Tag Archives: typhoid fever

September 18, 1985: Mineral Water from Georgia; 1981: Valley of the Drums

September 18, 1985New York Times headline–Mineral Water From Georgia Being Bottled. Mineral-rich water from a spring that was once known for its supposed curative powers is being bottled for sale again for the first time in almost 50 years.

Water flowing beneath the 750 million-year-old granite formation underlying much of metropolitan Atlanta picks up minute amounts of salt, potassium, magnesium and lithium, a rare light metal that gave Lithia Springs its name and its reputation. Lithium, a potentially dangerous substance in large doses, is used in the treatment of manic depression.

In the late 1800′s and early 1900′s, tourists and invalids flocked to Lithia Springs, a small city 20 miles west of Atlanta, to drink and bathe in the mineral water. A Congress of Physicians was held there in 1887, which recommended the salty-tasting water for dozens of ailments including kidney stones, typhoid fever, eczema, nervous prostration, and ”diseases of delicate women.” [Typhoid fever?  Really?]

September 18, 1981USEPA Press Release–”An expenditure of $400,000 will be made from the new Superfund for emergency cleanup work at Kentucky’s top priority hazardous waste site–the Valley of the Drums, near Louisville. Anne M. Gorsuch, Administrator of the U.S. Environmental Protection Agency, said today EPA will spend the money to pay for removal of about 1,500 drums containing chemical waste to reduce the possibility of fire.

The Valley of the Drums drew national attention in 1979 as one of the country’s worst abandoned hazardous waste sites. Thousands of drums–accumulated over a 10-year period–were strewn in pits and trenches over a 23-acre site in Bullitt County. The drums of the site scheduled for cleanup are deteriorating quickly. When it rains, they overflow and leak into Wilson Creek, a tributary of the Ohio River. They contain such chemicals as benzene, toluene and methylmethacrylate.”

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September 12, 1909: Typhoid Fever in Seattle

Alaska Yukon Pacific Exposition

September 12, 1909:  Seattle health officials reported an outbreak of typhoid fever, later associated with the contamination of drinking water at the Alaska-Yukon-Pacific (A-Y-P) Exposition, on the campus of the University of Washington. Officials were not able to pinpoint the cause of the outbreak. By the end of 1909, 511 people–including about 200 A-Y-P visitors–were sickened by the disease, and 61 died.

August 25, 1909: Waverly, Kansas Typhoid Fever Outbreak

August 25, 1909: Municipal Journal and Engineer article. Surface Water in Reservoir Causes Typhoid. “Waverly, Kan.-Professor Hoad, Engineer of the State Board of Health, who is investigating the sanitary condition of Kansas towns, says the worst place he has seen for many days is Waverly. The town has a population of about 500 or more people, and for the last two years typhoid fever has been practically continuous. Professor Hoad said that he and Dr. Crumbine, Secretary of the Board, had studied carefully all the probable causes, eliminating them one by one-even Dr. Crumbine’s fly-until finally it was narrowed down to the city water. The city gets its water from a large well or small reservoir, and this had been continually polluted by surface washings. Professor Hoad made the statement that if at the present time the same per cent of cases to the number of population existed in Topeka as now exist in Waverly there would be about 550 cases of typhoid in Topeka. He and Dr. Crumbine appeared before the City Council and ordered them to cement the outside of the wall, which is to be raised three feet. Then the water is to be pumped out and the inside of the wall plastered, after which the well is to be thoroughly disinfected. When this is done Professor Hoad will inspect the work and make a test of the water.”

Commentary: Dr. Crumbine is the same fellow who championed the banning of the common cup in Kansas and was instrumental in getting it banned on interstate carriers by federal regulation.

