While Ebola is the most recent incredibly unexpected disease to show up in Texas, it isn't anywhere near the most deadly. Long before anyone even knew Ebola existed, the city of Galveston grappled with an outbreak of bubonic plague.
When the first few patients started getting sick in June 1920, bubonic plague was such a foreign possibility that most doctors in the town didn't even consider it, according to reports from the time. It was only after the first patient, a 17-year-old boy, died that tests confirmed he'd had plague.
The disease sprang up in four different Gulf ports at almost the same time, including Galveston, according to a report published in 1921 by Dr. Mark Boyd and Dr. T.W. Kemmerer, the doctors who ran Galveston's plague laboratories. The timing indicated that there was a common source for the disease, but they were never able to figure out what the source was.
Bubonic plague has been around for centuries. It first made the history books when an epidemic swept through the Byzantine Empire during the sixth century. The Plague of Justinian (named after Justinian I, the then-ruler of the Eastern Roman Empire), killed thousands of people and weakened the Byzantine Empire just as Justinian was on the verge of reuniting with the core of the Western Roman Empire. Justinian himself caught the disease but survived. His empire wasn't so lucky.
The Plague of Justinian was bad, but it was nothing compared to the Black Death, which swept through Europe from 1346 to 1353 killing more than 25 million (and that's only according to conservative estimates.) While the Justinian plague reshaped the course of an empire, some historians believe the Black Death took a croquet mallet to the course of history. During the Black Death one Florentine chronicler described the devastation, according to History Today:
"All the citizens did little else except to carry dead bodies to be buried [...] At every church they dug deep pits down to the water-table; and thus those who were poor who died during the night were bundled up quickly and thrown into the pit. In the morning when a large number of bodies were found in the pit, they took some earth and shoveled it down on top of them; and later others were placed on top of them and then another layer of earth, just as one makes lasagne with layers of pasta and cheese."
The Black Death is believed to have begun with the first recorded instance of germ warfare, described by the Centers for Disease Control as "the most spectacular of biological warfare ever." A Mongol army had been sitting outside of Caffa (now a part of Crimea) for years trying to get in. Well, as luck would have it, soldiers in the army started dying from a mysterious sickness, and, even though they were in the grips of plague and thus losing interest in the siege, the Mongols didn't waste an opportunity, reportedly catapulting decomposing infected corpses into Caffa. With that we have the beginning of the Black Death, a pandemic that historians believe caused a loss of regard for life, general social upheaval and a hell of a lot of wars.
And no one really understood what was causing the disease or how to cure it. Many believed it was a judgment from God, many believed you could avoid the disease by walking around with flowers around your nose to keep the bad smells away. Doctors thought it was caused by nasty fumes, see, so they also advised people to move away from the bad smells. This helped out, sort of, since it also meant people moved away from the rats and the infected fleas. Of course, this prescription also caused the disease to spread.
While it seems like the Black Death was the only instance of a bubonic plague epidemic, there were other bouts with plague over the following centuries, including another pandemic that started in Asia in the 19th century. The World Health Organization didn't consider this pandemic officially over until 1959 when the annual deaths dropped to less than 200.
And the crazy thing was that it all came from rats, or specifically, the fleas on rats. (In 1898 French physician and biologist Dr. Paul-Louis Simond discovered that rat fleas were spreading the disease.) It's believed the disease came in through the ports, specifically from Egyptian grain shipments that brought both grain that the Byzantine Empire depended on and plague-infected rats that helped alter the empire's path.
Throughout history, the plague has spread in a fairly predictable way. Black rats, which tend to live near humans, would get infected with the disease (rat colonies were usually wiped out about two weeks after the first rat was infected.) The rats died relatively quickly, leaving the rat fleas with nothing to feed on. After a few days, rat fleas would then jump to humans, according to History Today.
The flea bite would infect a person with the bacterium Yersinia pestis, which would travel to a lymph node, usually in the groin, the thigh, neck or armpit, causing bubos (incredibly painful swollen lumps) to form. Once infected it usually takes a person three to five days to show symptoms. From there more than 80 percent of those infected with the disease were dead within a week.
In 1920 Galveston, that "oozy prairie," as early settlers described it, was only 20 years removed from the devastating 1900 hurricane. Houston had completely overshadowed Galveston in the wake of that destructive storm, but Galveston And then came the plague.
A 17-year-old feed store worker was the first to contract and die from the disease.
The first case was diagnosed in early June 1920. Over the following months eighteen people in total were diagnosed with plague, including a longshoreman, a housewife, a school girl, a couple of feed store workers and a pathologist. Only seven of those infected survived. The doctors found there wasn't any real correlation between who caught the disease, except for the places they lived and worked (which makes absolute sense when you think about it.) When rats in these areas were examined (and by examined we mean dissected) the source of the plague was discovered.
As with the recent Ebola scare in Dallas, there was some initial mishandling with plague. In two cases the doctors note in their report that the patient isolation "was not accomplished as rapidly as desired," both because families were slow to call in a doctor and because the doctor didn't consider bubonic plague to be an actual possibility.
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Once it became clear this was in fact plague, things got rolling. The state's health board supplied a small amount of one of the few known treatments at the time, Mulford's Anti-plague Serum. (Catchy name, no?) After that supply was exhausted, the state health board and the United States Public Health Service worked together to procure the serum from the Pasteur Institute in Paris. Of the 11 treated with the serum, five recovered.
Meanwhile, Galveston officials launched an anti-plague campaign they dubbed "War on Rats." City officials enlisted 40 rat trappers, each armed with a garbage pail, oil can, file and wire brush. Trapped rats were dipped in kerosene, iced and sent back to a laboratory where workers examined the rats for signs of plague. Using this system more than 500 rats were collected each day from June to December for a grand totally of 46,623 rats wiped out. (It seems they kept count.)
While plague-infected rats continued to turn up for the next couple years (the last one was found in May 1922) the human bubonic plague ended with a final case diagnosed in December.
Officials with the city of Houston were also worried about the whole plague thing, since Galveston was just down the road. Houston rat trappers captured more than 15,000 rats, at a cost of about 70 cents per rat, according to Dr. Arthur Flickwir, a Houston health officer. He also noted that, at 70 cents per rat, Houston was cleaning up its rodent problem at a much lower cost than certain other cities. Because of course Houston officials finagled the best deal for exterminating potential plague rats.