Newfoundlandia: We Were Years Ahead of the World in Tackling The Cholera Epidemic

While the great cities of Europe and North America still focused on noxious vapours as the primary mechanism of transmission, we here in St. John's were focused on drinking water. At least 6 years ahead of the rest of the world

The nineteenth century was a time of progress and pain, global trade and global disease. The Newfoundland experience was remarkable and singular in the Western world and deserves to be shared.

In the Bengal region of India, near the East India Companies trading port of Calcutta, now  Kolkata, the first cholera pandemic began. It spread easily enough along trade routes, but it wasn’t until it arrived in Russia in 1817 that word reached us. Something new made a slow crawl out of Russia across Europe and Asia, arriving in Great Britain in 1831. Once it hit Britain, it was everywhere.

Fear of cholera was, for the people of St. John’s, unlike anything that had come before. News from the outside world trickled into every ear, the blue death, king cholera, a painful humiliating thing. Someone could awake healthy and before midday, be completely overcome and dead not two days later. No one knew what it was or how it spread, but they could see it coming.

Early in 1832 it had made the jump across the Atlantic to North America. It was now just outside the door.

On July 2nd, an emergency meeting was called. Action was immediate, a Board of Health, which only became active when need arose, was appointed. A 40 member committee was formed from the business community to inspect and clean the town. A war chest was raised, homes were limed, the 6 natural brooks the town used as surface drains were cleaned: The Darkuses, Parson’s, Cuddihy’s, YellowBelly, Bell’s Chute, and Keen’s were made ready. Scavengers were hired to collect night-soil from homes, and residents were forbidden from throwing any garbage or filth into the streets.

Quarantine was imposed. All incoming vessels were forced to anchor in the narrows, the entrance to St. John’s harbour, at an inspection station. Crews were systematically inspected and medically examined. The vessels themselves were made to pay for the new medical services via a tonnage fee and remain in quarantine for at least 6 days. If a vessel refused to pay or wait they were free to leave, but not to enter.

 

Dr. William Carson

The whole operation was orchestrated and overseen by the District Surgeon, Dr. William Warner. Why 6 days was chosen remains a mystery. No one knew anything about this new disease, yet 6 days was the perfect amount of time, as the illness could remain in a host for up to 5 days without any symptoms. A stroke of luck and the power of a single decision.

Elsewhere, the world burned. Outbreaks in Quebec City, Montreal, Halifax, New York, Boston, Upper and Lower Canada, and all American states failed to stop the spread.

Under increasing economic pressure, and with our busiest shipping months approaching, the quarantine was relaxed in September to only 48 hours. Fortunately that would not be a fatal mistake and our quarantine held. St. John’s would succeed where New York and the rest of the world failed, and would remain completely untouched by cholera throughout the 1830s, an incredible achievement. But could it last?

The 1850s saw another wave of cholera pulse throughout the world in what is generally termed the third cholera pandemic. This one followed a similar progression, and was even deadlier in Asia and Europe.

While the great cities of Europe and North America still focused on miasmas, noxious vapours, as the primary mechanism of transmission, we here in St. John’s were focused on drinking water. In 1849, legislation was passed to close all cemeteries within city limits fearing that diseased remains seeping into drinking water could be the cause of outbreak. Wrong to focus on cemeteries, but absolutely correct about drinking water. At least 6 years ahead of the rest of the world, consistently ahead in both procedure and conception. Toward the end of 1854,the London physician Dr. John Snow was able to conclusively prove that cholera was being transmitted via contaminated drinking water.

Earlier in 1854, our newspapers followed the spread of cholera to North America. The Board of Health, which had been disbanded after the previous pandemics, was re-formed on May 23rd, and the new District Surgeon for St. John’s, Dr. Samuel Carson, oversaw operations. A quarantine was imposed on all ships beginning in July, but this was a much different town than it was in the 1830s, and the new  quarantine wasn’t as robust. The 1846 fire had left its mark, resources were strained, money was tight, and resolve was about to fail. Outbreak was reported in August.

All those showing symptoms were quickly isolated and the town held its breath. 3 people died, but in another success, containment heldm and the general population were spared. A week passed and the town relaxed, 2 weeks passed with no further illness and people began to chafe against the restrictions and quarantine. 3 weeks, economic pressures swell to bursting with our busiest shipping months upon us, and residents began to openly question whether the doctors were keeping the quarantine and Board of Health going simply to line their own pockets. Quarantine was dialled back further, and the pace of shipping increased.

Stories swirled around town of approaching ships dumping bodies overboard so as to avoid any delays, whether those bodies still breathed or not. Weeks 5 and 6 pass without illness, everything was fine, until it wasn’t.

When the walls fell, the epidemic broke like a brush fire. Fear and chaos raced through the streets. The military refused to allow any civilians access to its medical facilities. As a consequence, the only civilian hospital, the Riverhead Hospital (located where Victoria park is today)  admitted 212 during the months of October, November, and December (despite the fact Riverhead Hospital only had the  facilities to handle 20 patients on a good day).

88 of those patients would die. Many others who fell ill refused to go to hospital upon hearing of how many were dying there, and locked themselves in their homes. Containment was regained toward the end of December with the help of some cold weather. In all, some 500 lives were lost out of a population of 21,000. In comparison, Quebec City lost over 3,100 lives out of a population of 20,000. St. John’s also succeeded in containing the illness within its border, the rest of the island was spared.

With the completion of a sewerage system, and the establishment of Windsor Lake as the city’s primary water source in the following years, the residents of St. John’s would never be touched by cholera again. The St. John’s experience, although tragic, exemplified one of the most successful efforts on Earth at protecting its residents, and must in hindsight be viewed as a triumph.

Cholera would not be fully understood until 1885 when Spanish physician Jaume Ferran I Clua developed a cholera inoculation, the first to immunize humans against a bacterial disease. According to the W.H.O., cholera still causes between 28,800 and 130,000 deaths every year.

(Source: MUN Archives)

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