Colonial Disease

Last week I was talking to my 97 year old mother about our current crisis in dealing with the Corona Virus.
She pointed out, that her generation had dealt with terrible outbreaks of disease and yet they somehow managed to survive.
Think about it. They survived, polio, tuberculosis, scarlet fever and many other terrible disease in their day and did not have the medical expertise or facilities we now have available.
In my research I found a fascinating site. The Tully (NY) Area Historical Society News & Databases. So today I thought I would share what I found.
For many of us deadly diseases such as typhoid, smallpox, cholera, yellow fever, measles, and polio are all diseases of the distant past. They have been eradicated or vaccinations have been found.
However, our ancestors all lived with the threat of disease.
Disease was common in the large cities of Europe, from where most early colonizers came.
The Black Death, or Bubonic Plague, of Medieval Europe was still in recent memory for most immigrants. It was just accepted that disease and premature death was part of life.
Europeans brought many Old World diseases like smallpox, influenza, and measles to the New World. Many of these settlers had survived outbreaks in their homelands and developed immunities.
However, the native American Indians had no previous exposure and diseases decimated their populations. With their numbers weakened, Native Americas were unable to stop European immigrants from settling on their lands. With Native American and European troops marching over colonial America, diseases traveled swiftly from colony to colony, country to country.
It was disease, not the rifle that wiped out the American Indian population.

So let’s look at a few of the diseases that wreaked havoc not only on the native Americans, but all of our forefathers who traved to America.
The first disease that we will examine is smallpox. The disease was called smallpox because its victims often had pox marks on the face or body
In her book, Pox Americana, Elizabeth Fenn describes the 32-day timeline of the smallpox virus. She calls it a parasitic virus that consumes its host.
Introduced by either touch or inhalation, Smallpox usually incubates in its new victim for 10-12 days before the first symptoms present themselves.
At first, the victim may feel as if they have the flu with symptoms such as backache, headache, fever, and nausea. At this stage, the victim can contaminate others, yet not even know they are seriously infected.
On about the 15th day a rash and eruptions appear on the skin. They eventually burst, then scab over. Sometimes victims developed internal sores that would cause them to bleed to death from various body openings, such as the eyes and ears. The entire process is full of immense pain and suffering.
By day 30, if the victim is still alive, he or she is no longer contagious, though often scarred for life. The very young and the very old were the largest group of victims.
In one study that Fenn recorded, there was a 29% mortality rate for children under one year of age, 8% for children 5-14 years, and 32% for adults over 45 years.
The mortality rate was highest for pregnant women: 96%. Surprisingly enough, smallpox could survive for long periods outside the human body. A blanket used on a victim, unwashed and stored away for years, could still contain an active virus. You can see why smallpox was so feared in North American colonies.
Large cities usually quarantined ships with known carriers of disease. Eventually, quarantine laws were enacted. Sometimes a house was chosen outside of town in which infected individuals lived out their quarantine.
Whole communities were often quarantined. As Fenn points out, these tactics sometimes worked. For example, in 1721, 900 of the 10,700 citizens of Boston fled to the countryside to escape the smallpox. The problem with such isolation methods was that those who fled the city often carried the disease into the countryside with them, thus spreading, rather than containing, the disease.
Fenn gives a conservative estimate of 130,658 deaths from smallpox during the years 1775-82. And not only were many lives lost, but schools, businesses, and governments all virtually shut down during smallpox epidemics. Life came to a complete and deathly halt during these Colonial epidemics.
Eventually Dr. Edward Jenner developed a vaccine for smallpox in 1796. Today the World Health Organization considers the disease extinct.
Small pox is considered by many to be the most horrifying epidemic of colonial times because of the terrible suffering it inflicted, the high mortality rates, and disfigurement it left behind.
However, John Duffy claims, in his book Epidemics in Colonial America, that respiratory diseases weakened and eventually killed more colonists than small pox .
