1916 — July-Sep esp. Polio, esp. NYC/NY State (3,331), NJ (1,180), PA (414) –6,745->7,000
–27,000 Tweton. “North Dakota and the Polio Killer Virus. North Dakota Studies. Oct 1965.
–~7,000 Kohn, George Childs (Ed.). Encyclopedia of Plague and Pestilence. 2001, p. 365.
–>7,000 Rinaldo, C. R. Jr. “Passive Immunization Against Poliomyelitis…” 2005, abstract.
–>7,000 Rosenberg/Peck. “Megadeaths,” in Bryant, Handbook of Death & Dying. 2003, 231.
— 6,745 Blanchard tabulation based upon State and locality breakouts below.
— 6,000 CDC. Polio Vaccine: What You Need to Know. 2000
— 6,000 eMedTV. OPV (Oral Polio Vaccine), “History of Polio and OPV.” 2006
–~6,000 Levenson. “Polio outbreak threatened Bucks, Montgomery co’s…” Phillyburbs. 2013.
— 6,000 McCreedy, The Polio Vaccine: Freedom from Fear, “Polio Epidemic of 1916,” 2005
— 6,000 June-Nov. NYC DPH. Monograph…Epidemic…Poliomyelitis… NYC…, 1917, 11.
— 6,000 Rogers, Naomi. Dirt and Disease: Polio before FDR. New Brunswick, NJ: 1992, p. 10.
— 6,000 Seavey, Smith, Wagner. A Paralyzing Fear: The Triumph Over Polio. 1998, 23.
–~6,000 Wilson, Daniel J. Polio. 2009, p. 11.
— 5,000 Trevelyan, et al. “The spatial structure of epidemic emergence…polio…” 2005.
— 5,000 Wyatt. “The 1916 New York City Epidemic of Poliomyelitis…,” 2011, p. 13.

Summary of States with more than Ten Deaths

Alabama ( 51) Maryland ( 111) Ohio ( 45)
California ( 26) Massachusetts (452) Pennsylvania (414)
Connecticut ( 235) Michigan ( 138) Rhode Island ( 23)
Illinois ( 80) Minnesota ( 105) South Carolina ( 36)
Indiana ( 50) Mississippi ( 31) Texas ( 35)
Iowa ( 51) Missouri ( 20) Vermont ( 12)
Kansas ( 26) Montana ( 26) Virginia ( 59)
Kentucky ( 48) New Jersey (1,180) West Virginia ( 13)
Louisiana ( 18) New York (3,331) Wisconsin ( 79)

Breakout by States (43), the District of Columbia, and Localities

Alabama ( 51)
–51 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 3 Birmingham (20 cases). USPHS. “Poliomyelitis…Prevalence in Cities…1916,” PH Rpts.
— ? Mobile (10 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.

Arizona ( 1)
— 1 Phoenix ~Nov 24. Fort Wayne Weekly Sentinel (IN). “Woodburn News,” 10-25-1916, 10.

California ( 26)
–26 Statewide. USPHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 1 Gustine. Oct 25. Bakersfield Californian. “One Fatality…Infantile Paralysis,” 10-25-1916.
— 4 Los Angeles. USPHS. “Poliomyelitis…Prevalence in Cities…1916,” Public Health Rpts.
— ? Oakland (2 cases). USPHS. “Poliomyelitis…Prevalence…Cities…1916,” Pub. Health Rpts.
— 2 San Francisco (31 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health. 1917, 563
— 1 “ Sep 6. Oakland Tribune. “Steps Taken to Halt Paralysis…,” 9-6-1916, p. 1.

Colorado ( ?)
— 0 Denver (7 cases). USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts, 1917, p.563.

Connecticut ( 235) (July-Oct)
–235 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 22 Bridgeport (73 cases). USPHS. “Poliomyelitis…Cities…1916,” PH Rpts. 1917, 564.
— 1 Ellington. July 12. New York Times. “New Cases in Connecticut,” July 14, 1916, p. 5.
— ? Fairfield (237 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 181.
— 1 Greenwich. Aug 13. NY Times. “1,008 Victims in N.Y. State,” Aug 15, 1916, p. 18.
— 10 Hartford (62 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts, 1917, 564
— 1 “ July 12. New York Times. “New Cases in Connecticut,” July 14, 1916, p. 5.
— ? Litchfield (37 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 181.
— ? Middlesex (21 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 181.
— 1 New Britain Oct 21. New York Times. “Paralysis Germ Probably Found,” 10-22-1916.
— 17 New Haven (95 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health. 1917, 564.
— 1 “ July 14. New York Times. “Paralysis in Various States,” July 15, 1916, p. 16.
— ? New London (53 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, 181.
— 1 Stamford. July 1. New York Times. “Jersey Ejects 22 Families” July 2, 1916, 16.
— ? “ 8 cases, July 30-Aug 5. USPHS. Public Health Reports, V31, N34, 8-25-1916, 2284.
— ? Tolland (15 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 181.
— ? Windham (40 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 181.

Delaware ( >1)
–? State (71 cases). MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8.
–? Kent Co. (9 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
–? New Castle Co., 54 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p182.
–? Sussex Co. (9 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
–1 Willow Grove, Aug 16. The News, Frederick MD. “Paralysis Makes…Record,” 8-17-1916.

District of Col. ( 6)
–6 US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
–1 Oct 7. JAMA. “Medical News,” Vol. 67, No. 17, 10-21-1916, p. 1236.

Florida ( ?)
— ? State (8 cases). MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8.
— ? Perry (2 cases, July 30-Aug 5). USPHS. Public Health Reports, 31/34, 8-25-1916, p. 2279.
— ? Sanford (1 case, Jul 30-Aug 5). USPHS. Public Health Reports, 31/34, 8-25-1916, p. 2279.

Georgia ( 2)
— 2 Atlanta. USPHS. “Poliomyelitis…in Cities…1916,” Pub. Health Rpts. 1917, p. 564.

Illinois ( 80) (July-Nov)
–80 State, July 1-Nov 28. Decatur Review. “80 Deaths in State…Baby Plague, 11-28-1916
— 1 Atwood (no date). Edwardsville Intelligencer (IL). “Told of the Cause,” 10-7-1916, p. 4.
–49 Chicago. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Reports. 1917, 563.
— 1 “ July 6. Beatrice Daily Sun (NE). “One Death in Chicago,” July 7, 1916, p. 1.
— 2 “ (no date). Edwardsville Intelligencer (IL). “May Examine Public,” 8-28-1916, 1.
— 1 Dana. Aug 27. Edwardsville Intelligencer (IL). “May Examine Public,” 8-28-1916, 1.
— 1 Danville The Pointer, Dolton, IL. “Plague Death Near Danville.” 8-11-1916, p.3.
— 1 Decatur. Oct 21. Decatur Review (IL). “Funerals,” Oct 22 1916, p. 17.
— 1 Dixon, Sep 7. Freeport Journal-Standard. “Boy of 17 Dies…Infantile Paralysis.” 9-8-1916.
— 1 Edgar County. The Pointer (Dolton, IL). “Plague in Edgar County,” Aug 11, 1916, 3.
— ? Evanston (8 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Gilman. Nov 27. Decatur Review. “80 Deaths in State…Baby Plague, 11-28-1916, p. 9.
— ? La Salle (6 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Oak Park. Aug 27. Edwardsville Intelligencer (IL). “May Examine Public,” 8-28-1916, 1.
— 1 Ottawa Jul 27. Freeport Journal-Standard. “Ottawa Child…Infantile Paralysis,” 9-28-1916
— ? Rockford, 1 case, July 30-Aug 5. USPHS. Pub. Health Rpts., V31, N34, 8-25-1916, 2284.
— ? Springfield (2 cases). NYT. “Paralysis Kills 22 More Babies in New York City.” 7-8-1916.

Indiana ( 50) (especially Sep)
–50 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— ? Evansville (7 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Fort Wayne (1 case). NYT. “Paralysis Kills 22 More Babies in New York City.” 7-8-1916.
— 1 near Headlee, Sep 23. Logansport Tribune (IN). “Royal Center,” Sep 26, 1916, p. 7.
— 5 Indianapolis. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts. 1917, p.563
— 2 “ by Sep 18. Fort Wayne Journal-Gazette. “13 Paralysis Cases…,” 9-19-1916.
— 1 Logansport Aug 29. Logansport Tribune, IN. “Resume of Local Events…,” 12-31-1916.
— 1 “ Sep 17. Logansport Tribune, IN. “Deaths and Funerals,” Sep 19, 1916, p. 2.
— 1 “ ~Sep 12. Logansport Tribune, IN. “No More Infantile Paralysis…,” 9-13-1916.
— 1 Moore’s Hill Aug 7. Washington Gazette, IN. “Indiana Youth is Victim,” 8-11-1916, p. 5.
— 1 Shelbyville. Nov 27 Fort Wayne News, IN. “Hoosier Happenings,” 11-28-1916, p. 7.
— ? Terre Haute (1 case). NYT. “Paralysis Kills 22 More Babies in New York City.” 7-8-1916.
— 1 Thorncreek Twp., Sep 1. Weekly Sentinel, Fort Wayne. “Austin Cook Dies,” 9-6-1916.
— 1 “ ~Aug 30. Weekly Sentinel, Fort Wayne. “Second Death in Whitley Ct.,” 9-6-1916
— 1 Wheeling, Dec 6. Logansport Tribune, IN. “Obituaries – Wheeling,” 12-17-1916, p. 18.

Iowa ( 51) (esp. late Aug-Nov 13)
–51 Statewide. USPHS. Public Health Rpts., “Poliomyelitis…By States, 1916,” p. 840.
–18 State, as of Sep 27. Des Moines News. “18 Paralysis Deaths in Iowa,” 9-27-1916, 8.
— 7 “ as of Aug 31. State Center Enterprise. “Paralysis…Thirty-Six Counties,” 8-31-1916.
— 1 Batavia, Sep 29. Humboldt Republican (IA). “Little Boy Dies…at Batavia,” 9-29-1916.
— 1 Berwick. ~Sep 28. Postville Review (IA). “Iowa News Briefs,” Sep 29, 1916, p. 8.
— ? Cedar Rapids (5 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 4 Des Moines (12 cases). USPHS. “Poliomyelitis…Prevalence in Cities…1916,” PH Rpts.
— 1 Des Moines. Sep 26. Des Moines News. “18 Paralysis Deaths in Iowa,” 9-27-1916, p. 8.
— 1 Fremont, ~Oct 12. Cedar Rapids Republican. “Infantile Paralysis…Dallas Co.” 10-14-1916
— 1 Fredonia Nov 13. Muscatine Journal, IA. “Youth a Victim of the Plague,” 11-14-1916, p.6.
— 1 Harper, ~Oct 17. Des Moines Daily News, IA. “One New Paralysis Case,” 11-20-1916, p9.
— 1 Mason City, as of Aug 31. State Center Enterprise. “Paralysis…,” 8-31-1916.
— 1 ~Oelwein. Sep 26. Oelwein Daily Register, IA. “Passing of Donna Adams,” 9-28-1916. 4.
— 1 Storm Lake. Oct 7. Emmetsburg Democrat, IA. “Infantile Paralysis Death at Storm Lake.”
— ? Waterloo (5 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Webster City, Sep 28. Webster City Tribune, IA. “Infantile Paralysis Victim Dies,” 9-29-16

Kansas ( 26)
–26 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
–17 “ The year. Emporia Weekly Gazette, KS. “Danger in Water,” 12-14-1916, p. 3.
— ? Colleyville (5 cases). USPHS. Public Health Reports, Vol. 32, No. 26, 6-29-1917, p.1016.
— ? Jefferson Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2280.
— ? Morris Co. (1 case). USPHS. Public Health Reports, Vol. 31, No. 34, 8-25-1916, p. 2280.
— ? Morton Co. (1 case). USPHS. Public Health Reports, Vol. 31, No. 34, 8-25-1916, p. 2280.
— ? Phillips Co. (1 case). USPHS. Public Health Reports, Vol. 31, No. 34, 8-25-1916, p. 2280.
— ? Riley Co. (1 case). USPHS. Public Health Reports, Vol. 31, No. 34, 8-25-1916, p. 2280.

Kentucky ( 48)
–48 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 5 Statewide. Pinnacle News, KY. “Vital Statistics…Deaths.” Nov 9, 1916, p. 5.
— 1 Belleview. USPHS. Public Health Reports, Vol. 31, No. 34, 8-25-1916, p. 2280.
— 1 Louisville. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts. 1917, p. 563.
— 1 Salyersville, Magoffin Co. USPHS. Public Health Reports, V.31, N.34, 8-25-1916, p.2279.

Louisiana ( 18)
–18 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 2 New Orleans. USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts. 1917, p. 563.

Maine ( 23) (especially July-Oct 18)
–132 Cases. State. The year. Daily Kennebec Journal. “Infantile Paralysis,” 12-29-1916, p. 12.
— 23 Deaths. “ Daily Kennebec Journal. “Infantile Paralysis,” 12-29-1916, p. 12.
— ? Androscoggin Co., 4 cases, July 1-Oct 18. Smallman-Raynor. Poliomyelitis. 2006, p. 182.
— ? Aroostook Co. (4 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, 182
— ? Cumberland Co., (6 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, 182.
— ? “ Portland (5 cases). USPHS. Pub. Health Rpts., 32/26, 6-29-1917, 1016.
— ? Franklin Co. (3 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p.182.
— ? Hancock Co. (6 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p.182.
— ? Kennebec Co. (4 cases, Jul 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p.182.
— ? Knox Co. (65 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
— 2 “ Rockland (5 cases). USPHS. Pub. Health Rpts., V31, N34, 8-25-1916, p. 2280.
— ? Lincoln Co. (2 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
— ? Oxford Co. (3 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
— ? Penobscot Co. (1 case, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p182.
— ? Piscataquis Co., 1 case, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Somerset Co., 3 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Waldo Co., 1 case, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Washington Co., 5 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 183.
— ? York Co., 6 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.

Maryland ( 111) (Summer-Fall)
–111 State. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— ? Allegheny Co. (4 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, 182.
— ? Anne Arundel Co. (2 cases, July 1-Oct 18). Smallman-Raynor. Poliomyelitis. 2006, p.182.
— 70 Baltimore. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts. 1917, p. 563.
— 1 “ Aug 9. The News, Frederick MD. “Guarding Against Scourge…,” 8-11-1916.
— ? “ Co. (183 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, 182.
— ? Brunswick. JAMA. ”Medical News,” Vol. 62, No. 16, 10-14-1916, p. 1169.
— ? Carroll Co. (3 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p.182.
— ? Cumberland (5 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Garrett Co. (10 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
— ? Talbot Co. (1 case, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
— ? Washington Co., 1 case, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p.182.

Massachusetts (452) (especially July-Nov)
–452 Statewide. Year. MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, 19.
–424 “ USPHS. Public Health Rpts., “Poliomyelitis…By States, 1916,” 840.
— ? Adams (15 cases). MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p.18.
— ? Amesbury (22 cases). MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919,18
— ? Barnstable Twp. USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2283.
— ? “ Co. (10 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p182.
— ? Berkshire Co., 138 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 182.
— ? Beverly (24 cases). USPHS. Public Health Reports, V. 32, No. 26, 6-29-1917, p. 1016.
–159 Boston. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts. 1917, p. 563.
–124 “ by Nov 22. Boston Globe. “Two New Paralysis Cases…Boston…,” 11-22-1916.
— ? Bridgewater Twp. (1 case). USPHS. Public Health Reports, V31, N34, 8-25-1916, p.2283.
— ? Bristol Co. (43 cases, Jul 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
— ? Brookline (21 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Cambridge (71 cases) MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919,18
— ? Chelsea (8 cases). USPHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Chicopee (15 cases). MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919,52.
— ? Dalton (17 cases). MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p. 18.
— ? Dartmouth Twp. USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2283.
— ? Dedham (18 cases). MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p18
— ? Dudley Twp. (2 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2283.
— ? Dukes Co. (2 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
— ? Easthampton Twp. (1 case). USPHS. Public Health Reports, 31/34, 8-25-1916, p. 2283.
— ? Essex Co. (168 cases, July 1-Oct 18). Smallman-Raynor, et al. Poliomyelitis. 2006, p.182.
— ? Everett (27 cases). USPHS. Public Health Reports, V. 32, N. 26, 6-29-1917, p. 1016.
— ? Fairhaven Twp. (1 case). USPHS. Public Health Reports, V. 31, N.34, 8-25-1916, p. 2283.
— 2 Fall River (10 cases). USPHS. “Poliomyelitis…Prevalence in Cities…1916,” PH Rpts.
— ? Fitchburg (9 cases). USPHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Flint (1 case). USPHS. Public Health Reports, V.31, N34, 8-25-1916, p. 2284.
— ? Franklin Co., 23 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p.182.
— ? Greenfield Twp. (1 case). USPHS. Public Health Reports, V.31, N34, 8-25-1916, p. 2283.
— ? Hampden Co., 234 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 182
— ? Hampshire Co., 38 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 182
— ? Haverhill (12 cases). USPHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Hawley Twp. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2283.
— ? Hingham Twp. (2 cases). USPHS. Public Health Reports, V.31, N.34, 8-25-1916, p. 2283.
— ? Holyoke. JAMA, “Medical News,” Vol. 67, No. 16, 10-14-1916, p. 1169.
— ? “ MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p. 52.
— 2 Lawrence (7 cases). USPHS. “Poliomyelitis…in Cities…1916,” PHealth Rpts. 1917, 564.
— 4 Lowell (17 cases). USPHS. “Poliomyelitis…in Cities…1916,” PH Rpts. 1917, p. 564.
— 1 “ Aug 30. Lowell Sun, MA. “Death From Paralysis,” 8-31-1916, p. 16.
— 14 Lynn (44 cases). USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts. 1917, 564.
— ? Malden (46 cases). USPHS. Public Health Reports, V. 32, N. 26, 6-29-1917, p. 1016.
— ? Marlborough (2 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2283.
— ? Maynard Twp. (1 case). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2283.
— ? Medford (20 cases). USPHS. Public Health Reports, V. 32, N. 26, 6-29-1917, p. 1016.
— ? Medway Twp. (2 cases). USPHS. Public Health Reports, V. 31, N.34, 8-25-1916, p. 2283.
— ? Melrose (17 cases) MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p.18
— ? Middleborough Twp. (1 case). USPHS. Public Health Reports, 31/34, 8-25-1916, p. 2283.
— ? Middlesex Co., 286 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 182.
— ? Nantucket Co., 1 case, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 182.
— 1 New Bedford (21 cases). USPHS. “Poliomyelitis…Cities…1916,” PH Rpts, 1917, p. 564.
— ? Newburyport (22 cases). MA Health Dept. 1916 Infantile Paralysis…in MA. 1919, p. 18.
— ? Newton (20 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Norfolk Co., 132 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p182.
— ? North Adams (38 cases). USPHS. Public Health Reports, V.32, N.26, 6-29-1917, p. 1016.
— 1 “ July 30-Aug 5. USPHS. Public Health Reports, V.31, N.34, 8-25-1916, p. 2284.
— 1 North Andover, Dec 29. Boston Daily Globe. “Daniel McCarthy Dead,” Dec 30, 1916.
— ? Northampton (22 cases). US PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Norwood Twp. (1 case). USPHS. Public Health Reports, V. 31, N.34, 8-25-1916, p. 2283.
— ? Palmer Twp. (3 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2283.
— ? Peabody Twp. (1 case). USPHS. Public Health Reports, V.31, No. 34, 8-25-1916, p. 2283.
— ? Pittsfield (67 cases). USPHS. Public Health Reports, V.32, No. 26, 6-29-1917, p. 1016.
— ? Plymouth Co., 56 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 182.
— ? Quincy (66 cases). USPHS. Public Health Reports, V.32, No. 26, 6-29-1917, p. 1016.
— ? Raynham Twp. (1 case). USPHS. Public Health Reports, V.31, N. 34, 8-25-1916, p. 2283.
— ? Revere (15 cases) MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p.18.
— ? Salem (8 cases). USPHS. Public Health Reports, V. 32, No. 26, 6-29-1917, p. 1016.
— ? Sharon Twp. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2283.
— ? Sheffield Twp. (1 case). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2283.
— ? Somerville (48 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Southbridge (5 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 22 Springfield (88 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health. 1917, 564.
— ? Suffolk Co., 449 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p.182.
— ? Taunton (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2283.
— ? Townsend Twp. (1 case). USPHS. Public Health Reports, V. 31, N34, 8-25-1916, p. 2283.
— ? Waltham (28 cases). USPHS. Public Health Reports, V. 32, No, 26, 6-29-1917, p. 1016.
— ? Webster (5 cases). USPHS. Public Health Reports, V. 32, No. 26, 6-29-1917, p. 1016.
— 1 Wellesley, Aug 25. New York Times. “Scourge Kills College Girls” [Polio], 8-26-1916.
— ? West Springfield Twp. (2 cases). USPHS. Public Health Reports, 31/34, 8-25-1916, 2283.
— ? Westfield (14 cases). USPHS. Public Health Reports, V. 32, No. 26, 6-29-1917, p. 1016.
— ? Weston Twp. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2283.
— ? Woburn (6 cases). USPHS. Public Health Reports, V. 32, No. 26, 6-29-1917, p. 1016.
— 3 Worcester (25 cases). USPHS. “Poliomyelitis…Cities…1916,” PH Rpts. 1917, p. 564.
— ? “ Co., 93 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p182.
— ? Worthington Twp. (1 case). USPHS. Public Health Reports, V31/N34, 8-25-1916, p.2283.

Massachusetts Polio Cases by Months in 1916 (MA Health Dept. 1919, p. 8.)
Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec
4 3 6 3 4 10 107 253 627 704 180 36

Michigan ( 138) (especially late July-Oct)
–138 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 28 “ Aug 1-30. Ironwood Times, MI. “Child Paralysis Kills 28,” 9-30-1916, p. 2.
— ? Adrian (6 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 3 Battle Creek, by Oct 23. Ludington Daily News, MI. “Plague at Battle Creek,” 10-23-16.
— ? Bay City (25 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 16 Detroit. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 564.
— ? Flint (44 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 6 Grand Rapids (32 cases). USPHS. “Poliomyelitis…in Cities…1916,” PH Rpts. 1917, 564.
— 1 Homer. Oct 14. Marshall News Statesman, MI. “News of a Day,” 10-16-1916, p.1.
— ? Jackson (9 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Kalamazoo (11 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Lansing (25 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Marshall ~Oct 15. Marshall News Statesman, MI. “News of a Day,” 11-15-1916, p.2.
— ? Pontiac (9 cases). USPHS. Public Health Reports, V32, N26, 6-29-1917, p. 1016.
— ? Saginaw (18 cases). USPHS. Public Health Reports, V32, N26, 6-29-1917, p. 1016.
— 1 “ July 30-Aug 5. USPHS. Public Health Reports, V31, N34, 8-25-1916, p. 2284.
— 1 (no date or place). Daily Herald (Chicago). Sep 29, 1916. p. 5.

Minnesota ( 105)
–105 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 30 Statewide. by Aug 14. La Crosse Tribune, WI. “Dreaded Child Paralysis…,” 8-18-1916.
— ? Duluth (6 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Freeman Twp., Sep 28. Evening Tribune, Albert Lea MN. “Infantile Paralysis,” 9-29-1916
— 11 Minneapolis. USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts., 1917, p. 563.
— 8 St. Paul. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 563.
— 1 “ Jul 30-Aug 5. USPHS. Public Health Reports, V31, N34, 8-25-1916, p. 2284.
— 1 “ Aug 14. La Crosse Tribune (WI). “Dreaded Child Paralysis…,” 8-18-1916.
— ? Winona (38 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? 366 cases by County up to Aug 25. USPHS. Public Health Rpts., 31/34, 8-25-1916, 2281.
— ? Aitkin Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Anoka Co. (9 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Beltrami Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Blue Earth Co. (1 case). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— ? Brown Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Carlton Co. (4 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Carver Co. (6 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Cass Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Chippewa Co. (1 case). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— ? Chisago Co. (3 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Cottonwood Co. (1 case). USPHS. Public Health Reports, V31, N34, 8-25-1916, p. 2281.
— ? Crow Wing Co. (4 cases). USPHS. Public Health Reports, V31, N34, 8-25-1916, p. 2281.
— ? Dakota Co. (4 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Douglas Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Freeborn Co., Freeman Twp., 1 case, Sep 28. Evening Tribune, Albert Lea, MN.
— ? Goodhue Co. (7 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— ? Grant Co. (3 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Hennepin Co. (97 cases). USPHS. Public Health Reports, V. 31, N34, 8-25-1916, p. 2281.
— 11 “ Minneapolis. USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts., 1917, 563.
— ? Isanti Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Jackson Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Kanabec Co. (4 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Kandiyohi Co. (4 cases). USPHS. Public Health Reports, V. 31, N.34, 8-25-1916, p. 2281.
— ? Lacque Parle Co. (2 cases). USPHS. Public Health Reports, V31/N34, 8-25-1916, p. 2281.
— ? McLeod Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Mahnomen Co. (4 cases). USPHS. Public Health Reports, V.31, N34, 8-25-1916, p. 2281.
— ? Marshall Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Martin Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Mille Lacs Co. (1 case). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— ? Morrison Co. (5 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— ? Mower Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Murray Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Nicollet Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Norman Co. (3 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Olmsted Co. (30 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— ? Ottertail Co. (5 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Polk Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Pope Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Ramsey Co. (37 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— 8 “ St. Paul. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, 563.
— ? Red Lake Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Redwood Co. (3 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— ? Renville Co. (3 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? St. Louis Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? “ Duluth (6 cases). US PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Scott Co. (3 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Sibley Co. (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Stearns Co. (32 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Swift Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Todd Co. (9 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Traverse Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Wabasha Co. (13 cases). USPHS. Public Health Reports, V. 31, N.34, 8-25-1916, p. 2281.
— ? Waseca Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— ? Washington Co. (6 cases). USPHS. Public Health Reports, V31, N34, 8-25-1916, p. 2281.
— ? Winona Co. (27 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2281.
— ? “ Winona (38 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Wright Co. (1 case). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.

Mississippi ( 31)
— 31 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 3 New York Times. “75 Cases in 26 Mississippi Cities,” July 16, 1916, p. 12.

Missouri ( 20)
— 0 Kansas City. USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts., 1917, p. 563.
— 1 Moberly, Aug 29. Moberly Monitor (MO). “Paralysis Believed…Under…,” 8-19-1916.
–19 St. Louis. USPHS. “Poliomyelitis…in Cities During 1916” P. H. Reports, 1917, p. 563.

Montana ( 26)
–26 Statewide. USPHS. Public Health Rpts., “Poliomyelitis…By States, 1916,” 840.
— ? Billings (30 cases). USPHS. Public Health Reports, V. 32, No. 26, 6-29-1917, p. 1016.
— ? Carbon Co, (2 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2281.
— 5 Crow Indian Res. up to Aug 20. NYT. “Epidemic Reaches Montana Indians,” 9-21-1916.
— ? Harlowtown, Meagher Co. USPHS. Public Health Reports, V31, N34, 8-25-1916, p. 2281.

Nebraska ( 1)
–? Lincoln, 2 cases, July 30-Aug 5. USPHS. Public Health Reports, V31/N34, 8-25-1916, 2284.
–1 Kearney July 11. Beatrice Daily Sun, NE. “Infantile Paralysis Fatal at Kearney,” 7-13-1916.
–0 Omaha (6 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts., 1917, p. 564.

New Hampshire ( ?)
— ? State (27 cases). MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8.
— ? Manchester (18 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.

