A Shot in the Arm

 By Rachel Dworkin, Archivist

 The first mass inoculation in North America occurred in Boston during an outbreak of smallpox in 1721. The inoculation campaign was spearheaded by Cotton Mather and Zabdiel Boylston, using a technique known as variolation which had been taught to Mather by an enslaved man named Onesiumus. Variolation, as practiced in Onesiumus’s native West Africa, involved rubbing dried pus from smallpox scabs into shallow cuts in a patient’s arm. They would then develop a relatively mild case of the disease and henceforth be immune. Over the course of the epidemic, Boylston and Mather managed to inoculate 247 people before anti-inoculation mobs forced them to stop. Still, the success of their efforts lead to the widespread adoption of variolation throughout the Colonies, especially in urban areas. In 1777, George Washington ordered that the entire Continental Army be variolated to prevent outbreaks in military encampments.

Modern vaccines are a bit different from variolation, although the basic idea is the same: give the body a taste of the disease so it knows how to fight it when it encounters the real thing. With variolation, the idea is to give the patient the actual disease, just a mild form. Vaccines, on the other hand, confer immunity without actually infecting the patient. There are seven types of vaccines currently in use:

1. Inactivated vaccine using dead cells from the virus or bacteria. Examples include the Salk polio vaccine, hepatitis A vaccine, and most flu vaccines.
2.  Attenuated vaccine using live, but weakened, strains of the virus (similar to variolation). Examples include the mumps, measles, and rubella vaccines.
3. Toxoid vaccines using inactivated versions of toxic compounds which cause illnesses. Examples include tetanus, diphtheria and rattlesnake venom. 
4.  Subunit vaccines using a fragment of a virus or bacteria rather than the whole thing. Examples include vaccines for hepatitis B, human papillomavirus, and the plague.
5. Conjugate vaccine using a virus or bacteria along with a toxoid to boost immune response. Examples include vaccines for meningitis and typhoid fever.
6. Heterotypic vaccines using a virus or bacteria which cause diseases in animals, not people. Examples include the original smallpox vaccine and the current tuberculosis vaccine.
7. RNA vaccine using a virus’s genetic material. Examples include the COVID vaccine. This is the most cutting-edge type of vaccine on the market.

The first Chemung County residents to be vaccinated were soldiers. Beginning in 1812, the United States Army began regularly vaccinating troops against smallpox. During the Spanish-American War of 1898, all mobilized volunteer and militia members received the smallpox vaccine too. In fact, members of the US military were vaccinated against smallpox as late as 1990, long after the disease had been eradicated in civilian populations. Typhoid vaccines have been mandatory for members of the armed services since 1911. Even today, military members receive a battery of vaccines not commonly in use by civilians.

The first wide-scale civilian vaccination drive in Chemung County occurred in the summer of 1925. The Elmira Health Department worked with the Elmira City School District to vaccinate children under the age of 11 with the new toxoid diphtheria vaccine. Diphtheria is a potentially life-threatening bacterial infection which causes fever, cough, sore throat, and swelling of the throat resulting in difficulty swallowing or breathing. Over the course of the summer, the health department managed to vaccinate 1,468 children. Over the coming years, they continued to vaccinate children at their free Child Welfare Clinics and with the assistance of school nurses. By 1937, approximately 41% of pre-school aged children and 70% of school-aged children throughout the city were vaccinated against diphtheria. 

Dr. George Murphy of Elmira Health Department vaccinates child, 1935

 

During the 1940s, the city health department stepped up their vaccination efforts, adding vaccines for tetanus and whooping cough. In 1942, they launched a smallpox vaccination campaign. Starting on May 5, they offered weekly vaccination clinics. By year’s end, they’d vaccinated 1,218 children. Today, New York school children are required to be vaccinated against diphtheria, tetanus, and whooping cough, but not smallpox. 

Certificate of vaccination, 1886

 In 1955, Dr. Jonas Salk developed the world’s first polio vaccine. Just two years earlier in 1953, the county had suffered a serious outbreak of the illness. Beginning in May 1955, the county launched a massive and unprecedented vaccination drive. Children were bused from the schools to the County Health Center for their shots. Civil Defense volunteers were called up to help control the young crowds and direct traffic. Between May and October, they vaccinated 12,472 first, second, third, and fourth graders using vaccines donated from the Polio Foundation and the federal government. When the Sabine oral polio vaccine was released in 1962, the health department did it all over again, this time vaccinating 100,000 people of all ages.  

