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San Francisco plague of 1900–1904 From Wikipedia, the free encyclopedia San Francisco plague of 1900–04 Date	1900 – 1904 Location	San Francisco Cause	Bubonic plague Outcome	121 cases Deaths	119 deaths The San Francisco plague of 1900–1904 was an epidemic of bubonic plague centered on San Francisco's Chinatown. It was the first plague epidemic in the continental United States.[1] The epidemic was recognized by medical authorities in March 1900, but its existence was denied for more than two years by Henry Gage, the Governor of California. His denial was based on business reasons: the wish to keep the reputations of San Francisco and California clean and to prevent the loss of revenue from trade stopped by quarantine. The failure to act quickly may have allowed the disease to establish itself among local animal populations.[2] Federal authorities worked to build a case to prove that there was a major medical health problem, and they isolated the affected area. Proof that an epidemic was occurring served to undermine the credibility of Gage, and he lost the governorship in the 1902 elections. The new governor, George Pardee, quietly implemented a medical solution and the epidemic was stopped in 1904. There were 121 cases identified, including 119 deaths.[3][4]

After the 1906 San Francisco earthquake, much of urban San Francisco was destroyed by fire, including all of the Chinatown district. The process of rebuilding began immediately but took several years. While reconstruction was in full swing, a second plague epidemic hit San Francisco in May and August 1907 but it was not centered in Chinatown. Rather, cases occurred randomly throughout the city; a few more cases were identified across the bay in Oakland. San Francisco's politicians and press reacted very differently this time: they wanted the problem solved speedily.[5] Health authorities worked quickly to assess and eradicate the disease.[6] To control one of the disease's vectors, some $2 million was spent between 1907 and 1911 to kill as many rats as possible in the city.[7] By the end of the second plague outbreak in June 1908, 160 more cases had been identified, including 78 deaths, a much lower mortality rate than 1900–1904.[8] This time, all of the infected people were Caucasian.[7] Shortly thereafter, the California ground squirrel was identified as another vector of the disease.[6] The initial denial and obstructionist response to the 1900 infection may have allowed the pathogen to gain its first toehold in North America, from which it spread sporadically to other states in the form of sylvatic plague (rural plague), though it is possible the squirrel population infection predated 1900.[2][9][10][11][12]

Contents [hide] 1	Background 2	Infection 3	Reaction 3.1    1900 3.3     1902 4	See also 5	References 6	External links Background[edit source] Main article: Third plague pandemic The third pandemic of the plague started in 1855 in China and eventually killed about 15 million people, mainly in India. In 1894, the plague hit Hong Kong, a major trade port between China and the US.[13][14] US officials were worried that other would get infection from cargo carried by ships that would cross the Pacific Ocean, for these reasons all ships were rigorously inspected. At that time, however, it was not widely known that rats could carry plague, and that fleas on those rats could transmit the disease to humans.[15] Ships arriving in US ports were declared clean after inspection of the passengers showed no signs of disease. Health officials conducted no tests on rats or fleas.[16] Despite important advances in the 1890s in the fight against bubonic plague, many of the world's doctors did not immediately change their ineffective and outdated methods.[16][17][18] In November 1898, the US Marine Hospital Service (MHS) chief surgeon, James M. Gassaway, felt obliged to refute rumors of plague in San Francisco. Supported by the city's health officer, he said that some Chinese residents had died of pneumonia or lung edema, but it was not bubonic plague.[19]

In January 1900, Honolulu's Chinatown burned down in an effort to control bubonic plague. In the newly formed US Territory of Hawaii, the city of Honolulu fell victim to the plague in December 1899. Residents of Chinatown, Honolulu, were reporting cases of fever and swollen lymph glands forming bubos, with severe internal organ damage quickly leading to death. Not knowing precisely how to control the spread of the disease, health officials of the city determined to burn the houses where victims had been found. Thousands of area residents were evacuated and quarantined for four months. Infected buildings were identified and destroyed by fire. On January 20, 1900, changing winds fanned the flames out of control, and nearly all of Chinatown burned—38 acres (15 ha)—leaving 6,000 without homes.[20][21]

San Francisco's harbor was only one short ocean voyage away from Honolulu, and medical men such as Joseph J. Kinyoun, the chief quarantine officer of the MHS in San Francisco, were worried about the infection coming to California. A Japanese ship, the S.S. Nippon Maru, arriving in San Francisco Bay in June 1899 had two plague deaths at sea, and two more cases of stowaways found dead in the bay, with postmortem cultures proving they had the plague.[22] In New York in November 1899, the British ship J.W. Taylor brought three cases of plague from Brazil, but the cases were confined to the ship.[22] The Japanese freighter S.S. Nanyo Maru arrived in Port Townsend, Washington, on January 30, 1900, with 3 deaths out of 17 cases of confirmed plague. All of these ships were quarantined; they are not known to have infected the general population. However, it is possible that plague escaped some unknown ship by way of fleas or rats, later to infect US residents.[22]