New Jersey (1,180)
–1,180 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 10 “ Jul 8. Brownsville Herald, TX. “Infantile Paralysis in Newark, N. J.,” 7-8-1916
— 178 “ July 1-31. NYT. “Expects Epidemic to End by Sept. 15,” Aug 29, 1916.
— 1 Arlington July 11. NYT. “Paralysis Takes Lives of 32 More…,” July 12, 1916, 1.
— ? Asbury Park (26 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Atlantic City Aug 30. Tyrone Daily Herald, PA. “Plague Kills Doctor’s Child,” 8-31-1916
— 1 Atlantic Highlands Aug 9 NYT. “Rich Men Give Plague Fund,” Aug 10, 1016, 5.
— 1 Bayonne Jul 10. NYT. “Arrest Hundreds…Fight to Check Infant Paralysis,” 7-11-16
— 1 Bloomfield July 25. NYT. “Sixty-seven New Cases Reported Yesterday…,” 7-26-1916
— 1 Burlington July 11. NYT. “Paralysis Takes Lives of 32 More…,” July 12, 1916, p. 1.
— 22 Camden (66 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts. 1917, 564
— 1 “ Aug 14. News, Frederick MD. “Seven New Cases in Philadelphia,” 8-14-1916.
— 12 “ up to Aug 19. News, Frederick MD. “Plague Still Spreads in PA,” 8-19-1916.
— 5 “ Aug 19. The News, Frederick, MD. “Plague Still Spreads in PA,” 8-19-1916.
— 2 “ Aug 30-31. Daily News, Frederick MD. “Plague Kills Doctor’s Child,” 9-1-1916
— 1 East Orange (56 cases). USPHS. Public Health Reports, V.31, N.34, 8-25-1916, p. 2283.
— 1 Elizabeth July 21. NYT. “Day Shows a Drop in Infant Paralysis,” July 21, 1916, 18.
— 1 Florence ~Aug 23. News, Frederick, MD. “Plague Victim at Florence, NJ,” 8-23-1916.
— 1 Hackensack July 12. NYT. “Noted Scientists…to Curb Infant Paralysis…, 7-13-1916, 1
— 1 “ Aug 13. NYT. “1,008 Victims in N.Y. State,” Aug 15, 1916, p. 18.
— ? Harrison (36 cases). USPHS. Public Health Reports, V.32, N.26, 6-29-1917, p. 1016.
— ? Hoboken (10 cases). USPHS. Public Health Reports, V.32, N.26, 6-29-1917, p. 1016.
— 1 “ Aug 1-5. USPHS. Public Health Reports, V.31, N.34, 8-25-1916, p. 2284.
— 31 Jersey City. USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts., 1917, p. 563.
— 1 Jersey City July 22. NYT. “39 Die of Paralysis; Highest Day’s Toll,” 7-23-1916,7.
— 4 “ July 28. NYT. “Paralysis Experts Named By Emerson,” July 29, 1916, 16.
— 3 “ Aug 2. Petersburg Daily Progress, VA. “Probe Infantile Paralysis…,” 8-3-1916
— 3 “ Aug 7. NYT. “13 Die in New York State,” 8-8-1916, 18.
— ? Kearny (46 cases). USPHS. Public Health Reports, V.32, N.26, 6-29-1917, p. 1016.
— 2 “ July 30-Aug 5. USPHS. Public Health Reports, V.31, N.34, 8-25-1916, p. 2284.
— 1 Lambertville, Aug 18 The News, Frederick MD, “Lambertville Plague Victim,” 8-19-1916
— ? Long Branch (25 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Merchantville Aug 17 News, Frederick MD. “Paralysis Makes High Record,” 8-17-1916.
— 1 Montcalm Aug 13. NYT. “1,008 Victims in N.Y. State,” Aug 15, 1916, p. 18.
— 1 “ Aug 9. NYT. “Rich Men Give Plague Fund,” Aug 10, 1916, 5.
— 1 Montclair Aug 17. NYT. “69 New Cases in Jersey,” Aug 18, 1916.
— 1 “ Aug 25. NYT. “100 More Ill; 2 Die in State” [Polio], Aug 26, 1916.
— ? Morristown (6 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 3 New Brunswick, Aug 19 NYT. “Fears Paralysis Will Flare Again,” Aug 20, 1916.
–376 Newark. Galishoff. “Newark and the Great Polio Epidemic of 1916.” NJ History, 1976.
–375 “ USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 563.
— 2 “ July 2-8. Lavinder 1916, 3353. (First death was on July 3 (p. 3354).)
— 18 “ July 9-15. Lavinder 1916, 3353.
— 1 “ July 18 NYT. “Gain in [Infant] Paralysis Due to a Holiday,” 19 Jul 1916, 3.
— 3 “ July 19 NYT. “Paralysis Gains Only in Manhattan,” July 20, 1916, p. 11.
— 1 “ July 20 NYT. “Day Shows a Drop in Infant Paralysis,” July 21, 1916, p. 18.
— 38 “ up to July 21. NYT. “Day Shows a Drop in Infant Paralysis,” July 21, 1916, p. 18.
— 5 “ July 22. NYT. “39 Die of Paralysis; Highest Day’s Toll,” 7-23-1916, p. 7.
— 22 “ July 16-22. Lavinder 1916, 3353.
— 6 “ July 25. NYT. “Sixty-seven New Cases Reported Yesterday…,” 7-26-1916, p. 5.
— 4 “ July 26. NYT. “Record Day for New Cases,” July 27, 1916, p. 18.
— 5 “ July 28. NYT. “Paralysis Experts Named By Emerson,” 7-29-1916, p. 16.
— 29 “ July 23-29. Lavinder 1916, p. 3353.
— 72 “ July 30-Aug 5 (247 cases). USPHS. Pub. Health Reports, 31/34, 8-25-1916, 2284.
— 11 “ July 31. Lavinder 1916, p. 3354.
— 14 “ Aug 2. Lavinder 1916, p. 3354.
— 13 “ Aug 4. Lavinder 1916, 3354.
— 14 “ Aug 5. Lavinder 1916, 3354.
— 72 “ Jul 30-Aug 5. Lavinder 1916, 3353.
— 12 “ Aug 6. Lavinder 1916, 3354.
— 10 “ Aug 7. New York Times. “13 Die in New York State,” 8-8-1916, p. 18.
— 12 “ Aug 8. Lavinder 1916, 3354.
— 7 “ Aug 9. New York Times. “Rich Men Give Plague Fund,” Aug 10, 1016, 5.
— 13 “ Aug 10. Lavinder 1916, 3354.
— 10 “ Aug 11. NY Times. “Disease [Polio] Spreads in Jersey,” 8-12-1916, p. 16.
— 67 “ Aug 6-12. Lavinder 1916, 3353.
— 44 “ Aug 13-19. Lavinder 1916, 3353.
— 42 “ Aug 20-26. Lavinder 1916, 3353.
— 24 “ Aug 27-Sep 2. Lavinder 1916, 3353.
— 3 “ Sep 8. NY Times. “Believes Mosquito Spreads Paralysis,” 9-9-1916.
— 16 “ Sep 3-9. Lavinder 1916, 3353.
— 7 “ Sep 10-16. Lavinder 1916, 3353.
— 10 “ Sep 17-23. Lavinder 1916, 3353.
— 1 “ Sep 24-30. Lavinder 1916, 3353.
— 0 “ Oct 1-7. Lavinder 1916, 3353.
— 4 “ Oct 8-14. Lavinder 1916, 3353.
— 5 “ Oct 15-21. Lavinder 1916, 3353.
— 0 “ Oct 22-28. Lavinder 1916, 3353.
— 1 Orange, July 25. NYT. “Sixty-seven New Cases Reported Yesterday…,” 7-26-1916.
— 1 “ July 28. NYT. “Paralysis Experts Named By Emerson,” July 29, 1916, p.16.
— 3 “ July 30-Aug 5. USPHS. Public Health Reports, V.31, N34, 8-25-1916, p. 2284.
— 1 “ Aug 7. NYT. “13 Die in New York State,” 8-8-1916, p. 18.
— 1 “ Aug 10. NYT. “Cases of Paralysis Brought Into City,” 8-11-1916, p. 5.
— 1 Passaic, July 22. NYT. “39 Die of Paralysis; Highest Day’s Toll,” 7-23-1916, p. 7.
— 20 Paterson (98 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts. 1917, 564
— 1 “ July 10. NYT. “Arrest Hundreds…Fight to Check Infant Paralysis,” 7-11-1916.
— ? Perth Amboy (30 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 7 “ (21 cases). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2282.
— 1 Phillipsburg Aug 10 NYT. “Cases of Paralysis Brought Into City,” 8-11-1916, p. 5.
— ? Plainfield (45 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Pompton, Aug 16 NYT. “New York Schools May Open Sept. 25,” 8-17-1916, p.6.
— 1 Princeton, Oct 15. NYT. “Princeton Alarmed by Paralysis Death,” Oct 16, 1916.
— 1 Sharpstown, Sep 30.
— 2 South Orange, July 25. NYT. “Sixty-seven New Cases Reported Yesterday…,” 7-26-1916.
— 1 “ Aug 7. NYT. “13 Die in New York State,” 8-8-1916, p. 18.
— 1 Spring Lake Aug 5. NYT. “73 Cases in New Jersey; Stricter Quarantine…,” 8-6-1916.
— 50 Trenton (167 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health. 1917, 564.
— 1 “ Oct 17. NYT. “Cornell Isolates Eleven Students,” Oct 18, 1916.
— ? West Hoboken (36 cases). US PHS. Public Health Reports, V32/N26, 6-29-1917, 1016.
— 1 “ July 30-Aug 5. USPHS. Public Health Reports, V31, N34, 8-25-1916, p. 2284.
— ? West New York (47 cases). US PHS. Public Health Reports, V32/N26, 6-29-1917, 1016.
— ? West Orange (40 cases). US PHS. Public Health Reports, V32/N26, 6-29-1917, 1016.
— 1 Woodstown, ~Sep 29. The News, Frederick, MD. “School Girl Dies…Paralysis,” 10-3-16.

By County:
— ? Atlantic, 38 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Bergen, 162 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Burlington, 55 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Camden, 116 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Cape May, 33 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Cumberland, 35 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Essex, 1,823 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Gloucester, 36 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Hudson, 553 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Hunterdon, 47 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Mercer, 217 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Middlesex, 177 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Monmouth, 204 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Morris, 125 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Ocean, 14 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Passaic, 109 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Salem, 55 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Somerset, 31 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Sussex, 16 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Union, 257 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.
— ? Warren, 17 cases, Jul 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 183.

New York (3,331) June 29-Dec
–3,331 Statewide. US PHS. –2,800 “ –2,626 “ — 9 — 28 “ — 45 “ — 71 “ — 145 “ — 166 “ — 224 “ — 255 “ — 296 “ — 302 “ — 4 — 4 — 1 Antwerp — 1 — 1 Auburn — 1 Babylon, L.I. — 5 “ — 1 Bayport — 2 — ? — 1 — 5 — 1 “ — 1 “ — 1 Campbell — 1 Casenova — 1 — 1 Colonie — ? — 1 — ? — 1 Durham — 1 — 1 East Fishkill — 1 East Meadow — 1 Ellenville — 1 Elmford — 1 Farmingdale — 1 Fayetteville — ? — 2 Floral Park, — 1 Fulton Sep 5. — 1 Fultonville — 1 “ — 1 — ? — 3 Glen Cove — 1 Gouverneur — 1 — 1 Hartsdale — 1 Hensonville — 1 Hicksville — 1 Highlands — 1 “ — ? — ? — 1 Huntington — 1 “ — 1 “ — 1 Hyde Park — 1 Ithaca — 2 “ — ? — ? — 1 Kingston — 1 Lake View — 2 Larchmont — 1 Lexington — 1 Manlius — 1 — 1 McCrawville — ? — 1 Mineola — 1 Mineville — 1 — 2 — 5 “ — 1 — 1 — 1 “ — 3 “ — 13 “ — 1 “ –2,448 NYC, –2,448 — 2,448 — 2,400 –>2000 — 17 — 12 — 64 — 12 — 59 — 75 — 23 — 101 — 27 — 25 — 126 — 150 — 22 — 18 — 20 — 14 — 238 — 14 — 32 — 270 — 17 — 24 — 31 — 27 — 17 — 369 — 14 — 26 — 30 — 31 — 32 — 555 — 39 — 23 — 31 — 38 — 35 — 682 — 31 — 35 — 44 — 793 — 13 — 277 “ — 35 — 55 — 896 — 41 — 43 — 45 — 41 –1,066 — 33 — 44 — 52 — 57 — 38 — 31 — 42 –1,371 — 22 “ — 31 “ — 39 “ — 34 “ — 32 “ — 32 “ — 36 “ –1,597 — 20 “ — 33 “ — 39 “ — 42 “ — 31 “ — 22 “ — 25 “ –1,810 — 21 “ — 25 “ — 32 “ — 22 “ — 21 “ –1,932 — 17 “ — 19 “ — 20 “ — 16 “ –2,004 “up to Sep 4 — 21 “ — 22 “ — 28 “ — 15 “ — 10 “ — 14 “ — 9 “ –2,123 “ — 18 “ — 9 “ — 11 “ — 10 “ — 13 “ — 15 “ — 6 “ –2,187 — 10 “ — 10 “ — 6 “ — 11 [?] “ — 6 “ –2,226 — 6 “ — 5 “ — 7 “ –2,244 — 11 “ — 5 “ — 10 “ — 12 “ –2,489 — 4 “ –2,286 — 6 “ — 8 “ — 8 “ — 8 “ — 6 “ –2,321 — 5 “ — 6 “ — 11 “ — 2 “ — 0 “ –2,375 — 3 “ — ? — ? — ? — ? — ? — 1 Newburg, July 24. — 1 — ? — 1 — 1 — 1 “ — 1 Oneida — ? — 1 Oswego — 1 “ — 1 Otisville — 1 “ — 2 Oyster Bay, L.I. — 1 “ — 3 Patchogue, L.I. — 1 “ — 1 “ — 1 Peekskill — 1 Port Jefferson — 2 Poughkeepsie — 2 “ — 1 Red Hook — 1 Rensselaerville — 1 — 1 Richland — 1 Riverhead, L.I. — 2 — 1 Saratoga — 1 Saratoga Springs — 2 — ? — ? — 1 Skaneatles — 1 Smithtown — 1 — 1 Suffolk County — 64 — 1 “ — 6 “ — 1 — 1 Troy — 1 Utica — ? — 1 Wavarsing — 1 Waverly — 1 West Islip — 1 West Monroe — 1 — 1 White Plains — 1 Wilton — 2 Windham — 3 Yonkers — 1 “ — 1 “ — 2 “ — 18 “ — 1 “ — 1 “ — 2 “ — 2 “ Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
by Aug 31. Woodland Daily Democrat (CA). “Infantile Paralysis…” 8-31-1916.
Blanchard tally of locality breakouts below.
State (other than NYC) Jun 1-Jul 14. NYT. “N.Y. State Cases Total 100,” 7-15-1916.
“ up to July 26. NYT. “Record Day for New Cases,” 27 July 1916, 18.
“ up to Aug 3. NYT. “Thirty New Cases in…State,” 3 Aug 1916, 7.
“ up to Aug 8. NYT. “13 Die in New York State,” 8 Aug 1916, 18.
“ up to Aug 15. NYT. “75 New Cases in This State,” Aug 16, 1916, p. 18.
“ up to Aug 22 NYT. “Record Increase in State,” Aug 24, 1916.
“ up to Aug 31. NYT. “Movie Ban Modified as Paralysis Wanes,” 9-1-1916
“ up to Sep 5. NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
“up to Sep 14. NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
“up to Sep 16 NYT. “Paralysis Makes Unexpected Gain,” Sep 17, 1916.
Albany (28 cases). USPHS. “Poliomyelitis…Cities…1916,” PHealth Rpts. 1917, 564.
Amityville, as of Jul 19. NYT. “Paralysis Gains Only in Manhattan,” 7-20-1916, 11.
Aug 16. NYT. “50 More Victims in the State,” Aug 16, 1916.
Aquebogue, L.I. Aug 5. NYT. “Ask Rockefellers for Paralysis Aid,” 6 Aug 1916, 15
Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
Aug 5. NYT. “Ask Rockefellers for Paralysis Aid,” 6 Aug 1916, 15
July 27-Aug 7. NYT. “13 Die in New York State,” 8 Aug 1916, 18.
Aug 7. NYT. “13 Die in New York State,” 8 Aug 1916, 18.
Beacon, by July 7. NYT. “Paralysis Kills 22 More Babies in [NYC].” 7-8-1916.
Binghamton (7 cases). US PHS. Public Health Reports, 32/26, 6-29-1917, 1016.
Briarcliff Manor Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
Buffalo. USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts., 1917, p. 563.
July 14. NYT. “Brooklyn Child Dies in Buffalo, July 15, 1916, 16.
Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
Aug 16. NYT. “50 More Victims in the State,” Aug 16, 1916.
Aug 22 NYT. “73 Cases [Polio] in New York State,” Aug 23, 1916.
Cold Spring Harbor, L.I. Aug 13. NYT. “1,008 Victims in N.Y. State,” 15 Aug 1916, 18
Aug 18. NYT. “71 New Cases in This State,” Aug 19, 1916.
Copiague (July 7 case). NYT. “Paralysis Kills 22 More Babies in [NYC].” 7-8-1916.
Cornwall-on-Hudson, July 27. NYT. “28 New Cases Up State” [Polio], July 28, 1916, 5.
Dunkirk (6 cases). US PHS. Public Health Reports, 32/26, 6-29-1917, p. 1016.
Aug 15. NYT. “75 New Cases in This State,” Aug 16, 1916, p. 18.
Dutchess Junction, July 7 case. NYT. “Paralysis Kills 22 More Babies in [NYC].” 7-8-16
Aug 22 NYT. “Record Increase in State,” Aug 24, 1916.
July 25. NYT. “Nineteen New Cases in State,” July 26, 1916, p. 5.
Aug 13. NYT. “1,008 Victims in N.Y. State,” Aug 15, 1916, p. 18.
Aug 12. NYT. “To Bar Children From Fairs,” Aug 12, 1916, p. 16.
July 22. NYT. “39 Die of Paralysis; Highest Day’s Toll,” 7-23-1916, 7
Aug 15. NYT “75 New Cases in This State,” Aug 16, 1916, p. 18.
Fishkill (cases reported). NYT. “Paralysis Kills 22 More Babies in [NYC].” 7-8-1916.
Aug 5. NYT. “Disease Spreads in State,” Aug 6, 1916, p. 15.
NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
Aug 25 NYT. “100 More Ill; 2 Die in State” [Polio], Aug 26, 1916.
Sep 5. NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
Garden City, LI. Aug 12. Fairbanks Daily Times, AK. “Mrs. Frank Page…,” 8-13-1916.
Garden City Park, L.I. (5 cases reported as of July 7.)
July 20-22 NYT. “39 Die of Paralysis; Highest Day’s Toll,” 7-23-1916, 7.
Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
Greenport (cases reported). NYT. “Paralysis Kills 22 More Babies in [NYC].” 7-8-1916.
July 14. NYT. “Hoboken Bars All Comers,” July 15, 1916, p. 1.
Aug 15. NYT. “75 New Cases in This State,” Aug 16, 1916, p. 18.
July 20-22. NYT. “39 Die of Paralysis; Highest Day’s Toll,” 7-23-1916, 7
July 31. NYT. “Disease Spread in State,” Aug 1, 1916, 5.
Aug 16. NYT. “50 More Victims in the State,” Aug 16, 1916.
Hornell, July 7 case. NYT. “Paralysis Kills 22 More Babies in [NYC].” 7-8-1916.
Hudson (cases reported). NYT. “Paralysis Kills 22 More Babies in [NYC].” 7-8-1916.
July 26. NYT. “Record Day for New Cases,” July 27, 1916, p. 18.
Aug 13. NYT. “1,008 Victims in N.Y. State,” Aug 15, 1916, p. 18.
Aug 22 NYT. “Record Increase in State,” Aug 24, 1916.
Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
Aug 29. NYT. “Look For Schools to Reopen Sept. 15,” 8-30-1916.
Sep 4-5. NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
Jasper (July 7 case). NYT. “Paralysis Kills 22 More Babies in New York City.” 7-8-1916
Johnstown (10 cases). US PHS. Public Health Rpts., V32/N26, 6-29-1917, 1016.
Sep 30 Kingston Daily Freeman. “History of 1916,” 30 Dec 1916.
July 26. NYT. “Record Day for New Cases,” July 27, 1916, p. 18.
Aug 5. NYT. “Disease Spreads in State,” Aug 6, 1916, p. 15.
Aug 18. NYT. “71 New Cases in This State,” Aug 19, 1916.
Aug 15. NYT “75 New Cases in This State,” Aug 16, 1916, p. 18.
“ Sep 5. NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
Aug 22 NYT “73 Cases [Polio] in New York State,” Aug 23, 1916.
Middletown (18 cases). US PHS. Public Health Rpts., V32/N26, 6-29-1917, 1016.
Aug 10. NYT. “Cases of Paralysis Brought Into City,” 8-11-1916, 5.
Aug 20 NYT. “Record High Total in State,” Aug 22, 1916.
Mohawk, Montgomery Co., ~Sep 10.
Mount Vernon Aug 7. NYT. “13 Die in New York State,” 8-8-1916, p. 18.
as of Aug 22. NYT. “36 More Ill on Long Island,” Aug 23, 1916.
New Baltimore Aug 7. NYT. “13 Die in New York State,” 8-8-1916, p. 18.
New Rochelle July 20. NYT. “Day Shows a Drop in Infant Paralysis,” 7-21-1916, 18
July 26. NYT. “Record Day for New Cases,” July 27, 1916, p. 18.
Aug 6. NYT. “13 Die in New York State,” 8-8-1916, p. 18.
as of Aug 22. NYT. “36 More Ill on Long Island,” Aug 23, 1916.
Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
the year. Draper, George, M.D. Infantile Paralysis. NY & London: 1935, p.20.
“ USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 563.
“ Wyatt. “The 1916 New York City Epidemic of Poliomyelitis…” 2011, p. 13.
“ the year, Offit 2007, pp. 7-9; Oshinsky 2005, 22; Wilson. Polio. 2007, p. 11.
“ Wikipedia. “History of Poliomyelitis.” 10-8-2011 modification.
“ By May 30. NYT. “Bar All Children From The Movies in Paralysis War. 7-4-1916.
“ By June 29 NYT. “All Unite to Check Infant Paralysis,” 6-30-1916, p. 8.
“ By July 1. NYT. “Infant Paralysis Starts a Cleanup.” 7-1-1916, p. 7.
“ July 1. New York Times. “Day Shows 12 Dead by Infant Paralysis.” 7-2-1916.
“ June 25-July 1. NYT. “Day Shows 12 Dead by Infant Paralysis.” 7-2-1916.
“ By July 1. New York Times. “Day Shows 12 Dead by Infant Paralysis.” 7-2-1916.
“ July 2-3 (noon). NYT. “Bar All Children From…Movies in Paralysis War. 7-4-1916
“ By July 3. NYT. “Bar All Children From The Movies in Paralysis War. 7-4-1916.
“ July 3-4 (24 hrs.). Brownsville Herald (TX). “27 NY Babies Die…,” 7-4-1916, p.1.
“ July 3 (9 pm)-July 4 (9 pm). NYT. “25 More Deaths From Paralysis.” 7-5-1916.
“ By July 4 (9 pm). NYT. “25 More Deaths From Paralysis.” 7-5-1916.
“ By July 6. Beatrice Daily Sun, NE. “Dread Disease Raging,” 7 July 1916, 1.
“ July 7. Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551.
“ July 8. Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551.
“ July 9. Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551.
“ July 10. Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551.
“ By July 10. Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551
“ July 10 NYT. “Arrest Hundreds…Fight to Check Infant Paralysis” 7-11-1916, 1
“ July 11 NYT. “Dept. Issues Cards to Those in Infected Districts…,” 7-14-1916.
“as of July 11. NYT. “Paralysis Takes Lives of 32 More…,” July 12, 1916, p. 1.
“ July 12 NYT. “Dept. Issues Cards to Those in Infected Districts…,” 7-14-1916.
“ July 13 NYT. “Offers New Cure in Fight Against Infant Paralysis,” 7-14-1916.
“ July 14 NYT. “Rockefeller Cash to Fight Paralysis,” July 16, 1916, p. 1.
“ July 15 NYT. “Rockefeller Cash to Fight Paralysis,” July 16, 1916, p. 1.
“ July 16 NYT. “Paralysis Deaths Show Falling Off,” July 17, 1916, p. 1.
“as of July 16 NYT. “Rockefeller Cash to Fight Paralysis,” July 16, 1916, p. 1.
“ July 17 NYT. “Gain in Paralysis Due to a Holiday,” July 19, 1916, p. 3.
“ July 18 NYT. “Paralysis Gains Only in Manhattan,” July 20, 1916, p. 11.
“ July 19 NYT. “Paralysis Gains Only in Manhattan,” July 20, 1916, p. 11.
“ July 20 NYT. “Day Shows a Drop in Infant Paralysis,” July 21, 1916, p. 18.
“ July 21 NYT. “More Gains Made In Paralysis Fight,” July 22, 1916, p. 16.
“ up to July 22 NYT. “39 Die of Paralysis; Highest Day’s Toll,” 23 Jul 1916, p. 7.
“ July 22. NYT. “39 Die of Paralysis; Highest Day’s Toll,” July 23, 1916, p. 7.
“ July 23. NYT. “Fewer Fatal Cases on Paralysis Rolls,” July 24, 1916, p. 16.
“ July 24. NYT. “New Federal Rules in War on Paralysis,” July 25, 1916, p. 20.
“ July 25. NYT. “Paralysis Figures Rise in Manhattan,” July 26, 1916, p. 5.
“ July 26. NYT. “Paralysis Spread Near High Mark,” July 27, 1916, p. 18.
“up to July 26. NYT. “Paralysis Spread Near High Mark,” July 27, 1916, p. 18.
“ July 27. NYT. “Scientists to Study New York Paralysis,” 7-28-1916, p. 5.
“ July 28. NYT. “Paralysis Experts Named By Emerson,” 7-29-1916, p. 16.
“ July 29. NYT. “Paralysis Deaths Number 44 in Day,” July 30, 1916, p. 12.
“up to July 29. NYT. “Paralysis Deaths Number 44 in Day,” July 30, 1916, p. 12.
“ July 30. NYT. “Paralysis Cripples a Problem for City,” Aug 1, 1916, p. 18.
July 30-Aug 5. USPHS. Public Health Reports, V.31, N.34, 8-25-1916, p. 2284.
“ July 31. NYT. “Deaths Show Increase…,” Aug 1, 1916, p. 5.
“ Aug 1. NYT. “55 Die of Paralysis in This City in a Day,” 8-2-1916, p. 4.
“up to Aug 1. NYT. “55 Die of Paralysis in This City in a Day,” Aug 2, 1916, 4.
“ Aug 2. NYT. “Paralysis Grows; Experts Sit Today,” Aug 3, 1916, p. 7.
“ Aug 3. NYT. “Paralysis Growth Passes High Record,” Aug 4, 1916, p. 7.
“ Aug 4. NYT. “Oppose Home Care in Paralysis Cases,” Aug 5, 1916, p. 16.
“ Aug 5. NYT. “Ask Rockefellers for Paralysis Aid,” Aug 6, 1916, p. 15.
“up to Aug 5. NYT. “Ask Rockefellers for Paralysis Aid,” Aug 6, 1916, p. 15.
“ Aug 6. NYT. “Paralysis Increase Quickened by Heat…, 8-7-1916, p. 16.
“ Aug 7. NYT. “Experts Indorse Paralysis Serum,” Aug 8, 1916, p. 18.
“ Aug 8. NYT. “Paralysis Cripples Glad to Aid Others,” Aug 9, 1916, p. 3.
“ Aug 9. NYT. “Schools to be Shut Till Epidemic Ends.” Aug 10, 1916, p. 1.
“ Aug 10. NYT. “Cases of Paralysis Brought Into City,” Aug 11, 1916, p. 5.
“ Aug 11. NYT. “31 Die in 24-Hour Period,” Aug 12, 1916, p. 16.
“ Aug 12. NYT. “Paralysis Kills…Young Bride…, Aug 13, 1916, p. 1.
“up to Aug 12. NYT. “Paralysis Kills…Young Bride…, Aug 13, 1916, p. 1.
Aug 13. NYT. “Fewer Fatal Cases In Epidemic Report,” Aug 14, 1916, 16.
Aug 14. NYT. “Suggests Serum For All Children,” Aug 15, 1916, p. 18.
Aug 15. NYT. “Paralysis Gains Following Lull…, Aug 16, 1916, p. 18.
Aug 16. NYT. “New York Schools May Open Sept. 25,” Aug 17, 1916, p.6.
Aug 17. NYT. “Drop in Paralysis Encourages City,” Aug 18, 1916.
Aug 18. NYT. “Fears Paralysis Will Flare Again,” Aug 20, 1916.
Aug 19. NYT. “Fears Paralysis Will Flare Again,” Aug 20, 1916.
“up to Aug 19 NYT. “Fears Paralysis Will Flare Again,” Aug 20, 1916.
Aug 20. NYT. “Drop in Paralysis Pleases Officials,” Aug 21, 1916.
Aug 21. NYT. “Paralysis Crest Believed Passed,” Aug 22, 1916.
Aug 22. NYT. “Find Heat Spreads Paralysis Deaths,” Aug 23, 1916.
Aug 23. NYT. “A Gain of 13 Cases on Paralysis Roll,” Aug 24, 1916.
Aug 24. NYT. “Want Blood of 1,000 in Paralysis Fight,” Aug 25, 1916.
Aug 25. NYT. “End of Epidemic Believed at Hand,” Aug 26, 1916.
Aug 26. NYT. “Threaten To Wreck Paralysis Hospital,” Aug 27, 1916.
“up to Aug 26. NYT. “Threaten To Wreck Paralysis Hospital,” Aug 27, 1916.
Aug 27 NYT. “Paralysis Fighters Expect a Rest Soon,” Aug 28, 1916.
Aug 28 NYT. “Expects Epidemic to End by Sept. 15,” Aug 29, 1916.
Aug 29 NYT. “Look For Schools to Reopen Sept. 15,” Aug 30, 1916.
Aug 30 NYT. “Paralysis Defers College Openings,” Aug 31, 1916.
Aug 31 NYT. “Movie Ban Modified as Paralysis Wanes,” Sep 1, 1916.
“up to Aug 31 NYT. “Movie Ban Modified as Paralysis Wanes,” Sep 1, 1916.
Sep 1 NYT. “Asks $100,000 Fund for Cripples’ Care,” Sep 3, 1916.
Sep 2 NYT. “Asks $100,000 Fund for Cripples’ Care,” Sep 3, 1916.
Sep 3 NYT. “Paralysis Forecast Cut by 1,000 Cases,” Sep 4, 1916.
Sep 4 NYT. “Let Children Romp as Epidemic Wanes,” Sep 5, 1916.
NYT. “Let Children Romp as Epidemic Wanes,” 5 Sep 1916.
Sep 5 NYT. “Paralysis Workers See End of Labors,” Sep 6, 1916.
Sep 6 NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
Sep 7 NYT. “Paralysis Up Again – Due to Hot Weather,” Sep 8, 1916.
Sep 8 NYT. “Believes Mosquito Spreads Paralysis,” Sep 9, 1916.
Sep 9 NYT. “Cost of Epidemic will be $1,000,000,” Sep 10, 1916.
Sep 10 NYT. “The Public Schools to open on Sept. 25,” Sep 12, 1916.
Sep 11 NYT. “The Public Schools to open on Sept. 25,” Sep 12, 1916.
Sep 11 NYT. “The Public Schools to open on Sept. 25,” Sep 12, 1916.
Sep 12 NYT. “Paralysis Shows a Slight Advance,” Sep 13, 1916.
Sep 13 NYT. “Paralysis Drops in Every Borough,” Sep 14, 1916.
Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” Sep 15, 1916.
Sep 15 NYT. “Paralysis Cases Gain For the Day,” Sep 16, 1916.
Sep 16 NYT. “Paralysis Makes Unexpected Gain,” Sep 17, 1916.
Sep 17 NYT. “New Cases and Deaths,” Sep 19, 1916.
Sep 18 NYT. “Parents Plan Fight on the School Date,” Sep 19, 1916.
“up to Sep 18. NYT. “Parents Plan Fight on the School Date,” Sep 19, 1916.
Sep 19 NYT. “Paralysis Fight on School Opening,” Sep 20, 1916.
Sep 20 NYT. “Appeal to Mitchel in Paralysis Fight,” Sep 21, 1916.
Sep 21 NYT. “New Cases and Deaths,” Sep 22, 1916.
Sep 22 Daily News, Frederick MD. “Close School…Pupil Dies,” 9-23-1916.
Sep 22. JAMA. “Medical News,” Vol. 67, 9-30-1916, p. 1028.
“ by Sep 23. JAMA. “Medical News,” Vol. 67, 9-30-1916, p. 1028.
Sep 24 NYT. “94,000 Absentees as Schools Open.” Sep 25 1916.
Sep 25 NYT. “94,000 Absentees as Schools Open.” Sep 25 1916.
Sep 25 Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551
“up to Sep 25 NYT. “94,000 Absentees as Schools Open.” Sep 25 1916.
Sep 26 NYT. “Spurt in Paralysis is Called Sporadic,” Sep 28, 1916.
Sep 27 NYT. “Spurt in Paralysis is Called Sporadic,” Sep 28, 1916.
Sep 28 NYT. “Vaccination Theory of Paralysis Denied,” Sep 29, 1916.
Sep 29 NYT. “Trace Paralysis Spread to an Adult,” Sep 30, 1916.
“up to Sep 29 Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551
Sep 30 NYT. “Emerson Defends Opening of School,” Oct 1, 1916.
“up to Sep 30 NYT. “Emerson Defends Opening of School,” Oct 1, 1916.
Oct 1 NYT. “200,000 Children Stay From School,” Oct 3, 1916.
Oct 2 NYT. “200,000 Children Stay From School,” Oct 3, 1916.
Oct 3 NYT. “Federal Inspection of Paralysis Ends,” Oct 4, 1916.
Oct 4. JAMA. “Medical News,” Vol. 67, 10-14-1916, p. 1170.
Oct 6 Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551.
“as of Oct 6 Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551.
Oct 7 NYT. “Doubts Schools Spread Paralysis,” Oct 8, 1916.
Oct 16 NYT. “Cornell Isolates Eleven Students,” Oct 18, 1916.
Oct 17 NYT. “Cornell Isolates Eleven Students,” Oct 18, 1916.
Oct 18 Brooklyn Daily Eagle Almanac. “Local Chronology of 1916.” 1917, 551
Oct 19 Daily News, Frederick MD. “No Paralysis Deaths in NYC,” 10-20-1916
“ by Oct 19 Daily News, Frederick MD. “No Paralysis Deaths in NYC,” 10-20-1916
Oct 21 NYT. “Paralysis Germ Probably Found,” Oct 22, 1916.
NYC, Bronx, 687 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 183.
“ Brooklyn, 4,037 cases, July 1-Oct 18. Smallman-Raynor. Poliomyelitis. 2006, 183.
“ Manhattan, 2628 cases, July 1-Oct 18. Smallman-Raynor. Poliomyelitis. 2006, 183.
“ Queens, 1,255 cases, July 1-Oct 18. Smallman-Raynor. Poliomyelitis. 2006, 183.
“ Richmond, 277 cases, July 1-Oct 18. Smallman-Raynor. Poliomyelitis. 2006, 183.
NYT. “26 New Victims Outside City,” July 25, 1916, p. 20.
North Castle, Aug 7. NYT. “13 Die in New York State,” 8 Aug 1916, 18.
North Hempstead (cases reported). NYT. “Paralysis Kills 22…Babies in [NYC].” 7-8-16.
North Tarrytown. Aug 18. NYT. “State Board Not Alarmed” [Polio]. Aug 19, 1916.
Ocean Beach, L.I. Aug 16. NYT. “NYC Schools May Open Sept. 25,” 17 Aug 1916, 6.
Aug 22 NYT. “Record Increase in State,” Aug 24, 1916.
Aug 20 NYT. “Record High Total in State,” Aug 22, 1916.
Ossining (23 cases). US PHS. Public Health Reports, 32/26, 6-29-1917, p. 1016.
Sep 4. NYT. “Let Children Romp as Epidemic Wanes,” 9-5-1916.
Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
Aug 5. NYT. “Paralysis Invades a Camp,” Aug 7, 1916, p. 16.
Aug 7. NYT. “13 Die in New York State,” 8-8-1916, 18.
July 22. NYT. “39 Die of Paralysis; Highest Day’s Toll,” 7-23-1916.
Aug 20 NYT. “Record High Total in State,” Aug 22, 1916.
Aug 3. NYT. “Paralysis Growth Passes High Record,” 8-4-1916, 7.
Aug 7. NYT. “13 Die in New York State,” 8 Aug 1916, 18.
Aug 16. NYT. “NYC Schools May Open Sept. 25,” 17 Aug 1916, 6.
Sep 14 NYT. “Now Think Rat Flea Carries Paralysis,” 9-15-1916.
Sep 8 NYT. “Believes Mosquito Spreads Paralysis,” Sep 9, 1916.
July 27. NYT. “28 New Cases Up State,” July 28, 1916, p. 5.
Aug 2. NYT. “Thirty New Cases in…State,” 3 Aug 1916, 7.
Aug 22 NYT. “Record Increase in State,” Aug 24, 1916.
Sep 5. NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
Richfield Springs Sep 5. NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
Aug 22 NYT. “Record Increase in State,” Aug 24, 1916.
Aug 16. NYT. “NYC Schools May Open Sept. 25,” 17 Aug 1916, 6.
Rochester. USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts., 1917, p.563.
July 31. NYT. “Disease Spread in State,” Aug 1, 1916, 5.
Aug 7. NYT. “13 Die in New York State,” 8 Aug 1916, 18.
“ July 30-Aug 5. USPHS. Public Health Reports, 31/34, 8-25-1916, 2284.
Schenectady (10 cases). USPHS. Public Health Reports, 32/26, 6-29-1917, 1016.
Seacliff, L.I. (case reported July 7). NYT. “Paralysis Kills…in [NYC].” 7-8-1916.
Aug 29. NYT. “Look For Schools to Reopen Sept. 15,” 8-30-1916.
Aug 25. NYT. “100 More Ill; 2 Die in State” [Polio], Aug 26, 1916.
South Hempstead Aug 22 NYT. “Record Increase in State,” Aug 24, 1916.
July 26. NYT. “Record Day for New Cases,” July 27, 1916, p. 18.
Syracuse (229 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health, 1917, 564
Aug 7. NYT. “13 Die in New York State,” 8 Aug 1916, p. 18.
Sep 4-5. NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.
Tottenville, Staten Island, July 3.
Aug 29. NYT. “Look For Schools to Reopen Sept. 15,” 8-30-1916.
Aug 13. NYT. “First Paralysis Death in Utica,” Aug 14, 1916, p.16.
Warwick (July 7 case). NYT. “Paralysis Kills 22 More Babies…” 7-8-1916.
July 24. NYT. “26 New Victims Outside City,” July 25, 1916, p. 20.
Aug 20 NYT. “Record High Total in State,” Aug 22, 1916.
July 31. NYT. “Disease Spread in State,” Aug 1, 1916, 5.
Aug 22 NYT “73 Cases [Polio] in New York State,” Aug 23, 1916.
West Park, late Jul Kingston Daily Freeman NY. “Another Case…West Park, 7-31-1916
Aug 20 NYT. “Record High Total in State,” Aug 22, 1916.
Aug 7. NYT. “13 Die in New York State,” 8 Aug 1916, 18.
Aug 13. NYT. “1,008 Victims in N.Y. State,” Aug 15, 1916, p. 18.
as of July 19. NYT. “Paralysis Gains Only in Manhattan,” 7-20-1916, 11.
July 21. NYT. “Jersey Ejects 22 Families,” July 2, 1916, p. 16.
Aug 20. NYT. “Chauffeur Dies of Paralysis,” Aug 21, 1916.
Aug 22. NYT. “36 More Ill on Long Island,” Aug 23, 1916.
as of Aug 22. NYT. “36 More Ill on Long Island,” Aug 23, 1916.
Aug 25. NYT. “100 More Ill; 2 Die in State” [Polio], Aug 26, 1916.
Aug 26. NYT. “Threaten To Wreck Paralysis Hospital,” 8- 27-1916.
Aug 30. NYT. “Look For Schools to Reopen Sept. 15,” 8-30-1916.
Sep 4-5. NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.

