Tag Archives: typhoid fever

November 16, 1918: Sanitary Survey of Unnamed City

Privy in terrible condition

November 16, 1918Municipal Journal. A Sanitary Survey of an Unnamed City. The conditions about which you will read were by no means unusual in 1918 in the U.S. “A State Board of Health a few months ago, made a sanitary survey of a certain city (the name of which is unessential) which was of more than usual interest, because of its thoroughness and the sensible recommendations based upon it….

The city in question has a population of about 30,000, of which negroes form a small percentage for a southern city. Although the city is not large, topographical conditions are such as to confine its growth in area, with the result that it presents many of the characteristics of a large, crowded city…. In 1916 fifteen cases of death from typhoid fever were reported, and it is believed that the number was even somewhat greater than this…. A comparison of the distribution of the typhoid cases with the wells and privies indicates that the latter have played an important role in the spread of the disease, the typhoid areas largely coinciding with the unsewered districts, without city water. It should be noted further that these “typhoid areas” are located on steep hillsides where the drainage from privy to well is rapid and direct….

The water supply of the city is derived from the river that flows through it, the intake being located at a point near the upper boundary of the city. This river has a water-shed of 1,550 square miles of mountainous and rather thinly populated territory….Examinations of the river for miles upstream have shown its waters to be heavily polluted before they enter the city. While none of the municipal sewers empty into the river above the waterworks intake [thank goodness], there are two small runs draining an extensive unsewered area which is thickly populated….Thus it is seen that the source of supply is always polluted to a greater or less degree, becoming at times a source of most extreme danger. Only the most thorough filtration and after-treatment can render a water of this character uniformly safe for drinking purposes. Unfortunately the skilled attention that is absolutely essential for the successful operation of a filter plant has not been had until recently.

Purification is secured by coagulation and sedimentation, followed by filtration through so-called mechanical or rapid gravity filters and final treatment with chlorine gas….Just before entering the sedimentation basins, the water receives its dose of coagulant consisting of lime and sulphate of alumina in amounts depending upon the character of the river water as shown by its alkalinity and turbidity….

The man who installed the original hypochlorite plant for final treatment of the water painted its virtues so very bright that he assured the water company that when the river was clear they need not use any chemicals except hypochlorite of lime. It is felt that this ill-advised suggestion may have been in part responsible for the epidemic of typhoid fever the city has just experienced.

The sedimentation basins are two in number, each having a capacity of about 238,000 gallons. At the normal rate of filtration this provides for but one and three-fourths hours storage, a period that is considered far too short to be comparable with adequate coagulation and sedimentation. The control of the chemicals constitutes another objection. The solutions are prepared in large tanks from which they are fed through hand-operated orifices and the rate of dosing is recorded as inches in depth of the tank per hour. Constant-feed, calibrated orifice boxes should be supplied, that the dosing may be more accurately controlled. [see design of such a feed system by George Warren Fuller at the Little Falls treatment plant, Fuller 1903]

From the sedimentation basins the water flows by gravity to the filters, of which there are ten units, each having a superficial area of 230 square feet. At a normal rate of two gallons per square foot a minute, or 125 million gallons per acre per twenty-four hours, the ten units have a combined capacity of about 6.5 million gallons a day. As originally constructed, each unit was provided with a loss-of-head gage, rate controller, and individual sampling pump, all of which equipment has now been dismantled. A loss-of-head gage is essential if accurate knowledge of what each unit is doing and of the proper time to wash is to be had. As it now is, the filter man guesses at the proper time to wash the dirt out of the filter by the position of the inlet float; the dirtier the sand, the higher the level of water on the bed and the more quiet the float—a rather round-about method.

After washing, the filters are allowed to waste for a short time and then turned into the clear well. The lack of any rate controllers on the filters makes it certain that the most recently washed units will be filtering far in excess of the rate for which they were designed. Rate controllers would prevent the units from delivering more than a definite maximum at any time. With as small a clear-well as the one here provided (approximately 37,000 gallons), the lack of this important device becomes even more dangerous in that the pull of the high-service pumps is thrown almost directly upon the filters….

Washing of the filters is effected by forcing water and air through them from below. The water for washing is taken directly from the clear well by an electrically driven centrifugal pump. As has been previously noted, washing cannot be conducted on anything like a scientific basis owing to the lack of loss-of-head gages. The filters are, however, washed at least once a day, and more often if deemed necessary.