Also, the endemic diseases of malaria and dysentery were common in colonial times. These diseases did not always kill people; often they were weakened enough that a mild outbreak of influenza or measles would finish them off.
Children and older adults were often the first victims in any epidemic. Along with age, poor diet and hygiene also contributed to the high mortality rates in colonial North America.
Now on to the next major diseases.
A disease is considered what they call endemic if it is localized and recurs year after year.
Malaria and dysentery were endemic for the entire colonial period.
Malaria was also known as “ague”, “quartan ague”, “tertian ague”, and “the Kentish disorder” .
Passed to humans by mosquitoes, the parasites that cause malaria led to chills and fever, vomiting, and other flu-like symptoms. Eventually, victims either die because their red-blood cells are destroyed and anemia results or their capillaries, which lead to the brain or vital organs, are clogged . Either way, malaria was a horrible disease.
Specific colonies-New Jersey, Pennsylvania, New York, and Delaware-were more prone to malaria because of their climate and the resident mosquitoes.
The mosquito’s role in transmitting the disease was not discovered until the twentieth century. Colonials believed in the miasmic theory; that breathing air near stagnant water made one sick . The term malaria itself comes from the Italian words mala and aria, which mean “bad air” .
Malaria was so common that outbreaks often were not recorded. Indeed, Duffy says that for the colonists, “the spring and fall flare ups of malaria were as inevitable as the seasons themselves”.
In his opinion, malaria was “directly or indirectly one of the most fatal of colonial diseases”. Colonists who survived malaria often developed some immunity and resistance, but often they were physically weakened and more susceptible to other diseases or another malaria outbreak.
Newly arrived immigrants were often among the fatalities from the diseases. Indeed, Duffy claims that malaria was more widespread and affected more people than small pox or yellow fever and calls it a “major hurdle in the development of the American colonies”.

Charleston, which was often hard-hit with other diseases, was never really bothered by malaria. Duffy attributes this to the city’s close proximity to salt water, an inhospitable climate for mosquitoes .
New England, while troubled by malaria outbreaks during the early colonial days, had almost eradicated the disease by the American Revolution. However, outbreaks became more severe in the other colonies in the late 1700s.

Another terrible disease to afflict our forefathers was dysentery.
Like malaria, dysentery had devastating effects on colonists. Also known as “camp fever” and “camp disorder” the disease was spread by either a bacteria, parasitic worms, or through feces-contaminated water and food, flies, or handling of food in unsanitary conditions.
A soldiers’ camp or immigrant ship would be just such a place for dysentery to start.
Those with the disease usually died from dehydration because of severe diarrhea. Children were especially susceptible to the disease.
While today we have a better understanding of the importance of cleanliness and greater availability of antibiotics, in colonial times people just had to endure and let the disease run its course.
Some people suffered for long periods before dying while others suffered for short amounts of time; there was no timeline of infection and recovery with dysentery like with small pox.
Unfortunately, like malaria, dysentery often left its survivors sufficiently weakened to be susceptible to other diseases.
Yellow Fever
John Duffy calls it a “strange and unaccountable pestilence that brought death in a horrible fashion to its victims”. Known also as “Bilious Plague” and “Black Vomit” it was transmitted by mosquitoes and often arrived from the West Indies.
The mosquitoes are thought to have survived in buckets or containers of stagnant water on board ship; and once the mosquitoes hit port cities with temperate climates-like Charleston-the yellow fever quickly spread.
The virus transmitted by the mosquitoes had a quick on set and left its victims tired, feverish, jaundiced, and they often would hemorrhage.
Duffy says it “was one of the most dreaded diseases in the affected regions [and had it] adapted itself to all areas in the British American colonies, yellow fever would undoubtedly have ranked with small pox as a leading cause of death”.
Between the years of 1760 and 1793, Duffy states that yellow fever disappeared from the colonies. He credits this to stronger and better-enforced quarantine laws.
Diphtheria and Scarlet Fever
In a time when almost half the children under age five died, diphtheria and scarlet fever were major causes of childhood death. The symptoms of both diseases were so similar that they were not differentiated between until the late 1800s.