North Carolina ( 2)
–1 Fairmont. ~Aug 23. Robesonian, Lumberton NC. “No…Paralysis…County…,” 8-24-1916.
–1 Greensboro Aug 17 The News, Frederick MD. “Paralysis Makes High Record,” 8-17-1916.

North Dakota ( 1)
–1 Embden Sep 24. Bismarck Daily Tribune. “Station Agent Dies…Paralysis,” 9-26-1916, p.3.

Ohio ( 45)
— 4 Cincinnati. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 564.
— 6 Cleveland. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 564.
— 3 Columbus. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 564.
— 3 Dayton (17 cases). USPHS. “Poliomyelitis…in Cities…1916,” PH Rpts. 1917, p. 564.
— ? Hamilton, 1 case, Aug 1-5. USPHS. Public Health Reports, V.31, N34, 8-25-1916, p. 2284.
— 1 Marion, Dec 27. Hamilton Evening Journ. “Infantile Paralysis Victim Died…,”12-27-1916.
–25 Toledo (110 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts, 1917, 564.
— 3 Youngstown. USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts. 1917, p. 564.

Oklahoma ( 1)
–1 Tulsa, early Oct. Boynton Index, OK. “State News Notes,” 10-27-1916, p. 6.

Oregon ( 4)
–4 State. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p.840. (38 cases)
–2 Portland. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 564.
–? Salem (7 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.

Pennsylvania ( 414)
–414 State. July 1-Oct 15. JAMA, “Medical News,” 67/16, 10-14-1916, p. 1171. (1,163 cases)
–332 “ June 22-Dec 14. Blanchard tabulation of locality breakouts below.
–324 “ Levenson. “Polio outbreak threatened Bucks, Montgomery counties…,” Sep 2013.
–307 “ July 1-Sep 16. JAMA. “Medical News,” Vol. 67, 9-30-1916, p. 1028.
–288 “ as of Sep 11. NYT. “658 Cases in Philadelphia,” Sep 12, 1916.)
— ? “ USPHS. Public Health Reports, “Poliomyelitis…by States, 1916,” 840 (2181 cases)
— 1 Conshohocken, Aug 19. News, Frederick, MD. “Plague Still Spreads in PA,” 8-19-1916.
— 1 “ Aug 22. News, Frederick, MD. “Infant Plague is Unchecked,” 8-22-1916, 1
— 3 “ by Aug 22. News, Frederick, MD. “Infant Plague is Unchecked,” 8-22-1916, 1.
— 1 Covode, June 22. Indiana Progress, Indiana, PA. “Fred Sutter,” 6-28-1916, p. 4.
— ? Erie (7 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Harrisburg, 1 case, Aug 1-5. USPHS. Public Health Reports, V31, N34, 8-25-1916, 2284.
— ? Hazleton (7 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Indiana, Dec 26. Indiana Weekly Messenger, PA. “Recent Deaths,” 12-27-1916, 8.
— 1 Irvine, Dec 28. Warren Evening Times, PA. “Death Claims First Infantile…” 12-29-1916.
— 1 Johnstown, Sep 4. Daily News, Frederick, MD. “Bitten Boys Baby Plague,” 9-4-1916, p7.
— 1 Lancaster (21 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Langhorne. Levenson. “Polio outbreak threatened Bucks, Montgomery counties…” 2013.
— 1 Lower Southampton. Levenson. “Polio outbreak threatened Bucks, Montgomery…” 2013.
— ? McKeesport (12 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Mt. Gretna, Sep 5. Daily News, Frederick, MD. “Soldier Paralysis Victim,” 9-5-1916, 7.
— ? Norristown (19 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Norwood, Delaware Co. JAMA. “Medical News,” Vol. 67, No. 17, 10-21-1916, p. 1237.
–307 Philadelphia. USPHS. “Poliomyelitis…in Cities…1916,” Pub. H. Rpts., 1917, p. 563.
–282 “ July 1-Oct 20. JAMA. “Medical News,” Vol. 67, N18, 10-28-1916, p. 1312.
— 92 “ up to Aug 23. News, Frederick, MD. “Plague Unabated…,” 8-23-1916, 1.
— 2 “ July 19. Daily News-Record, Harrisonburg VA. “Two Deaths in Philly,” 7-19-1916.
— 3 “ July 31. New York Times. “86 New Cases in New Jersey,” 8-1-1916, p. 5.
— 3 “ Aug 8. NYT. “Calls Jersey Officials Lax; PA Health Commissioner,” 8-10-1916, 5
— 26 “ July 1-Aug 8. NYT. “Calls Jersey Officials Lax; PA Health Commissioner,” 8-10-1916
— 4 “ Aug 11. NYT. “Paralysis in Other States,” 8-12-1916, p. 16.
— 6 “ Aug 14-15. Frederick Post, MD. “At Odds Over Cure,” 8-16-1916, p. 2.
— 7 “ Aug 16. Billings Gazette, MT. “Spreads in Philadelphia,” 8-18-1916, p. 2.
— 5 “ Aug 17. The News, Frederick, MD. “Paralysis Makes High Record,” 8-17-1916.
— 3 “ Aug 19. The News, Frederick, MD. “Plague Still Spreads in PA,” 8-19-1916.
— 4 “ Aug 20. The News, Frederick, MD. “Infant Plague is Unchecked,” 8-22-1916, 1.
— 4 “ Aug 22. The News, Frederick, MD. “Infant Plague is Unchecked,” 8-22-1916, 1
— 3 “ Aug 23. News, Frederick, MD. “Plague Unabated in Philadelphia,” 8-23-1916.
— 6 “ Aug 30. Tyrone Daily Herald, PA. “Plague Kills Doctor’s Child,” 8-31-1916.
— 4 “ Sep 4. Daily News, Frederick, MD. “Paralysis Unchecked,” 9-4-1916, p. 7.
— 1 “ Sep 6. Daily News, Frederick MD. “Paralysis Kills Doctor,” 9-6-1916, p. 7.
— 4 “ Sep 8. Daily News, Frederick, MD. “Plague Continues in Phila.,” 9-8-1916, 7.
— 2 “ Sep 13. Daily News, Frederick, MD. “Decrease in Plague,” 9-13-1916, p. 7.
— 6 “ Sep 19. Daily News, Frederick, MD. “Six Plague Deaths in Philadelphia,” 9-19-1916.
— 6 “ Sep 21. Daily News, Frederick, MD. “Six Die of Paralysis,” 9-21-1916, p. 7.
— 12 Pittsburgh. USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts., 1917, p. 563.
— ? Plymouth (5 cases). USPHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 0 Reading (5 cases). USPHS. “Poliomyelitis…Prevalence in Cities…1916,” PH Rpts. 1917.
— 2 Scranton (17 cases). USPHS. “Poliomyelitis…Prevalence in Cities…1916,” PHealth Rpts.
— 1 South Bethlehem. NYT. “Paralysis Kills 22 More Babies in New York City,” 7-8-1916.
— 1 Upper Darby, Dec 14. Chester Times, PA. “Infantile Paralysis Fatal…,” 12-15-1916.
— 1 Wilkes-Barre, Nov 15. Fort Wayne News, IN. 11-16-1916, p. 4.

Rhode Island ( 23)
— 9 State (56 cases), by July 31. USPHS. Public Health Reports, V31/N34, 8-25-1916, p. 2282.
— ? Bristol Co., 21 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 184.
— ? Kent Co., 6 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 184.
— ? Newport Co., 17 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, p. 184.
— 1 “ Middletown ~Aug 18. Newport Mercury, RI. “Death…Infantile Paralysis,” 8-19-1916
— 1 “ Newport, 13 cases. U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Providence Co., 157 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 185.
— ? “ Cranston, 12 cases. U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 “ Lincoln, 8 cases by Aug 15. USPHS. Pub. Health Rpts., V31/N34, 8-25-1916, 2282.
— ? “ Pawtucket, 13 cases. USPHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
–20 “ Providence. USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts., 1917, 563
— ? Washington Co., 13 cases, July 1-Oct 18. Smallman-Raynor, et al. Poliomyelitis. 2006, 185.

South Carolina ( 36)
–36 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 5 Statewide. By Aug 11. NYT. “Paralysis in Other States,” Aug 12, 1916, p. 16.
— ? Greenville (5 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.

Tennessee ( ?)
— ? State (29 cases in June). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2282.
— ? “ (18 cases, July). USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2282.
— 0 Nashville (1 case). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts., 1917, p. 564.

Texas ( 35)
–35 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— 0 Dallas (2 cases). USPHS. “Poliomyelitis…Cities…1916,” Pub. Health Rpts., 1917, p. 564.
— ? El Paso (5 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 0 Fort Worth (2 cases). USPHS. “Poliomyelitis…in Cities…1916,” PH Rpts. 1917, p. 564.
— 3 Houston. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 564.
— 3 San Antonio. USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts., 1917, p. 564.

Utah ( ?)
— ? Salt Lake City (4 cases). USPHS. “Poliomyelitis…in Cities…1916,” PH Rpts., 1917, p. 564.

Vermont ( 12)
–12-13 Caverly. “Infantile Paralysis (Poliomyelitis) in Vermont 1916-1917.” 1924, p. 148.
— 12 State. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
— ? Arlington. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 151.
— ? Bradford (1 case). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Brandon. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Bristol (2 cases). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— >2 Brookfield. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 151.
— ? Burlington (6 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— ? Craftsbury (1 case). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p.156.
— ? Dorsey. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Elmore (1 case). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Essex (1 case). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Fair Haven. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 157.
— ? Georgia (1 case). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Grand Isle (6 cases). Caverly. “Infantile Paralysis…Vermont 1916-1917.” 1924, p.145.
— ? New Haven (1 case). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, 156.
— ? Pawlet. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 144.
— ? Poultney (6 cases). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Pownal. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Readsboro. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Rockingham. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Rupert. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 157.
— ? Rutland. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 160.
— ? South Hero (2 cases). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, 156.
— ? Tinmouth. Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p. 156.
— ? Underhill (2 cases). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p151.
— ? Woodstock (2 cases). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, 156.
— ? Worcester (1 case). Caverly. “Infantile Paralysis…in Vermont 1916-1917.” 1924, p.156.

Virginia ( 59)
–59 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” 840.
— 1 Barton Heights. Sep 23. News, Frederick MD. “Close School When Pupil Dies,” 9-23-1916
— ? Lynchburg (20 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 3 Richmond (20 cases). USPHS. “Poliomyelitis…in Cities…1916,” PH Rpts. 1917, p. 564.
— 1 Richmond. Late July. Petersburg Daily Progress, VA. “Council Meeting Tonight,” 8-3-1916
— ? Roanoke (5 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Tyreanna. Aug 29. Daily News Record, Harrisonburg VA. “Case of Infantile…,” 8-30-1916

Washington ( 7)
–7 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
–? Seattle. USPHS. “Poliomyelitis…in Cities…1916,” Public Health Rpts., 1917, p. 564.
–0 Spokane (1 case). USPHS. “Poliomyelitis…Prevalence in Cities…1916,” Pub. Health Rpts.
–1 Tacoma. USPHS. “Poliomyelitis…Prevalence…Cities…1916,” Pub. Health Rpts. 4-20-1917

West Virginia ( 13)
–? State. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840 (82 cases).
–? Charleston, Kanawha Co. (1 case). USPHS. Public Health Reports, 31/34, 8-25-1916, 2283
–1 Clarksburg, Harrison Co. USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2283.
–9 Elkins, Grafton, Fairmont. Municipal Journal, “Supreme Court…,” 25 Jan 1917, 108.
–3 Fairmont, Marion County, Jan. Draper 1917, p. 19.
–6 Grafton, Taylor County, Dec-Feb. Draper 1917, p. 19.
–1 Huntington, Cabell Co. USPHS. Public Health Reports, V. 31, No. 34, 8-25-1916, p. 2283.
–? McDowell Co. (2 cases). USPHS. Public Health Reports, V. 31, N. 34, 8-25-1916, p. 2283.
–1 New Martinsville, Wetzel Co. (2 cases). USPHS. Pub. Health Rpts, 31/34, 8-25-1916, 2283
–1 Wheeling, July 30-Aug 5. USPHS. Public Health Reports, V31, N34, 8-25-1916, p. 2284.

Wisconsin ( 79)
–79 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.
–30 “ up to Sep 27. Daily Northwestern (Oshkosh). “Infantile Paralysis in WI,” 9-27-16
— 5 “ up to Aug 15. La Crosse Tribune (WI). “Dreaded Child Paralysis…,” 8-18-1916.
— 1 Appleton (8 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Ashwaubenon. Oct. Daily Northwestern, Oshkosh WI. “Death Rate in October,” 12-1-1916
— 2 Eau Claire. Oct. Daily Northwestern, Oshkosh WI. “Death Rate in October,” 12-1-1916.
— 1 Glenwood City. ~Sep 27. La Crosse Tribune, WI. “Dies of Infant Plague,” 9-27-1916, 11.
— 1 Green Bay, ~Dec 9. Stevens Point Daily Journal. “Is Victim of Paralysis,” 12-9-1916, p5.
— 1 Greenfield twp. Oct. Daily Northwestern, Oshkosh, WI. “Death Rate in October,” 12-1-16.
— ? Kenosha (7 cases). U.S. PHS. Public Health Reports, Vol. 32, No. 26, 6-29-1917, p. 1016.
— 1 Lake Geneva. Oct. Daily Northwestern, Oshkosh, WI. “Death Rate in October,” 12-1-1916.
— ? Manitowoc (6 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Milton Twp. Oct. Daily Northwestern, Oshkosh, WI. “Death Rate in October,” 12-1-1916
— 2 Milwaukee. Oct. Daily Northwestern, Oshkosh, WI. “Death Rate in October,” 12-1-1916.
— 2 “ USPHS. “Poliomyelitis…Cities…1916,” Public Health Rpts., 1917, p. 564.
— 1 Trempealeau Aug 15. La Crosse Tribune, WI. “Dreaded Child Paralysis…,” 8-18-1916.
— ? Wausau (8 cases). U.S. PHS. Public Health Reports, V32/N26, 6-29-1917, p. 1016.
— 1 Wittenberg. Oct. Daily Northwestern, Oshkosh, WI. “Death Rate in October,” 12-1-1916.

Wyoming ( 3)
–3 Statewide. US PHS. Public Health Reports, “Poliomyelitis…By States, 1916,” p. 840.

What Is Polio?

Draper, Allison: “The word ‘poliomyelitis’ comes from the Greek words polios, which means ‘gray,’ and myelos,’ which means ‘matter.’ Gray matter is the nerve material found in the brain and spinal cord, the central nervous system (CNS). The CNS is responsible for controlling muscular functions in your body by relaying messages from your brain to your muscles. It allows you to move your body. If your CNS is damaged, you loose the ability to move or easily control the parts of your body that are connected to and controlled by that damaged nerve tissue. Sometimes when this happens, you are left totally unable to move the effected parts of your body. Those parts are paralyzed. Other times, people’s limbs become only partially paralyzed which causes them to shrivel from lack of use and become deformed. Polio is a virus that attacks the CNS. It has also been called infantile paralysis, because it most frequently affects children, or paralysis of the morning, because paralysis generally sets in overnight and people experience it in the morning. People who contract polio often go to sleep feeling only mildly ill but wake up to find that they are unable to walk, move one of their arms, or breathe without great difficulty. In fact, people whose chest muscles become paralyzed can lose the ability to breathe, which is one reason why people die from polio.” (Draper. Polio. 2001, 6)

Draper, George: “…acute poliomyelitis is a general infectious disease, in the course of which paralysis is but an accidental and incidental occurrence.” (Draper 1917, viii.)

Gould: Polio is caused by a virus which attacks “the nerves in the spine, cutting off the impulse from the brain to the muscles and causing the affected muscle fibres to shrivel and die…the unpredictable element came in through not knowing how much of the initial damage was temporary – the nerves, as it were, merely stunned, rather than taken out by the virus – and how much was permanent; and that the only way to find that out was through a rigorous programme of physiotherapy lasting anything up to two years.” (Gould 1995, xv.)