From the clear-water well, which is located beneath the filters, the water flows to the high-service pumps, receiving on the way a final treatment with chlorine. Chlorine gas is an excellent sterilizing agent in water, and small doses can effect a remarkable reduction in the number of bacteria present. The chlorine gas is introduced by a direct-feed manual-control chlorinator. In this plant the fact that the dose is not automatically controlled is extremely unfortunate, and if the plant were not in the hands of a skilled filter operator would be a very serious objection….

With a safe and potable water available [forsooth!], there is no excuse for the continuation in use of the 189 private wells in the city. While no analyses have been made to learn the extent to which the wells are polluted, there can be little doubt from their location and construction that many of them are dangerously contaminated.” (emphasis added)

Commentary:  The hard, cold, and alarming facts related in this 1918 sanitary survey of an anonymous southern U.S. city make it quite evident why its identity was not revealed. The typhoid death rate of 50 per 100,000 people in 1916 is shockingly high for a city that is served by a water supply that was both filtered and chlorinated. Obviously, something is terribly wrong with the operation of the treatment plant and the condition of private wells. The person conducting the sanitary survey expressed some optimism about current personnel and operations, but a sanitary survey conducted a year after would be needed to see if that optimism was justified.

The problems related in this sanitary survey should make us all glad that we live in the 21st century where we are blessed (at least in developed countries) with safe drinking water supplies.

Reference:  “A Sanitary Survey of a City.” 1918. Municipal Journal. 45:19 November 9, 1918, 359-61, 383-6.


October 22, 1914: Trenton Water Treatment Plant

October 22, 1914: Municipal Journal feature article–Water Purification at Trenton. “For fifteen years the improvement of the public water supply at Trenton, N.J., which was drawn from the Delaware River without treatment, has been a question that has received much consideration. Johnson and Fuller, consulting engineers, of New York City, who were retained to design a plant, in 1912 presented plans for rapid sand filters with a capacity of 30,000,000 gallons per day. This plant is now practically completed….For several years past, the typhoid death rate in Trenton has shown the need of a modern filtration plant. The average death rate from that cause for the ten years ending 1900 was 28 [per 100,000 people], while for the years 1908, 1909 and 1910 it was 54, 36 and 53, respectively. In 1911 the use of hypochlorite was adopted and was effective in reducing the typhoid death rate, but the unfiltered water is very unsatisfactory, especially in appearance. The plant, which is located at the foot of Calhoun street, just above the present pumping works, consists of covered sedimentation basins, sixteen filters, a clear water basin, a low-lift pumping plant, a head house, conduits and complete filter equipment.”

Reference: “Water Purification at Trenton.” Municipal Journal. 37:17 (October 22, 1914): 589-91.

Commentary:  There were people in Trenton who opposed any move to treat the disease-laden water from the Delaware River. It is incomprehensible that they resisted all attempts. Below is an excerpt from my book The Chlorine Revolution:  Water Disinfection and the Fight To Save Lives.

“Trenton, the capital of New Jersey, was home to about 97,000 citizens in 1911. The city’s water source was the Delaware River, which had been grossly contaminated with sewage for decades. Typhoid fever was ever-present in the city, and occasionally epidemics broke out, causing much higher death rates. The typhoid fever death rate during 1902–1911 ranged from 26.2 to 84.3 per 100,000 people, with an average of 49.7 per 100,000.

Despite the water supply’s wholesale killing of Trenton’s citizens, there was tremendous opposition to installing filtration or any other kind of effective treatment. Outstanding treatment experts such as Allen Hazen and George Warren Fuller prepared two separate designs for filtration plants, both of which languished without being implemented. Finally, the New Jersey Board of Health had had enough. In early 1910, the board issued a “compulsory order” for Trenton to treat its water supply and made the order effective shortly thereafter, on June 15. The Trenton Water Board began to install a chloride of lime feed system, but, incredibly, the local health board vetoed the plan. Wasting no time, the New Jersey Board of Health filed a lawsuit shortly after the June 15 deadline to compel the city to move forward with its plans.”

Even after all of this, it would still take a long time to get filtration and disinfection into place.