Little girl takes Sabine oral polio vaccine, July 1962. Image courtesy Star-Gazette

 The current push to vaccinate everyone against COVID-19 is unprecedented only in its scale. Approximately 70% of the nation’s population will need to be vaccinated in order to generate herd immunity. Already, local efforts are underway. Employees at the local hospitals are being vaccinated and the Chemung County Health Department just opened up the Arctic League Headquarters at 249 W. Clinton Street as a vaccination center. The process will take months but, together, we can get there.  

The Smallpox Epidemic at the Elmira Prison Camp

By Gary Emerson

Speaker in 2020 CCHS Civil War Speaker Series

Schuyler County Historian

PhD candidate in American History at Binghamton University

(Mr. Emerson has recorded his Civil War talk for us to post on our video page of Facebook on 4/30, this timely blog highlights some of the topic he will cover.)

 The smallpox epidemic that struck the Elmira Prison Camp during the Civil War provides a didactic message for the present. With the proper precautions, the epidemic could have been managed with a minimal loss of life, but without the preventative steps or proper social distancing the virus spread and became the third leading killer at the prison camp. 

Elmira Prison Camp

Smallpox was a feared disease in the 19^th century. Before the rise of germ theory, medical science did not know what caused smallpox and had no cure for it. To this day, there is no cure. The only available tool was prevention. Isolation, vaccination, and inoculation were the main methods of smallpox prevention, and they were applied too late at Elmira. 

All Civil War prison camps were visited by smallpox, with most experiencing similar problems in bringing it under control, even though the means for preventing it were widely known. The spread of crowd diseases, like smallpox, became one of the unintended consequences of the decision to establish military prison camps during the war, as nature and the environment became another enemy to battle with.

The presence of smallpox in the prison camp presented the possibility that it could spread to the civilian population in Elmira. By good fortune it did not, but the city leaders took the precaution of establishing a pest house to allow for the isolation of any cases that should crop up. The Elmira pest house was maintained into the early 20^th century as a first line of defense whenever smallpox or any other contagious disease visited the area.

Today, we must defend against a new virus that threatens our well-being. Many of the lessons applicable in 1865 are still important in our current response to covid-19. Let us hope that people heed those lessons well to lessen the impact of the illness, while we wait for a vaccine to bolster our arsenal against it.

Join our Facebook page on Thursday April 30^th at 7 pm for a recorded talk by Gary Emerson.

The Reconstruction Home, FDR, and the Iron Lung Club: A History of Polio in Chemung County

by Erin Doane, curator

From April 17 to May 1, 2016 the World Health Organization (WHO) undertook the largest synchronized event in the history of vaccines. The organization coordinated 155 countries and areas around the world in the simultaneous switch from the old oral polio vaccine to a new vaccine in the hope of fully eradicating polio worldwide by 2019.

The United States stopped using the oral polio vaccine entirely in 1999, so we were not part of this world health event. There has not been a reported case of polio in Chemung County since 1961. People born here in the last 50 years have never experienced the fear of contagion or the effects of the crippling disease that swept through the population on a fairly regular basis before the development of a vaccine in the 1950s. Many people today may not even know what polio is or why it is so important to finally eradicate it forever.

Governor Roosevelt meeting a child stricken

by polio on his visit to Elmira in 1929.

Poliomyelitis, or polio, is also known as infantile paralysis. According to the WHO website, polio is a highly infectious disease caused by a virus that is transmitted person-to-person through the fecal-oral routine. Children under 5 years old are at the greatest risk of infection. Early symptoms of polio include fever, fatigue, headache, vomiting, stiffness of the neck, and pain in the limbs. The infection can spread to the nervous system causing paralysis, usually in the legs. 1 in 200 infections leads to irreversible paralysis. Among those paralyzed, 5 to 10 percent die when their breathing muscles become immobilized. There is no cure for polio.