Sore throats, major symptoms for both diphtheria and scarlet fever, were common and often unattributable to a specific disease. Duffy believes diphtheria was present in the early colonial days but “it did not attract the attention of the medical profession until the occurrence of a huge outbreak in New England during 1735-36”.
Caused by bacteria, a membrane would form in the throat, which would swell and often led to suffocation.
The bacterium was contagious and “transmitted from person to person by droplet infection produced from respiratory secretions”. Until a vaccination was developed in the 1920’s, the only solution was a tracheotomy that would bypass the membrane and allow the victim to breathe freely.
Families often lost half and sometimes all of their children to the disease.
In the epidemic of 1735-36, there were over 1,000 deaths. And 90% of the deaths in New Hampshire were of children under the age of 10.
By 1740, over 1,000 people had died in Connecticut alone. Such statistics led Noah Webster to call diphtheria “‘the plague among children'”.
Scarlet Fever
Like diphtheria, many of this disease’s victims were small children. Spread by close contact, streptococcus leads to a high fever, vomiting, sore throat, enlarged tonsils, and a red or “scarlet” rash .
In severe cases, the throat enlarges and the victim suffocates similarly to diphtheria. Even though Duffy believes scarlet fever was first identified in 1675, it was often confused with small pox, measles, and diphtheria .
It was called a “frontier disease” because it did not start in large urban centers like other diseases.
Typhus
While there are a variety of typhus fevers, the most common and fatal in colonial times was Rickettsia prowazeki .
Also known as “jail fever”, “prison fever”, “military fever”, “hospital fever”, “camp fever”, “putrid fever”, “ship fever”, and “spotted fever” it was transmitted through the feces of body lice.
Duffy tells us typhus was more common in the filthy, poor, and overcrowded urban European communities than in the American colonies “where land was cheap and the economy predominantly agricultural”.
Therefore, the disease was never endemic and only reached epidemic proportions either when large immigrant groups arrived in port from Europe or during wartime. There were outbreaks of the disease during battles of the American Revolutionary War. Besides these few outbreaks, typhus was rarely present in colonial America.
When typhus first presents itself, the symptoms are similar to influenza and include headache, fever, chills, and weakening of the limbs. Eventually a rash develops and covers the body.
Victims often become “deranged with fever…and death becomes a welcome release”. The best prevention for typhus is adequate sanitation. Pesticides are also used to kill the lice and prevent the spread of the disease.
Now the one we are probably most familiar with is Typhoid Fever.
Caused by poor sanitation, infected water, overcrowding, and war, typhoid fever was transmitted by the bacteria salmonella typhi in feces, vomit, and urine.
Experts were not sure when typhoid fever first appeared in the colonies, but the “burning fevers” of the Jamestown settlers in 1607 may have been typhoid fever .
Typhoid was “one of the first epidemics to occur in the United States [and] took place in Virginia between 1607-1624. Approximately 85% of the arrivals in James River died from disease which began as a typhoid epidemic”.
Typhus was also known as “slow fever”, “nervous fever”, “continued fever”, “burning fever”, “long fever”, and “bilious fever”.
Some of the early symptoms of typhus were fever, overall pain, loss of appetite, headache, muscle pain, cough, and restlessness. Later delirium and severe constipation and dehydration occur, which lead to cardiac arrest and death. The disease runs its course in one to three weeks.
While the epidemics of typhus in Colonial times were not as frequent as small pox and yellow fever, Duffy tells us typhus has a “high rank among destructive sicknesses…[due to] the increasing extent of the sickness and the number of deaths” from 1730-1770 .
With increased sanitation, the epidemics began to subside. Today, along with proper sanitation, the typhoid vaccine, first developed in 1896, has eradicated the disease from most developed nations.
So there you have it folks. Is the corona virus terrible? You bet. Is it the worst disease America has ever had to deal with? Maybe not.