Throughout the 19th century, Mobile and the South survived despite numerous outbursts of health threats, including typhoid, cholera and tuberculosis. The deadliest of that century, however, was yellow fever, which arrived seemingly without warning in the early summers and then disappeared with the first frosts of autumn. In 1878 alone, 20,000 died in the Mississippi Valley out of an estimated 120,000 sufferers.
During the hot and humid summer of 1819, one-third of Mobile’s population died, overloading the existing burial grounds and leading to the establishment of Church Street Graveyard. The 1839 epidemic took old and young, rich and poor. Millionaire Henry Hitchcock, whose generosity had helped construct both the Government Street Presbyterian Church and Barton Academy, fell victim and was one of the early inhabitants of New City Cemetery, which has long been known as Magnolia.
Dr. Josiah Nott, who would later help to establish the state’s first medical college in Mobile, suspected that swarms of mosquitoes were to blame, but no one was listening. The prevailing notion was that the fevers were caused by fogs or “miasmas” rising from the damp earth after nightfall.
Cures ranged from sucking on lemons all day to drinking large doses of coffee laced with whiskey. Others decided to lock the fever out by shutting themselves up behind locked doors and windows despite the summer heat. As miserable as this must have been, it may have at least kept the culprit — the mosquitoes — out.
Physicians were hesitant to announce a case of yellow fever as it would lead to a quarantine. Even a rumor of the dreaded disease sent panicked residents rushing for the train station or boat docks to get out of town. Symptoms were unmistakable: fever, chills and a gruesome black vomit. The patient would experience a “yellow effusion” about their eyes and jaundice, hence the name.
Communities around the South battled each other when a rumor of yellow fever surfaced. In 1886, citizens of Pass Christian established a “strict shotgun quarantine” against neighboring citizens of Biloxi, placing armed guards around the edge of town. Well into the end of the century, these shotgun quarantines were reported around the region with news accounts of travelers being forced from trains and made to walk to their destinations. Escambia County maintained a “pest house” during outbreaks where suspected carriers would be taken at gunpoint.
During the 1894 outbreak, Mobile’s hospitals were so overrun with patients that tents were erected behind City Hospital on St. Anthony Street.
In February of 1898, representatives from all Southern states convened in Mobile to discuss the future of quarantines. Delegates voted in favor of a national system for quarantine rather than local, but the matter never made it to Congress. The last yellow fever epidemic in the United States struck New Orleans in 1905 and killed some 900. By that date, it was estimated that New Orleans had lost 41,000 over the course of a century, due to the outbreaks.
Although yellow fever scares ended, a new deadly epidemic, later termed a pandemic, was on the horizon: the Spanish Flu.
Spanish Influenza — Bacteria not Miasmas
Although the jury is out as to where the deadly strain of flu originated in 1918, Spain experienced the first fatal blows from the disease and bore the blame for decades. The first cases in Alabama arrived in Huntsville but quickly spread southward, paralyzing communities in its wake.
Although Americans had suffered with bouts of the flu or “the grippe” for years, this new form was especially fatal. And what was even more shocking, fatalities were especially high among adults aged 20 to 40, a group previously relatively unharmed by flu.
The Medical Association of the State of Alabama met in 1919 and reported “the disease spread like wildfire. In two or three days, entire families were prostrate. The epidemic begins with chilliness and pains in the arms, legs, back and head accompanied by coughing and sneezing. Pregnant women are particularly hit and often lose the baby. Up to one-third of communities are stricken, and of this number, at least 10 percent developed pneumonia, the mortality of which is between 40 to 50 percent.” Those who survived had lungs one physician described as being “shot to pieces.”
The flu spread as World War I was coming to an end, and the close quarters suffered by soldiers and sailors made the disease rampant. Cities finally recognized the problem and established rules eerily similar to those in place during the 2020 pandemic. Everything from churches to theatres were closed, masks were worn in public and Americans were bombarded with leaflets asking them to cover their coughs and sneeze toward the ground, not each other.
By the time the state’s medical association met in 1920, the pandemic was over. They were informed “more U.S. citizens have died from this disease than were killed in the recent conflict.” The cause was determined to be “due to an air-born bacteria as yet un-identified.” After administering a new vaccination to 5,000 people, the percent of the population affected dropped from 30 to 4.
As history shows, the 2020 pandemic is not the first serious health threat to strike Mobile and may not be the last.