Some Historical Background Prior to 1916

Draper, Allison: “In 1789, an English doctor named Michael Underwood recognized and described a still-unnamed disease. He noticed that it occurred less often in London – a big, dirty city without plumbing – than it did in the countryside.” (Draper. Polio. 2001, 8)

“By the mid-1800s, there had been so many cases that doctors started in investigate. A German doctor named Jacob von Heine thought the fact that the disease started with a fever might mean it was contagious – that it could be spread from persons to person as opposed to being a disease that developed inside the body, like cancer. Heine worked with numerous cases and thought the disease should be treated with exercise and baths. He taught his patients to use braces to support their weakened limbs and help themselves learn to walk again.” (Draper. Polio. 2001, 8-9)

“In 1887…Karl Oskar Medin saw that there were different forms of the disease. HE recognized that the attack was made up of two fevers. The first fever was simply a fever, while the second attacked and damaged the central nervous system.” (Draper. Polio. 2001, 9)

“In 1905, a Swedish children’s doctor named Ivar Wickman dealt with an outbreak of more than 1,000 cases of the disease. He named it the Heine-Medin disease. In 1907, he investigated whether the disease was indeed contagious, as Heine had believed. If it was contagious, he wanted to know how it spread. He wanted to find out whether children got sick only from direct contact with children who were already sick, of whether they could get sick from carriers – people who are infected but do not get sick or show signs of the disease. Carriers are dangerous because they unknowingly carry and spread disease to people who will get sick and suffer harmful symptoms. If people could be carriers of polio, Wickman reasoned, that would explain how polio could spread so quickly and so fatally even when everyone sick from it was usually separated from healthy people. Wickman thought that many, many people were carriers.” (Draper. Polio. 2001, 9-10)

Draper, George: “The story of the development of our knowledge of poliomyelitis does not follow a single path continuously from the earliest beginnings to the present time, but rather represents the converging of several lines of study. Three distinct avenues of investigation present themselves, the clinical, the pathological, and the experimental. Each of these has a very definite history and the contributions to each path have been made by various observers quite distinct from those working in other paths. The first observation of the clinical phase of the disease was probably made by Underwood in 1774. His description is very meager and only suggests that he recognized the fact that children might suddenly become paralyzed after a brief illness. The next mention of the disease in the literature is that made by the English physician Badham in 1835. His description is much more definite and has to do with a small group of children in a circumscribed neighborhood. There can be very little doubt that Badham described acute poliomyelitis. But the first systematic study of the clinical picture of this malady was made by Jacob Von Heine in 1840 in the village of Kolmar in Germany. Heine was an orthopedic surgeon and saw a great many cases of paralysis in children, and became interested in the subject. His investigations led him to investigate the stage of the disease nut usually seen by the orthopedic surgeon and he was the first to realize that this peculiar paralytic visitation was always preceded by an acute febrile period. Heine’s description of this phase of the disease demonstrates that he appreciated that there as a febrile reaction which might be so mild as not to arouse any anxiety in the minds of the parents and pointed out indeed the great contrast between their feelings during the acute stage and later when they suddenly discovered the paralyzed leg on the morning following the acute symptoms. To Heine undoubtedly belongs the credit for first having drawn attention to this disease as being a clinical entity and also for having given the first complete description of it.

“Following Heine’s work, the literature is barren of any discussion of the disease until 1884 when Strumpell in Vienna described an encephalitic type which he believed to be similar to the true poliomyelitis anterior of children as described by Heine. He also drew attention to the fact that there were certain forms of acute neuritis in children which belonged also in this same group; thus, he brought together the neuritis type, the poliomyelitic type and he encephalitic type and supposed that they were all one and the same disease. He also threw out the suggestion which was the first of its kind, that the disease was probably of an infectious nature.

“The next important step in the clinical study was that of Medin who published in 1889 a description of the large epidemic in Sweden. In Medin’s work appears for the first time an excellent description of the acute stage of the disease, and we are first given the impression that we have to do here not alone with the paralytic affliction but also with an acute general infection.

“Then again there follows a long silence on the subject until Wickman in 1905, studying the vast epidemic in Sweden, developed what may well be considered the modern conception of the disease. His pathological, clinical and epidemiological studies form a classical contribution to the growth of our knowledge of acute poliomyelitis, and established the disease finally as a clinical entity. Wickman was the first to point out the so-called abortive type, a name which is undesirable, and which has remained attached to those cases which never develop paralysis. His epidemiological studies also gave strong support to the view that the disease was transmitted by contact.” (Draper 1917, 1-2.)

“When the fact had been finally established that the disease was infectious, the next step obviously was to discover the infective agent – the germ. In the following year (1908) the first advance in this difficult quest was accomplished in Paris by Landsteiner and Popper. They succeeded, by injecting monkeys with portions of the brain and spinal cord taken from a fatal case of poliomyelitis, in setting up the disease in the animals and so placing it on an experimental basis. Very soon after this had been done, Flexner and Lewis of New York, Leiner and Von Wiesner in Vienna, and Landsteiner and Levaditi in Paris all were able to pass the disease from one monkey to another. When this series had been finally established the door was open to intensive experimental study of the mechanism of the disease.” (Draper, G. 1935, p. 14.)

Lavinder, Freeman and Frost, 1917: “The development of our knowledge in its larger steps is associated with the names of few men. Poliomyelitis has undoubtedly existed for a long period of years. It is no new disease. It was reserved for Heine, however, about 1840, to differentiate it from the multitudinous forms of paralysis affecting children and place it upon a firm foundation as a clinical entity.” (Lavinder, Freeman, and Frost. Epidemiologic Studies of Poliomyelitis in New York City and the North Eastern United States During The Year 1916 (Public Health Bulletin No. 91, July, 1918.)

NYC Health Dept: “Poliomyelitis has been recorded in the United States as among the rarer diseases of the central nervous system since it was first described by Heine in 1840. In 1874 it was a disease of such rare occurrence or so seldom recognized as a distinct clinical entity, that the leading consulting physicians of the largest cities in this country and abroad had not, in their whole professional careers, seen more than a handful of cases.” (NYC Dept. of Health. A Monograph on The Epidemic of Poliomyelitis… NYC…1916. 1917.)

Robbins and Daniel: “Thirty-five hundred years ago an Egyptian craftsman carved a bas relief stela depicting a young man with a crippled, withered leg. Egyptologists believe the young man represented in the stela was a priest. He is supporting himself with a staff held under his arm much as one might use a crutch. The deformity of his shrunken leg is typical of that seen following paralysis in childhood. The young man probably ad the disease we call poliomyelitis – polio, for short – as a child.

“Moving forward in time about 1500 years, the early depiction in stone of a paralyzed leg from Egypt is joined by descriptions of a famous Greek physician Hippocrates and his Roman disciple Galen, both of whom wrote about acquired club foot in terms that suggest they many have been describing polio. Across thousands of years, our ancestors tell us that polio is an ancient curse of humankind…. If polio has been present among people since antiquity, it has kept a quiet profile during most of history. Sporadic accounts of paralysis undoubtedly due to polio appeared during the eighteenth century…. (pp. 5-8)

“…in 1813 the first clear medical description of polio was published by an Italian surgeon Giovanni Battista Monteggia. However, the disease of that time was not that which swept across Europe and North America in more modern times.

Until the latter part of the nineteenth century, polio was an endemic infection, common and always present, occurring early in life, with paralysis as an infrequent complication. In fact, the infection may have been very common at that time, for paralysis in infants with polio is not usual, and only the few with paralysis were noted. Infantile paralysis, the name given to polio by a German orthopedist, Jakob Heine, in the mid nineteenth century, quite accurately denominated the disease as it was then seen by medical practitioners. Heine described this disease as one of infants between six and 36 months of age. Thus polio smoldered, by-and-large an unrecognized and unimportant but common infection of early childhood, a cause of fever, headache, and malaise, but only occasionally a cause of paralysis….

“During the nineteenth century, an increasing number of small outbreaks of polio occurred in which adults were affected. In 1887 a major epidemic hit Stockholm. Fourth-four cases of paralytic polio occurred in a city that had previously experienced one or two cases a year. Investigating this epidemic, Karl Oskar Medin realized for the first time that the paralytic cases were only a small part of the epidemic, and that persons with only mild illnesses were spreading the disease to others.” (Robbins and Daniel, “A History of Poliomyelitis,” Ch. 1, Polio, 1997)

“About this time Andre’ Cornil, a French pathologist, performed the first autopsy on the brain and spinal cord of a patient who had paralytic polio. Subsequently, Jean Martin Charcot, his colleague and one of the founders of the science of neurology, extended that first autopsy study and demonstrated that the site of tissue destruction was in the part of the spinal cord known as the anterior horn, the area of origin of nerve cells controlling muscles…. (pp. 5-8)

“As the twentieth century dawned, epidemics became the usual pattern of polio in the industrialized countries of the temperate zones, with outbreaks occurring regularly every summer and early fall. The age of the persons afflicted also increased. Polio is a different disease in young children and in adults. In children, it is usually a mild illness, often unrecognized, and infantile paralysis is uncommon among those infected with poliovirus. However, this mild infection produces life-long immunity against further attacks by the same virus. Polio in adults is more severe, and paralysis occurs much more frequently in this age group.

“Poliovirus is excreted in large quantity by infected individuals in their stools. In communities where sanitary systems are primitive, poliovirus circulates readily in the population, and almost all children are infected at a young age and become immune. This pattern of spread was usual throughout the world prior to the industrial revolution and continues to the present in developing countries. In modern times, improved sanitation has reduced transmission by the fecal-oral route and has left adults non-immune in developed countries. Transmission of infection usually required close contact, and the source of virus was commonly the throat. With the shift to older patients, paralysis became a more frequent complication of polio. Even though fewer cases of infection were occurring, the disease’s manifestations were more severe and more alarming. At the same time, polio became a seasonal disease, but it is not clear why.

“The mysterious seasonal occurrence of polio epidemics in the industrialized countries, the lack of a clear understanding of how the infection was transmitted, the crippling nature of the disease, the increase in the involvement of young adults….all led to a great concern about the disease and sometimes panic among the public….” (Robbins and Daniel “A History of Poliomyelitis,” Chapter 1 in Daniel and Robbins, Polio, 1997, pp. 5-8)

Wilson: “In the late 1880s and early 1890s, doctors began to notice an increasing number of polio cases, especially in and around Boston. There were, for example, twenty-six cases in eastern Massachusetts in the summer of 1893. The following year the first significant and well-documented epidemic of polio occurred in nearby Vermont. Dr. Charles S. Caverly, who was a public health officer for the state, provided the best description of the epidemic. It began in June in Rutland and Wallingford, and by July had spread to other towns and villages in the date. Caverly’s investigations revealed 132 cases of mainly infants and children. However, somewhat surprisingly a number of adults were also diagnosed with the disease. Many patients recovered, but at least thirty were permanently paralyzed and 13.5 percent of the patients died…..

“In the years following the Vermont epidemic, polio continued to appear in the northeastern states. It is difficult to know just how widespread these cases of polio were because the doctors were not always required to report their diagnosis of the disease to public health authorities. In New York, for example, polio did not become a reportable disease until 1911. The largest outbreak in the first decade of the twentieth century occurred in New York in 1907, when there were over 1,000 cases in and around the city. Because the disease was not yet reportable, many mild cases probably went unrecognized by parents and unrecorded by physicians. The Vermont epidemic of 1894 and the New York epidemic of 1907 did suggest that the disease was beginning to change its character and its prevalence. Epidemics of polio were increasing in frequency, size, and severity. Although most polio patients were young children, the number of older children and even adults who succumbed to the disease was rising. The increasing number of older patients was particularly worrisome because it was more likely to be severe and paralytic among them.” (Wilson. Polio. 2009, 10-11.)

NYC Health Dept: “In the years 1912-1915 there were respectively 70, 54, 34 and 13 deaths from the disease and in 1916 up to June 1, there were only 6 deaths, while the average weekly number of deaths from July 1 to September 9, 1916, was 209.” (NYC Dept. of Health. A Monograph on The Epidemic of Poliomyelitis… NYC…1916. 1917, 11)

NYC Health Dept: “Since the early years of this century there has been an increasing general area of distribution in this country and a growing incidence of the disease. Over 5,000 deaths from poliomyelitis are recorded by the United States Census Bureau, as having occurred in the registration area in the quinquenium 1910 to 1914. A conservative estimate would place the probable number of cases during these five years in this area as 30,000.” (NYC Dept. of Health. A Monograph on The Epidemic of Poliomyelitis… NYC…1916. 1917, 11)

General Information, 1916

Draper, George (1935): “During the summer of 1916 a severe epidemic of infantile paralysis, starting in a small area of Brooklyn, swept like wildfire through all the boroughs of the greater city, then down upon Long Island, and finally over New York and the neighboring Atlantic states. Day by day the number of new cases and deaths mounted rapidly; and as the staring headlines of each morning newspaper announced the rising toll, fear waxed in men’s hearts faster and more intensely than the epidemic itself. In rural communities where neighbors knew intimately of each other’s family affairs, and garbled rumors of the stalking invader which maimed and strangled little children sped swiftly from lip to lip through adjacent villages, terror grew apace. Indeed, there were moments in that memorable summer when one wondered whether the demoralizing effect of general fear was not a graver issue than the disease. (pp. 5-6.)

“No doubt many scenes which occurred in London during the great plague of 1665 were reenacted in our Long Island and Westchester towns. Under the sway of panic people looked with skepticism and suspicion on government health officers. The selectmen of many villages, whose doctors were struggling with the impossible and failing to stop the epidemic or save the individual case from paralysis, resorted to home-made martial law. Deputy sheriffs, hastily appointed and armed with shot-guns, patrolled the roads leading in and out of towns, grimly turning back all vehicles in which were found children under sixteen years of age. Railways refused tickets to these selected youngsters, the innocent victims of ignorance and despair. Indeed, the notion was fairly held that below the magic age, called sweet at other times, there lurked the dread disease, whereas above it no menace existed either for the individual or the community.” (George Draper. Infantile Paralysis. NY: Appleton-Century, 1935, p. 6.)

“…nearly 90 per cent of the total incidence occurred in children below the age of five years [1916]. (p. 56)

“A further general peculiarity of the disease is that more males than females are regularly afflicted….from New York in 1916 boys were 56.3 per cent and girls 43.7 per cent. This distribution has maintained a remarkable constancy in other localities, but when a greater discrepancy has appeared it has been due to an increase in the masculine percentage. From a table compiled and reported by the Milbank International Committee for the Study of Infantile Paralysis, the same remarkable constancy is shown. The average ratio of males to one female attacked is 1.30 : 1 – that is, roughly, four boys to three girls. So far as we now know, qualities in which one sex differs from another are related to the glandular forces, especially those represented by the pituitary and the sex glands; and perhaps also the adrenal cortex.” (Draper 1935, 57-58)

“…recently some indications have appeared that persons carrying the A group [blood type] are apparently more often subject to infantile paralysis than the others. The B group seems to be especially free from poliomyelitis. The O group stands midway.” (Draper 1935, 71)

“It is well known that the Eskimo and North American Indians rarely contract the disease.” (p. Draper 1935, 71.

“…poliomyelitis is actually rather a rare and mild disease…even the great epidemic of 1916 in New York, not quite three individuals for every thousand of population were stricken. In most average epidemics of poliomyelitis not more than one individual in a thousand of population, or two in four thousand are attacked. Furthermore, of those cases which are correctly diagnosed only a part develop muscular weakness at all and nearly half of these regain full muscular power.” (Draper 1935, 87-88.)

“…it is probably fairly near the truth to say that of all the cases of epidemic illness which can be recognized as poliomyelitis, 50 to 80 per cent do not go on to paralysis. This means that the apparent size of any given epidemic in terms of paralysis represents only from a fifth on one half its actual extent….

“One of the interesting peculiarities about poliomyelitis is the fact that so rarely more than one case in a family appears.” (Draper 1935, 91.)

“The phenomenon of respiratory paralysis constitutes a very special problem within the general one of poliomyelitis, and for this reason a description of its aspect, written with remarkable vividness and accuracy by the late Professor F. W. Peabody of Harvard, is quoted in full:

With the onset of respiratory difficulty, it seems almost as if the children were suddenly awakened and made to realize the struggle before them. Little children seem to age in a few hours. One sees a heedless, careless, sleepy child become all at once wide awake, high strung, alert to the matter in hand, and this is breathing. The whole mind and body appear to be concentrated on respiration. Respiration becomes an active, voluntary process, and every breath represents hard work. The child gives the impression of one who has a fight on his hands, and who knows perfectly how to manage it. All he wants is to be left alone, not to be interfered with, to be allowed to carry out his fight on his own lines. Instinctively he husbands his strength, refuses food, and speaks, when speech is necessary, quietly and with few words. One little child of four, so helplessly paralyzed that she was unable to move, but with a mind that seemed to take in the whole situation, said he the nurse clearly but rather abruptly, between her hard-taken breaths, ‘My arm hurts’; ‘Turn me over’; ‘Scratch my nostril’; and then when the doctor approached, ‘Let me alone, doctor! Don’t touch my chest.’

Pressure on the chest, tight neck bands, anything that obstructs easy respiration is immediately resented. The child demands constant attention, is irritated unless everything is done exactly as he wishes it, and often shows an instinctive appreciation for some especially efficient nurse. He is nervous, fearful, and dreads being left alone. The mouth becomes filled with frothy saliva which the child is unable to swallow, so he collects it between his lips and waits for the nurse to wipe it away. He likes to have his lips wet with cold water, but rarely attempts to take it into his mouth for he knows he cannot swallow it.

“During the whole course it is remarkable that cyanosis is absent. There is a little bluish tingeing of the lips and tongue, but much more distinctive is the pallor, which is sometimes striking. Sweating is profuse. Then, as respiration gets weaker, the mind becomes dull, and with the occasional return of a lucid interval, he gradually drifts into unconsciousness. An hour or more later respiration ceases.

This peculiarly alert, keen mental state has been much less noticeable in small babies. They tend to be dull and drowsy most of the time; but in the older children this alertness has been such a characteristic feature of the fatal cases, that we almost preferred to have a child brought to us in a stuporous condition, rather than with a mind whose nervous acuity seemed due to a perception of impending danger.” (Quoted in Draper 1935, 134-135.).

“…the death rate in poliomyelitis…[was] 27 per cent…in 1916…” (Draper 1935, 140.)

“In the great epidemic of 1916, which was not only very extensive but of exceedingly virulent form there were 32.6 per cent recoveries from paralysis.” (Draper 1935, 142.)

Flexner: “The epidemic of poliomyelitis which swept over the Eastern United States during the past summer and autumn achieved a new record. The number of cases exceeded that of any previous epidemic reported and the mortality approached the maximum recorded.”
(Draper 1917, v.)

Lavinder, et al: (U.S. Public Health Service, 1918 abstract of Lavinder, Freeman and Frost report.): “In Public Health Bulletin 91 of the Treasury Department, United States Public Health Service, C. H. Lavinder, A. W. Freeman and W. H. Frost have reported the results of their study of the 1916 epidemic of poliomyelitis in New York City and the Northeastern United States, including the whole of New England, the Middle Atlantic states, Delaware, Maryland and the District of Columbia. The report treats separately of the epidemic in Greater New York, with nearly 9,000 cases, and in the outside area comprising the states named, including New York State, with nearly 12,000 cases. In each area a general epidemiologic study was made, and in certain of the districts also an intensive epidemiologic study. The information gathered is analyzed, tabulated and represented in graphic charts, and covers every aspect of the subject. In this outbreak, the greatest in numbers and intensity that has ever been reported, with a high fatality rate, the epidemiologic features are quite similar to those of other epidemics that have been studied. There is nothing peculiar or unique either in seasonal incidence, age, distribution, comparative fatality rates at different ages, or in special conditions, such as environmental surroundings, source of milk and water supplies, occupation, prevalence of insects, or presence of animals, to which could be attributed any influence on the occurrence of the disease. There is also the usual lack of evidence as to contact relationships between cases of the disease. Any idea of a new or powerful strain of the virus is open o doubt, s far as New York City is concerned. The disease is endemic in that city, and the origin in this epidemic was quite possibly indigenous. The development of endemic diseases into epidemic proportions is a common observation, the reasons for which are still unknown. One of the notable features of the epidemic was the definite geographic focus in Brooklyn, and the striking uniformity of its spread both in rate and intensity from this point. Plotted curves of the rise and decline of the disease would seem to indicate that it spread by constantly multiplying foci of infection. As for the epidemic outside the city of New York, it many perhaps be accounted for much on the same grounds, the endemic presence of the disease, with the sudden extension to epidemic proportions for the same unknown reasons that apply to these phenomena. An interesting part of the study was the attempt to trace the relations of the New York City epidemic to the occurrence of cases in neighboring cities and the adjacent country. It was possible to trace a number of cases whose source of infection was probably in New York, and in a small number of cases almost certainly in that city, as these were the first cases occurring in the communities to which the patients had recently migrated from New York City. The report offers the conclusion, however, that the study does not show that the cases actually in persons from New York City were a very large factor in the spread of the epidemic, since such known cases were the first known source of infection in only 9 percent of the infected towns, and constituted only 1.4 percent of the cases that occurred in the states included. Interesting also is the finding that the development of cases in persons going out from New York City was quite irregular; but in a large proportion of those probably definitely infected before leaving the city, the disease developed within seven days after their exodus.” (Placed before the title page.)

Lavinder, et al: “….The work of the Public Health Service…in this epidemic, developed along two lines and was conducted by two entirely different and separate groups of officers. One of these groups, under the charge of Senior Surg. Charles E. Banks, was engaged in the supervision of interstate traffic in relation to the disease and the notification of local health authorities concerning the movements of persons from the epidemic area. The other group of officers, under the supervision of Surg. C. H. Lavinder, was engaged in scientific investigations of the disease. This present report is concerned solely with the work of the latter group.

“As originally contemplated the investigation was to include both epidemiologic and experimental studies. By reason, however, of administrative and other difficulties the laboratory work was ultimately transferred to the Hygienic Laboratory in Washington, material for study being supplied from New York City and vicinity. The studies made with this material form no part of this report, which is concerned entirely with the epidemiological and statistical aspects of the question. [pp. 7-8]

“Originally the investigations were confined to New York City, but as the epidemic developed they were extended to the States surrounding New York City. Through access to the records of the city health department, by the courtesy of the commissioner, it was possible in New York City to collect general epidemiologic data with regard to all cases that occurred in the city. Moreover, opportunity was offered o make detailed, intensive studies of all the cases that occurred in one borough – that is, the borough of Richmond, which comprises the whole of Staten Island.

“Outside of New York City, through the courtesy of the State health authorities, it was possible to obtain daily general information with reference to the prevalence and spread of poliomyelitis in the States of New Jersey, New York, Connecticut, Rhode Island, and Massachusetts, and also to make detailed studies of cases in certain parts of New Jersey, Connecticut, and Rhode Island. At the conclusion of the epidemic it was feasible to collect information with regard to the disease in certain other States which bore a more or less close relation to the epidemic….

“…as will appear in the following pages, some investigations have been made as to the prevalence of poliomyelitis throughout the world in past years, and particularly its prevalence throughout the continental United States. The disease was not reportable in the United States previous to 1909…. [pp. 7-8]

“In the preparation of the maps and data for the Northeastern United States…it is a matter of regret that we could not secure comparable data for the State of Pennsylvania. This information has not been made available, and it was necessary simply to leave this State blank….” [ p. 11]
(Lavinder, Freeman, and Frost. Epidemiologic Studies of Poliomyelitis in New York City and the North Eastern United States During The Year 1916 (Public Health Bulletin No. 91, July, 1918).

McCreedy: “The polio epidemic of the summer of 1916 appears to have begun in Brooklyn, New York when a limited number of children awoke one morning unable to move their arms or their legs. Desperate, their parents rushed the stricken children to neighborhood health stations, but the doctors and nurses were puzzled by the various symptoms. As the days passed, the cases continued to steadily increase. By the end of June, the professionals finally recognized that they were facing an epidemic of infantile paralysis or polio. But, the doctors could not explain it, accurately diagnosis it, treat it, or prevent it–circumstances that enhanced the public’s fear and uncertainty, especially since most Americans in the early twentieth century believed that they were living in a new age of science and medicine.” (McCreedy 2005)

“By December of 1916, the polio epidemic had spread from New York City to twenty-seven states along the eastern seaboard and into the mid-west. Over the course of seven months, out of twenty-seven thousand reported cases of polio, six thousand people had died, and thousands more would be paralyzed or deformed for the rest of their lives.” (McCreedy 2005)

Smallman-Raynor, et al.: “The great epidemic of poliomyelitis that swept New York City and the northeastern United States in 1916 ranks as one of the largest and most intense outbreaks of the disease ever globally recorded….As a dramatic example of the epidemic emergence of a once rare and sporadic malady, the events of 1916 eclipsed all earlier outbreaks of the disease and heralded the recognition of poliomyelitis as a major public health problem in the United States (Emerson, 1917; Lavinder et al., 1918).” (p. 150) (Smallman-Raynor, Cliff, Trevelyan, Nettleton, Sneddon. Poliomyelitis: Emergency to Eradication – A World Geography. 2006.)

U.S. Public Health Service, 1919: “…an epidemic of poliomyelitis appeared in New York City early in the summer of 1916. This epidemic rapidly assumed alarming proportions….The number of cases in Greater New York, according to the figures of the department of health, was 9,023. The number in the entire epidemic area was upwards of 20,000. The epidemic spread rather rapidly over a wide area. The infection was a virulent one and the mortality high.

“This epidemic is a notable event in the history of poliomyelitis, being, in numbers involved, many times larger than any epidemic previously recorded for this disease. Poliomyelitis as an epidemic disease seems really to be a development of our own time. Its rapid and continuous spread with the culmination in an epidemic of such size has placed this malady in the list of epidemic communicable diseases which demand the serious attention of all public-health officers….” (p. 30.)

“The summer of 1916 witnessed an outbreak of poliomyelitis (infantile paralysis) of unprecedented proportions in various sections of the United States. Beginning early in June in the congested districts of the city of New York, the wave of infection rapidly extended for a hundred miles in every direction, and finally touched even far distant sections, invading in its passage across the country more than 30 States. The crest of the wave was reached early in August, after which time the disease slowly subsided, but it was not until late autumn or early winter that the epidemic could be regarded as quiescent and a normal incidence of the disease again obtained. The number of cases actually recorded from the inception of the outbreak until its close was more than 27,000 nearly half of which developed in New York City alone, and if unreported and unrecognized cases are included it is believed that the actual total was not far from 35,000.

“From the very onset of the epidemic a feeling of apprehension, if not of actual alarm, prevailed throughout the country, even in communities altogether remote from the centers of infection. The affection was rightfully regarded as mysterious in its nature and origin, more or less permanently disabling in its effects, if not actually fatal, and in large measure not responsive to the ordinary procedures enforced for the suppression of communicable diseases. In view of these facts it is not surprising that almost from the inception of the outbreak radical, and at times impractical, procedures should have been demanded by the public to prevent the introduction and dissemination of the disease, and that individual communities should have attempted to afford protection to their citizens in every possible manner.

“The methods adopted to accomplish this purpose for the most part took the form of quarantine restrictions promulgated and established by local, city, and State authorities. These restrictions were necessarily widely variant in their character, lacking in uniformity and frequently conceived without regard to the principles governing disease control, although the result of entirely honest efforts. Many of the restrictions were absolute in their prohibitions, debarring not only those afflicted with poliomyelitis from entering a given district, but also healthy adults and children coming from infected zones, and even those who were merely in transit through such areas. In 71 communities in a single State alone, children from New York City were debarred from detraining, while in other States the regulations were no less stringent. Radical and unusual methods were employed at terminals and bridges, highways were patrolled, and certificates of examination from physicians and city authorities were demanded. In other instances the quarantine restrictions were comparatively mild and consisted of medical inspection, the determination of the fact that the remises occupied were not infected with the disease, and the registration of the destination address, followed if necessary by the enforcement of quarantine for a varying period. Not only were these restrictions enforced by communities in immediate and direct communication by rail or boat with infected localities but hey were likewise established and enforced by towns and cities altogether remote from infected areas and frequently extended the entire length of State boundaries.

