Tag Archives: typhoid fever

January 23, 1913: Night soil Incinerator and NYC Death Rate

January 23, 1913:  Two articles in Engineering News.

“Night Soil Incinerating Furnace at a Contractor’s Camp.” By Arthur W. Tidd, “The new 500-million-gallons-daily Catskill water-system for New York City, now being built by the Board of Water Supply, necessitates that construction work shall be carried on from the Ashokan Reservoir in the Catskill Mountains to New York City, a distance of approximately 100 miles. Throughout the whole length of the line a sanitary control is exercised, under the supervision of sanitary experts employed by the Board of Water Supply, over the housing and living of the laborers employed on the work and the disposal of all wastes.

Clauses are inserted in the specifications of each contract placing upon the contractor the duty of carrying out the provisions required for proper sanitation and specifying in many cases just what these provisions shall be. One of these is the provision that buildings for the sanitary necessities of all persons employed on the work shall be provided, and that all excreta shall be incinerated daily….

For the camp the four corners of the incinerator house are partitioned off into independent closets, entered only from the outside, two for the men having six seats each, two for the women having two seats each. The galvanized pans are used here also, being removed from the back of the closets on the inside of the building as indicated in cross-section of the building shown in Fig. 2.” (emphasis added)

Commentary:  An early commitment by New York City to protect the water supply for the City.

NYC Street Scene, 1913

“A Low Record Death Rate for New York City.” “A total of 73,008 deaths in a single city in one year seems appalling until it is known that the city was New York, with a population sufficiently above five million to bring the rate per 1000 down to the remarkably low figure of 14.11. There are possibilities, of course, that the population estimate is too high or that the death registration was incomplete, but there seems to be reasonable basis for confidence in both. This confidence is increased when it is noted that the total number of deaths in 1912 was 2418 less than in 1911, and much less than the average for the ten years 1902-11; that there were heavy reductions over the average for 1902-11, in all the communicable diseases, in mortality from diarrheal diseases under five years of age, and in infant mortality; and that in the large non-communicable class the only increases in 1912 were in deaths from cancer, homicide and organic heart disease–the latter being offset by a decline in deaths from apoplexy and diseases of the arteries.

It is particularly gratifying to note that the typhoid fever death rate for 1912 was 34% less than the average for the previous decade and that the infant-mortality rate for the year was only105 per 1000 reported births, the lowest ever recorded.”

Commentary:  Improvement in the sanitary quality of the New York City water supply, improvement in the milk supply and better medical care account for much of the progress noted. NYC still had a long way to go. The infant mortality rate was 10% of live births which would be unconscionable today.

Reference:  Engineering News. 1913. 69:4(January 23, 1913): 164, 175.

January 14, 1973: First Recorded Typhoid Case in South Florida Outbreak; 1829: First Slow Sand Filter in England

5/13/1976, Roy Bartley/Miami Herald: Everglades farm labor camp 19400 SW 376th St.

January 14, 1973:  First Recorded Typhoid Case in South Florida Outbreak.The last major recorded epidemic of typhoid fever in the United States occurred in Manteno State Hospital, Illinois, in 1939. There were 453 cases, with 60 deaths. Sanitation procedures generally have been improved markedly since that time, but despite such improvement the South Dade Labor Camp near Homestead, Florida, developed a sizable outbreak early in 1973 (172 hospitalized, 38 not hospitalized,no deaths).

Intensive investigation of the water supply and of the sewage system was begun immediately. A number of suspicious findings  were observed. These systems had originally been installed about 1940, and were replaced in 1969. The water  was supplied from  two wells. The first suspicious finding  was that these wells were reported at first to be 50 feet deep with 38 feet of casing. The well driller’s job log confirmed these depths. By sounding, however,  an approximate depth of 20 feet was discovered. Later in our studies,  we noted that the certificate provided by the state’s Sanitary Engineering office had approved the 20 foot depth.

Second, in the center of the well house was a floor drain connected to an outside dry well surrounded by a vitreous clay pipe. When fluorescent dye was introduced into this well, it appeared in the water supply in 3 1/2 min.

Third, dye was also painted on the ground about 10 feet from the water wells. In less than 15 min, the dye appeared in the water.

Fourth, several holes were dug in the area of the well house. The old sewer system, abandoned in 1969, but close to the origin of the water supply, was found to contain human feces, as evidenced by the recovery of Salmonella saint-paul.

Fifth, inspection of the character of the ground revealed many solution channels in the area surrounding the wells.