August 14, 1913: Sewerage and Health

Typhoid Fever Death Rate and Sewer Construction in Louisville, KY

August 14, 1913: Municipal Journal article. Effect of Sewerage Upon Health. “Although nearly all intelligent people will to-day agree that there is great value in a comprehensive sewer system, it is not always easy to demonstrate in particular cases all the advantages gained by its installation. A system for the drainage of storm water in a city is not only a convenience but is a valuable asset because, by preventing damage from flooding in storms, it increases the value of property. In a system of sanitary sewers, the beneficial results are convenience in the disposal of household wastes, a saving in the expense of repeated emptying of cesspools, and above all the resulting improvement in the public health. It has not always been possible to establish and define the relation existing between the prevalence of disease and the degree of sewerage in any community, even by those whose confidence has been greatest in the existence of an intimate relation. It is of the greatest importance, however, that the value of all agencies affecting the public health should be well understood, particularly by those in whose hands have been entrusted the responsibility of the government.

For years typhoid fever has been considered a preventable disease, and on this account the degree of its prevalence indicates the efficiency of a community in guarding the welfare of its own inhabitants. It is well known that this disease is caused by the typhoid bacillus which, under the favorable environment within the human body, multiplies rapidly and is cast off in countless numbers from the alimentary canal and kidneys. It is a function of the sewer system to convey the waste products containing these germs from the patient to a point of disposal where they can do no harm. Should they be carried to any stream or body of water without treatment to be drawn into a water supply or to infect shellfish growing therein, an epidemic may result. The infection is too often communicated directly from a sick person to a well one. In the absence of an efficient sewer system, it might find its way, on account of unsanitary conditions, to milk cans or food supplies. If deposited in exposed privies, the infection might be washed over the surface or through underground channels to shallow wells, or it might be conveyed by flies to accessible food.”

Commentary: Many authors tried to show that building sewers saved lives. However, the data was just not there. As I said in my book, The Chlorine Revolution, “It’s the Drinking Water Stupid.” The conquest of typhoid fever and other waterborne illnesses was not complete until the drinking water supply was protected with multiple barriers including filtration and chlorination. The graphic in this article shows that there was a lot of variation in the typhoid fever rate until a filtration plant was installed in 1909. After filtration was installed and operational, the death rate plummeted.

June 19, 1986: 1986 SDWA Amendments Became Law 1865: NYC Sanitary Survey;

June 19, 1986: June 19, 1986: The 1986 amendments to the Safe Drinking Water Act became law. “The 1986 SDWA amendments required EPA to apply future NPDWRs to both community and non-transient non-community water systems when it evaluated and revised current regulations. The first case in which this was applied was the “Phase I” final rule, published on July 8, 1987. At that time NPDWRs were promulgated for certain synthetic volatile organic compounds and applied to non-transient non-community water systems as well as community water systems. This rulemaking also clarified that non-transient non-community water systems were not subject to MCLs that were promulgated before July 8, 1987. The 1986 amendments were signed into law by President Ronald Reagan on June 19, 1986.

In addition to requiring more contaminants to be regulated, the 1986 amendments included:

  • Well head protection
  • New monitoring for certain substances
  • Filtration for certain surface water systems
  • Disinfection for certain groundwater systems
  • Restriction on lead in solder and plumbing
  • More enforcement powers.”

Commentary: The 1986 amendments arose out of Congress’s frustration with how slow EPA was adopting regulations under the original 1974 Safe Drinking Water Act. The 1986 amendments were prescriptive in that the law told EPA what it had to do and set strict time limits for the requirements to be accomplished. One provision that was doomed from the start was the requirement for EPA to set 25 new maximum contaminant levels every three years. This problem would be fixed in the 1996 amendments.

Note the timing of these two blog posts. It took 101 years but some of the major problems identified in the sanitary survey of NYC were solved by drinking water legislation and regulation including the SDWA Amendments of 1986.

June 19, 1865: New York Times Book Review—Report of the Council of Hygiene and Public Health of the Citizens’ Association of New York Upon the Sanitary Condition of the City. “At last we have a reliable report upon the social condition of New-York City; a report, moreover, that is no common one; no more compilation of statistical data, overpowering with figures and perplexing with misstatements. This is a book demanding and arresting attention; a live book; remarkable, not more for the extent of research and magnitude of labor involved in its preparation, than for the public spirit it represents and whereof it is the offspring….

