill, Whistler and Mobile in the southern part of the State were visited. Athens had 2 cases, with 2 deaths; Court-land, one case with one death; Decatur 187 cases, 51 deaths; Florence 1,409 cases, 50 deaths; Huntsville 33 cases, 13 deaths, none of these being resident cases; Leighton, 4 cases, 1 death; Mobile 297 cases, 83 deaths; Spring Hill, 1 death among the refugees, no local cases; Stevenson 11 cases, and 6 deaths, first case on September 1; Town Creek, 4 deaths; Tuscaloosa 2 cases, 2 deaths; Tuscumbia 97 cases, 31 deaths; Whistler several cases among refugees, 1 death only, inhabitants not attacked. The epidemic of this year was general over the entire Mississippi Valley, as far north as Cairo, Ill. Many cases in the north Alabama towns were refugees from other points. In only a few cases were the natives affected. The infection in Mobile was from Biloxi, Miss., the first case showing early in August. Most of the cases were in the southern section of the town. The last death, October 30; a slight frost had fallen October 23.

1880. One case developed on board a vessel from Havana, then in Mobile Harbor. No cases in the city.

1883. Severe epidemic at Brewton; the first case, September 12, the last, November 6; 70 cases, 28 deaths. The presence of yellow fever was never admitted by the local physicians, but it was so pronounced by the U. S. Marine Health Service and the State health officer.

1888. Outbreak at Decatur, in which there were 10 cases and 1 death; the first case, September 4. Nearly the 'whole population of the town fled.

1893. Two cases, with one death at Fort Morgan.

1897. The outbreak of this year was widespread, cases occurring at Alco, Bay Minette, Flomaton, Greensboro, Mobile, Montgomery, Notasulga, Selma, Sandy Ridge and Wagar. Alco, 1 case, no death; Bay Minette, 1 case, 1 death; Flomaton, 98 cases, 5 deaths; Greensboro, 1 case, 1 death; Mobile, infected from Ocean Springs, Miss., 361 cases, 48 deaths; Montgomery, 120 cases, 11 deaths; the epidemic lasting from October 18 to November 10; Notasulga, 1 case, no deaths; Selma, 12 cases, 2 deaths, epidemic lasting from October 23 to October 31; Sandy Ridge, 1 case, no death; Wagar, 45 cases, 3 deaths.

1903. One case and death at Mobile.

1905. Cases at Castleberry, Mobile quarantine station, and Montgomery. Two cases and two deaths occurred at Castleberry. The case at Montgomery was a refugee.
Source: History of Alabama and Dictionary of Alabama Biography By Thomas McAdory Owen, Marie Bankhead Owen Published by The S. J. Clarke publishing company, 1921; Submitted by Barb Ziegenmeyer.

EPIDEMICS

Diseases assuming epidemic proportions in Alabama in the past are yellow fever, smallpox, malarial fever, typhoid fever, spinal meningitis and infantile paralysis. The two last named have been strictly local, but the number of localities over the State in which cases were noted in 1916, caused considerable apprehension on the part of health officials in reference to the possibility of their general spread. The state board of health, in conjunction with the local boards of health, has been prompt in stamping out epidemic diseases from their first appearance. Strict quarantines are put in force in all cases. Placards or signs are displayed on houses in which sick patients are confined. Smallpox patients are treated in hospitals, provided for that purpose by local authorities. The health authorities have conducted successful educational campaigns for the eradication of conditions favorable to epidemics.

Malaria.

Owing to peculiar climatic conditions malaria is generally prevalent in the State during the late spring and summer months, particularly when there is a wet season after May 1, followed by a pronounced drought. These conditions produce the mosquito which is the sole cause of the disease. Malaria epidemics are local, but they occur in all sections of the State, and have been reported in every month of the year. The majority of cases occur in July, August, September and October, with the smallest number in January and February. The months of greatest mortality are August, September and October. The mortality records for the past six years are: 1910, 467; 1911, 437; 1912, 546; 1913. 434; 1914, 488; 1915, 500.

Typhoid fever.

While epidemic, this disease is of local occurrence, and in nearly all cases has been brought in from other localities. New foci will always be established where exposed persons are allowed to go into uninfected places. During the summer and fall of 1881, there were 347 cases, with 49 deaths in Birmingham. Since that date the disease has occurred in the State at intervals, but has always been well under control of the health authorities. A notable epidemic occurred at Riverton in Colbert County in 1896, when more than 30 persons became infected. Tuscaloosa County has been infected on several occasions but it has always been traced to local conditions. The big spring at Huntsville, the source of the water supply of the city, became infected at one time, and several deaths resulted before the spread could be controlled. The source of infection in most epidemics has been traced to the water supply, though in a few cases to milk infection.

Smallpox.

This disease occurred locally, from time to time prior to 1860, but few records are available. Since 1865 the records have been more or less complete. During the Mobile epidemic of 1865-1866 there were between 500 and 600 cases with 100 deaths. In the epidemic of 1874-75 there were 990 cases with 262 deaths. Of this number 204 of the deaths were among the colored population. No further outbreaks occurred until 1882 when the disease was epidemic in Calhoun, Chilton and Limestone Counties, but there was only a small number of cases with five deaths. The disease was quite prevalent throughout the state in 1897 and 1898, and quarantines were established, locally, in many places.
Submitted by Barb Ziegenmeyer.