Sixth, about 100 yards from the wells was a common toilet facility. Immediately outside this facility was a grease trap, connected only to the sinks. Upon emptying the trap, human feces were found in it.

Seventh, about 1000 feet away from the wells was a 50,000-gallon storage tank. This tank was cleaned and found to contain beer cans, bottles, other rubbish, and feces.

Commentary:  I guess that there is no real surprise that there was a typhoid outbreak in this labor camp given all of the sanitary defects in the water and wastewater systems. Remember, this typhoid outbreak occurred in 1973. 1973!

January 14, 1829:  The first slow sand filter in England was put into operation by James Simpson. “Best known of all the filtration pioneers is James Simpson. He was born July 25, 1799, at the official residence of his father, who was Inspector General (engineer) of the Chelsea Water Works Co. The house was on the north bank of the Thames, near the pumping station and near what was to become the site of the filter that was copied the world over. At the early age of 24, James Simpson was appointed Inspector (engineer) of the water company at a salary of £300 a year, after having acted in that capacity for a year and a half during the illness of his father. At 26, he was elected to the recently created Institution of Civil Engineers. At 28, he made his 2,000-mile inspection trip to Manchester, Glasgow and other towns in the North, after designing the model for a working-scale filter to be executed in his absence. On January 14, 1829, when Simpson was in his thirtieth year, the one-acre filter at Chelsea commonly known as the first English slow sand filter, was put into operation….

Skepticism as to the wholesomeness of filtered water in 1828 and Simpson’s reassurances on the subject are amusing today. At the hearing before the Royal Commission a member asked whether any persons had been in the habit of drinking the water filtered on a small scale. ‘Yes,’ answered Simpson. Had they complained of the water ‘being insalubrious, giving them cholic or any other complaints?’ To this, the engineer replied that none of the more than 100 men working on the ground (presumably on the permanent filter) had complained of the filtered water…Fish, the commission was assured, did not die in the filtered water.Simpson willingly admitted that ‘water may contain so many ingredients chemically dissolved, that filtration will not purify it.’ Asked whether the discharge from King’s Scholars Sewer could be ‘so filtered as to be fit to drink,’ Simpson cannily said he had never tried it. Asked whether filtration would remove bad taste from water, Simpson replied that ‘Thames water has a taste according to season, of animal and vegetable matter’; filtration ‘seems to deprive it of the whole of that, and we cannot discover it after it has passed the bed.’”

Commentary:  It is a good thing that fish did not die in the filtered water. That would have been the end of the sanitary engineering profession.

Reference:  Baker, Moses N. 1981. The Quest for Pure Water: the History of Water Purification from the Earliest Records to the Twentieth Century. 2nd Edition. Vol. 1. Denver, Co.: American Water Works Association, 99, 109.

December 31, 1914: Great Lakes Pollution; 1914: Lowell Filtration Plant

Dover, Passenger and freight sidewheel, Great Lakes Ship, Registry No. US. 120796, Built 1890. Credit: Fr. Dowling, S.J. Marine Historical Collection.

December 31, 1914:  Municipal Journalarticle—Lake Pollution Increases Typhoid. Washington, D.C.-Pollution of the Great Lakes and tributary rivers is becoming a serious menace to health, according to the annual report of Surgeon General Rupert Blue, of the Public Health Service. He points out that about 16,000,000 passengers are carried each year over the Great Lakes, and that more than 1600 vessels use these waters. ‘It becomes apparent, therefore,’ Dr. Blue declares, ‘that these inland vessels play an important role in the maintenance of the high typhoid fever rate in the United States.’ Dr. Blue says that, although the prevalence of typhoid in this country is being reduced gradually, and that the rate is not more than one-half what it was thirty years ago, it is still higher than for some other advanced countries.”

December 31, 1914:  Municipal Journalarticle—Progress of Lowell Filtration Plant. “About 80 men are working all day and part of the night on the new boulevard filtration plant and the contractor hopes to have the job completed before August 1, 1915, the time limit, as the weather has been very good, but there have been a number of delays due to caving in of the sand banks. The filtration plant consists of six coke prefilters, 10 feet in depth and two-fifths of an acre in total area; a settling basin, divided into two unites, with a total capacity of 500,000 gallons; six sand filters, with a total area of one acre; and a filtered water reservoir of 1,000,000 gallons capacity….

