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Tag: New York Medical Journal

We have no fear of the coffee

If you’ve taken a microbiology class you probably learned how the bacterial pathogen known as “plague” still exists in the United States. It’s still virulent, but has degraded so far from its status as a civilization-toppling “black death” that it’s mostly associated with the undignified creatures known as prairie dogs.

Here’s something I didn’t know. Before the San Francisco Plague of 1900-04, plague was believed to be unknown in the Western Hemisphere. This was reviewed clearly and concisely by Elizabeth T. Anderson in an article called “Plague in the Continental United States, 1900-76”. (available here for free download (1))

From Anderson (1978), Plague in the Continental United States, 1900-76

From Anderson (1978), Plague in the Continental United States, 1900-76

The “Third Plague Pandemic” was largely an Asian phenomenon, killing millions in the Far East. In the 1890s the disease was ravaging Hong Kong, it reached India in 1896, and there was great concern in North and South America that it would arrive aboard a steamship. Anderson quotes the Surgeon General as saying at the time:

The appearance of the plague in Santos, Brazil, in October 1899 marks an important epoch in plague literature as furnishing the very first recorded instances of the occurrence of the disease in the Western Hemisphere.

In 1899 the inevitable happened. Ships with infected passengers arrived in Honolulu, New York City, and also Port Townsend, Washington. The latter two threats were eliminated via quarantine, but bubonic plague victims started to be seen in the Chinatown region of Honolulu. Authorities tried to control the illness by burning the houses of victims, which led to out-of-control fires that destroyed most of Chinatown.

So it was through San Francisco that the disease came to the mainland. The San Francisco plague was comprehensively mishandled in an effort to downplay the risks, including claims that it had been “eradicated” in 1904 which ignored the possibility that it had not been eradicated in rodents.

But it surely would have become endemic here at some point. Ever since then, there have been incidents of plague in North America, mostly in rural, dry areas. Like so many unfortunate things, it is now most common in Africa. See this review by Thomas Butler (2) for the present state of affairs.

The “plague-ship” that menaced New York was the J. W. Taylor, bringing a cargo of coffee from the previously-menaced Brazilian port of Santos. Here’s a Public Health Reports report (3) on how the threat was dealt with, written at the height of the crisis.

Immediately after the arrival of the ship in quarantine, and after the removal of the patients, the living apartments, cabin, and forecastle of the ship were most thoroughly disinfected by sulphur and corrosive sublimate solution, and all bedding, clothing, and textile fabrics, without exception, were subjected to the action of steam at a temperature of 230°F. for fifteen minutes, a perfectly safe and efficient process of disinfection.

The sacks have been so stowed upon the lighters as to admit abundant circulation of air and exposure to wind and sunlight during the day, and in addition have, during every night, been subjected to a temperature very near the freezing point, as there has been a heavy frost every night since the unloading was commenced. In addition to this thorough aëration, disinfection, and low temperature, it is the determination of Dr. Doty to keep these lighters in quarantine for a period of at least eight days before discharging them.

…The stevedores engaged in the unloading are kept in quarantine and are every night sent to Hoffman Island and brought back to their work in the morning. A careful watch has also been kept for rats, especially those dead; but 1 dead rat has been found and bacteriological examination so far would seem to indicate that he was a victim to the sulphur fumigation and not to plague. I should mention here that the hawsers securing the lighters to the ship are also guarded by large funnels of galvanized iron to prevent the passage of rats from the ship to the lighters.

From these passages, it becomes clear that the authorities had no desire to destroy the ship’s cargo. In fact, it was an insult to the brave people of New York to suggest that they were petrified of these sacks of coffee. Here’s an editorial from the New York Medical Journal, that concludes with an inspirational call to arms.

Let the cargo come to town!

plague-ship-1899

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1. Anderson ET (1978), Plague in the continental United States, 1900-76. Public Health Reports 93(3):297-301.

2. Butler T (2009), Plague into the 21st century. Clinical Infectious Diseases 49(5):736-742.

3. Geddings HD (1899). Plague on the steamship J. W. Taylor at New York quarantine. Public Health Reports XIV(49):2165-2167.

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Mosquitoes? Malaria? I don’t buy it.

Question: Is malaria spread by the Anopheles mosquito?

Nowadays, we would say the answer is yes.

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In July 1899, the answer was also yes. But it had been only a year or two since publication of the Nobel-winning work by Sir Ronald Ross which proved malaria was one of the diseases spread by mosquitoes.

Even for the best-supported hypothesis, there will be some evidence that points against it, and some people who are more easily convinced than others. Here’s a letter written by southern doctor Thomas W. Davis to the New York Medical Journal, pointing out that there is far from a perfect correlation between areas where man is made miserable by mosquitoes, and areas where man is made malarious by malaria. And therefore, in his opinion, the jury is still out regarding what sort of mechanism spreads this particular parasite from person to person.

Most of the NYMJ‘s readers and contributors could be expected to be northerners with little practical experience of the tropical disease in question, so Dr. Davis’s perspective is worth considering.

malaria-mosquito-evidence

Source: New York Medical Journal (August 19, 1899), volume LXX, page 277.