The report before us, however, does not hinge on hearsay or repeat misrepresentations. Its facts are hard, palpable; its deductions convincing, its arguments unanswerable. They are the production not of an individual or a committee, but of an agency which may be called ubiquitous, since its operations penetrated every [part] of our city, and its personal scrutiny progressed, almost simultaneously, in every neighborhood. A retrospect of the actual labor performed by that agency would embrace the social and sanitary history of half a million of our people.”

Here is a 21st century analysis. “New York City Sanitary Survey reports a death rate of 33 per thousand (compared to Philadelphia at 20 and London at 22). Public health had deteriorated to conditions like those of London two centuries earlier said Dr. John Griscom, who wrote the first sanitary report in 1844. The 1865 report shocked the city: Domestic garbage, filth and the refuse of bedrooms of those sick with typhoid fever, scarlet fever and smallpox is frequently thrown into the streets, there to contaminate the air, and no doubt aid in the spread of these pestilential diseases. Some 18,000 people are living in cellars below the high water mark. ‘At high tide the water often wells up through the floors, submerging them to a considerable depth. In very many cases, the vaults of privies (latrines) are situated on the same or a higher level, and their contents frequently ooze through the walls into the occupied apartments beside them.’ As a cholera epidemic sweeps the city, the mayor of NY refuses to call together the aldermen who constituted the old Board of Health, maintaining that they are more dangerous to the city than the disease itself.”

May 30, 1923: Death of Rudolph Hering; 1912: Death of Wilbur Wright

Rudolph Hering

May 30, 1923: Death of Rudolph Hering. “Although Dr. Hering was one of the first to recommend mechanical filters for pumping the water supplies at Atlanta, and elsewhere, and was connected with important water supply investigations at New York, Philadelphia, Washington, New Orleans, Columbus, Montreal, Minneapolis and numerous smaller places, his accomplishments were greatest in the field of sewerage and sewage disposal and led to his having been designated years ago as the ‘Dean of Sanitary Engineering” in this country. Recognition of such standing was perhaps first made by President Harrison, who, in 1889, appointed him Chairman of a Commission to prepare a program for sewerage improvements for Washington, D. C.

Dr. Hering was an active worker on the committees of various professional organizations as well as civic movements. His most important work was undoubtedly that for the American Public Health Association in the matter of the collection and disposal of refuse. He gathered statistics as to results of operation and otherwise elucidated practice in this country and Europe. Some twenty-five years ago he gave liberally of his own time and money for gathering information upon this subject, although his activities in the field of water supply and sewerage did not permit him to publish the results of his investigations in the disposal of solid wastes of the municipalities.

Dr. Hering was in partnership with George W. Fuller, M. Am. Soc. C. E., from 1901 to 1911 and with John H. Gregory, M. Am. Soc. C. E., from 1911 to 1915. After the latter date his activities were confined largely to work upon a book on ‘Collection and Disposal of Refuse’ of which he was a joint author with Samuel A. Greeley, M. Am. Soc. C. E….

He received an honorary degree of Doctor of Science from the University of Pennsylvania in 1907, and an honorary degree of Doctor of Engineering from the Polytechnic Institute at Dresden in 1922. He was a member of a large number of engineering societies both in this country and in Europe. He was an honorary member of the New England Water Works Association and of the American Water Works Association and a Past President of the American Public Health Association. He became a member of the American Society of Civil Engineers in 1876, was Director in 1891, 1897 to 1899, and Vice President in 1900 to 1901.”

Reference: “Rudolph Hering.” 1924. Journal AWWA. 11:1(January): 305.

May 30, 1912: Wilbur Wright dies of typhoid fever.

The year 1908 signaled the beginning of drinking water disinfection in the U.S. A lot of important things happened in that year and later. Jim Rasenberger in his book, America 1908, chronicled the technological, exploration, political and sociological milestones in the U.S. during 1908. On the first page of his book, he stated succinctly the thrills attendant to the year, “…1908, by whatever quirk of history or cosmology, was one hell of a ride around the sun.” During these 366 days, the Wright brothers amazed the world with extended flights of heavier-than-air machines, the Model T went into production, two explorers reached for the North Pole, a 20,000 mile race in automobiles from New York to Paris was started and completed, a new President was elected, the national pastime captured the attention of the country in a strange pennant race, the Great White fleet started its round-the-world cruise and deadly race riots and other violence scarred the national conscience.

