A polio vaccine vial is shown from the Jefferson County Historical Society artifact collection. (Jefferson County Historical Society)

A polio vaccine vial is shown from the Jefferson County Historical Society artifact collection. (Jefferson County Historical Society)

BACK WHEN: Contagious diseases affect Jefferson County

THE JEFFERSON COUNTY Historical Society Research Center recently added a donation of scrapbooks containing clippings on the variety of community health and safety issues that fell under the purview of the local Health Department during the years between 1930 and 1970.

Some of the clippings provide an overview of the communicable diseases that were major concerns early in that era, but began to be brought under control, and sometimes even eradicated, during those four decades due to the development and use of modern antibiotics and vaccines.

Measles, rubella, mumps, whooping cough, chickenpox, scarlet fever, polio, tuberculosis, diphtheria and smallpox were often mentioned in reports from the 1930s and 1940s.

Statewide statistics for numbers of contagious disease cases reported in 1949 were: scarlet fever, 1,612; chickenpox, 9,250; measles (rubeola), 12,600; rubella (“German measles”), 2,729; mumps, 4,441; diphtheria, 46; poliomyelitis, 585; typhoid fever, 5. Other mentions were made of whooping cough, rheumatic fever, tuberculosis and polio during those years.

The bacterial diseases that then caused severe illnesses such as strep throat, scarlet fever, rheumatic fever and nephritis caused by streptococcus bacteria have become curable through the use of modern antibiotics.

Although vaccination against smallpox had been used since the late 1700s, and began to be mandated by individual states in the U.S. as early as 1809, a 1936 article urging Jefferson County parents to bring their children to a vaccination program mentions that “… many people of Washington do not know that this state has the largest number of smallpox cases per year of any state in the union.”

One case was reported in the year end county health statistics for 1938.

In the mid 1930s, the state of Washington averaged about 1,500 cases of smallpox per year.

By 1945, increased vaccination had brought the number down to “… less than a dozen.”

The 1949 statewide report noted that there had been no cases of smallpox in the state since an outbreak in 1946 when there were 68 cases reported in Seattle causing 29 deaths.

That outbreak started with a soldier returning from occupation service in Japan on a troopship and spread from Harborview Hospital into the community.

It even reached as far as Port Angeles, when a man from there picked up his son, who had been a tuberculosis patient at Harborview and was exposed in the admitting room to an incoming smallpox patient.

He died after exposing five other people on the Olympic Peninsula, including his son. The son also died.

Upside of epidemic

The upside of this final epidemic in our state was that a massive inoculation campaign was carried out in Washington resulting in a half million people being inoculated who had not previously been vaccinated in public school campaigns.

By 1972, smallpox was virtually eradicated in the U.S. and routine smallpox vaccination ceased.

The U.S. military continued to vaccinate service men until 1990 when smallpox was believed to be eradicated worldwide.

Inoculations against diphtheria by the local health department began in the 1930s, soon bringing this serious killer of young children to a halt.

Before the diphtheria antitoxin became available, it was not unusual for this disease to sweep through a family, sometimes killing all of the children and perhaps also the young mother caring for them.

It was an especially deadly disease among infants.

Within two to three days from onset, severe cases of diphtheria could destroy healthy tissues in the respiratory system.

Dead tissue could form a thick, gray coating, called a “pseudomembrane” that would build up in the throat or nose.

It would cover tissues in the nose, tonsils, larynx and throat, making it very hard to breathe and swallow.

In spite of active inoculation programs, there were still 23 cases in Washington in 1955 (one of those in Jefferson County) and 12 in 1956.

Whooping cough vaccine was developed by 1939 and, for inoculations, was combined with vaccines for diphtheria and tetanus.

Public Health Department clinics were held in the county before the beginning of each school year, and at other intervals, offering smallpox and DPT vaccinations at little or no charge.

Through the 1940s in Jefferson County, there was still an active program of quarantining patients with contagious diseases, and anyone who had contact with them, in their homes for 10 days after all symptoms of the disease were gone.

In 1949, new regulations took effect, noting that many people were the most contagious before their symptoms were diagnosed.

New quarantine rules for rubella, chicken pox, mumps and other minor illnesses stated that the patient should still be isolated, but the families would no longer be quarantined.

They indicated that child contacts exposed to the more serious diseases such as measles and whooping cough should still be quarantined if they displayed symptoms of a cold, which might indicate they had these diseases.

An article in April of 1950 asked people in Port Townsend to keep victims of an outbreak of whooping cough home for at least three weeks after the first appearance of the characteristic “whoop.”

By the late 1940s, contagious disease emphasis for the county had moved to major efforts to eliminate tuberculosis and polio.

Initially the main way to deal with these two diseases was prevention.

In 1946, tuberculosis had the top death rate among contagious diseases in the United States.

In Washington, 667 people died from TB in 1945. Six of those deaths were in Jefferson County.

Schoolchildren were given skin tests to check for possible exposure to tuberculosis. Positive skin tests were followed up with chest X-rays.

Mobile chest X-ray units were parked in the various communities to check adults for TB.

Free X-rays

The local Tuberculosis League raised money in the community to make these free X-rays possible.

A June 1955 article stated that 4,575 Jefferson County residents had been X-rayed during a visit of three mobile X-rays in the preceding two weeks.

In November 1957, 72 people in the county were reported to have had or be suspected of having TB.