September 26, 1994: Tucson Shuts off CAP Supply; 1908: First Chlorine Use in US; 1855: Handle Put Back on Broad Street Pump

September 26, 1994: Tucson Shuts off Direct Delivery of Central Arizona Project Water Supply. Corrosive water destroying pipes in a major American city preceded the events in Flint, Michigan by over two decades. On November 4, 1992, the water department for Tucson, Arizona, (Tucson Water or TW) began delivery of a new water supply: treated surface water from the Central Arizona Project (CAP)—primarily Colorado River water. Putting treated CAP water into the TW distribution system caused a corrosion problem that resulted in colored water (e.g., rusty, red, orange, yellow and brown) flowing from customer taps. Tucson’s introduction of CAP water is a story of mistakes committed at all levels of the utility and by the Tucson City Council.

Technical mistakes included not preparing the distribution system to receive a more complex surface water supply. TW was a groundwater utility that relied on about 200 wells distributed throughout the system. Recognizing their lack of experience with treating surface water, they hired treatment plant operators from other utilities to run the new $80 million leading-edge-technology treatment plant. Unfortunately, the same level of focus and preparation was not applied to the aging distribution system, which received, literally overnight, a chloraminated supply to half its customers from a single point of entry.

One of the biggest mistakes was not testing the impact of treated CAP water on corroded galvanized steel pipes. There were about 200 miles of this 2-inch substandard pipe in the system. When treated CAP water hit these pipes, the iron corrosion deposits inside the pipes were stripped away causing colored water, taste and odor problems, and damage to home plumbing, appliances and property due to flooding.

There was a rush to deliver CAP water and to hold down costs to the detriment of needed studies, which would have shown that raising the treated water pH for corrosion control was the proper approach.

Also high on the list of pre-delivery problems was a lack of political will to replace the substandard galvanized and cast iron street mains. The presence of these substandard pipes made the TW distribution system ripe for a catastrophic corrosion problem due to unsound corrosion control practices.

Delivery of CAP water was terminated on September 26, 1994, because of the inability of TW to control the colored water problem and the resulting political uproar. The $80 million treatment plant was shut down and has not been used since.

After a series of management resignations and firings over several years, Tucson hired David Modeer as the Director of TW. Modeer and his management team put the utility on the road to recovery. Along with a carefully planned technical program to select the correct corrosion treatment and deal with the taste and odor problems, an innovative public information campaign that also included a public apology for the CAP debacle, began to restore the credibility of TW. Customers were invited to actively participate in determining the future use, treatment and quality of CAP water via such methods as consumer preference research and participation in an extensive bottled water program.

Dedication of CAVSARP/Clearwater Project, 5/3/01

After the voters defeated a proposition in 1999 that would have severely limited the ability to use CAP water in the future, TW completed an aquifer storage and recovery project in the nearby Avra Valley. The Central Avra Valley Storage and Recovery Project (CAVSARP) allowed the utility to fully use its CAP allotment and serve a recovered groundwater/recharged CAP water mix that was accepted by TW customers. Tucson Water turned around a disaster into a singular success. Because of its ability to conjunctively use CAP water and groundwater, Tucson is now one of the more drought-resistant communities in the Southwest.

Commentary: Marie Pearthree and I are writing a book about what happened in Tucson before, during and after the corrosion problem doomed their new water supply. A wealth of material has revealed previously unknown information related to TW’s problems. The results of these efforts are much-needed lessons for water utilities on how to avoid TW’s mistakes and how to successfully introduce a new water supply. As of this date in 2017, we are finishing up the research and beginning to write some of the chapters. It is hard to predict when we will complete the book, but we will be giving papers on what we have found during our research at several venues in 2018. Watch this space for presentation times, dates and locations.

Building on the right housed the chloride of lime feed facility at Boonton Reservoir

September 26, 1908:  106th anniversary of the first day of operation of the chlorination facility at Boonton Reservoir for Jersey City, NJ.  This was the first continuous use of chlorine in the U.S. for drinking water disinfection.

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 the 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. One of the company’s employees, Dr. John L. Leal, would have an enormous impact on this water supply and the history of water treatment. Leal was a physician, public health professional and water quality expert. 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 1908 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 such a large-scale basis.

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.

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, 2013, marks the 105th anniversary of the first continuous use of chlorine on a water supply—the longest period of water disinfection anywhere in the world.

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

Broadwick [formerly, Broad] Street showing the John Snow memorial and public house.

September 26, 1855:  The St. James Board of Commissioners of Paving voted 10 to 2 to reopen the Broad Street pump at the urging of local residents.  Dr. John Snow had prevailed upon them a year earlier to remove the pump handle after he presented his evidence that cholera deaths were geographically clustered around the well site.

Reference: Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. Cholera, Chloroform, and the Science of Medicine. New York:Oxford University, 2003, 310.

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.”

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.