The capstone to 1908 was a two-hour and twenty minute flight by Wilbur Wright on December 31 in a suburb of Paris, which shattered all previous records for continuous flight. For manned flight, this was truly a major year. “In tracing the development of aeronautics, the historian of the future will point to the year 1908 as that in which the problem of mechanical flight was first mastered…”

To put the achievements of the Wright brothers in the context of their time and the history of application of scientific principles, part of Wilbur’s obituary summed up their accomplishments.

“The death of Wilbur Wright has brought intense personal sorrow to all who were in any way associated with him…The science of aviation has lost its greatest student, and in time to come the name of Wilbur Wright will be recorded in the annals of invention with the names of such pioneers as Robert Fulton, Stephenson (first steam locomotive engine), Bell, and others who have given to the world the value of practical experiments and successful achievements.” (emphasis added)

Thus, Wilbur Wright was not the first person to gaze at a bird and wonder how humans could fly. Nor was he the first person to build an airplane and try to lift off the ground. He and his brother, Orville, were the first to actually accomplish powered flight, but, more importantly, they demonstrated in a practical manner how to control that flight. Once again, technological progress is made by those who make an idea work.   An original idea without practical implementation is just a waste of oxygen feeding the brain.

Wilbur Wright died of typhoid fever on May 30, 1912. He was just 45 years old. Four years earlier, he had astonished the world with his extended flights near Paris. What might he have achieved in continued partnership with his brother, Orville, had he not been struck down so early? The disinfection revolution did not spread fast enough to save the life of this inventor and world-renowned figure. But chlorination did travel fast enough and far enough to save the lives of hundreds of thousands of future inventors, engineers and scientists who transformed the U.S. and the world with their creativity.

What does the author of America 1908 make of the disinfection revolution that occurred during this seminal year a few miles from the center of his story, New York City? Not surprisingly, no mention is made of the events that occurred at Boonton Reservoir. Only passing mention is made of public health and water supply with millions dying from infectious diseases, a cholera epidemic in Manila when the Great White Fleet visited and the construction of a new water supply by Mulholland for Los Angeles. The cause of Wright’s typhoid fever has been described as coming from various sources. Wilbur’s obituary mentioned bad fish in a Boston restaurant, but the author of the obituary had no particular reason for believing that was the source.   The only thing that appears to be certain is that he contracted the disease on a business trip back East (that is, east of Dayton, Ohio).

As noted in the previous chapter, chlorination had been instituted in hundreds of U.S. cities by 1912 but the typhoid death rate was still high. Boston had a typhoid fever death rate of 8 per 100,000 in 1912. In the same year, Washington, DC and Baltimore had typhoid death rates of 22 and 24 per 100,000.   Wilbur Wright more likely died from contaminated water rather than bad fish.

Reference: McGuire, Michael J. 2013. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

May 5, 1858: Birth of John L. Leal

May 5, 1858: 159th anniversary of the birth of John L. Leal, physician and water treatment expert who pioneered chlorine disinfection in the U.S. There are many unsung heroes who contributed significantly to public health at the turn of the 20th century. John L. Leal is one of them and after reading this, I think you will agree that he did more than most to save people’s lives.

John L. Leal was born in the small town of Andes, New York on May 5, 1858. His father, John Rose Leal was a physician who joined the 144th Regiment, New York Volunteers and fought in the Civil War. During the siege of Charleston, South Carolina, John Rose Leal contracted what was most likely a case of amoebic dysentery from contaminated drinking water. He suffered from the disease for more than 17 years before he finally died of it in 1882.

