Hometown History #73: State Sleuth Investigates Franklin Epidemics

There was no shortage of communicable diseases visited upon Franklin in the pre-antibiotic era. One such event (and not the last), was the great Scarlet Fever and Typhoid Epidemic of 1899-1900. What is interesting about it is that the state felt compelled to send a top official to investigate, since the whole thing was a bit unusual, even for those times.

His report in the annual state health report tells of his scientific sleuthing  and finger pointing in a country town...

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During the months of February, March, and April, the town was visited with an extensive epidemic of scarlet fever. Fifty-eight cases of that disease occurred in Franklin during that year. It is greatly to be regretted that early in the epidemic there were those who did not realize the necessity of strict quarantine, and were induced, from motives best known to themselves, to interfere with the efforts of this board to stamp out the disease. Professional incompatibilities, in which we cannot think the people generally have much interest, and which most certainly ought to have nothing to do with matters of quarantine and sanitary regulation, seem to have operated to hinder and obstruct the board of health in carrying out its proper and required work.

The following reports of Medical Inspector Morse related to epidemics of scarlet fever and typhoid fever at Franklin, one of which is referred to in the foregoing extract from the report of the local board of health.

On March 20 an anonymous letter was received at this office, containing information that an epidemic of scarlet fever existed in the town of Franklin, and that the usual precautions taken in such cases had not been observed. It was further stated that a case of the disease existed at Elm Farm in the village of Unionville, and that milk from this farm was distributed about the town, and certain amount of it sent to Boston. I accordingly went to Franklin on March 23 to investigate these cases.

The first case to appear was in November of 1899, since which time thirty-four cases of scarlet fever had been reported to the local board of health. As the investigation proceeded, it was evident that the local board of health was somewhat impeded in preventing the spread of the disease by one of the practicing physicians of the town, who, it is said, stated to his patients that the board of health had no authority to quarantine his cases, and told them that they might go about the town as usual; in fact, somebody went so far as to take down one of the red flags placed by the local board of health at a house where scarlet fever existed. Other legal technicalities were also presented to me by both parties, but concerning which I refused to offer any opinion.

After consultation with the local board of health, I advised them regarding the usual ways of preventing the spread of scarlet fever, and that they give definite directions to the householder wherever a case appeared. Formaldehyde had never been used as a disinfectant in the town, and I also advised the board to procured a supply, and thoroughly disinfect each house with it after the patient had recovered.

These measures seemed to efficacious in stopping the disease, for in the following month, only four new cases appeared.

During the latter part of September and the early part of October it was apparent that an unusual number of cases of typhoid fever was present in the town of Franklin, and in a communication from the chairman of the board of health, Dr. G.A. Martin, a request was made for advice relative to the cause of the disease.

On October 5 I made a visit to the town, and found that there were twenty-three cases of the disease which had been reported since September 20. Visits were made to their houses, the date of their going to bed obtained, an all other information relative to the origin of the disease. In five of these cases, the origin of the disease could not be definitely stated, the patients having various milk and water supplies, and no common source of infection could be ascertained. In the seventeen remaining cases it was found that eight of them had milk of one milkman and the remaining nine of another milkman. A visit was made to the first farm, and it was learned upon inquiry that no case of typhoid had been present. It was ascertained, however, that a daughter of the farmer who had used this supply was ill with typhoid fever, and had been one of the first to go to bed. She lived some distance from the farm but it is possible that some of the infection in her case was carried by means of the milk cans subsequently distributed to the other customers becoming ill with the disease.

Of the nine cases developing from the other supply, all were in three families, four existing in one, two in another, and three in the third, and these were the only families supplied by this dealer. He kept only one cow, and the amount of milk was consequently limited. The surroundings about this place were entirely unfit for the production of milk, for the barn was small and poorly ventilated, the family was poor and unable to keep help, and when the milkman’s wife was taken ill during the early part of this epidemic, the man himself nursed her and did most of the housework, beside attending to the duties about the place and the distribution of the milk. Two of his children were also subsequently taken ill with the disease.

In the family where two cases appeared there were only three in the family, the third member being an elderly woman, who probably was immune to the disease, and in the family where four members were ill the entire family contracted the disease.

The board of health, through its chairman, was made acquainted with the conditions existing at this farm and with the results of the analysis of several samples of water taken in the course of the investigation. these samples were obtained from wells at some two or three houses where patients were ill, and at the farms in question. In every instance all of them were dangerously polluted and it was advised that new supplies be obtained.

During the month of October seven other cases appeared, but it could not be definitely stated that infection was received from the sources above discovered. With the presence of the disease in town, however, it would be possible for the infection to spread in some other manner than through the milk supply.