In this atmosphere of grave danger, in January 1900 Kinyoun ordered all ships coming to San Francisco from China, Japan, Australia and Hawaii to fly yellow flags to warn of possible plague on board.[23] Many entrepreneurs and sailing men felt that this was bad for business, and unfair to ships that were free of plague. City promoters were confident that plague could not take hold, and they were unhappy with what they saw as Kinyoun's high-handed abuse of authority. On February 4, 1900, the Sunday magazine supplement of the San Francisco Examiner carried an article titled "Why San Francisco Is Plague-Proof".[24] Certain American experts held the mistaken belief that a rice-based diet left Asians with a lower resistance to plague, and that a diet of meat kept Caucasians free from this disease.[25]

Infection[edit source]

Mayor James D. Phelan thought that Chinatown was a public health hazard. In January 1900, the four-masted steamship S.S. Australia laid anchor in the Port of San Francisco.[26] The ship sailed between Honolulu and San Francisco regularly, and its passengers and crew were declared clean. Its cargo from Honolulu was unloaded at a dock near the outfall of Chinatown's sewers, and rats carrying the plague may also have left the ship, though it is difficult to trace the infection to a single vessel.[27] Wherever it came from, the disease was soon established in the cramped Chinese ghetto neighborhood. A sudden increase in dead rats was seen by Chinese-American residents, possibly the result of ship-borne rats traveling up the sewers and infecting local rats.[28] Rumors of the plague's presence abounded in the city, quickly gaining the notice of authorities from MHS stationed on Angel Island in San Francisco Bay, including Chief Kinyoun.[29][30][31]

A Chinese American named Chick Gin, Wing Chung Ging or Wong Chut King became the first official plague victim in California.[32][33][34] The 41-year-old man, born in China but a resident of San Francisco for 16 years, was a bachelor living in the basement of the Globe Hotel in Chinatown at the intersection of the streets now called Grant and Jackson.[35] The Globe Hotel was built in 1857 as one of the better San Francisco hotels, with the appearance of an Italian palazzo, but by the mid-1870s it was a squalid tenement crowded with Chinese residents. Just outside, Jackson Street was the Chinese red-light district, where unmarried men could visit "hundred-men's-wives".[34] On February 7, 1900, Wong Chut King, the owner of a lumber yard, fell sick with what the Chinese doctors thought was typhus or gonorrhea, the latter a sexually transmitted disease common to Chinatown's residents at that time.[5][33] The medicine they prescribed did not give any relief and he died in his bed after suffering for four weeks. In the morning, the body was taken to a Chinese undertaker where it was examined by San Francisco police surgeon Frank P. Wilson on March 6, 1900. Wilson called for A.P. O'Brien, a city health department officer, after finding suspiciously swollen lymph glands. Wilson and O'Brien then summoned Wilfred H. Kellogg, San Francisco's city bacteriologist, and the three men performed an autopsy as night closed. Looking through his microscope, Kellogg thought he saw plague bacilli.[23][36]

Late at night, Kellogg ran the suspicious samples of lymph fluid to Angel Island to be tested on animals in Kinyoun's better-equipped laboratory; an operation that would take at least four days. Meanwhile, Wilson and O'Brien called upon the city's Board of Health and insisted that Chinatown be quarantined immediately.[37] When dawn came on March 7, 1900, Chinatown was circled by rope and surrounded by policemen preventing egress or access to anyone but Whites. The 12-block area was bordered by four streets: Broadway, Kearney, California and Stockton. Approximately 25,000–35,000 residents were unable to leave.[38][39] Chinese Consul General Ho Yow felt that the quarantine was likely based on false assumptions and that it was entirely unfair to Chinese people; he said that he would seek an injunction to lift the quarantine.[40] San Francisco mayor James D. Phelan was in favor of keeping the Chinese-speaking residents separated from the Anglo Americans; he said that the Chinese Americans were unclean, filthy, and "a constant menace to the public health."[40] Nevertheless, the Board of Health lifted the quarantine on March 9 after it had been in force for only 2½ days. O'Brien said by way of explanation that "the general clamor had become too great to ignore".[40] The animals tested in Kinyoun's lab seemed to be in normal conditions after the first 48 hours of being exposed to the possible plague-causing agents; this lack of early response cast doubt on the theory that plague was the cause of Wong Chut King's death.[41]