Chemung County suffered a polio epidemic in 1921 that left many disabled children without rehabilitative or long-term care. In January 1923, the Elmira Rotary Club took steps to help those children. The club purchased the former home of Governor Lucius Robinson at 563 Maple Avenue in Elmira and created the Reconstruction Home for Crippled Children. The home opened its doors just a month later. Children who came to live in the home received physical therapy and had around-the-clock care. There was also a classroom in the home, equipped and staffed by the Elmira school system.

The Reconstruction Home for Crippled Children on Maple Avenue in Elmira, c. 1920s

Shortly after the Rotary Club began its charitable undertaking, the members’ wives got together and formed the Rotary Anns, an auxiliary group dedicated to the Reconstruction Home. They raised money for furnishings and equipment for the home, sewed linens, and provided special treats for the children. The Anns’ goal was to make the place feel more like home to the children, many of whom lived there for months at a time. Whenever possible, they took the children on outings to the movies or the circus. There was also a picnic at the Roy Farm in Wellsburg each summer. All the children, whether they were ambulatory, in wheelchairs, or on frames, were loaded into cars and trucks and taken out to enjoy a day in the countryside.

Christmas at the Reconstruction Home, 1924

In August 1929, the Reconstruction Home received a famous visitor – then-governor Franklin D. Roosevelt. Roosevelt made the brief stop while in the area to inspect the State Reformatory in Elmira. In 1921, he himself had been stricken with polio and became permanently paralyzed from the waist down. The Elmira Star-Gazette reported that the children were a bit shy at first about meeting the governor but “when Roosevelt smiled they all hobbled up to meet him.” One youngster in a wheelchair declared, “I wanna meet the guvnor. Take me to him.”

Governor Roosevelt visiting the Reconstruction Home in Elmira, August 1929

Eddie Wright of Hornell, resident of the Reconstruction

Home, meeting Governor Roosevelt,

Elmira Star-Gazette, August 14, 1929

By the late 1930s, demand for the rehabilitation services and care at the Reconstruction Home had waned. At the end of 1936, there were only five children left in residence. The home closed its doors for good in February 1937. It had operated in Elmira for 15 years during which time nearly 350 children had received care.

Children outside of the Reconstruction Home, c. 1920s

In 1944, Chemung County suffered its worst polio epidemic. The first case was reported on June 20. By the time the outbreak ended in December of that year, 293 patients from the region had been treated at St. Joseph’s and Arnot Ogden Memorial Hospitals. Six people died in the epidemic and many more were permanently paralyzed by the disease. Five out of the six deaths were children. One of the reasons that this outbreak was particularly bad was because it took place while World War II was raging. Of Chemung County’s 60 physicians, nearly half were away in military service.

Another polio outbreak hit the county in May 1953. While not as severe as the 1944 epidemic, there were still 80 cases reported and four deaths. St. Joseph’s Hospital started what became known as the “Iron Lung Club.” The hospital had been presented with an iron lung in 1946 by the National Foundation. An iron lung is a negative pressure ventilator that was essential in treating people with polio when they could not breathe on their own. Patients would stay in the iron lung for weeks, months, and even years at a time.

Diane Bacon, last respirator polio patient at St. Joseph’s Hospital

in Elmira, is transported in an iron lung for further treatment in

Buffalo, September 22, 1953, Elmira Star-Gazette

In 1952, Dr. Jonas Salk first tested his polio vaccine. Five years later, Dr. Albert Sabin developed a new oral vaccine. Sabin’s vaccine was licensed in 1962 and became used world-wide to prevent the disease. Starting in 1962, the Chemung County Medical Society sponsored mass clinics for the administration of the Sabin vaccine. That year, some 92,000 area residents were inoculated. The final clinics took place on “Sabin Oral Sunday,” November 15, 1964.

In 1988, there was an estimated 350,000 cases of polio in 125 countries worldwide. In 2015, those numbers were down to just 74 reported cases in two countries, Afghanistan and Pakistan. That is a decrease of over 99 percent. The WHO’s dream to completely eradicate polio may well have a chance of becoming a reality.

Children and staff at the Reconstruction Home, c. 1930s