John L. Leal attended Princeton College and graduated in 1880. He went on to Columbia College of Physicians and Surgeons finishing his medical education in 1883. He opened a medical practice in Paterson, New Jersey and went to work for the Paterson Board of Health where he remained until 1899. He left City employment and became the sanitary adviser to private water companies including the East Jersey Water Company and the Jersey City Water Supply Company. In 1888, he married Amy L. Arrowsmith and they had one son, Graham, later that year. So far, his life was well spent but not exemplary.

In the field of water supply, there were big moves afoot in the state of New Jersey at the turn of the 20th century. Jersey City had suffered with a contaminated water supply for decades causing tens of thousands of deaths from typhoid fever and diarrheal diseases. In 1899, the City contracted with Jersey City Water Supply Company to build a dam on the Rockaway River and provide a new water supply. The dam created Boonton Reservoir, which had a storage capacity of over seven billion gallons. Leal’s job with the company was to remove sources of contamination in the Rockaway River watershed above the reservoir. Water from the project was served to the City beginning on May 23, 1904.

When it came time for Jersey City to pay the company for the new water supply, they balked. The price tag was steep—over $175 million in current dollars. Using newly developed bacteriological methods, consultants for the City claimed that the water was not “pure and wholesome,” and they filed suit against the company to get a reduced purchase price. The trial that resulted pitted the water quality experts of the day against one another in a battle of expert witnesses. The opinion of the judge was published on May 1, 1909. In that opinion, Vice Chancellor Frederic W. Stevens said that Boonton Reservoir did a good job on average of reducing the bacteria concentrations in the water provided. However, he noted that two to three times per year, especially after intense rainstorms, the reservoir short-circuited and relatively high bacteria levels resulted.

Rather than build expensive sewers that would deal with only part of the bacteria contamination problem (an early recognition of non-point source pollution) Leal and the company attorney argued to install “other plans or devices” that would do a better job. The judge agreed and gave them a little over three months to prove their idea. Leal had decided in May 1909 that it was time to add a chemical disinfectant to drinking water. He was all too familiar with the suffering and death caused by typhoid fever and diarrheal diseases. He knew of some successful instances of using forms of chlorine in Europe, but nothing had been attempted in the U.S. on a large-scale basis or over any continuous time period.

But, there was a problem. The public feared chemicals in their food, medicines and water. Adulteration of food and medicines was rampant during this period, which was faithfully catalogued in Upton Sinclair’s The Jungle.

“How could they know that the pale-blue milk that they bought around the corner was watered, and doctored with formaldehyde besides?. . .How could they find out that their tea and coffee, their sugar and flour, had been doctored; that their canned peas had been colored with copper salts, and their fruit jams with aniline dyes?”(1)

At any conference of water professionals in the late 19th and early 20th centuries, strong language was used to oppose chemical disinfection. Even George W. Fuller early in his career was not supportive of chemical disinfectants.

1893, George Warren Fuller: “While chemicals have been of much aid in surgery by bringing about antisepsis and asepsis, it is very improbable that people would allow their drinking water to be drugged with chemicals, even with the view of removing dangerous bacteria–indeed, such a method might prove very dangerous in many cases.”(2)

1894, Thomas M. Drown: “…the idea itself of chemical disinfection is repellent.”(3)

1904, George C. Whipple: “Thus in St. Louis the popular prejudice against the use of alum in clarifying the water is said to be so intense that a local engineer has said ‘it is very doubtful if alum could be used, no matter how excellent the results which might be obtained.’. . .‘We don’t want to drink puckered water.’”(4)

1906, George C. Whipple: “The idea of adding poisonous chemicals [like chlorine] to water for the purpose of improving its quality for drinking purposes has generally been considered as illogical and unsafe. . .”(5)

1906, William P. Mason: “I very much question if the public at large would be willing to disinfect water to-day. We are scarcely driven that far yet.”(6)

1906, P.A. Maignen: “Among the so-called ‘disinfectants’ tried may be cited copper, chlorine and oxalic acid. . .Such poisonous materials should not be permitted to be used on water intended for public supplies.”(7)

Nonetheless, Leal was convinced that adding a disinfectant to the Jersey City water supply was the best course. He had done laboratory studies that convinced him that a fraction of a ppm of chlorine would kill disease-causing bacteria. In the face of the certain disapproval of his peers and possible condemnation by the public, he moved forward. Where he found the courage to follow the path of chemical disinfection when all of the experts railed against it is not known for certain. His father’s gruesome illness and death and the unnecessary deaths he personally observed as Health Officer for Paterson must have contributed to his decision.