The most common treatment of victims of tuberculosis was to send them to sanitarium hospitals throughout the state where they were to rest, eat healthful foods and breathe fresh air.

Eventually a combination of antibiotic drugs was formulated to provide a cure for those who contract tuberculosis.

Before the 1960s, poliomyelitis was a serious concern. Epidemics among children and young adults were reported throughout years covered by the scrapbooks.

Gael Stuart, who was a member of the Olympic Health District Board as part of his job as superintendent of schools, spoke about the problem in his oral history.

“Any good health district believes in prevention. So my interest in health was in prevention of … polio. We had a number of polio cases on the Peninsula.”

A clipping from June 3, 1948, is a polio warning for summer months.

It explained that polio was considered an epidemic because there were about 20 cases per 100,000 in the population of the U.S.

About half of the cases resulted in some degree of crippling.

Instructions for what to do if cases appear in the community included: avoid crowds, keep children from getting overtired, avoid chilling and staying too long in cold water, and don’t swim in polluted water.

Symptoms listed were fever, a cold, upset stomach, muscle soreness or stiffness.

In 1946, there were five cases in the county reported March 7, 1946: four children in Port Ludlow and a Navy wife in Port Townsend.

A sixth case, a sixth-grader at Port Townsend School, was reported March 28.

This might be the outbreak related by Dr. Harry Plut, in his oral history: “While I was practicing here I was exposed to a polio epidemic; we had six cases of polio at one time and one death.

“I was very much concerned about it because my daughter had a light case.

“She had all the symptoms but no paralysis, for which we were very pleased.”

All polio cases in Jefferson County were transported to the children’s orthopedic hospital in Seattle for treatment during their illness and follow-up “water therapy.”

$50K for an iron lung

Gael Stuart estimated that the cost for keeping a person in an iron lung there was about $50,000 a year.

The 1949 Washington state health summary reported it had been a “severe year for poliomyelitis.” There were 585 cases, compared to 385 in 1948 and 519 in 1946.

A clipping from October 1953 reported that at a regional meeting about polio for the five northwestern states, it was reported that, “After years of research we now have gamma globulin, a temporary deterrent to paralytic polio … it is only a holding action.

“Our highest hopes lie in an experimental vaccine which March of Dimes researchers have developed …”

At the regional meeting it was also reported that new polio cases in the U.S. decreased from an all-time high in 1952 of 38,982 to 26,468 as of Sept. 26, 1953.

“By the end of 1953, 66,000 polio patients of this and former years will be receiving financial aid from [March of Dimes] chapters.”

The beginning of the end of polio was heralded by a clipping from March 17, 1955, headlined “Polio Vaccination Planned Here for 430 First and Second Graders.”

It announced that the Salk vaccine would be shipped (if licensed) without charge by the National Foundation for Infantile Paralysis.

Distribution was to be limited to children ages 1 through 13 and pregnant women.

There were several delays in the government licensing process and the vaccine was finally licensed in mid-April.

Inoculation clinic

The first polio inoculation clinic in Jefferson County was held May 24 in a kindergarten room in the primary school in Port Townsend.

Four Port Townsend doctors, aided by 10 nurses, and nine women from the community, who registered patients and acted as general assistants, administered 290 doses of Salk vaccine.

Later in the year, clinics were held to administer the second and third recommended doses.

Students from all county schools were transported to Port Townsend by buses.

The first to be inoculated was Frank Cassalery from the primary school at Discover Bay.

In September 1955, the Health District reported three cases of polio since July 15, and indicated that they had only one case in 1954 and three in 1953.

In October, they reported that a 12-year-old Port Townsend girl and her 2½-year-old brother were sent to Seattle with suspected cased of polio.

Age restrictions lifted

In July 1956, age restrictions for receiving the Salk vaccine were lifted and everyone was eligible for inoculation.

In August 1956, the state health department reported that 12 of the state’s 66 polio cased in the year, that far, had Salk vaccine last year, but only one had had all three doses. Fifty-four had had no shots.

In February 1957, the statewide health summary showed a decrease to 188 cases of polio.

Sixteen counties were polio free in 1956.

By August 1957, there had been only three polio cases, two adults and one infant, confirmed in the state that year.

Eliminated in U.S.

By 1994, polio was considered to be eliminated in the United States, and by 2000 there was a 99 percent reduction in polio worldwide.

It is still of concern in certain underdeveloped areas of the world.

The virus-caused “childhood diseases” of measles, mumps, rubella and chickenpox were still epidemic in the 1960s.

Inoculations for them were developed by the late 1970s and a world-wide eradication program for measles and rubella is still underway.

By 1981, measles cases in the U.S. had dropped dramatically.

Measles is said to be the most contagious disease ever known, and it is still a major cause of death of children.

In 2014, more than 115,000 children died.

Measles outbreaks

Recent outbreaks in the U.S. have been initiated by contact of unvaccinated travelers with epidemics in other parts of the world.

Rubella, if contracted during the first three months of pregnancy, often results in multiple birth defects including heart problems, deafness and blindness.

More than 100,000 children a year are born with Congenital Rubella Syndrome defects.

________

Linnea Patrick is a historian and retired Port Townsend Public Library director.

Her Jefferson County history column, Back When, appears on the third Sunday of each month, alternating with Alice Alexander’s Clallam County history column on the first Sunday of the month.

Patrick can be reached at [email protected]. Her next column will appear Jan. 21.

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