The scientist who confirmed the existence of plague in California, Dr. Joseph J. Kinyoun alienated the local population and government with his autocratic manner. On March 11, Kinyoun's lab presented its results. Two guinea pigs and one rat died after being exposed to samples from the first victim; this proved that plague was indeed in Chinatown.[40][42] Without restoring the quarantine, the Board of Health inspected every building in Chinatown, and labored to disinfect the neighborhood. Property was taken and burned if it was suspected of harboring filth. Using physical violence, policemen enforced compliance with the Board of Health's directives. The Chinese community was angered, and they reacted by hiding anyone who was sick.[43] On March 13, another lab animal died: a monkey that had been exposed. All the dead animals tested positive for the plague bacteria.[44] U.S. Surgeon General Walter Wyman informed the San Francisco doctors at the end of March 1900 that his laboratory confirmed the fact that fleas can carry the plague and transmit it to a new host.[45]

Reaction[edit source]

California governor Henry Gage denied there was a plague. Allied with powerful railroad and city business interests, California governor Henry Gage publicly denied the existence of any pestilent outbreak in the San Francisco, fearing that any word of the bubonic plague's presence would deeply damage the city's and state's economy.[46] Supportive newspapers, such as the Call, the Chronicle and the Bulletin, echoed Gage's denials, beginning what was to become an intense defamation campaign against quarantine officer Kinyoun.[47] In response to the state's denial, Wyman recommended to federal Treasury Secretary Lyman J. Gage that he intervene. Secretary Gage agreed, creating a three-man commission of investigators who were respected medical scholars, experienced with identifying and treating the plague in China or India. The commission examined six San Francisco cases and conclusively determined that bubonic plague was present.[11][48]

Like Kinyoun, the Treasury commission's findings were again immediately denounced by Governor Gage.[46] Gage believed the federal government's growing presence in the matter was a gross intrusion of what he viewed as a state concern. In his retaliation, Gage denied the federal commission any use of the University of California's laboratories in Berkeley to further study the outbreak, by threatening the university's state funding.[46] The Bulletin also attacked the federal commission, branding it as a "youthful and inexperienced trio."[4]

A political cartoon published in a Chinese-language daily paper in June 1900; epidemiologist Joseph J. Kinyoun being injected in the head with Waldemar Haffkine's experimental plague vaccine. Two other doctors appear to be developing buboes on their heads from the oversized inoculations. Federal judge William W. Morrow looks on. The clash between Gage and federal authorities intensified. Wyman instructed Kinyoun to place Chinatown under a second quarantine, as well as blocking all East Asians from entering state borders. Wyman also instructed Kinyoun to inoculate all persons of Asian heritage in Chinatown, using an experimental vaccine developed by Waldemar Haffkine, one known to have severe side effects. Spokesmen in Chinatown protested strenuously; they did not give their permission for this kind of mass experimentation.[49] The Chinese Consolidated Benevolent Association, also known as the Six Companies, filed suit on behalf of Wong Wai, a merchant who took a stance against what he perceived as a violation of his personal liberty. Not quite a class action suit, the arguments included similar wording such as complaints that all residents of Chinatown were being denied "equal protection under the law", part of the Fourteenth Amendment to the US constitution. Federal judge William W. Morrow ruled uncharacteristically in favor of the Chinese, largely because the defense by the State of California was unable to prove that Chinese Americans were more susceptible to plague than Anglo Americans. The decision set a precedent for greater limits placed on public health authorities seeking to isolate diseased populations.[50][51]

Between 1901 and 1902, the plague outbreak continued to worsen. In a 1901 address to both houses of the California State Legislature, Gage accused federal authorities, particularly Kinyoun, of injecting plague bacteria into cadavers, falsifying evidence.[52] In response to what he said to be massive scaremongering by the MHS, Gage pushed a censorship bill to gag any media reports of plague infection. The bill failed in the California State Legislature, yet laws to gag reports amongst the medical community succeeded in passage and were signed into law by the governor. In addition, $100,000 was allocated to a public campaign led by Gage to deny the plague's existence.[46] Privately, however, Gage sent a special commission to Washington, D.C., consisting of Southern Pacific, newspaper and shipping lawyers to negotiate a settlement with the MHS, whereby the federal government would remove Kinyoun from San Francisco with the promise that the state would secretly cooperate with the MHS in stamping out the plague epidemic.[52]