“The results of these unsystematized efforts toward the control of the disease were almost immediately apparent. Travelers were subjected to great personal inconvenience and at times to actual hardship. Cases were recorded of families with children journeying several hundred miles only to find upon completion of their journey that they would not be permitted to take up their residence in the city to which they were destined on the ground that they might have been exposed to infection or came from a locality where the disease was supposed to prevail. In many instances injustice was done and people were debarred from communities without good or sufficient reasons, while occasionally almost inhuman treatment was complained of, as for example the ejection of persons from hotels and trains. Owing to the wide diversity of the regulations promulgated by separate communities common carriers and transportation lines found it difficult or impossible to comply with the different requirements affecting passengers and were often put to considerable inconvenience, so that complaints from this source were common. The normal exodus of the summer season was heightened during the early days of the epidemic through the determination of parents to send their children out of infected areas into districts where the disease did not prevail. This but added to the confusion and was doubtless largely responsible for the further extension of the infection.

“As the epidemic increased in magnitude and gave evidence of wider dissemination it became apparent, early in July, that Federal action for the relief of existing conditions and for the prevention of the interstate spread of the disease would become necessary. Under the act of February 15, 1893, authority of law was ample and could be invoked at any time for the enforcement of justifiable measures looking to this end, but unfortunately funds for this purpose were limited in amount, the appropriation for the prevention of the interstate spread of disease being limited to $15,000 annually, and officers for carrying into effect the measures contemplated were not available. In spite of these deterrent factors it was decided that remediable measures were necessary. Fortunately, Congress on August 7, 1916, following the establishment of the notification system, came to the relief of the situation by making an additional appropriation of $85,000 for cooperative effort in the control of the interstate spread of contagious and infectious diseases, bringing the amount available for this purpose to $100,000. At the same time an expenditure of $50,000 was authorized for additional assistant surgeons.

“In a review of the situation before determining what measures were applicable for the control of poliomyelitis under the interstate quarantine law certain facts concerning the epidemiology of this disease, as considered from others of an infectious character, were necessarily borne in mind. As these facts had an important bearing upon the measures adopted their enumeration is necessary.

“It was recognized that poliomyelitis is in all probability disseminated by personal contact, either direct or indirect, and that the infection is doubtless due to a specific virus present in certain secretions of those afflicted. In addition it was accepted that the active agent was frequently present in the secretions of convalescents, of healthy carriers, and of those who had suffered atypical and often unsuspected forms of the disease, It was further recognized that no practical or workable means for determining or identifying these carriers were at hand; neither was it possible to establish the identity of those who had suffered from mild and atypical attacks; therefore it was considered inevitable that these classes were bound to serve, irrespective of whatever quarantine or restrictive measures were adopted, as reservoirs of infection. From the history of past epidemics it was known that an incidence of two or three cases of poliomyelitis per thousand population constituted an epidemic, and that when this degree of prevalence was attained the disease frequently subside without visibly affecting the remaining portion of the population. For this reason it was deemed impracticable, even in the worst infected districts, to limit the movements of the large uninfected class. The fact that the disease occurred principally in children, 90 per cent of all recognizable cases developing in those under 15 years of age, constituted sufficient and justifiable reason for concentrating all regulations upon this particular element of the population without regard to the feasibility of controlling the movements of adults, although it may be stated in passing that the impracticability of this latter plan, so strongly demanded at certain stages of the epidemic by those who were of the opinion that the infection was being disseminated by adults, was early apparent. All of these factors necessarily bore an important relation to the plans finally put into effect.

“On July 5, 1916, the Board of Health of the City of New York passed a resolution declaring that great and imminent peril existed to the public health by reason of the outbreak of poliomyelitis and the following day the Secretary of the Treasury proffered the services of the Public Health Service in the suppression of the epidemic. This offer was almost immediately accepted. It was decided that the work of cooperation, so far as it related to the Public Health Service, should be carried on under two distinct divisions, the first to concern itself with epidemiological and scientific investigations and the second to measures for the prevention of the interstate spread of the disease. On July 13 Senior Surg. Charles E. Banks was summoned to Washington for a conference relative to the situation and subsequent to arrival was detailed as chief of the party which should undertake this latter phase of the work, with instructions to proceed to New York City immediately.

“Upon arrival in New York City the morning of July 15 Senior Surg. Banks made a careful survey of the situation relative to the measures of safeguarding other States. Coincident with this, the cooperation of the various railroad and steamboat systems radiating from the city was sought and secured and their obligation as common carriers under the act of February 15, 1893, as detailed in the Interstate Quarantine Regulations, was set forth. It was ascertained that the Health Commissioner of New York City had already, namely on July 14, put into effect a plan of issuing health certificates to residents who desired to travel and who were accompanied by children under 16 years of age, and that this plan had proved of value to other communities. The cooperation of the Health Commissioner in the extension of this system was requested and assured. The plan outlined following conferences with the Health Commissioner of New York concerning every aspect of the local situation was as follows:

“First. It was determined that all children 16 years of age and under should constitute a registered class of travel, and that whenever such children were destined by rail, boat, or other means of conveyance to points outside of New York City the parent or guardian should first secure a certificate stating that the premises occupied ere and had been free from poliomyelitis, this certificate to be obtained from the board of health within 24 hours of the time of entraining or embarking.

“Second. Medical inspection of outgoing travel was to be maintained at every avenue of exit from New York City, exclusive of a few trolley lines, and automobile traffic was to be similarly supervised by the same means, with the exception of a few roads at the northerly point of th borough. The examination of outgoing travel was to consist of as careful and accurate inspection of each child as the rapidity of movement and exigencies of the situation permitted.

“Third. As a part of the system of registration of travel, railroad and steamboat lines were to be required under the interstate quarantine law to refuse passage to all children under 16 years of age leaving New York City whenever the traveler was not provided with a certificate of identification issued by officers of the Public Health Service, this certificate to be given only when the applicant presented evidence from the board of health that poliomyelitis had not recently occurred on the premises from which he came. This procedure was to constitute the only quarantine measure imposed, and was only to apply to individuals actually coming from premises where poliomyelitis had occurred. Adults were free to come and go without registration or certification.

“Fourth. Supplementing the above procedures, a notification card, accomplished by a Public Health Service officer, was to be immediately mailed to the health officer of the locality to which the passenger was destined, informing him of the expected arrival of the persons mentioned, and giving the future street and house address in the town or city to which the traveler was bound. It was contemplated that the receipt of this card would enable the local health authorities to adopt whatever measures were warranted, such as registration and daily observation, and entirely obviate the necessity of maintaining inspectors at railroad terminals and other points of ingress. At the same time the system of notification would tend to standardize the methods adopted by local quarantine officers of other States, through cooperation with the plan of registration, and eliminate harsh restrictive measures which had been enforced owing to lack of knowledge of the extent of the epidemic or absence of information of the origin of travel into the community. It is apparent that these measures were not in any sense a quarantine restriction, but essentially a frank inspection and notification system to health officers of travel to their localities from New York City, established for the purpose of enabling those officers to adopt such supplemental measures as were deemed necessary to meet the problem of contagion. A quarantine of the children of New York City was considered wholly impracticable and, under the existing circumstances, inadvisable, but it was hoped that the system as adopted would have the effect of lessening outgoing travel and entirely prevent children from infected families leaving for other localities.

“The plan as outlined having been adopted, the system of notification was inaugurated on July 18. Offices had previously been opened in room 425, Post Office Building, and a force of clerks, stenographers, and employees had been secured and were assigned to duty at each avenue of outgoing travel for the purpose of facilitating the issuance of notification cards….

“As rapidly as officers became available the work of certification, which upon inauguration of the system was only applied at the more important terminals and ferries, was extended to every known point of exit from the city, including automobile travel….

“An integral and essential part of the notification system was the furnishing of information in the form of certificates by the New York City health department of freedom from poliomyelitis of the premises from which the applicant came. This information was based upon the accurate records of the health department, and without data of this character the value of the notification system would have been materially lessened. In its work of certification of the city board of health rejected more than 500 applicants for certificates on the ground that the premises were not free from poliomyelitis and those who dwelt on infected premises or came from households where the disease prevailed and were kept from applying for certificates necessarily must have been several times this number, so that the value of the system in the prevention of travel by this class of persons was unquestioned.

“In the issuance of the certificates in question it was at first required that the applicant should bring the child or children intending to travel to the offices of the board of health for medical inspection, but as this practice resulted in the mingling of those from infected and uninfected districts, with more or less promiscuity and consequent danger of the dissemination of the disease by contact, it was abandoned following a conference with the Commissioner of Health, and medical inspection at the time of departure from the city substituted therefor. In those cases where children were found actually ill at the time of departure they were debarred from entraining, in spite of the fact that they held certificates, and were returned to their homes.

“Upon arrival of the traveler at the station or ferry the certificate of the city board of health was presented to the officer on duty, who ascertained that the person applying was the one named in the certificate, that the document was dated within 24 hours of the time of departure, and that the child was apparently in good physical condition. If all of these requirements were satisfied the service identification card was issued to the traveler, and simultaneously with the issuance of this card the duplicate thereof was immediately mailed to the health officer of the city or town to which the passenger was destined.

“It was to be expected that in the limited time at the disposal of travelers, the haste to board trains, and the difficulties encountered from those unable to make themselves comprehended, that errors in obtaining addresses would occur, but these were exceptionally rare, and it can be safely asserted that during the time the system was in operation in practically every instance health officers were promptly notified of arrivals from the infected city.

“The Public Health Service did not at any time purport to guarantee safe entry into the place of destination, and it was made clear to all travelers that the local authorities had complete power to raise whatever barriers seemed necessary for the protection of their communities. It was also made plain that the service exercised no jurisdiction over intrastate traffic. The notification cards as received by the health officer at the point of destination merely guaranteed that the traveler came from uninfected premises and was apparently well at the time of departure from the city.

“During the early days of the epidemic the notification cards were forwarded directly to the local health authorities. Subsequently, at the special conference of State and Territorial health officers with the Public Health Service for the consideration of the prevention of the spread of poliomyelitis, it was suggested that in dealing with communities of less than 10,000 population, many of which were without boards of health or other organizations capable of handling the situation, that the original cards be forwarded to the State board of health for official record and whatever further action appeared desirable, and that the duplicates thereof be sent to the local authorities. This recommendation met with the official endorsement of the conference. Thereafter the modified procedure was followed. Inasmuch as a number of States required that al newcomers make their presence known to the health authorities immediately after arrival the system served as a double check upon persons of this class originating in New York City….

“In those instances where travelers were unwilling or unable to give their local address at the point of destination, they were informed that notification cards would be withheld pending final decision in the matter. As a result of this action local health officers encountered but little difficulty in locating those arriving from New York City.

“An embarrassing complication in the supervision of travel which it was necessary to overcome related to commuters having employment in the stores, shops, and factories of the city but living in Connecticut or New Jersey. Many persons of this class were under 16 years of age and daily traveled to their homes outside the city. Travelers of this class were cared for by the issuance of commuters’ identification cards, secured in the ordinary manner and based upon information of the same character as that furnished by other persons, with the provision that the cards should be recognized as valid for a period of one week from thee date of issue.

“The handling of week-end excursionists destined to the beaches and other resorts also proved to be somewhat of a problem. This class of travel was both intrastate and interstate and was largely composed of children from infected as well as uninfected districts, so that it offered an excellent opportunity for the dissemination of the infection. After careful consideration the conclusion was reached that every attempt should be made to discourage this element of travel, and accordingly the certification of outgoing traffic of this character, so far as it could be determined, was refused. Baby parades at near-by New Jersey resorts and similar unnecessary gatherings of children at fairs and festivals were effectively controlled through notification of the respective managers of these affairs that restrictive measures would be applied in so far as the participation of children was concerned. It is believed that this attitude met with the hearty approval and support of the public in general.

“It was expected that some difficulty would be encountered in handling travel in transit through New York City, but not originating therein, although fortunately but little trouble arose in this regard. The fear of the disease naturally led large numbers of those with children to select routes of travel, so that the amount of traffic was considerably reduced, while the publicity given the epidemic and the almost universal requirement regarding certificates compelled others to obtain documentary proof of their place of origin. Under the conditions following the subsidence of the epidemic there was some relaxation on the part of local authorities at other places than New York City in issuing these certificates; this inevitably led to some confusion and made it necessary to secure other means of determining the place of departure. Officers were accordingly instructed to act upon such evidence as the possession of through tickets, baggage checks and other confirmatory data, and to accord due credence for statements made in connection therewith.

“From the date of the inauguration of the notification system, July 18, 1917, until October 2, 1917, when it was terminated, registration cards for 85,242 children were forwarded to health officers of the United States and foreign countries and slightly more than that number were medically inspected. On an average 1,122 children were daily certified for travel out of New York City. The largest number certified on any one day was 2,088 on August 5, at the height of the epidemic, and the next larges number was 2,061 on September 2. From the beginning it was found that many adults were requesting an even demanding certification, having come from uninfected localities, and in order to accommodate these persons certificates for adults were also issued, so that a total of 22,647 persons certified should be added to the amount of work necessitated by this inspection.

“In view of the enormous amount of travel from the many stations and ferries of New York City the cordial cooperation of the traffic managers of railroad and steamboat lines was essential to the perfection of any arrangement of the character described. It was the first time there had ever been regulation of travel placed upon the large number of transient visitors to that city and the many thousands who daily passed to and fro between New York and near-by communities. After consultation with the managers of the respective roads this cooperation and assurance of accord with the purposes of the measures taken were readily obtained, and throughout the epidemic the aid and assistance rendered by transportation lines were of the utmost value.

“Aside from the inconvenience to travelers brought about by the necessity of securing certificates, which the public bore with equanimity and generally without complaint, the effect of the adoption of the notification system upon the volume of travel is naturally a mater of interest. Obviously it is difficult to present definite figures regarding the movement of children to and from a city the size of New York, but the following conclusions seem warranted:

“The travel of children into the infected area was unquestionably diminished. The factors in producing this result were the fear of the disease, which was at all times operating, and in part also the establishment of the notification system, particularly as it related to unnecessary travel. In so far as the movement of susceptible individuals into the city was reduced, the result was beneficial and certainly of some importance in limiting the extent of the infection and protecting other communities.

“The travel of children from the infected area constitutes different question. During the early days of the epidemic, previous to the establishment of the notification system, the normal exodus of the summer season was greatly accentuated and thousands of children departed from the city, not to return until the outbreak had subsided. However, nearby communities soon began to realize the dangers from this unrestricted flow and instituted more or less rigid quarantine regulations, so that ultimately this migration was considerably decreased. Many persons also, on account of these stringent regulations, elected to remain in the city throughout the epidemic. These facts must be taken into consideration in any estimation of the volume of travel. Bearing these facts in mind it is a safe conclusion that from the middle of July until the end of the season outgoing travel was perceptibly diminished, so far as children were concerned. This conclusion is corroborated by the testimony of passenger agents who reported a decided diminution in the amount of outgoing travel as judged by the sale of tickets. While this effect was not wholly due to the operation of the notification system, it is probable that such was a factor and should, therefore, be in part credited with whatever benefits were derived therefrom.

“During the course of the epidemic information, as well as direct notice, was received from many towns, especially in Connecticut and New Jersey, that an absolute quarantine against children under 16 years of age arriving from New York City had been established. In such instances the health officer of the community was immediately informed that inasmuch as further notification of arrivals would be useless instructions had been given that the issuance of notification cards for the community concerned had been ordered discontinued until such time as the embargo was lifted. In numerous instances this had the effect of raising the restrictions and the notifying of the public of such modifications. The standardization of the methods adopted by local quarantine officers of other States, through cooperation with the plan of notification above described, was therefore an important outcome of the registration system.

“Visits of health officers from adjoining States to New York City for the purpose of inspecting the work in progress and the holding of conferences relative thereto tended toward the adoption of uniform methods. In all such instances the service representative recommended daily inspection and detention of incoming children, based upon the existing notification system, and this plan was quite generally followed. Medical officers were also detailed to nearby towns to confer with local health authorities on various aspects of the situation and this also served to acquaint outside officials with what was being accomplished….

“In regard to the direct effect the establishment of the notification system had upon the dissemination of the disease it is believed that no claims are justified. With out almost entire lack of knowledge regarding the means of transmission of poliomyelitis, whether by adults or children, and other facts of importance concerning its etiology, it would be misleading to attribute more than certain indirect benefits from the procedures instituted. In so far as travel was restricted and the commingling of those from infected and uninfected districts was prevented it is believed that benefit necessarily accrued and tended toward the reduction of the incidence of the disease. It is also safe to assert, in view of the regulation of travel from infected premises and the consequent inability to obtain the necessary certificates, that certified travel was to a degree safer than that which was uncertified.

“Toward to close of the outbreak in the latter part of September, it became problematical what effect the opening of the schools and the return to the city of many thousand of susceptible children would have upon the course of the epidemic. It was decided, therefore, to continue the work of notification, with slight modifications, until such time as this effect had opportunity to manifest itself, that is, for a sufficient number of days after the opening of schools to cover what was believed to be the ordinary period of incubation of the disease. As no increased incidence resulted from this accession of susceptible material an as the epidemic gave every indication of being upon the wane, the work of notification was discontinued on October 2, health officers throughout the country being notified to this effect.” (U. S. Public Health Service. Annual Report of the Surgeon General of the Public Health Service of the United States for the Fiscal Year 1917. 1919, pp. 188-198.)

Wyatt: “Abstract: Previous accounts of the 1916 devastating epidemic have been faulty. The unique features of the epidemic and its sudden appearance have never been explained. A New York laboratory was passaging poliovirus in primate brains, a technique which increased pathogenicity. I propose that highly virulent virus escaped and caused the epidemic. Scientists, technical and animal house staff were unaware that they could be infected by poliovirus which could then infect others. All laboratory workers must be constantly reminded of the dangers which can arise from the escape of pathogens from their work.

“There were 13 cases of polio in New York in January to April 1916, fewer than in any corresponding period since the disease was made reportable. However, these cases were widely scattered over the whole of the city and were never considered to be part of the epidemic itself. The epidemic began with 2 children in the Italian community in Brooklyn on 8 and 9 May, with 2 more on 15 May in the next street… By the end of the month there had been 24 cases in Brooklyn, of which 14 were in the vicinity of the original – 13 were Italian children of which 12 were at the original locus. At the end of May there had been 5 more cases in Manhattan, of which 4 were Italian, as well as a few cases in other boroughs. On 1 June there were 17 new cases in Brooklyn and by the end of June there had been 646 cases in that borough.

“After 2 weeks 150 children had been affected in five city boroughs. In spite of efforts at quarantine, by August the epidemic had spread to New Jersey, Connecticut, Pennsylvania and upstate New York, but faded out by December. In New York there had been 8,900 cases of paralysis with 2,448 deaths. The epidemic was thought to have affected 23,000 cases with 5,000 deaths through New England and the Middle Atlantic states, reaching Delaware, Maryland and the District of Columbia with a few cases in Vermont and Canada. It had no apparent connection to lesser epidemics in West Virginia and in Minnesota, Wisconsin and Michigan.

“Very few children who had been present during the previous 1907 epidemic were affected in 1916, suggesting that both were probably caused by type I poliovirus. The paralytic rate among the 2 and 3 yr olds approached 2%, the highest rate recorded for this age group anywhere in the world, with decreasing rates to about 9 yr olds suggesting that most children in 1907 had been infected.

“An Extraordinary Epidemic — The definitive account of the epidemic from the US Public Health Service concluded that the outbreak had remarkable features: the extent and intensity was beyond all previous experience; the origin was remarkably definite in time and place; there was a strikingly uniform radial spread from this focus…with intensity progressively decreasing in proportion to the distance from the original focus; and a demonstrable mathematical regularity in its whole evolution.

“These features were never experienced again. Three other aspects were not noted at the time: the number of children age 2 yr affected was the highest ever recorded; the case fatality rate of 25% was the highest ever recorded…; the epidemic started in early May, well before the normal summer polio season. [p. 13]

“Although this epidemic was so severe and features in most books about polio, the only explanation advanced is the one favored at the time – it must have been brought by children who had arrived in May from Italy. There was, however, no evidence that these children were involved and the epidemic began before they arrived. At the time, there was no real idea how polio was spread so that flies and other insects were blamed. Dogs and cats were thought to be carriers: one headline proclaimed ‘72 thousand cats killed.’

“The 1916 epidemic coincided with the war in Europe and was overtaken by the entry of the US against Germany in early 1917. It was then overshadowed by the great ‘flu pandemic of 1918.

“The epidemic is unique in having such a pronounced focus, extraordinary infectivity and very high incidence and fatality rates. The virus must have mutated to an extent never seen before or since. It was as though a new virus had suddenly been dropped at the focus. The 1916 virus was so different that several mutations would have been required and each in turn selected although no prior cases of paralysis were discovered.

“An Explanation — Three miles from the epicenter of the outbreak, Simon Flexner and his associates at the Rockefeller Institute at 63rd Street and York Avenue, near Queensborough Bridge on Manhattan Island, had been passaging spinal cord tissue containing poliovirus, from one Rhesus monkey spinal cord to another. They had been unable to infect monkeys by feeding. These experiments continued with the passage virus which at times was reinforced with newly acquired virus from patients….

“In natural infection, poliovirus replicates in the gut and produces a viremia. In the muscles, it enters the nerve endings of the motor neurones and ascends to the spinal cord. By the time that virus enters those cells and the cells are attacked by lymphocytes, the virus cannot escape as specific antibodies are circulating in the blood. Therefore mutations for pathogenicity are accidental and occur outside the spinal cord. Passage of virus from monkey spinal cord to monkey cord, however, selects for neural mutants. In natural infections, poliovirus loses its virulence and epidemics fade as in 1916.” [pp. 13-14]

“At the New York City Department of Health, doctors passaged material from polio cases in 17 Rhesus monkeys. In the middle of the largest polio epidemic ever seen, these doctors wrote that ‘passage of this virus will be continued with the hope of increasing its virulence’ Why? They carried out autopsies of the monkeys in the animal house and ‘the material was brought immediately to the laboratory’. I assume that this procedure was similar to that at the Rockefeller Institute.

“Those doctors had no awareness of what they were handling. In the 1950’s in my London hospital, the animal-house keeper was an ex-serviceman with no training. Fifteen years later at the National Cancer Institute in Bethesda, US, our animal-house attendants were young men, also without training. I suggest that the animal-house workers in 1916 were also of poor education and wages and, like the doctors, had little idea of the nature of the infected material they were using.

“I suggest that by 1916, mutants of the original Rockefeller virus had been selected for replication in monkey motor neurones, but were still capable of high levels of replication in other cells. An animal-house worker might have been infected during a post-mortem examination, with accidental carriage into a household in Brooklyn and probably further dissemination in the community until it reached susceptible children without immunity. It would have been the same type that caused the 1907 epidemic which had still been circulating. With its passage through many cycles of human guts in the months that followed, it became more adapted to humans and finally lost its unique characteristics.” [p. 15]

“A few blocks from the Rockefeller Institute at Lexington Avenue and 63rd Street the 3rd Avenue elevated line linked at Municipal Building station to the BRT line to Brooklyn over Brooklyn Bridge with a stop at 3rd Street and 5th Avenue where the first case lived. However, almost anywhere in New York was within a few streets of a rail link to the Rockefeller Institute.” [pp. 15-16]

“The 1916 epidemic is featured in many accounts of polio, but details and emphases differ and many are incorrect. The early cases in May in Brooklyn had not been reported, but were found at a later date by the USPHS researchers. Writers seem to have missed these early cases so that the mistaken suggestion that the epidemic arose from Italian child emigrants took hold. …. The start of the epidemic before the usual summer dates was therefore missed by these authors. The only work to mention the early appearance in May is a quote from the New York Times of 6 July ‘since May 15….where the outbreak appeared at about the date named.’ Even this date is a week later than the first case on 8 May….

“Since the escape of smallpox virus from research laboratories in England in 1973 and 1978, we have become acutely aware of the need for containment of infectious agents: in 1916 – and for many decades after – many workers were unaware of the dangers. While diseases were present outside the laboratory, reinforcement from cultures or infected animals was not considered. The enquiry into the 1973 escape showed that more than 50 yr after the New York epidemic, dangerous practices still continued, e.g. lab coats were not routinely autoclaved even when they might be contaminated. This escape killed two persons at third (or fourth) hand with no recognized illness in between. The smallpox escapes were only found because smallpox was no longer endemic in Britain and finding the source of the virus was vital. Flexner’s rigid separation of research from clinical aspects meant that the researchers at the Rockefeller Institute took no part in the epidemic. If they had compared the epidemic virus with their own MV strain, they might have noticed similarities.

“Polio has a particularly hidden risk as it was not realized that adults with immunity could be infected and shed virus, infecting other adults as well as children. Most infected children would also shed virus, but without any symptoms. Some years ago I visited an Indian laboratory which monitored stools sent from paralyzed children. The scientist in charge was unaware that staff who handled the stools could be infected and shed virus in the community even though they were themselves immune.

“Billions of doses of oral poliovirus have been given and only a handful of reversions to greater virulence have been found. In the episodes following these reversions, there have been few cases of paralysis and no epidemics to compare with 1916. Nevertheless, throughout the world, WHO is destroying all samples which might contain poliovirus, except those used for vaccine production. The Salk vaccine uses the virulent Type I strain which might be very dangerous if it escaped from the manufacturing sites. It might be wise to regularly test the stools of all who work with polioviruses.

“Conclusion: It is not possible to prove that the 1916 epidemic was caused by the escape of MV from the Rockefeller Institute. Neither can we know if there have been other escapes of poliovirus from laboratories. However it is a remarkable coincidence that a unique neurotropic strain of poliovirus was developed a few miles from an epidemic caused by a uniquely pathogenic strain of the virus. My theory would not be proved even if it could be shown that a Rockefeller worker had lived in Brooklyn. Nevertheless such an extraordinary epidemic requires an extraordinary explanation: it is the only suggestion to be offered so far. Correct or not, it provides a powerful message for everyone who works with pathogens.” [p. 16]

(Wyatt, H. V. “The 1916 New York City Epidemic of Poliomyelitis: Where did the Virus Come From?” The Open Vaccine Journal, Vol. 4, 2011, pp. 13-17.)

Treatments:

“The prize suggestion came from abroad, in the form of the following description:

Place hydrogen conductors at soles of feet and hands, and cause attraction for this fine hydrogen by neg. electricity or neg. applications. Apply cantharides and mustard plasters. Diet must be high in fine oxygen, such as rice, bread and oxygen waters. Give oxygen through lower extremities, by positive electricity. Frequent baths using almond meal, or oxidizing the water. Applications of poultices of Roman chamomile, slippery elm, arnica, mustard, cantharis, amygdalae dulcis oil, and of special merit, spikened oil and Xanthoxolinum. Internally use, caffeine, Fl. Kola, dry muriate of quinine, elixir of cinchona, radium water, chloride of gold, liquor calcis and wine of pepsin.

“One’s only embarrassment would be which one to use first.”

(Emerson, Haven, M.D. A Monograph on The Epidemic of Poliomyelitis (Infantile Paralysis) in New York City in 1916. Published under the direction of the Dept. of Health of NYC. 1917.)

General, Chronological

July 11: “Washington, July 11.—The fact that the present law as to the suppression of epidemic diseases makes no mention by name of poliomyelitis, or infantile paralysis, has made it necessary to ask Congress for a special appropriation to maintain the interstate campaign by the Public Health Service to stamp out the disease, and especially to prevent, as early as possible, all tendency to spread through the country from New York and vicinity. Secretary McAdoo today asked Congress for $135,000, to be used by the Public Health Service in the suppression of the disease.

“Of this amount it is proposed to expend $85,000 for the purpose of co-operating with State and municipal health authorities in preventing the spread of the disease, and $50,000 for the employment of additional physicians as assistant surgeons of the Public Health service.