At a rate of 75 million gallons per acre per day through the prefilters, and a 10 million gallon rate through the sand filters the areas provided are equal to a 10 million gallon daily output. Allowing for cleaning and for the possible desirability of a lower rate through the coke, the plant is believed to be ample for an average daily supply of 7,500,000 to 8,500,000 gallons…sufficient for the needs of the city until 1935.”

Reference: Municipal Journal. (1914). 37:27(December 31, 1914): 963-4.

December 6, 1866: Chicago: First Water Supply Tunnel

December 6, 1866:  “First water supply tunnelfor U.S. city completed for Chicago, IL; Chicago Lake Tunnel extended 10,587 feet under Lake Michigan to an inlet crib; 5 feet in diameter, final cost of $380,784; March 17, 1864 – work started; March 25, 1867 – water allowed into the tunnel. Pumping station with the standpipe tower still stands at the intersection of Michigan Blvd and Chicago Ave., escaped destruction in the 1871 Chicago fire.”

The two-mile tunnel under Lake Michiganproposed by Ellis Chesbrough in 1863 brought him international fame when it was completed and, with its remarkable Two-mile Crib intake structure, was heralded as the eighth wonder of the world. Tunnel construction began in May 1864 and then continued for 24 hours a day and six days a week. A lower semicircular arch was dug and built about six feet in advance of the upper arch. Two men could work side by side, with the miners in front and the masons laying brick about 10-20 feet behind.

Two small mules were found to work in the tunnel, pulling railroad cars to move clay out and building materials in. Digging proceeded first from the shore end and later from the lake end of the tunnel. Chesbrough and a few other dignitaries descended into the tunnel to remove the final inches separating the two tunnels in November 1866. The mayor placed the final masonry stone, and fresh water from the lake entered the tunnel for the first time with great fanfare in March 1867, bringing pure unpolluted water into the city through the structure.”

Commentary:  The purity of the water from this tunnel was grossly overstated in this article and in the minds of Chicagoans in 1866. Cholera and typhoid fever continued to kill tens of thousands of people in Chicago because the city’s sewage was also discharged into the lake for many decades after 1866.

References:

“Business History.” Website http://www.businesshistory.com/index.php, Accessed November 14, 2012.

“The Lake Tunnel in Chicago.” Website http://www.lindahall.org/events_exhib/exhibit/exhibits/civil/lake_tunnel_2.shtmlAccessed December 5, 2012.

December 1, 1902: Leal Report to RI Board of Health; 1909: Philadelphia Typhoid Fight

Upper Roxborough Filters, with sand in place but before water was let in, 1903.

December 1, 1902: Letter to Rhode Island State Board of Health. Dr. John L. Lealwas hired by the Bristol [Rhode Island] and Warren Water Company after the Rhode Island State Board of Health severely criticized them about the sanitary quality of their water supply.

“Gentlemen: We hand you herewith a report upon the sanitary condition of the water supply of this company, of which we wrote you in our letter of October 10th.

This report was prepared by Dr. John L. Leal, and embodies the findings and conclusions of Prof. J.H. Appleton, Prof. F.P. Gorham, and Dr. F.T. Fulton, who, as well as Dr. Leal, made a thorough examination of the water in question and its sources.

John L. Leal, M.D., of Paterson, N.J., A.B., A.M., Princeton; ex-health officer of Paterson, N.J. (for thirteen years); Sanitary Adviser to the East Jersey Water Company (the largest [private] water company in America) and of the Montclair and of the New York & New Jersey Water Companies; President, New Jersey State Sanitary Association, etc., etc., is, we feel, an expert who, you will agree with us, is entirely competent to pass upon the subject at hand….

The findings conclusively establish, as Dr. Leal states in closing his report, that the conditions of the water and the water sheds “do not in any way justify the action of the Board of Health.”

We therefore request that your Board shall, in justice to ourselves and in the interest of those who take our water, withdraw as promptly as may be its recent recommendation to the town of Bristol, and take such other steps as will, as far as possible, make the effect caused by the unwarranted attack made by your Board in its action of October 3rd, upon the sanitary quality of the water and the water sheds of this company. Respectfully, George H. Norman, President.”

Reference: Twentieth-Fifth Annual Report of the State Board of Health, of the State of Rhode Island. 1910.  (for the year ending December 31, 1902). Providence, RI:E. L. Freeman Co., 262-3.