U. S. TYPHUS

Puzzling is the constant (endemic) presence of mild typhus fever in a certain few sections of the U. S. Hospitals in the Atlantic Coast cities from Boston south always have a few cases. They appear in the Piedmont section of the Carolinas. Alabama, Georgia and Florida have quite the largest number sick with typhus. But Mississippi or Louisiana have had none reported to health officers. Tampa, Pensacola, Mobile, Galveston and Houston (among Gulf cities) have had their mild affliction, and the lower Rio Grande Valley from Laredo to Mercedes. On the Pacific Coast only Los Angeles has reported a considerable number of cases; the interior of the U. S. has practically none.

Why the endemics are so sharply limited disconcerts epidemiologists. They have long believed typhus an acute disease, carried from one person to another directly or by mediancy of head or body lice. But when they studied the Montgomery, Ala., district, the worst typhus focus in the U. S., they found the whites and Negroes of that region as little lousy as the whites and Negroes of the more northerly Birmingham district. Indeed body lice are almost unknown in Alabama, although head lice are found occasionally in school children. Lice apparently are not responsible for Montgomery typhus. In places further south the health officers found cases popping up in isolated places, without traceable association with a previous case and without subsequent secondary or contact cases. So people have not been infecting other people.

Only a guess can be made as to the cause of this peculiar typhus endemic; and no one up to last week had made that guess. Some agency other than man and his lice would appear to be responsible for the long preservation of the typhus virus in those limited districts. That agency, be it insect alone or an insect which feeds on some host other than man, must be correspondingly limited in its distribution. Or at least its capacity for acting as a vector to man must be so limited.

The death rate of this mild endemic typhus is very low, one death in about every 500 cases. The death rate of epidemic typhus is very high, on the average 100 in every 500 cases. In filthy crowded districts, like Serbia during the first years of the War, the rate goes to 300 out of every 500 cases. Victims develop high fever (104 degrees & 105 degrees), chills, vomiting, headache, delirium, exhaustion, toxemia, death.
[Time Magazine, Monday, Jan. 28, 1929 - Submitted by K. Torp]

LEPROSY

In Newark, N. J., a public school teacher asked so simple a question that almost everyone knew the answer. But the woman, as she gazed down the row of small, lifted hands, forgot what she had asked, for she had caught sight of one small fist whose aspect caused her, inexplicably, to shudder. It was not dirtier than the others; it was not mis-hapen, and it was unmarked except for a few minutes bulging sores. Yet if gave her an indefinable and malign impression of deformity, of horror. She sent the boy attached to the hand—one Frank George, 11—to Dr. E. D. Newman, skin specialist. A short time afterward this medico asked to see the boy's brother, one Hale George, 13. The two boys did not return to school. There was some whispering and then, without ostentation, the books and desks which they had used were burned. Their parents had emigrated from Bermuda where, the specialist affirmed, the lads had doubtless contracted, six years previously, the thing that afflicted them. For in spite of all reticence, the grisly fact, once discovered, could not be concealed. The two George boys had leprosy.

Leprosy (the grey death), according to certain medieval conjecturers, issued in the form of a woman's body with a rat's head from the grave of the stillborn Antichrist; scientists have lately suggested that it is bred from putrid fish. Rising out of the East, it has crept down the centuries, a slow, fatal smoke, eating in secret. When Godfrey de Bouillon rode against the Paladin in the 11th Century, it withered the flesh of his captains under their painted armor, followed their retreating banners into Europe. Contagious, it is never hereditary.

Symptoms, in the beginning, are those which attend the incubation of various diseases—irregular fever dizziness, hyperaesthesia of the skin, pains in the arms and legs, loss of sexual power. Forebodings appals the sufferer; faceless shapes of doom brawl in his mind; ulcers corrupt his arms; his skin greys; his eyebrows, loosened, overhang his eyes like disheveled blinds; while his voice shrinks and becomes raucous, as if he contended for possession of it with an evil spirit. Little by little, as his body rots, an odor pervades it, more deathly and infinitely more revolting than that of the carnal house; the bones of his nose break off; toes, fingers, ears, drop away like dead hair. Insanity follows, terminated by death. In rare instances, the disease unaccountably vanishes, after eight years or so.

Occasional cures are affected—in Hawaii, with Chaulmoogra oil; in the U. S. with injections of bichloride of mercury, with arsenic; X-ray treatment affects temporary relief. Lepers are daily boiled in hot baths; given strychnine; put on a diet. After a period of eight years, the disease sometimes vanishes.

In the U. S., Louisiana, Texas, Mississippi, Alabama, Florida, Minnesota are endemically affected. More than one-third of the states of the U. S. have, from time to time, recorded cases. Massachusetts provides state institutional care for lepers. It is almost impossible for leprosy to spread in the climate of the Northern U. S. So slight is the danger of infection that the act of destroying the school effects of the young Newark lazars was rather a sop to Nemesis than a scientific necessity.

Colonies for lepers are many. In India alone there are 8,850 lepers and 92 asylums. Just inside the East gate of Canton live 1,400 grey men; more lodge at Hokchiang, at Purulia; there is a famed colony at Molokai, Hawaii; an even more elaborate one on the island of Culion, Philippines, established by the U. S. at great expense in 1906; where the lepers have their own stores, theatres and a special kind of currency.

[Source: Time Magazine, Monday, Jul. 06, 1925 - Submitted by K. Torp]

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