“Secretary McAdoo has already tendered the assistance of the Public Health Service to the New York health authorities, and seven Public Health surgeons are co-operating in the work in that city….

“The reports received at the Public Health Service offices here indicate that while the outbreak of the disease has been most severe in New York it is spreading rapidly, and it is the opinion here the allotment of $85,000 to prevent the disease becoming epidemic over the country will not be sufficient….It is estimated that thirteen additional assistant surgeons will be needed to attend the interstate work…..

“President Wilson today signed the Siegel resolution permitting the use of hospital facilities at the Ellis Island Immigration Station for the New York victims of infantile paralysis. Representative Siegel introduced another resolution during the day, authorizing the President to give a gold medal and $100,000 to any person who might discover a preventive or cure for the malady.” (NYT. “McAdoo Asks $135,000 to Combat Paralysis,” July 12, 1916, p. 4.)

July 12: “Washington, July 12.—Chairman Fitzgerald of the House Appropriation Committee said today that the Committee would take up at the earliest opportunity the emergency estimates submitted by the Treasury Department asking an appropriation to enable the Public Health Service to combat the spread of infantile paralysis. The Committee probably will meet tomorrow. Secretary McAdoo’s estimates call for an appropriation of $135,000, but it is not likely that the entire amount will be allowed.” (NYT. “To Cut McAdoo Plague Fund,” 7-13- 1916, p. 3.)

July 13, NYC, Presentation (abridged) by Dr. Simon Flexner, Rockefeller Institute for Medical Research, before the New York Academy of Medicine:

Infantile paralysis is an infectious and communicable disease caused by the invasion of the central nervous organs—the spinal cord and brain—of a minute, filterable micro-organism which has now been secured in artificial culture and as such is distinctly visible under the higher powers of the microscope.

The virus of infantile paralysis, as the microorganism causing it is termed, exists constantly in the central nervous organs and upon the mucous membrane of the nose and throat and of the intestines in persons suffering from the disease; it occurs, less frequently in the other internal organs, and it has not been detected in the general circulating blood of patients.

The difficulties attending the artificial cultivation of the micro-organism and identification under the microscope are such as to make futile the employment of ordinary bacteriological tests for its detection. Nevertheless, the virus can be detected by inoculation tests upon monkeys, which animals develop a disease corresponding to infantile paralysis in human beings. In this manner the fact has been determined that healthy persons may become carriers of the disease.

The virus has, apparently, an identical distribution irrespective of the types or severity of cases of infantile paralysis. Whether the cases correspond with the so-called abortive forms of the disease in which definite paralysis of the muscles does not occur at all, or is so slight and fleeting as often to escape detection; whether they correspond with the meningeal forms in which the symptoms resemble those of acute meningitis with which muscular paralysis may or may not be associated; or whether they consist of the familiar paralytic condition, the virus is present not only within the nervous organs, but also upon the mucous membranes of the nose, throat and intestines.

The virus of infantile paralysis is known to leave the infected human body in the secretions of the nose, throat and intestines. Whether it ever leaves the infected body in other ways is unknown. At one time certain experiments seemed to show that biting insects and particularly the stable fly might withdraw the virus from the blood of infected persons and inoculate it into the blood of healthy persons. But this means of escape of the virus must he considered doubtful.

The virus enters the body, as a rule if not exclusively, by way of the mucous membrane of the nose and throat. Having gained entrance to those easily accessible parts of the body, multiplication of the virus occurs there, after which it penetrates to the brain and spinal cord by way of the lymphatic channels which connect the upper nasal membrane with the interior of the skull. Whether the virus ever enters the body in any other way is unknown.

The physical properties of the virus of infantile paralysis adapt it well for conveyance to the nose and throat. Being contained in their secretions, it is readily distributed by coughing, sneezing, kissing, and by means of fingers and articles contaminated with these secretions, as well as with the intestinal discharges. Moreover, as the virus is thrown off from the body mingled with the secretions, it withstands for a long time even the highest summer temperatures, complete drying, and even the action of weak chemicals, such as glycerine and carbolic acid, which destroy ordinary bacteria. Hence, mere drying of the secretions is no protection; on the contrary as the dried secretions may be converted into dust which is breathed into the nose and throat, they become a potential source of infection. The survival of the virus in the secretions is favored by weak daylight and darkness, and hindered by bright daylight and sunshine. It is readily destroyed by exposure to sunlight.

While our present knowledge excludes insects from being active agents in the dissemination of infantile paralysis, they nevertheless fall under suspicion as being potential mechanical carriers of the virus of that disease.

Experimental studies have excluded certain domestic animals from being carriers of the virus of infantile paralysis. The paralytic diseases which they suffer have long been known and are quite different from infantile paralysis. Their occurrence may be coincidental; in no instance investigated has one been found to be responsible for the other.

In extending from place to place or point to point, the route taken by the disease is that of ordinary travel. In other words, the evidence derived from this class of studies confirms the evidence obtained from other sources in connecting the distributing agency intimately with human beings and their activities.

The virus of infantile paralysis is destroyed in the interior of the body more quickly and completely than, in some instances, in the mucous membrane of the nose and throat.

The longest period after inoculation in which the virus has been detected in the mucous membrane of the nose and throat of monkeys is six months. It is difficult to detect human carriers, yet in an undoubted instance of the human disease the virus was detected in the mucous membrane of the throat five months after its acute onset. Hence, we possess conclusive evidence of the occurrence of occasional chronic human carriers of the virus of infantile paralysis.

Certain factors regarding the fluctuation in epidemics which vary from occasional instances to a mortality of 20 per cent, of those attacked have become apparent. A factor of high importance is the infective power or potency, or technically stated the virulence, of the microorganism or virus causing the disease. This virus is subject to fluctuations of intensity which can best be illustrated by an example. The virus as ordinarily present in human beings even during severe epidemics has low infective power for monkeys. But by passing it from monkey to monkey, it tends to acquire after a variable number of such passages an incredible activity. However, occasional samples of the human virus refuse to be thus intensified. But once rendered highly potent, the virus may be passed from monkey to monkey through a long but not indefinite series. Finally, in some samples of the virus at least a reverse change takes place —the virus begins to lose its virulence until it returns to the original or even to a diminished degree of infective power. In this respect the behavior of the virus corresponds to the onset, rise and then the fall in number and severity of cases as observed in the course of epidemics of infantile paralysis and other epidemic diseases. Hence, either a new active specimen of the virus may be introduced from without which, after a certain number of passages from person to person, acquires a high potency; or a specimen of virus already present and left over from a previous epidemic after a resting period and similar passages, again becomes active and reaches an infective power which equals or even exceeds that originally possessed.

Another but more indefinite factor relates to the degree of susceptibility among children and others affected which at one period may be greater or less than at another. Not all children and relatively few adults are susceptible to infantile paralysis. Young children are more susceptible generally speaking than older ones; but no age can be said to be absolutely insusceptible. The closer the family or other groups in which a case has occurred art studied by physicians, the more numerous it now appears are the number of light or abortive cases among them. This means that the term infantile paralysis is a misnomer, since the disease arises without causing any paralysis whatever, or such slight and fleeting paralysis as to be difficult of detection. The light or abortive cases, as they are called, indicate a greater general susceptibility than has always been recognized; and their discovery promises to have far-reaching consequences in respect to the means employed to limit the spread or eradicate foci of the disease.

Infantile paralysis arises after a period of incubation varying from two days to two weeks or possibly even longer. But the usual period does not exceed about eight days.

Probably the period at which the danger of communication is greatest is during the very early and acute stage of the disease. Judging from experiments on animals, the virus tends not to persist in the body longer than four or five weeks except in those exceptional instances in which chronic carriage is developed. Hence, cases of infantile paralysis which have been kept under supervision for a period of six weeks from the onset of the symptoms may be regarded as practically free of danger.

In all forms of infantile paralysis insusceptibility is conferred by one attack. The insusceptibility or immunity to subsequent infection rests on the presence of the destroying substances, the so-called immunity bodies, which arise in the internal organs and are yielded to the blood. So long as these immunity bodies persist in the body, protection is afforded; and their presence has been detected twenty years or even longer after recovery from infantile paralysis. Experiments have shown that the immunity bodies appear in the blood in the course of even the mildest attack of the disease, which fact explains why protection is afforded irrespective of the severity of the case.

Protection has been afforded monkeys against inoculation with effective quantities of the virus of infantile paralysis by previously subjecting them to inoculation with sub-effective quantities or doses of the virus. By this means and without any evident illness or effect of the protective inoculation, complete immunity has been achieved. But the method is not perfect since in certain instances not only was immunity not obtained, but unexpected paralysis intervened. In the instances in which protection was accomplished, the immunity bodies appeared in the blood.

By transferring the blood of immune monkeys to normal or untreated ones, they can be rendered insusceptible or immune, and the immunity will endure for a relatively short period during which the passively transferred immunity bodies persist. The accomplishment of passive immunization is somewhat uncertain, and its brief duration renders it useless for purposes of protective immunization.

On the other hand, a measure of success has been achieved in the experimental serum treatment of inoculated monkeys. For this purpose blood serum derived either from recovered and protected monkeys or human beings has been employed. The serum is injected into the membranes about the spinal cord, and the virus is inoculated into the brain. The injection of serum must be repeated several times in order to be effective. The results are said to be promising. Unfortunately, the quantity of the human immune serum is very limited, and no other animals than monkeys seem capable of yielding an immune serum and the monkey is not a practicable animal from which to obtain supplies.

The only drug which has shown any useful degree of activity against the microorganism is hexamethylenamin which is itself germicidal, and has the merit of entering the membranes, as well as the substance of the spinal cord and brain in which the virus is deposited. But experiments on monkeys have shown this chemical to be effective only very early in the course of the inoculation and only in a part of the animals treated.

Practical Deductions and Applications

1. The chief mode of demonstrated conveyance of the virus is through the agency of human beings. Whether still other modes of dissemination exist is unknown. According to our present knowledge, the virus leaves the body in the secretions of the nose and throat and in the discharges from the intestines. The conveyors of the virus include persons ill of infantile paralysis in any of its several forms and irrespective of whether they are paralyzed or not, and such healthy persons who may have become contaminated by attendance on or association with the ill. How numerous the latter class may be is unknown. But all attendants on or associates of the sick are suspect. These healthy carriers rarely themselves fall ill of the disease; they may, however, be the source of infection in others. On the other hand, the fact that the infantile paralysis is very rarely communicated in general hospitals to other persons, whether doctors, nurses or patients, indicates that its spread is subject to ready control under restricted and supervised sanitary conditions.

2. The chief means by which the secretions of the nose and throat are disseminated are through the act of kissing, coughing or sneezing. Hence, during the prevalence of an epidemic of infantile paralysis, care should be exercised to restrict the distribution as far as possible through these common means. Habits of self-denial, care and cleanliness and consideration for the public welfare can be made to go very far in limiting the dangers from these sources.

Moreover, since the disease attacks by preference young children and infants, in whom the secretions from the nose and mouth are wiped away by mother or nurse, the fingers of these persons readily become contaminated. Through attentions on other children or the preparation of food which may be contaminated, the virus may thus be conveyed from the sick to the healthy. The conditions which obtain in a household in which a mother waits on the sick child and attends the other children are directly contrasted with those existing in a well-ordered hospital: the one is a menace, the other a protection to the community. Moreover, in homes the practice of carrying small children about and comforting them is the rule, through which not only the hands, but other parts of the body and the clothing of parents may become contaminated.

3. Flies also often collect about the nose and mouth of patients ill of infantile paralysis and feed on the secretions, and they even gain access to the discharges from the intestines in homes unprotected by screens. This fact relates to the domestic fly, which, becoming grossly contaminated with the virus, may deposit it on the nose and mouth of healthy persons, or upon food or eating utensils. To what extent the biting stable fly is to be incriminated as a carrier of infection is doubtful; but we already know enough to wish to exclude from the sick, and hence from menacing the well, all objectionable household insects.

Food exposed for sale may become contaminated by flies or from fingers which have been in contact with secretions containing the virus; hence, food should not be exposed in shops and no person in attendance upon a case of infantile paralysis should be permitted to handle food for sale to the general public.

4. Protection to the public can be best secured through the discovery and isolation of those ill of the disease, and the sanitary control of those persons who have associated with the sick and whose business calls them away from home. Both these conditions can be secured without too great interference with the comforts and the rights of individuals.

In the first place, where homes are not suited to the care of the ill so that other children in the same or adjacent families are exposed, the parent should consent to removal to hospital in the interest of the sick child itself, as well as in the interest of other children. But this removal or care must include not only the frankly paralyzed cases, but also the other forms of the disease. In the event of doubtful diagnosis, the aid of the laboratory is to be sought since even in the mildest cases changes will be detected in the cerebro-spinal fluid removed by lumbar puncture. If the effort is to be made to control the disease by isolation and segregation of the ill, then these means must be made as inclusive as possible. It is obvious that in certain homes isolation can be carried out as effectively as in hospitals.

But what has been said of the small incidence of cases of the disease among the hospital personnel and those with whom they come into contact, indicates the extent to which personal care of the body by adults and responsible people can diminish the menace which those accidentally or unavoidably in contact with the ill are to the community. Care exercised not to scatter the secretions of the nose and throat by spitting, coughing and sneezing, the free use of clean handkerchiefs, cleanliness in habits affecting especially the hands and face, changes of clothes, etc., should all serve to diminish this danger.

In the end, the early detection and isolation of the cases of infantile paralysis in all of its forms, with the attendant control of the households from which they come, will have to be relied upon as the chief measure of staying the progress of the epidemic.

5. The degree of susceptibility of children and other members of the community to infantile paralysis is relatively small and is definitely lower than to such communicable diseases as measles, scarlet fever, and diphtheria. This fact in itself constitutes a measure of control; and while it does not justify the abatement of any practicable means which may be employed to limit and suppress the epidemic, it should tend to prevent a state of over-anxiety and panic from taking hold of the community.

6. A percentage of persons, children particularly, die during the acute stage of the disease. This percentage varies from five in certain severe epidemics to twenty in others. The average death rate of many epidemics has been below 10 per cent. A reported high death rate may not be actual, but only apparent, since in every instance the death will be recorded, while many cases which recover may not be reported at all to the authorities. In the present instance it is too early in the course of the epidemic to calculate the death rate, which may prove to be considerably lower than it now seems to be.

7. Of those who survive, a part make complete recoveries, in which no crippling whatever remains. This number is greater than is usually supposed, because it includes not only the relatively large number of slight or abortive cases, but also a considerable number of cases in which more or less of paralysis was present at one time. The disappearance of the paralysis may be rapid or gradual— may be complete in a few days or many require several weeks or months.

The remainder, and unfortunately not a small number, suffer some degree of permanent crippling. But even in this class, the extent to which recovery from the paralysis may occur is very great. In many instances the residue of paralysis may be so small as not seriously to hamper the life activities of the individual; in others in whom it is greater it may be relieved or minimized by suitable orthopedic treatment. But what it is imperative to keep in mind is that the recovery of paralyzed parts and the restoration of lost muscular power and function is a process which extends over a long period of time— that is, over months and even years. So that even a severely paralyzed child who has made little recovery of function by the time the acute stage of the disease is over, may go on gaining for weeks, months, and even years until in the end he has regained a large part of his losses. Fortunately, only a very small number of the attacked are left severely and helplessly crippled. Lamentable as it is that even one should be so affected, it is nevertheless a reassurance to know that so many recover altogether and so much of what appears to be permanent paralysis disappears in time.

There exists at present no safe method of preventive inoculation or vaccination, and no practicable method of specific treatment The prevention of the disease must be accomplished through general sanitary means; recovery from the disease is a spontaneous process which can be greatly assisted by proper medical and surgical care. Infantile paralysis is an infectious disease, due to a definite and specific microorganism or virus; recovery is accomplished by a process of immunization which takes place during the acute period of the disease. The tendency of the disease is toward recovery and it is chiefly or only because the paralysis in some instances involves those portions of the brain and spinal cord which control respiration or breathing and the heart’s action, that death results.

(Information Quarterly. “Infantile Paralysis,” Vol. II, October 1916, pp. 407-411.)

July 13: “New York, July 13, 1916. To the Editor of the New York Times;

“During the last week the public has learned more about an acute infectious disease than ever before, probably, in the same period of time. Along with a lot of valuable facts, both relevant and irrelevant, the average layman has, through a misleading emphasis, learned a good deal that probably isn’t so.

“Such an undigested mass of information has been heaped upon the public during the last few days through the Many news channels, including news stories, special articles, communications, editorials, &c., that an attempt to give relative values to the many factors involved may prove exceedingly difficult. However, the situation certainly justifies an effort to place the emphasis as regards the immediate disease hazards where it belongs. Physicians and sanitarians have competed with laymen in pointing out tot the public probable sources of infection. Among other thins spoken of as possible carriers of infantile paralysis are the following: Mild, water, house flies, mosquitoes, nose and throat discharges, street dust, healthy human carriers, food sewers, garbage, &c. Newspapers throughout the country have insisted that health officers ‘leave no stone unturned’ in attempting to ‘rout the plague.’ This, of course, has meant a desirable if not always relevant clean-up.

“To some extent, undoubtedly, the health officer is justified in using the immediate and pressing motive for the accomplishment of ends which he knows have no special bearing on the infantile paralysis situation. More thoroughly to clean out streets and more decently to remove out garbage can do no harm, an any event, as far an infantile paralysis is concerned, and will accomplish good in other directions; hence the partly conscious exploitation of the infantile paralysis motive for the accomplishment of general sanitary ends, an exploitation infinitely more justifiable than is that of certain private interests in their attempts to seize this opportunity to boost the sale of certain commodities, such as tooth pastes, mouth washes, disinfection devices, &c.

“The only risk in this misdirection of emphasis is that it may direct public attention into relatively unimportant channels and away from real points of danger, and we must, therefore, not neglect to emphasize the significant and urgent factors in the situation. Let us remember that the disease is probably either an insect-borne disease or an ordinary nose and throat disease, more likely the latter. The chief things to emphasize, then, in teaching the public how to combat the spread of infection are through screening for protection from insects, the avoidance of sick individuals and of individuals who have been in contact with cases of paralysis, the safe disposal of body discharges, particularly those from the nose and throat, and the enforcement of the rules of respiratory hygiene regarding kissing, sneezing, coughing, candy sucking, apple ‘swapping,’ &c.

“We have realized that the keystone of modern sanitary precaution is personal hygiene. Nowhere is this of more importance than in connection with the diseases spread by respiratory and mouth discharges….

“Yesterday, in a Staten Island village, where the playground was closed to prevent the spread of the disease – a wise step on the part of the health authorities – I saw a row of children sitting on a park bench chewing bark off sticks of wood and exchanging pieces of the same, thereby facilitating the exchange of any infectious material. Here the ‘anti-plague’ measures undoubtedly broke down. Personal hygiene was lacking. All the covered garbage cans, all the clean streets, and all the covered food in shops in the world will not protect these children, unless some one teaches them personal hygiene and puts that first in the program of prevention.

“In reality, we are very much in the Middle Ages as regards hygienic and sanitary precautions against anterior poliomyelitis. However, we do know more than our ancestors about the spread of insect and nose and throat diseases, and we should therefore take pains in our educational work to place first the things which are probably of first importance. We know that nearly all diseases breed in the human body and rarely ‘lurk’ in filth. Garbage has ever been accused of disease dissemination, and that is why many of our Health Departments are still required to spend an excessive proportion of their total appropriation for health work on garbage and refuse removal. From the points of view of decency and aestheticism, it is highly desirable to have our refuse carefully cared for. At the same time, as far as infantile paralysis is concerned, let us try first to place an effective barrier between the infected and the non-infected nasal mucous membranes. Let us realize that, as far as this disease is concerned, when the health authorities inspect certain urban districts for sanitary code violations, for garbage accumulations, &c., they are carrying out a practice quite similar to the mediaeval anti-plague measure of sulphur burning in the streets. Has any one heard of an excessive incidence of infantile paralysis among the families of our street cleaners or refuse and garbage handlers?

“I am told that in one section of the city the negro children are wearing about their necks bags containing camphor and asafetida. I learn also that in another section of the city a special effort is to be made to flush the streets. Of course both of these measures may be important, though I don’t believe they have any special bearing in the present emergency.

“If infantile paralysis is an insect disease, let us remember our experience with yellow fever, which we fought ineffectively by scavenging methods for years, and which has now been eliminated in this country by means of intelligent care in the prevention of the breeding of the stegomyia [sic] or yellow fever mosquito.

“If we are here dealing with a nose and throat disease, let us remember the history of diphtheria, thought for a long time to be spread by fomites, now under control through our knowledge of the organism, and the way in which it is carried by the sick and the well from one nose and throat to another.

“When the opportunity to teach sanitation and hygiene in a wholesale way occurs, it is, I presume, good policy to make the immediate instrument carry all the knowledge it will bear, even though some of it may not be apropos. It is important, however, that we put, the significant things first.” (Armstrong, Dr. D. B. “Misinformation on Infantile Paralysis,” NYT. 7-19-1916, 8)

July 15, NYT: “Reports concerning the spread of infantile paralysis in various parts of the United States were received by The Times last night as follows:”

Holyoke, Mass
New Bedford, Mass
Lawrence, Mass
Boston, Mass
Pittsfield, Mass
New Haven, Conn
Norwalk, Conn
Wilkes-Barre, Penn
Exeter, Penn
Morris Run, Penn
Old Forge, Penn
Toledo, Ohio
Chicago, Ill
Sidney, Ill
Central Falls, Mich
Larned, Kan
Sioux Falls, S.C.
Florence, Ala
Clio, Ala

”Two new cases were reported in the State of Colorado but the names of the towns were not given.” (NYT. “Paralysis in Various States,” July 15, 1916, p. 16.)

July 18: “Dr. G. D. Fairbanks, United States public health service surgeon at Brownsville, many have discovered the key to the prevention and cure of infantile paralysis. He has arrived at the conclusion that garlic may contain the specific for the disease. He admits that his theory is entirely a theory, but he bases his belief on the alleged successful results obtained by the use of garlic in hydrophobia cases.” (Brownsville Herald, TX. “Garlic May Be Infantile Paralysis Cure,” July 18, 1916, p. 1.)

July 23, NYT: “The United States Public Health Service yesterday issued a pamphlet entitled, ‘Poliomyelitis, (Infantile Paralysis) – What is Known of Its Cause and Modes of Transmission,’ prepared by Dr. Wade H. Frost, Past Assistant Surgeon of the service and one of the recognized authorities on the disease.

“Reading the pamphlet, one learns that the principal thing known about poliomyelitis is that it is one of the most baffling diseases studied by scientists, and that they really know very little about it.

“Laboratory experiments, Dr. Frost says, have resulted in the finding of the sources of infection in the secretions of persons ill with poliomyelitis, those convalescent from the infection, and ‘passive carriers’ – that is, persons apparently well, who are harboring the specific virus and discharging it in their secretions, and he says that, ‘on the whole, the experimental evidence, while not excluding other means of transmission, points to the conclusion that poliomyelitis is a contagious disease, spread from person to person through interchange of infectious secretions.’

“But Dr. Frost admits that extended observations of actual epidemics give almost no indication of local sources and routes of infection, and he adds that, though the disease seems to be contagious by personal contact, ‘the statistics presented in this report show that of 2,070 persons exposed to poliomyelitis by residence in the same house and same families as poliomyelitis patients, only fourteen (0.6 per cent.) developed the disease in frank paralytic form.’….

“Disease of Rich and Poor.

“Dr. Frost also finds that ‘the incidence of poliomyelitis is proportionately about the same among persons living under good conditions as persons living under poor hygienic conditions,’ and he adds:

‘This practically eliminates from consideration as of great importance in the causation of the disease such factors as are intimately associated with poor hygienic conditions – insufficient and improper food, overcrowding, personal uncleanliness, and association with verminous insects.’

“Dr. Frost, continuing says that ‘mass infection of common water and food supplies has been quite generally and definitely eliminated as a probable means of dissemination in the epidemics studied.’

“`While there is much to suggest that poliomyelitis is insect borne,’ says Dr. Frost, ‘its epidemiology appears to be equally well explained on the theory of direct transmissibility through infectious secretions, and the latter theory is at present supported by more experimental evidence than is the theory of insect transmission.’

“Concerning the fact that the disease is so generally infantile, Dr. Frost says: ‘There are certain facts which suggest that the very general immunity of adults may be specific, acquired from previous unrecognized infection with the virus of poliomyelitis.’ He admits, however, that the immunity of adults may be due ‘to a non-specific resistance, developing naturally with maturity’.” (New York Times. “Believes Paralysis ‘Mildly Contagious’,” July 23, 1916, p. 7.)

Aug 1, Washington, DC: “To control the present epidemic of infantile paralysis, according to a statement issued by the United States Public Health Service today, the chain of infection between persons harboring germs of the disease and the well members of the community should be broken. Infantile paralysis is probably caused by a very minute organism found in the nasal, mouth and bowel discharges of those who have the disease or who are carriers of the germ without themselves suffering from the ailment. All of the steps in the spread of the infection are not known but if this germ can be prevented from passing from the infected to the well person, the disease will cease. Infantile paralysis is not a disease of recent origin. Sporadic or scattered cases have occurred throughout the country for many years but it is only during the last decade that the infection has assumed epidemic proportions in the United States. The present epidemic in New York City, on account of its magnitude and virulence, has awakened the residents of many communities to the danger of the importation of the disease into their own midst. The danger is real, but if due precautions are exercised it is believed that the epidemic will subside…. Poliomyelitis is probably spread directly or indirectly, through the medium of infective secretions. Account must therefore be taken by communities of every means by which such secretions are disseminated. Promiscuous expectoration should be controlled. The common drinking cup affords a method for the interchange of material of this nature and should therefore be abolished. Rigid cleanliness of glasses and utensils at soda fountains, in saloons and other public places should be enforced. Flies, roaches and other vermin, by coming in contact with infective secretions, may possibly convey them to our food and thus directly bring about the development of disease. Therefore eliminate insects. Street and house dust bear a definite relation to the spread of many infections and it is not unreasonable to presume that they may be a factor in the dissemination of infantile paralysis. Maintain strict cleanliness of streets, yards and alleys in order to prevent the breeding of insects and other vermin. See that all garbage and waste are properly cared for and collected at regular and frequent intervals. Guard all food supplies, especially milk and other perishable products. Digestive troubles of children arising from the ingestion of food of questionable quality many lower resistance. Assemblies of children in infected localities are to be discouraged, if not actually forbidden. While the above measures are in sense general, and applicable to many epidemic diseases, their importance should not be overlooked….” (Daily News-Record, Harrisonburg, VA. “Prevention of Infantile Paralysis,” 8-1-1916, p. 4.)

Aug 7, NYT: “Definite endorsement of the use of human blood serum in cases if infantile paralysis based upon results so far obtained was given yesterday by Dr. Haven Emerson, Commissioner of Health [NYC]; Drs. C. H. Lavinder and Wade A. Frost of the United States Public Health Service, and other authorities on infantile paralysis. The medical staff of the Willard Parker Hospital…[reported] use of the serum has given great promise….” (NYT. “Experts Indorse Paralysis Serum,” Aug 8, 1916, p. 18.)

Aug 9, NYT: “Washington, Aug. 9. – The Federal Public Health today asked State health authorities throughout the country to send representatives to a conference here Aug. 17 to discuss means for preventing a further spread of infantile paralysis. It was said the meeting had not been called because there was any fear of a countrywide epidemic, but authorities from all the States had been invited because that was customary in the frequent conferences called by the service to discuss such subjects….” (NYT. “Call National Conference…to Discuss Paralysis,” 8-10-16, 5.)

Aug 10: “Even after weeks of investigation, there is still no definite knowledge on the subject of infantile paralysis, and on no point are the scientists more at sea than as to the nature of the carrier. One school has steadily flouted the theory of Dr. P. A. E. Sheppard that a species of stable fly transmitted the disease, but neither that school nor any other has identified the carrier. Announcement that a corps of naturalists from the United States Public Health Service will undertake the study of the insects that infest New York and its vicinity lends color to the Sheppard theory. At least it is an admission that the stable-fly possibility is no longer to be dismissed with a wave of th scientific hand….” (Daily News Record, Harrisonburg, VA. “Insects as Infantile Paralysis Carriers,” Aug 10, 1916, p. 4.)