December 1, 1909:  An excellent summary of aggressive municipal measures to eradicate typhoid fever from a major city. Municipal Journal and Engineer. Philadelphia Wars on Typhoid. “In an address at the Philadelphia College of Pharmacy, Dr. A. C. Abbott, Director of the Hygienic Laboratory of the University of Pennsylvania, and former Chief of the Bureau of Health, drew some striking comparisons between the present mortality rate from typhoid fever in Philadelphia and that which existed five years ago. In that time, he declared, by simple municipal measures, such as water filtration, strict supervision of the milk supply, and the cleaning up of river banks, the number of cases of typhoid fever had been reduced by fully 8o percent. Nearly one-half of the remaining cases are imported from other places by Philadelphians returning from their vacations. Still stricter regulation of dairies, the thorough disinfection of all sewage refuse, and, most important of all, the greatest personal care in the treatment of typhoid patients were urged as sure preventives of the disease. The use of uncooked vegetables raised on land fertilized with unsterilized sewage; the eating of raw oysters, not cleanly washed or handled, and the fly pest, which was characterized as a ‘filthy, intolerable nuisance, a disgrace to our civilization,’ were emphasized by Dr. Abbott as easily avoidable causes of the spread of typhoid. Vaccination, as a means of becoming immune to the disease, was described as entirely practicable and effective.”

Reference: Municipal Journal and Engineer. 1909. 27:22(December 1, 1909): 826.

November 30, 1917: U.S. Public Health Service Sanitation near Army Camps

November 30, 1917Municipal Journalarticle. How the U.S. Public Health Service Endeavored to Secure Healthful Conditions and Surroundings at Camp Bowie, the Aviation Fields Nearby and the Adjacent Area. “When a million men were ordered into military training in the summer of 1917, it was thoroughly realized that intensive health work would be necessary to adequately protect them from disease. It was also realized that to sanitate only their actual camping sites would not be sufficient. Disease germs will not stop at the camp border; the soldier is bound to mingle with the civilian population. The same restaurant, the same barber-shop, and the same movie attract the soldier and the civilian.

To protect the one it is necessary to protect the other. Insanitary conditions a hundred yards, or a mile, from the camp border may produce an epidemic as quickly as similar conditions within the camp limits….

Though anti-typhoid inoculation has practically eliminated typhoid from the army, it is still rife among the civilian population. Moreover, typhoid is but one of the filth-borne diseases, against most of which there is not a preventative inoculation. The control of these diseases demands a safe method of excreta disposal, whereby infectious material will be prevented from access to food and water supplies and protected from the fly.

In Fort Worth, as a beginning, immediate steps were taken to enforce the ordinance relative to sewer connections, and since work began in May, 2,000 sewer connections have been made. To reach those homes not accessible to the sewers, an ordinance was passed requiring the installation of a sanitary privy, the type of privy being specified. This consists of a fly-proof, tight wooden box with a screened opening in front and a connecting flue pipe behind, which extends above the top of the old privy house for the purposes of ventilation. Tight metallic cans, 15 inches in diameter and 15 inches high, are placed in the box for the catchment of excreta. The boxes and can are uniformly made according to specifications and installed in the old houses. This work has been done under the direction of the city, the installation costing $8.50. The privies are scavenged weekly at a cost of $1.50 per quarter, the full cans being removed and clean cans placed in their stead. The cans to be scavenged are hauled to disposal stations, which are large concrete risers built over sewer mains, and there thoroughly washed and deodorized. Nearly 4,000 of these privies have been installed in Fort Worth, while the incorporated towns of Niles and Polytechnic, adjoining Fort Worth, have also installed the system.”

Commentary:  In 1918, influenza killed over 650,000 in the U.S. However, epidemics of typhoid fever and diarrheal diseases were avoided by sanitary conditions such as described in this article. The famous sanitary engineer, George Warren Fullerplayed a role in the prevention of waterborne disease during WWI. “During the World War, he was a member of a sanitary committee at Washington regulating the engineering planning and sanitation of the various Army camps in this country.  As consulting engineer to the U.S. Public Health Service and the to the Construction Division of the Army, he was responsible for a considerable part of the practices which resulted in the unprecedented low typhoid fever death rate in the Army camps.”

References: Hardenbergh, W.A. 1918. “Extra-Cantonment Zone Sanitation.” Municipal Journal. 45:22(November 30, 1918): 423-4.

“Sad Milestone in Sanitary Engineering Progress.” 1934. American Journal of Public Health. 24:8: 895–6.

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 isalways 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 guessesat 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 21stcentury 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.