However, no chlorine feed system treating 40 million gallons per day had ever been designed or built and if the feed system failed to operate reliably, all of the courage of his convictions would not have amounted to much. He needed the best engineer in the country to do the work. He needed George Warren Fuller. In 1908, Fuller was famous for his work in filtration. He had designed an aluminum sulfate feed system treating 30 million gallons per day for the Little Falls treatment plant. On July 19, 1908, Leal left his attorney’s office in Jersey City and took the ferry to Manhattan. In Fuller’s office at 170 Broadway, he hired the famous engineer (undoubtedly on the basis of a handshake) and told him that the bad news was that he needed the work done in a little over three months.

Ninety-nine days later, the chlorine feed system was built and operational. Calcium hypochlorite (known then as chloride of lime or bleaching powder) was made into a concentrated solution, diluted with water and fed through a calibrated orifice to the water before it traveled by gravity to Jersey City. The feed system worked flawlessly from day one and continued to operate successfully for all of the following days. Liquid chlorine eventually replaced chloride of lime, but September 26, 2012, marks the 104th anniversary of the first continuous use of chlorine on a water supply—the longest period of water disinfection anywhere in the world.

In a second trial, the court vindicated Leal’s decision. Afterwards, the use of chlorine spread like wildfire throughout the U.S. Typhoid fever death rates plummeted and children under one year of age stopped dying by the hundreds of thousands.

John L. Leal was not a physically imposing figure. Photographs of him show a man of average height and build with a kind face. Nothing in his appearance hinted at the steel spine and dogged courage that he possessed. One definition of the word hero reads: “a man of distinguished courage or ability, admired for his brave deeds and noble qualities.” These days, many people feel that the word hero has been overused in this country. I think that promoting a water treatment process that saves millions of lives qualifies Leal to be known as a Hero of Public Health.

Why doesn’t everyone know about Leal? Another man, George A. Johnson was wrongly given the credit for the idea of chlorinating the water supply for Jersey City. Johnson was able to get away with his charade, in part, because John L. Leal died on March 13, 1914, and Johnson lived for another 20 years.

Still not convinced? Well, you will have to wait for the full story that has been published in my book, The Chlorine Revolution: Water Disinfection and the Fight to Save Lives which will be available for shipment on March 20, 2013.(8)

References

(1) Sinclair, Upton. The Jungle: With an Afterword by Emory Elliott. New York:Signet Classic, 1990, original copyright 1905, originally published in 1904.

(2) Fuller, George W. “Sand Filtration of Water, with Special Reference to Results Obtained, at Lawrence, Massachusetts.” In American Public Health Association, Public Health Papers and Reports. Vol. 20, Columbus, OH:APHA, 64-71. 1895.

(3) Drown, Thomas M. “The Electrical Purification of Water.” Journal NEWWA. 8 (1894): 183-7.

(4) Whipple, George C. Discussion of “Purification of Water for Domestic Use.” Transactions ASCE. 54:Part D (1905): 192-206.

(5) Whipple, George C. “Disinfection as a Means of Water Purification.” Proceedings AWWA. (1906): 266-80.

(6) Mason, William P. “Discussion.” Proceedings AWWA. (1906): 282-3.

(7) Maignen, P.A. “Discussion.” Proceedings AWWA. (1906): 285-6.

(8) McGuire, Michael J. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, Colorado:American Water Works Association. 2013.

Commentary: On May 5, 2013, at Cedar Lawn Cemetery in Paterson, New Jersey, a grave monument was dedicated to Dr. Leal. For 98 years, his grave was unmarked. The granite obelisk has the names of John L. Leal and five members of his immediate family carved on the sides. Under John L. Leal’s name is the descriptor: Hero of Public Health.

Grave Monument for Dr. Leal