Aug 17, Washington, DC: Conference called by the U.S. Public Health Service: “The exact figures from 38 States showed 11,117 cases, not confined to cities by any means. Many were reported from farms. A uniform, possibly a Federal, health certificate to facilitate travel of children was suggested. Most of the speakers thought there was little necessity of a quarantine by other States against travelers from the East. Practically all State officers reported rigid local quarantine regulations to check the spread of the disease in their own States.

“The following number of cases in 1916 or since the outbreak of the present epidemic, were reported:

Alabama, 64; Arkansas, 3; California, 4; Colorado, 4; Connecticut, 323; Delaware, a; District of Columbia, 16; Florida, 6; Illinois, 206; Indiana, 37; Iowa, as; Kentucky, 18; Louisiana, 51; Maine, 14; Maryland, 66; Massachusetts, 105; Michigan, 97; Minnesota, 318; Missouri, 11; Montana, 15; Nebraska, 10; New Hampshire, 7; New Jersey, 1714; New York, 7753 (6753 in New York city and 1000 estimated elsewhere); North Carolina, 20; Ohio, 166; Oregon, 3; Pennsylvania, 336; Rhode Island, 53; South Carolina, 55; South Dakota, 22; Tennessee, 36; Texas, 30; Vermont, 15; Virginia, 29; Washington, 5; West Virginia, 8; Wisconsin, 70.

“Dr. Haven Emerson, health commissioner of New York, said three striking facts had developed. Of 30,000 children in institutions under State supervision using the same milk, water and food as other New York children, not one had been afflicted with the disease. Near the city’s garbage dumping place, where the maximum contagion from flies and germs might be expected, not one case had developed. The death rate in the more congested Brooklyn districts, he stated, was lower than in more sparsely settled and wealthier communities. He could give no explanation of the fact that about eight times as many dead animals had been found in Brooklyn streets during the last six weeks than during the same period of 1915. The death of the animals was not found attributable to paralysis and no specific infection was found in them.” (Information Quarterly. “Infantile Paralysis,” Vol. II, October 1916, p. 411.)

Aug 28, Causes of Infantile Paralysis: “Mosquitoes, rats, the Gowanus Canal, improper sewers, high ground water caused by heat, humidity and excessive rain, human carriers, ice-cream cones, the ‘bent-over position of children in schools (ignoring the fact that the disease is most prevalent among children too young for schools), excavations, blue, stable and assorted flies, bedbugs, street dust, corn flakes, condition of the subway, a special parasite in water, alloys used in the manufacture of cooking utensils, gases from munition factories, mercurial poisoning due to use of calomel, earthquakes, volcanoes, internal disturbances of the earth, second-hand bedding, ‘acidosis,’ which is the effect of queer air on food causing rapid decay; electrical disturbances of the earth and air, sunburn, intestinal derangements, the wearing of white clothes and excitement due to glare, water reflection and automobiles, unclean milk bottles, the carrying of pennies, dimes and nickels in the mouth by children, tobacco.” (NYT. “The Twenty-nine Theories,” Aug 28, 1916.)

Sep 14: “Fleas abiding in the fur of rats are now supposed to be carriers of infantile paralysis, according to Health Commissioner Emerson. Dr. Emerson said yesterday, however, that the theory that human beings transmitted the disease through personal contact was still considered the most plausible by the New York health authorities…. ‘We have eliminated every other bug and animal,’ said Dr. Emerson, ‘but the rat flea. I am not prepared to say that we have found the carrier, and this theory has not been verified, but careful observations would indicate that we are on the right track.’…. The rat flea theory, it was said yesterday, has been held by physicians for half a dozen years, since Dr. H. W. Conn of the Connecticut State Laboratory made a report on the matter in 1910. At the outbreak of the epidemic in New York City, Dr. Mark Richardson, formerly Secretary of the State Board of Health of Massachusetts, warned doctors here to watch for rats.” (NYT. “Now Think Rat Flea Carries Paralysis,” Sep 15, 1916.)

By Sep 25: “Washington, Oct. 18. – The United States public health bureau announced that during the infantile epidemic from July 1 to September 25, there was a total of 23,262 cases in the United States. The number of deaths has not been reported.” (Daily News (Frederick, MD). “23,262 Paralysis Cases in U.S.,” Oct 18, 1916, 3.)

Sep 30: “A tramp in New Jersey is believed to have furnished the best evidence on record so far that infantile paralysis is spread by adults, and the health authorities of the State, as well as those of the United States Government, are now working on the case. On July 24 a farmer named Clark was living at Patricks Corners, near South River, N.J. Clark had five children, the oldest of whom was 8 years of age. When the epidemic first began in July Clark quarantined his house. On Aug. 8 a tramp, 50 years old, was hired as farm hand, with the understanding that he sleep in the barn and not come near the house. On Aug 12 one of Clark’s sons had poliomyelitis, and then within two weeks all of the children had been afflicted. The tramp had disappeared before the New Jersey Health Department had received the facts of the case, but inquiries are now being made with a view to ascertaining all facts concerning his previous wanderings.” (NYT. “Trace Paralysis Spread to an Adult,” Sep 30, 1916.)

Oct 7: “At the regular meeting of the Madison County Medical Society held yesterday afternoon at the Fireman’s Hall at Madison, Dr. E. W. Saunders of St. Louis, prominent physician and expert on children’s diseases told members of the society that the dreaded infantile paralysis is caused by the green fly which is so numerous in this country in the summer. Dr. Saunders has spent the past five years attempting to find out what caused the disease which has proved a fatal ailment throughout the east and is likewise dreaded in this section of the country. He said the green fly lays its eggs upon food and drink and that the eggs are poisonous to the human system. These eggs are consumed in the food and drink and cause a condition which results in the infantile paralysis. He adduced the fact because the green fly appears in the early spring and departs with the advent of cold weather. The infantile paralysis appears also in the spring and departs at the same time with the green fly. The fact that this disease does not lurk in the adult’s system is said to be because the adult’s system is stronger to withstand or ward off the poison, while the infant cannot. At times when an adult’s system is weak he is subjected to the disease.

“Since July 1 this year twenty cases of infantile paralysis were reported where persons over the age of 20 years were afflicted with the disease. Of this number one case proved fatal to a banker aged 42 years at Atwood, Ill.

“Dr. Saunders’ address or lecture lasted for more than an hour and was much appreciated by the thirty physicians of the county who were present.” (Edwardsville Intelligencer, IL. “Told of the Cause,” Oct 7, 1916, p. 4.)

Oct 26: “Cincinnati, O., Oct. 26. – Automobiles, not germs, are to blame for the epidemic of infantile paralysis that has swept the country. Dr. Thomas F. Hartington, deputy commissioner of labor of Massachusetts, made that assertion before the American Public Health Association today. ‘Infantile paralysis is due to chemical agents – namely: gases and fumes given off in the atmosphere by the combustion of oils and fluids used in automobiles,’ he declared. ‘Cases of gas and fume poisoning and cases of infantile paralysis agree in every essential. In infantile paralysis we are dealing with a chemical agent and not a microorganism. Infants and old persons are more susceptible to the malady. Although infantile paralysis has been endemic for years, its prevalence in epidemic form dates from the introduction and wide use of the automobile’.” (Freeport Journal-Standard, IL. “Blames Automobile Fumes…Infantile Paralysis,” 10-27-1916)

Oct 28 report: “Criticism of Methods of Quarantine in Infantile Paralysis. In an address delivered before the American Public Health Association this week on ‘The Essential Statistics of Infantile Paralysis,’ Mr. Frederick L. Hoffmann is reported to have said, in summarizing the results of his investigations, that ‘the evidence was apparently quite conclusive that the methods of federal and state quarantine adopted for the purpose of disease control had been quite ineffective, and possibly more of a hindrance than a help in the intelligent and rational administrative supervision and control of the disease.’ The Journal holds no brief for the federal and state health officers, but such a broad condemnation of the efforts of these public officials does not appear to be justified by scientific evidence, or by any statistics which thus far have been presented. No one can conjecture what the extent of the epidemic might have been without the establishment of the measures which were instituted.” (Journal of the American Medical Association, “Current Comment,” Vol. 67, No. 18, 10-28-1916, p. 1309.)

Nov 16: “Washington, Nov. 16. – The infantile paralysis epidemic in Greater New York is practically ended, according to Surgeon C. H. Lavinder of the Public Health Service who in a report just made said the number of cases in the entire city had fallen to less than 40 per week, with continued steady decline.

“In Massachusetts, where the epidemic reached its crest later than in other States, the disease is now steadily and sharply on the decline. Statistics compiled by Surgeon Lavinder, bringing returns up to late in October in most instances, show New Jersey with 134.25 cases per 1000,000
population was harder hit than any other State, outside of New York with Greater New York included. In Greater New York the rate was 165.82 and New York State, exclusive of New York City, was 84.91; in Connecticut it was 68.89; Massachusetts 42.88; Minnesota, 36.6; Delaware 31.4; Rhode Island 30.6; Pennsylvania 20.22; Maryland 19.9 Montana 17.4; Maine 14.13; Wisconsin 14.03; Michigan 14.01; New Hampshire 12.89; Illinois 12.5; and of remaining States below 10.

“Surgeon Lavender points out that in three groups of States the incidence rate was highest, being markedly above that of the rest of the country. These groups are in a general way arranged like a large inverted ‘Y’, the base being formed by the New England States, one arm stretching west along the Great Lakes and the other south along the Atlantic coast…. ‘We might reasonably conceive,’ says Dr. Lavinder, ‘that one focus, starting in New York and vicinity has stretched north through New England, west along the Great Lakes, say as far as Ohio and also somewhat west. Another focus, beginning with Minnesota, has stretched east toward Ohio and also somewhat west. A third focus might be conceived as originating in Mississippi or Alabama and stretching north along the coast to Virginia and Maryland. We lack any data of consequence o support this view. We know, however, that poliomyelitis appeared in epidemic form in Minnesota about the time it appeared in New York City and its vicinity and that the two foci were not connected with each other so far as can be determined. The crest of the prevalence in Alabama and Mississippi distinctly antedates that of states farther north. These comments are largely conjectural, but if the groups of States are marked out on a map, their arrangement will be found to be quite striking, whatever its meaning may be’.” (Corsicana Semi-Weekly Light (TX). “Infantile Paralysis. Epidemic Has Practically Ended in Greater NY,” Nov 17, 1916, p. 8.)

Narrative Information by State

Alabama

Alabama had 180 reported cases of infantile paralysis for the year, with cases every month except March. The largest concentrations of cases were in July (76 cases) and August (65). (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Arizona

There were eight cases during the year: 2 each in June, July, August and September. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8.)

Oct 25: “Word was received at this place last week of the death of Paul Amstutz, 9-year-old…of Phoenix, Ariz. Death was due to infantile paralysis, and the boy was only ill three days.” (Fort Wayne Weekly Sentinel (IN). “Woodburn News,” Oct 25, 1916, p. 10.)

Arkansas

There were 16 confirmed cases of poliomyelitis in Arkansas during the year: April (3), July (5), Aug (1), Sep (5), Oct (1), and Dec (1). (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

California

MA Health Department: There were a total of 130 cases of poliomyelitis in California for the year: Jan (4), Feb (6), March (1), April (3), May (2), June (4), July (12), Aug (18), Sep (13), Oct (210, Nov (25), and Dec (21). (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8.)

Dec 1: “From Tuesday’s Daily Courier. Dr. A. A. Maulhardt, county physician, said this morning that if no change appears in the children of the two Simi families quarantined on the suspicion of infantile paralysis, the quarantine will be lifted next Sunday. The indications of the infantile scourge were slight, but the quarantine was placed as a matter of public safety.” (Oxnard Courier (CA). “No More Sign of Infantile Paralysis,” Dec 1, 1916, 5.)

Colorado

There were 16 reported cases of poliomyelitis in Colorado for the year: March, 1; June, 1; July , 1; Aug, 3; Sep, 4; Oct, 10. (MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, 8)

Connecticut

The reported cases of poliomyelitis for the year in Connecticut are: Jan, 1; April, 7; May, 1; June, 4; July, 165; Aug, 367; Sep, 274; Oct, 91, Nov, 30, Dec, 11. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Newspapers

July 11: “New Haven, Conn., July 11.—Precautions are being taken by County Health Officers, co-operating with the State Board of Health, to safeguard children in rural districts from infantile paralysis. Thousands of children come to the State each Summer from New York City. The Colchester and other towns in eastern Connecticut there are Summer colonies maintained by Hebrew societies to which are sent scores of families. In the northwestern part of the State there are several fresh air camps for poor New York children. The authorities are advising societies which send these visitors to keep their children at home for the present. Children brought in probably will be subjected to quarantine for the present.

“The New York, New Haven & Hartford Railroad has boarded up all but two exits at the local railroad station to make it easier for health officers to intercept children brought in on trains.” (NYT. “Connecticut Quarantines,” July 12, 1916, p. 4.)

July 13: “New Haven, Conn., July 13.—A second case of infantile paralysis was found at Hartford today in a family which had recently entertained New York friends who had children. There was a death in that city and one in Ellington last night. The number of cases under observation increases in the State, and the influx of Summer visitors from New York City is so large that at most of the railroad stations doctors and nurses are stationed to examine the children. The New Britain authorities used the Boy Scouts today to distribute literature telling people how to guard their children against infection.

“All entrances to Bridgeport today were guarded by policemen and nurses. The city has been charted, and every person in a building in which there has been a case of the disease and all visitors from New York will be listed.

“Children under 16 years of age coming from New York or other cities where infantile paralysis is prevalent will be prohibited from entering Meriden after midnight Friday, and a heavy fine will be imposed upon any who secretly go there and are discovered. This ruling was made by the Health Committee tonight. Meriden is the first city in the State to take such action. Sixty-seven children from New York are already in the city, but they will not be deported as all have been examined and found to be free from the disease.

“Dr Abraham Sophian of the Rockefeller Institute, who was active in a similar epidemic in Texas, has been engaged by the Bridgeport authorities to direct the campaign there against the disease.

“A third case in Worcester since the outbreak in New York was reported today. The Board of Health of that city has issued a request that it be notified immediately of the arrival of children from New York so they can be watched for the disease.” (NYT. “New Cases in Connecticut,” July 14, 1916, p. 5.)

July 14: “New Haven, Conn., July 14.—One death, that of John Murphy, 16 years old, from infantile paralysis, and a new patient, a girl of 6, were reported by Health officers today. Murphy and is sister, Lucille, went to Yalesville from Brooklyn, N.Y., several days ago. They were taken ill and brought here. The sister is improving.” (NYT. “Boy of 16 Dies of Paralysis,” 15 Jul 1916, p. 16.)

July 21: “New London, Conn., July 21. – About thirty-five children and fifteen adults, parents of some of the children, all from New York, were detained on the New London Line steamer Chester W. Chapin today. The detention was in accordance with orders by the local Health Department excluding New York children from New London. A policeman is on guard at the steamer. The children are being fed at the expense of the steamboat company today, and tonight will be taken back to New York gratis. Three children who arrived on a train were put aboard the boat to be shipped back to New York.” (NYT. “Won’t let boat passengers land,” 7-22-1916, 18.)

July 22: “The Connecticut State Board of Health yesterday issued a bulletin urging communities to register and examine all children arriving from infected centres. Announcement from Greenwich and Stamford said that this policy had been adopted.” (NYT. “Jersey Ejects 22 Families,” July 2, 1916, p. 16.)

Sep 11: “Hartford, Conn., Sept. 11. – There are 600 cases of infantile paralysis in Connecticut, according to returns made to the State Board of Health, fourteen new cases being reported today from various parts of the State.” (NYT. “600 Cases in Connecticut,” Sep 12, 1916.)

Delaware

There were 71 reported and confirmed cases of poliomyelitis in Delaware for the year: July, 1; Aug, 10; Sep, 36; Oct, 24. (MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, 8)

Newspaper

Aug 17: “Wilmington, Del., Aug. 17. – The first case of infantile paralysis in Delaware was revealed when report was made of he death of Edgar H. Mouseley, five years old, at Penny Hill, on the Philadelphia pike, near Wilmington. Dr. B. R. Vessey was called to attend the child Monday night. He diagnosed the case as infantile paralysis and was informed the child had been taken to a picnic at Willow Grove August 7. The disease, however, did not develop until Monday night.” (The News (Frederick MD). “Paralysis Makes High Record.” 8-17-1916, p. 1.)

District of Columbia

Feb-Oct: There were 40 cases of poliomyelitis in the District of Columbia for the year: Feb, 1; March, 1; May, 1, July, 8, Aug, 18, Sep, 6; Oct, 5. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Newspaper and Periodical

Aug 19: “Another case of infantile paralysis in Washington was reported to the District health department yesterday, making a total of six now under treatment….All the cases reported have been mild.” (Washington Post. “Another Case of Paralysis Here, Aug 19, 1916, p. 2.)

Oct 7: “District of Columbia….Medical Inspector Dies of Infantile Paralysis. – Dr. Arthur Le Roy Hunt, a medical inspector in the service of the health department, died October 7 of infantile paralysis, believed to have been contracted in the line of duty. While Dr. Hunt had not been exposed to any known case of infantile paralysis since the middle of July, yet his daily duties had brought him into contact with many children who had come into the District of Columbia from infected areas, with certificates from the local authorities purporting to show absence of exposure to infection. Dr. Hunt was one of the best known anesthetists in Washington.” (JAMA. “Medical News,” Vol. 67, No. 17, 10-21-1916, p. 1236.)

Florida

July-Sep: There were 8 cases of poliomyelitis in Florida during the year: July, 4; Aug, 3; Sep, 1. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Georgia

The year: Georgia was one of the two States which reported no poliomyelitis cases during the year – the other being New Mexico (Alaska and Hawaii not yet States). (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Newspaper

July 12: “Savannah, Ga., July 12.—The Savannah Board of Sanitary Commissioners today appealed to citizens to report every person recently arriving from Greater New York. There is no infantile paralysis here now.” (NYT. “Savannah Watches New Yorkers,” July 13, 1916, p. 3.)

Idaho

June-Sep: There were nine reported cases in Idaho during the year: one in June, one in July, four in August, and three in September. (MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, 8)

Illinois

There were 672 reported cases of poliomyelitis in Illinois during the year: 76 in July, 339 in August, and 257 in September. (MA Health Dept. 1916 Infantile Paralysis Epidemic… 1919, 8.)

Newspapers

June 1: “Dr. Nelson of the state board of health was in Decatur Wednesday and confirmed the diagnosis in the cases of three children suspected of having Infantile paralysis. Two of these children and Donald Stucky, aged seven, and Ava Stucky, aged four, little children of Mr. and Mrs. L. Edward Stuckey… and Glenn Odor, eleven-year-old son of Ora C. Odor…just across the street from the Stuckey residence. All three of the children have been playing together. Dr. Nelson said there could be no doubt that the cases were Infantile paralysis, and Commissioner J. F. Matles ordered the children placed under quarantine. This makes four cases in the city, the other being in the family of L. Jean Wylie…” (Decatur Review (IL). “Diagnosis of Doctors Confirmed,” June 1, 1916, p. 7.)

July 6: “Chicago, July 6. – The first death in Chicago from infantile paralysis since June 29, when the epidemic in New York broke out, was reported late today. The health commissioner said the death could not be traced to the eastern epidemic.” (Beatrice Daily Sun (NE). “One Death in Chicago,” July 7, 1916, p. 1.)

July 11: “Springfield, Ill., July 11. – Four more cases of infantile paralysis, one each at Decatur, Dalton City, and… [unclear], Ill, were reported to the Illinois State Board of Health today, bringing the total number of cases in the state to thirty-one.” (San Antonio Light (TX). “Spread of Epidemic Causes Stringent Quarantine Rules in Some Localities,” July 11, 1916, 1.)

Aug 17: “Chicago, Aug. 17. – Spread of infantile paralysis in Chicago and suburbs was admitted by health authorities today. More cases have been reported thus far in August than were reported in July. There are fifty-six cases in the city, and a number in the suburbs. Children under 12 years old coming from the East are kept under surveillance for two weeks.” (NYT. “Disease Spreads in Chicago,” Aug 18, 1916.)

Aug 19: “Chicago, Aug. 19. – Eighty cases of infantile paralysis have been received at the Cook county and Durand hospitals in Chicago since July 1, it was announced. An average of three patients a day is being received at the county hospital, and emergency preparations are being made to receive a greater number.” (The News (Frederick MD). “Eighty Paralysis Cases in Chicago,” Aug 19, 1916, p. 1.)

Oct 27: “Geneva [IL] – East side Geneva schools again have been closed and a rigid quarantine established as a result of the recurrence of infantile paralysis.” (The Pointer (Dolton, IL). “Plague Closes Schools,” Oct 27, 1916, p. 3.)

Indiana

There were 211 reported cases of poliomyelitis in Indiana during the year: two in March, one in April, one in May, 25 in June, 39 in July, 64 in August, 57 in Oct, 16 in Nov, and 5 in December. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Newspapers

July 11: “Jeffersonville, Ind., July 11. The first case of infantile paralysis here was reported today.” (San Antonio Light (TX). “Indiana Town Has One Case,” 11 July 1916, 1.

Aug 7: “Lester Neiberger, sixteen-year-old son of Mrs. Alma Neiberger of Moore’s Hill, this state, is the first infantile paralysis victim at Moore’s hill. He died Monday. Many children were exposed to the disease before it was diagnosed.” (Washington Gazette, IN. “Indiana Youth is Victim,” 8-11-1916, 5.)

Sep 18: “Indianapolis, Ind., Sept 18. – The thirteenth case of infantile paralysis was reported in Indianapolis today. There have been two deaths from the disease. The thirteenth case was in a family of seven children, only one of whom was of school age, but had been kept out because of the order against admitting children not vaccinated against typhoid fever. Two of the city’s schools have been closed.” (Fort Wayne Journal-Gazette (IN). “13 Paralysis Cases at State Capital,” Sep 19, 1916, p. 8.)

Iowa

The cases reported in Iowa for the year are: 3 in Jan, 3 in Feb, 2 in April, 4 in June, 32 in July, 86 in August, 65 in September, 31 in October, 24 in November, and 6 in December. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Newspapers

July 14: “July 14 – Infantile paralysis reaches Iowa, three cases at Ottumwa.” (Des Moines Daily News (IA). “Important Events of 1916 From Daily News Files, Dec 31, 1916.)

Aug 9: “Aug 9 – Infantile paralysis cases in state total 50.” (Des Moines Daily News (IA). “Important Events of 1916 From Daily News Files, Dec 31, 1916.)

Aug 31: “Ottumwa. – There is infantile paralysis in 36 Iowa counties according to state board of health records. Cerro Gordo county leads in number of cases with 17. Most of these are in Mason City. Buchanan county is second with six. Wapello, Polk and Hancock counties each have four cases and Story, Cass, Scott and Hardin three each. The seventh death has been reported, the latest occurring at Mason City. There are now 86 cases in Iowa.” (State Center Enterprise (IA). “Paralysis in Thirty-Six Counties,” 31 Aug 1916, p. 2.)

Sep 28: “Des Moines. – Five new cases of infantile paralysis reported to the state board of health brings the number in the state up to 152….One case of infantile paralysis is reported at Buffalo, IA.” (Rake Register (IA). “New Infantile Cases,” Sep 28, 1916, p. 6.)

Dec 5: “One case of infantile paralysis was reported to the state board of health from Bluff Creek, Monroe co., Tuesday.” (Des Moines Daily News (IA). Dec 5, 1916, p. 3.)

Kansas

There were 106 reported cases of poliomyelitis during the year in Kansas: 3 in Jan, 1 in Feb, 1 in March, 2 in June, 14 in July, 23 in August, 21 in Sep, 24 in Oct, 10 in Nov and 7 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8)

Kentucky

There were 49 reported cases of poliomyelitis during the year in Kentucky: 3 each in Jan, Feb, March and April, 1 in May 4 in June, 9 in July, 12 in Aug, 5 in Sep, 3 in Oct, 2 in Nov, 1 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8)

Louisiana

There were 80 reported cases of poliomyelitis in Louisiana during the year: 4 in Jan, 2 in Feb, 2 in March, 10 in April, 3 in May, 6 in June, 25 in July, 9 in Aug, 7 in Sep, 3 in Oct, 5 in Nov, 4 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8)

Maine

There were 146 cases of poliomyelitis in Maine during the year: 1 in Jan, 1 in July, 25 in Aug, 56 in Sep, 43 in Oct, 15 in Nov, 5 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8)

Maryland

MA Health Dept: There were 348 reported cases of poliomyelitis in Maryland during the year: 2 in Jan, 1 in Feb, 1 in March, 10 in July, 63 in Aug, 102 in Sep, 121 in Oct, 43 in Nov, 5 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8.)

Newspapers

Aug 15: “Baltimore, Md., Aug 15. – Three new cases of infantile paralysis were reported to the health authorities. All three victims are children in the counties around Baltimore.” (The News (Frederick MD). “Three New Cases Near Baltimore,” Aug 15, 1916, p. 1.)

Aug 30: “Hagerstown, Md., August 30 – The first case of infantile paralysis appeared today in Hagerstown. John, the 2-year-old son of Lewis Mulligan, has the disease.” (Daily News Record (Harrisonburg, VA). “Paralysis Case in Hagerstown,” Aug 31, 1916, p. 4.)

Sep 16: “The United States government yesterday took a hand in the infantile paralysis epidemic prevailing in Baltimore and also in some other parts of the State, and sent Capt. James R. Hurley, past assistant surgeon of the United States Public Health Service, and a corps of assistants, to that city. Interstate travel of children will consequently be regulated. In his plan of action Capt. Hurley will link Maryland with New Jersey and New York under government supervision, and he installed yesterday a complete system of checking up travel of children under sixteen years of age. Not only will travel of children from the State be regulated, but into the State as well. The government officials have established headquarters in Baltimore and will operate from that city.

“Following the development of a case of infantile paralysis in the home of John Dinteman, Brunswick, his five-year-old child having the disease, a quarantine was placed on children under 13 years of age visiting moving picture shows, by Dr. Levin West, the town health officer. The child is now in the Sydenham Childs’ Nursery Hospital, it having been taken from its father at Camden Station, Baltimore, on Thursday….

“The development of another case of infantile paralysis in Montgomery county, making four cases of the malady in the county to date, has caused another postponement of the opening of the public schools of the county. The opening was originally scheduled for September 4. The appearance of the disease in the county, however, caused the school board to defer the opening date until September 18, and now a postponement to September 25 has been ordered. The latest case of the disease is at Washington Grove, the victim being a little child of Captain Randall.” (Daily News (Frederick MD). “U.S. Takes Hand in Scourge Fight,” Sep 16, 1916, p. 3.)

Sep 18: “Waynesboro, Pa., Sept 18. – The quarantine for infantile paralysis which is maintained at the Mason and Dixon line has resulted in the adoption of some unique methods by parents to get their children across the line. A young couple from Hagerstown put their year-old baby in a suit case and crossed the line with it. At Shady Grove, a trolley junction, they opened the suit case, to let the child get some air and it began to cry. Its cries were heard by a special quarantine officer and he sent the couple with the youngster back into Maryland.” (Daily News, Frederick, MD. “Hid Baby in Suit Case,” 9-18-1916 p. 7.)

Sep 24-30: “Infantile Paralysis Situation in Maryland. – Several new cases of infantile paralysis have been reported during the past week, but on Friday the records at the city health department were clear for the first time in five weeks, no cases having been reported that day. On account of one case in Brunswick, children under 13 years of age have been forbidden to attend moving picture theaters. – The city health department permitted children in the higher grades to attend school on Monday, September 25, but children in the kindergarten, primary department and grades up to the sixth will be kept at home until there is no longer any danger of the spread of infantile paralysis. Dr. C. Hampson Jones, Baltimore, head of the department of communicable diseases of the state board of health, is in favor of the county schools opening at once.” (Journal of the American Medical Association, “Medical News,” Vol. 67, No. 14, 9-30-1916, p. 1027.)