In October 1900, Kinyoun was the subject of a political cartoon about his being kicked out of his federal position. Despite the secret agreement allowing for Kinyoun's removal, Gage went back on his promise of assisting federal authorities and continued to obstruct their efforts for study and quarantine. A report issued by the State Board of Health on September 16, 1901, bolstered Gage's claims, denying the plague's outbreak.[46][53]

1900[edit source] Upon the death of Wong Chut King, the San Francisco Health Board took immediate action to prevent the spread of plague: Chinatown was quarantined. [54] Health officials wanted to prevent the propagation of the disease, they made the decision of placing Chinatown under quarantine without any notice to the residents. The quarantine was specific to Chinese residents, any white American person that was within the streets of Chinatown was allowed to leave, everybody else was forced to stay.[55] Physicians were restricted from crossing into Chinatown to identify and help the sick. The Health Board had to approve whether or not any health official crossed into the quarantined area. [56] Due to lack of evidence that the cause of death of King was plague, the quarantine was removed the day after to avoid controversy. [57]

Kinyoun's lab confirmed the disease was bubonic plague and informed the health board right away. In an attempt to avoid a second controversial quarantine, the health board continued with an house-to-house inspection to look for possible plague infested households and to disinfect those that were thought to be at risk of infection.[58] This house-to-house procedure was done mainly by volunteering physicians and residents. Other residents did not believe the inspection and disinfecting plan was done in good faith, they believed a second quarantine will be implemented. These residents that were in disbelief began to flee quietly and hide in friends' houses outside of Chinatown.[59]

As days passed, more dead bodies were reported and autopsies revealed the presence of plague bacilli, indicating that a plague epidemic had hit San Francisco's Chinatown, but the health board still was trying to deny it. The health board attempted to keep all the information regarding the outbreak secret by implementing strict regulations of what physicians could write official death certificates. [58] Nevertheless, newspapers published the news of the presence of bubonic plague in San Francisco to the entire nation.

The official inspection and disinfection of Chinatown finally began, thanks to the monetary contributions of the supervisors of the volunteer physicians, policemen, and inspectors that participated in the actual disinfection campaign. The sanitizing of Chinatown began to show results as the death toll slowly dropped through-out the month of March and the beginning of April. [58] Towards the end of April, the corpse of Law An, a Chinese laborer from a village near the Sacramento River, was found in an alley in Chinatown. The cause of death of Law An was determined to be bubonic plague. After that, a few more Chinese residents that died suddenly were determined to be infested with plague bacilli. [58] The fear that the bubonic plague was spreading intensified.

The controversy of the vaccination program organized by Kinyoun with the help of Surgeon General Wyman spiked. The plan was to inoculated the Chinese residents with a prophylactic serum that was intended to provide some protection against the plague for a 6-month period, no one spoke about the side effects and that the vaccine was still not approved for humans. [58] Most Chinese residents refused and demanded the vaccine to be tested in rats first. At first, representative of the Chinese community had agreed that inoculating the population with such serum could be a reasonable and safe solution, but soon after agreed with the rest of the Chinese population in that it was not ethical to try the vaccine in humans first. The representatives from the Chinese Six companies demanded the vaccination program to be eliminated as an option. With much pressure and insistence from the Chinese community, the vaccination program was detained, but by then hundreds of Chinese, Japanese, other residents had already received the vaccine and were presenting horrific side effects from the injection. [58]

1902[edit source] Countering the continued denials made by San Francisco-based newspapers, reports from the Sacramento Bee and the Associated Press describing the plague's spread had made the outbreak become publicly known throughout the US. The state governments of Colorado, Texas and Louisiana imposed quarantines of California, arguing that since the state had refused to admit a health crisis within its borders, states receiving rail or shipping cargo from California ports had the duty to protect themselves.[52] Threats of a national quarantine grew.[citation needed]

As the 1902 general elections approached, members of the Southern Pacific board and the "Railroad Republican" faction[54] increasingly saw Gage as an embarrassment to state Republicans. Gage's public denials of the plague outbreak were to protect the state's economy and the business interests of his political allies.[46][52] However, reports from federal agencies and certain newspapers continued to show Gage incorrect. At the state Republican convention that year, the Railroad Republican faction refused Gage renomination for the governorship. In his place, former Mayor of Oakland George Pardee, a German-trained medical physician, received the nomination. Pardee's nomination was largely a compromise between Republican factions.[citation needed]

In his final speech to the California State Legislature in early January 1903, Gage continued to deny the outbreak. He blamed the federal government, in particular Kinyoun, the MHS, and the San Francisco Board of Health for damaging the state's economy.[46][52]