Oct 14 report: “Maryland….The Infantile Paralysis Situation. – A number of new cases having been reported to the city and the state departments of health, Health Commissioner Blake has deferred the opening of the kindergarten and six lower school grades. These cases are scattered through all parts of the city and the various counties. In a number of instances, the disease has not been recognized promptly and that, in part, accounts for this spread. Children under 16 years of age are no longer required to obtain certificates to leave the city, but the health officials of New York, New Jersey and Pennsylvania have been notified that all children under 16 years must have health certificates before coming to Baltimore and these will be quarantined for fourteen days. Several cases have developed here shortly after children have arrived from other states. – The United States Public Health Service has issued an order withdrawing its forces from Baltimore, but has recommended that no let-up be made in the quarantine regulations.” .” (Journal of the American Medical Association, “Medical News,” Vol. 67, No. 16, 10-14-1916, p. 1169.)

Oct 28: “Maryland….Modification of Infantile Paralysis Quarantine. – A further modification of the infantile paralysis quarantine in Baltimore will permit children 9 years of age and over to return to school and to attend moving picture theaters. The quarantine may be lifted entirely after next week, as the plague seems to be on the wane. During the past week comparatively few cases were reported to the city health department. – The outbreak in Garrett County is being investigated by the state board of health to determine whether or not the disease was imported from Pennsylvania. There have been twenty-two cases in Garrett County since July 1.” (Journal of the American Medical Association, “Medical News,” Vol. 67, No. 18, 10-28-1916, p. 1310.)

Nov 1: “Maryland….Infantile Paralysis Quarantine to be Removed. – The infantile paralysis quarantine will be raised, November 1, according to a recent report from the city health department, Baltimore. Only three new cases have been found in the past two days, and this has been about the average for the last ten days. The conclusion reached is that the epidemic stage of the poliomyelitis has been warded off, and that there is no pressing fear of other outbreaks of the disease in the city. – There were still a number of cases reported to the state department of health during the week, especially from Garrett County, where there has been an epidemic of the disease, and conditions in the counties are not as favorable as in Baltimore.” (Journal of the American Medical Association. “Medical News,” Vol. 67, No. 19, 11-4-1916, p. 1379.)

Massachusetts

MA Health Dept. “The monthly breakout for reported poliomyelitis cases in Massachusetts for the year are 4 in Jan, 3 in Feb, 6 in March, 3 in April, 4 in May, 10 in June, 107 in July, 253 in Aug, 627 in Sep, 704 in Oct, 180 in Nov, 36 in Dec.” (MA Health Dept. 1916 Infantile Paralysis Epidemic…. 1919, 8)

“The epidemic of infantile paralysis in 1916 is the largest which has occurred in Massachusetts. A total of 1,927 cases was reported from 202 cities and towns; 152 communities reported no cases. (Commonwealth of Massachusetts State Department of Health. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919.p. 9.)

U.S. PHS: “….During the latter part of June and the early part of July there was an unusually heavy influx of families containing small children into Holyoke from New York City, the majority of these families leaving on account of the epidemic of poliomyelitis. On July 15 a case of infantile paralysis was discovered in a child recently arrived from New York City, and following the appearance of this case all families coming from suspected districts and all children from New York presenting service certificates were quarantined. No other cases were discovered until August 16, but between that time and October 1, 73 cases were reported, an incidence of slightly more than one per thousand.

“The local health authorities made unusual efforts to secure the early diagnosis of poliomyelitis cases, two physicians being employed to study and report on all illness occurring among children. In this way early recognition of the disease was possible. All patients, with few exceptions, were immediately removed to a specially constructed hospital and the family from which the patient came was quarantined, together with other families using the same entrance in apartments and tenements. Day and night watchmen were employed to guard all entrances and food supplies were furnished and delivered by the city during the period of quarantine. There can be no question that by the adoption of these methods direct personal contact between families in which the disease prevailed with others in the community was greatly restricted.

“….None of the cases in Holyoke showed any very close connection with New York families, 66 in number, certified by the service and arriving in Holyoke subsequent to July 15 (it was fairly certain that these persons came from premises where poliomyelitis did not prevail), but there was an apparent connection between the homes visited by New York families earlier in the season and the points at which the earliest cases developed (many of these families doubtless came from homes where the disease was present)….”

(United States Public Health Service. “Cooperation with the Massachusetts State Board of Health in Investigations of Poliomyelitis.” Annual Report of the Surgeon General of the Public Health Service of the United States for the Fiscal Year 1917. Washington: GPO, 1919, 201-202.)

Chronological

June 30: “On June 30 the State Department of Health received notice from the New York City Department of Health, stating that infantile paralysis was epidemic in the city.” (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p. 49.)

Late June – July 1: “For the week ending July 1 cases were reported from two western counties, Hampden and Franklin, from Worcester County in the central part of the State, and from three of the eastern counties.” (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, 14)

July 5: “On July 5 the following letter was sent to all local boards of health by the State Department of Health:

This Department has been advised that there is a serious and rapidly spreading epidemic of infantile paralysis in New York City. Many people are taking their children out of the city in order to avoid infection, and in this way the disease may spread to Massachusetts.

The Commissioner of Health thought it would be wise to warn you of this condition in order that you might be on the lookout for any cases coming into your community. This applies particularly to any suspicious cases of illness coming from New York City. If such cases are discovered it will be wise to establish a careful isolation and sanitary control.

There is no epidemic in Massachusetts. During June there were only 10 cases reported in widely scattered places in the Commonwealth.

This Department will be glad to assist your board in preventing the importation and spread of this infection. In case you desire assistance, call your State District Health Officer or the central office.”

(MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p. 49.)

July 8: “In the week ending July 8 cases were reported for the first time from Berkshire County in Western Massachusetts, again from Worcester County, and from four of the eastern counties.” (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p. 14.)

July 14: “Boston, July 14.—The first recent case of infantile paralysis in this city was reported today by physicians, who declared that Alfred M. Champney of Natick, 35 years of age, was suffering from the disease. He has been taken to a hospital. Officials of the Boston Board of Health were notified immediately, and Champney was isolated. It was said his case was not serious.” (New York Times. “Man of 35 Years Has Paralysis,” July 15, 1916, p. 16.)

Aug 15: “Boston, Aug. 15. – Thirteen cases of infantile paralysis were reported today to the State Department of Health, making a total of 94 in this State since Aug. 1, as against 117 in July…” (New York Times. “Paralysis Gains Following Lull…, Aug 16, 1916, p. 18.)

Aug 16: “Boston, Aug. 16. – The total number of cases of infantile paralysis in the State was increased to 107 today, thirteen new cases being reported to the State Board of Health….” (New York Times. “13 New Cases in Massachusetts,” Aug 17, 1916, p. 6.)

Sep 11: “Boston, Sept. 11. – Twenty-five cases of infantile paralysis, developing over Saturday and Sunday, were reported today to the State Department of Health, making a total of 172 this month. Seven were reported in Boston.” (NY Times. “25 New Cases in Boston,” 9-12-1916.)

Sep: “The Harvard Infantile Paralysis Commission was appointed in September, 1916, to furnish aid to the physicians in the neighborhood of Boston in the early diagnosis of the affection by laboratory methods and to place at the disposal of those physicians who cared to have it used, a supply of immune human blood serum which in the New York epidemic of the early summer had been extensively used and had been favorably reported on.

“The commission consisted of Professor Milton J. Roseanu, assistant Professor Francis W. Peabody and the writer, with Mr. Roger Pierce as secretary.

“Immediately after the formation of the commission there began a demand for its services in diagnosis and early treatment and this work was conducted under the supervision of Dr. Peabody.

“In October the commission was requested by the State Commissioner of Health, Dr. Allan J. McLaughlin, to act as the agent of the State Department of Health in supervising the after-care of the paralyzed children in Massachusetts. With the approval of the university authorities the commission consented to undertake this work. At the same time it became evident that another and most important aspect of the situation was in great need of sturdy, and that the commission must also consider and investigate the question of the cause and prevention of the disease.

“These three aspects of the question then constitute the activities of the commission. [(1) Diagnosis and early treatment, (2) supervision of after-care in the State, and (3) study of the cause and prevention of polio.] (Lovett, R. W. “The Harvard Infantile Paralysis Commission and Its Work in Massachusetts,” Boston Medical and Surgical Journal, Vol. 176, 1-11-1917, p. 62.)

Oct 10: “Boston, Oct. 10. – Two hundred young men living in the north hall, a dormitory of Simmons college, were quarantined today because of the development of infantile paralysis. Officials of the college, which has 1000 students, said that it probably would not be closed.” (Salt Lake Tribune. “College Boys Quarantined,” Oct 11, 1916, p. 3.)

Oct 14 report: “Massachusetts….Harvard and Poliomyelitis. – Harvard Medical School has established a commission to assist in the early recognition, treatment and study of infantile paralysis. The commission consists of Dr. Robert W. Lovett, chairman; Drs. Milton J. Rosenau and Francis W. Peabody, Boston, and Mr. Roger Pierce as secretary of the commission. The commission will work in close cooperation with the state department of health and the local health authorities.

“Poliomyelitis. – Surg. Lumsden D. Fricks, U.S. P.H.S., has reported for duty at Boston with the state board of health, and has gone to Holyoke, where infantile paralysis has obtained a strong hold, to give assistance to the local authorities, and to make a health survey. – On the recommendation of the governor, the legislature has passed the Bates bill, which allows local boards of health to establish quarantine when an epidemic of infantile paralysis in threatened. – Up to September 27, 523 cases of poliomyelitis had been reported to the state health department, or about double the number of cases reported in August.” (JAMA, “Medical News,” Vol. 67, No. 16, 10-14-1916, p. 1169.)

Michigan

The monthly breakout of poliomyelitis cases in Michigan for the year are: 3 in Jan, 4 in Feb, 3 in March, 1 in April, 5 in May, 6 in June, 63 in July, 179 in Aug, 191 in Sep, 102 in Oct, 28 in Nov, 16 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Minnesota

The monthly breakout of reported cases of poliomyelitis in Minnesota for the year are: 2 in Jan, 3 in Feb, 1 in March, 9 in May, 16 in June, 224 in July, 343 in Aug, 197 in Sep, 95 in Oct, 17 in Nov, 5 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8.)

Mississippi

Jan-Dec: There were 56 cases of poliomyelitis in Mississippi during the year according to the MA Board of Health, as follows: 7 in Jan, 3 in Feb, 2 in March, 5 in May, 9 in June, 7 in July, 5 in Aug, 1 in Sep, 4 in Oct, 7 in Nov, and 6 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8)

July 15: “Jackson, Miss., July 15.—There are 75 cases of infantile paralysis in 26 cities of Mississippi, according to a statement made here today by Dr. Willis Walley, State Sanitary Inspector, after he had checked up reports received from county health officials. Dr. Walley stated the showing was a great surprise, as previous reports had indicated cases at only a few isolated places. Only a few deaths have occurred.” (NYT. “75 Cases in 26 Mississippi Cities,” July 16, 1916, p. 12.)

Missouri

July-Sep: The monthly breakout of poliomyelitis in Missouri during the year…is as follows: 4 in July, 3 in Aug, 3 in Sep. (MA Health Dept. 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8)

Montana

The monthly breakout of poliomyelitis in Montana during the year, as reported, is as follows: 1 in 1 in June, 11 in July, 28 in Aug, 33 in Sep, 10 in Oct, 3 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Newspapers

Aug 20: “Billings, Mont., Aug. 20. – One death from infantile paralysis was reported today, that of a child less than one year old, bringing the total number of deaths to five. Twelve cases of the epidemic still exist. Dr. J. A. Murphy, Medical Superintendent of the United States Indian Service of Washington, D. C. arrived here today and left immediately to investigate conditions on the Crow Indian Reservation. Six cases of infantile paralysis are reported on the reservation at Pryor, three of them being Indians.” (NYT. “Epidemic Reaches Montana Indians,” 8-21-1916.)

Sep 6: “Billings, Mont., Sept 6. – Recrudescence of infantile paralysis on the Crow Indian Reservation near here was reported today by the State health authorities. Sixteen new cases have appeared.” (NYT. “Expects Epidemic to End in 2 Weeks,” Sep 7, 1916.)

Nebraska

The monthly breakout of poliomyelitis in Nebraska during the year, as reported, is as follows: 1 in July, 7 in Aug, 6 in Sep. (MA Health Dept. 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

Newspaper

Oct 21: “Hastings, Neb., Oct. 12. – What is believed to be one of the most serious cases of infantile paralysis ever placed on record in Adams county was quarantined this morning at the farm residence of Mr. and Mrs. Robert Schlachter, six miles southeast of town. Karl, ten years old, is the victim of the disease and his condition is a grave. The disease is now in an advanced stage. The boy is affected in his back and both arms and legs.” (Beatrice Daily Sun (NE). “Infantile Paralysis Prevails at Hastings,” Oct 13, 1916, p. 1.)

Nevada

The three reported cases of poliomyelitis during the year in Nevada are: 1 in Aug and 2 in Nov. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Newspaper

Sep 25: “Reno, Nev., Sept 25. – Two cases of infantile paralysis were discovered in Reno yesterday by the city board of health. The cases are said to be well developed and are in the same family. Public schools have bee ordered closed by the health board and children are denied admittance to theaters and other public places.” (Santa Fe New Mexican. “Infant Plague Is Discovered in Reno,” Sep 25, 1916, p. 1.)

New Hampshire

There were 27 reported in New Hampshire during the year: 1 each for Feb, March and April, 2 in July, 3 in Aug, 13 in Sep, 4 in Oct, 2 in Nov. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, 8)

Newspaper

Sep 12: “Sep 12, Portsmouth. Public schools are ordered closed by order of the City of Portsmouth Board of Health upon confirmation that infantile paralysis had entered the city. (Portsmouth Herald, NH. “City of Portsmouth, N.H. Board of Health [Notice] to the Public,” Sep 22, 1916, p. 2.)

New Jersey

Caverly: “According to the Public Health Reports….After the New York epidemic started there were many cases, occurring with increasing frequency in 30 states at least. The State of New Jersey had the greatest per capita number of cases of any state in the country for the whole year. The epidemic was especially severe in Jersey City and Newark.” (Caverly 1924, p. 155.)

Lavinder: “In the epidemic of poliomyelitis which during the past summer originated in New York City and spread over the adjacent territory, perhaps no city suffered worse than Newark, N.J. Newark is but a short distance away, and by means of excellent transportation facilities its inhabitants enjoy a very close daily association with New York City and its people. It is perhaps quite characteristic of poliomyelitis that other cities, such as Jersey City and Hoboken, for example, located even nearer to New York City and in just as close association with it, should have suffered comparatively lightly from the disease. It is true that quarantine and other methods of handling the situation may have varied somewhat with these different places, but under our present conception of the epidemiology of poliomyelitis, it is hardly conceivable that this variation in methods should have been the sole cause of such a wide difference in prevalence in the respective places concerned.

“…the incidence rate per 1,000 population in Newark was a little less than 4. The worst infected
boroughs of New York City gave a rate somewhat over 3, while Hoboken and Jersey City each gave a rate of less than 1….” (Lavinder 1916, pp. 3351-3352.)

Chronological

March-Dec: The monthly breakout of reported cases of poliomyelitis in New Jersey during the year is as follows: 6 in March, 1 in April, 2 in May, 4 in June, 640 in July, 2,144 in Aug, 957 in Sep, 254 in Oct, 39 in Nov, 7 in Dec. (Massachusetts Health Department. 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

July 7: “….Three new cases of infantile paralysis were reported in Newark yesterday [July 7], making twelve there since March 14. Health Officer Craster requested the Board of Education to close the six all-year schools in the city, and to defer the opening of the Summer schools. The closing of parochial and Sunday schools has also been requested. State Director of Health Price said that he had requested the Pennsylvania Railroad and he Central Railroad of New Jersey to cancel excursions scheduled to leave the city today. A conference will be held at the office of the Board of Health on Monday to consider ways and means for preventing further spread of the disease.

“Three cases of infant paralysis developed in Jersey City yesterday, bringing the total to four. All but one of the victims have been sent to the isolation hospital at Snake Hill, which was formerly used for smallpox cases, but which has been vacant for some years. There is accommodation there for more than 200 patients.

“It was necessary to resort to force in removing one patient last night, as a family of eleven joined in a refusal to allow the child to be taken away. The family was informed that unless the case was isolated no members of the family would be allowed to leave the house for some months, and that a police guard would be maintained to enforce the order.

“A total of ten cases in the North Hudson district were tabulated yesterday. They were distributed as follows: Weehawken, 5; Union Hill, 3; West Hoboken, 1, and North Bergen, 1. In addition there was a suspected case in Union Hill and another in North Bergen. There were two deaths in Weehawken and one in North Bergen. The death in North Bergen was that of a child taken there from New York by her parents, who had fled with the victim and two other children from Manhattan. The suspected case is that of a sister of the dead child.

“In Bayonne, and other places, children of less than 14 years – in some cases 16 – were yesterday forbidden to enter theatres and motion picture houses.

“The Health Officer of Elizabeth yesterday notified the Montclair Fresh Air and Convalescent Home at Verona not to admit any more children until the records of the families from which the children came could be investigated.

“There was alarm in the vicinity of Caldwell yesterday, when it was reported that thirty families had removed to that place from New York.” (New York Times. “Paralysis Kills 22 More Babies in New York City; Death Total Now 187, and 87 New Cases Bring Number in City to 797. Libraries Bar Children.” 7-8-1916.)

July 8: “Newark, N.J. (AP), July 8. – Ten deaths and two new cases of infantile paralysis were reported to the health authorities here today.” (Brownsville Herald (TX). “Infantile Paralysis in Newark, N. Jersey,” July 8, 1916, p. 1.)

July 10: “Patterson, N.J., where one death and one other case have been reported, excluded all children, no matter whence they came. It was announced there that 500 children from New York and Brooklyn and already been deported, and than, if necessary, armed guards would accompany others to the town’s borders. There were three deaths from infantile paralysis, six verified new cases, and two suspected cases in Newark, which brought the total for the last seven days up to five deaths and nineteen cases. One of the suspected cases was at large last night, a mother having fled from her home with her child when she learned that a physician had notified the Board of Health of his suspicions and that an official would soon arrive, perhaps, to take the child away to a hospital.

“Quarantine against New York was established yesterday in Tenafly, Bogata, and Ridgefield Park, and many children were turned back from these places. In Tenafly one family narrowly escaped arrest for attempting to elude the officers. Hackensack, it was said, would establish quarantine against New York today. There was one death in Bayonne yesterday, and more severe measures than formerly were taken. The first two cases of infantile paralysis were reported in Orange yesterday, and all children arriving from New York were met at the train by a physician and examined. One case was reported yesterday in Perth Amboy and one in Metuchen…” (NYT. “Arrest Hundreds in Fight to Check Infant Paralysis,” 11 July 1916, 1.)

July 11: “With the appearance of the first case in Elizabeth, N.J., the Board of Health held a meeting yesterday [11th] and decided to close all playgrounds and motion picture theatres. It also was decided to abandon Summer excursions and Summer schools….

In Fairview, N.J., a suspected case of paralysis is being closely watched by three physicians, and the house of the patient is guarded by policemen.

“The Board of Health of Montclair, N.J., has issued an order requiring all children entering that city from other communities to undergo a three weeks’ quarantine, although no case of paralysis has appeared in that place.” (NYT. “Paralysis Takes Lives of 32 More…,” July 12, 1916, p. 1.)

July 12, Hackensack, NJ: “Hackensack’s first death from infantile paralysis was reported yesterday, and Judge William M. Seufert issued a call for a mass meeting of the Mayors of the municipalities of Englewood County this evening. The aunt of the victim in Hackensack broke the quarantine against her home to attend the child’s funeral and was fined $25 for the offense.” (New York Times. “Noted Scientists Organize to Curb Infant Paralysis…, July 13, 1916, p. 1.)

July 15, Hoboken, NJ: “Suburban authorities yesterday increased their precautionary measures against infantile paralysis. Hoboken led the way by isolating itself from the world, so far as new residents were concerned. The city has not had a case of infantile paralysis, and if Health Commissioner John Stack’s drastic measures are efficacious, no case or contagion will come into the city. Policemen were stationed at every entrance to the city – tube, train, ferry, road, and cowpath – with instructions to turn back every van, car, cart, and person laden with furniture and to instruct all comers that they would not be permitted under any circumstances to take up their residence in the city. Four families who tried to enter Hoboken were thus refused admission, although only two of them were from New York.

“Furthermore, every unoccupied building in the city – dwellings, offices. Lofts, and stores – was listed, and notices were sent to all owners and renting agents that they must report to the Health Department the name and previous address of any person who rented space for any purpose. If any such persons, it was said, were found to have come into the city from the outside, the space would be refused them and they would be sent out of town.

“Last night seven gangs of men disinfected gutters and receiving basins in the city, and other gangs flushed the streets and sidewalks with water. All playgrounds were closed yesterday, and many prohibitions were placed on the movements of children of less than 16 years of age.

“It was announced that, in the last two days, Recorder Carstens imposed fines totaling $7650 on 163 persons for violations of the sanitary regulations, and had warned each offender that he would be sent to prison for at least ten days for a second violation.

“A dispatch from Trenton said twenty new cases of infantile paralysis were reported in New Jersey yesterday, distributed as follows: Newark, 16; Rockaway Township, 1; Hackensack, 1; Irvington, 1, and West New York, 1. This made a total of 130 cases in the State reported since the beginning of the outbreak in New York. A report direct from Newark, however, gave that city only eight new cases yesterday, and three deaths, making a total of fifty-nine cases and fourteen deaths in the city this month. One family in which there was a case of infantile paralysis was said to be at large in the city, having fled from its residence….” (New York Times. “Hoboken Bars All Comers,” July 15, 1916, p. 1.)

July 20, Hoboken: “All policemen on vacations have been recalled, and no vacations will be permitted before Fall. Policemen guard ferries night and day, as well as every street and avenue entrance to the city. Absolutely no children are permitted to enter till it is proved that they have not been near any infected district. Dairy, bakery, laundry, and other wagons are forbidden entrance to the city. Rags and paper cannot be brought into the city, although mills there need them for operation. A big load of discarded telephone directories was turned back yesterday.

“The Jersey City Board of Health yesterday decided that all persons moving into the city, whether children or adults, must show certificates that they come from a neighborhood free from infection. The board ahs requested all churches to close their Sunday schools.” (New York Times. “Day Shows a Drop in Infant Paralysis,” July 21, 1916, p. 18.)

July 20 Newark: “With twelve new cases of infantile paralysis and three deaths yesterday, the Newark Board of Education closed all schools to pupils below the fifth grade. Thus turned out about 15,000 children, leaving 10,000 in attendance.

“New cases reported elsewhere in New Jersey were: Jersey City, two; Union Hill, four; Montclair, one; Irvington, one, and Verona, one. The total in the State, since the beginning of the outbreak in New York, was 203…” (New York Times. “Day Shows a Drop in Infant Paralysis,” July 21, 1916, p. 18.)

July 22: “Ten new cases of infantile paralysis were reported in Newark yesterday and two deaths. There was one new case in Jersey City, one in Rutherford, one in East Rutherford, one in Elizabeth, two in Union Hill, one in Randolph township, one in Weehawken, and one in Rahway. The total cases in the State of New Jersey numbered 239 yesterday, according to a report from Trenton.

“Twenty-two New York and Brooklyn families spending the Summer in the bungalow colony at Mountainview, five miles from Paterson, were ordered yesterday to return to their homes by Chief of Police Charles Magee of Mountainview, as it was feared that infantile paralysis might be among them.

“The Ferrer colony of forty children at New Brunswick, supported by anarchists, was placed under quarantine by the New Brunswick authorities yesterday when a case of infantile paralysis was discovered among the children.” (NYT. “Jersey Ejects 22 Families,” July 2, 1916, p. 16.)

July 26: “Sixty-seven new cases of infantile paralysis were reported in New Jersey yesterday, the largest in a day, making a total of 351 cases for the State. Thirty-nine new cases were reported from Newark for Sunday and Monday, and nineteen new cases and six deaths yesterday….” (New York Times. “Sixty-seven New Cases Reported Yesterday, Making Total of 351,” July 26, 1916, p. 5.)

Aug 6: “Washington, Aug 6. – On account of the outbreak of infantile paralysis on the New Jersey coast, the Secretary of the Treasury has directed the United States Public Health Service to co-operate with the New Jersey health authorities in the same manner as the Public Health Service has been doing in New York….” (NYT. “Government Aid in Jersey,” 8-7-1916, p. 16.)

Aug 8: “The total of cases in the State since July 1, according to a dispatch from Trenton, has been 930.” (New York Times. “13 Die in New York State,” 8 Aug 1916, p. 18.)

Aug 10: “The Montclair Health Board yesterday notified the Caldwell Health Board that if Joseph A. Brady, Postmaster of Caldwell, entered Montclair within the next ten days he would be arrested. Mr. Brady’s son recently was attacked by poliomyelitis, yet the Postmaster, it was said, was permitted by the Caldwell Board of Health to continue to handle mail and was permitted to live temporarily in Montclair.” (NYT. “Rich Men Give Plague Fund,” 8-10- 1916, 5)

Aug 11: “The New Jersey State Department of Health yesterday promulgated a new chapter of the sanitary code to become effective on next Tuesday. The regulations require children under 16 to have health certificates fro travel from place to place within the State, and railroad and trolley companies will demand the certificates for transportation….A dispatch from Trenton put the total cases in New Jersey at 1,300…” (NYT. “Cases of Paralysis Brought Into City,” 8-11-1916, p. 5.)

Aug 12: “Infantile paralysis developed in fourteen communities in New Jersey, not hitherto affected, in the twenty-four hours ending an noon yesterday, according to reports made to the State Department of Health at Trenton. The total number of cases in the State, it was announces, was 1,385….” (New York Times. “Disease Spreads in Jersey,” Aug 12, 1916, p. 16.)

Aug 13: “Atlantic City, N.J., Aug 13. – Atlantic City today perfected an absolute quarantine on children leaving the resort without first obtaining health certificates. Dr. Talbot Reed, City Health Officer, deputized the physicians of the resort as inspectors. Members of his board sat at City Hall from 9 o’clock this morning until near midnight tonight, and hundreds of youngsters were examined. The order was sweeping, and parents in ignorance of the ordinance were inconvenienced in last-minute rushed for trains. The authorities were firm and no child was permitted on trains without a certificate….Only one known case of paralysis has developed here, with a floating population of approximately 200,000.” (New York Times. “Atlantic City Quarantine,” Aug 14, 1916, p. 16.)

Aug 15: “Trenton, N.J., Aug 15. – Notwithstanding the precautionary quarantine of local health boards, the infantile paralysis epidemic invaded five new municipalities. Reports to the state board of health exclusive of Newark, where the disease has made its greatest headway, show that fifty-three cases developed in the state over Sunday, making the total number of cases 1514, with Newark’s new cases yet to be totaled.” (The News, Frederick MD. “Paralysis Gets More Victims,” Aug 15, 1916, p. 1.)

Aug 19: “Trenton, N.J., Aug 19. – Daily reports to the state department of health in the infantile paralysis epidemic increase the number of cases in the state. Five new municipalities were affected, while sixty-two cases were recorded in the state, making a total of 1369. Five places in which the disease appeared for the first time are: Pleasantville, Atlantic county; Wildwood, Cape Many county; Shrewsbury township, Monmouth county; Long Beach township, Ocean county, and Springfield township, Union county.” (The News, Frederick MD. “Increases in New Jersey,” Aug 19, 1916, p. 1.)

Aug 29: “During July poliomyelitis caused 178 deaths in New Jersey, but tuberculosis caused 359 deaths in the same month, and intestinal diseases of children 355 deaths.

Sep 4: “The New Jersey State Board of Education yesterday decided not to open the State schools until Oct. 2.” (New York Times. “Expects Epidemic to End by Sept. 15,” Aug 29, 1916.)

Sep 8: “Orange, N.J., Sept. 8. – While three policemen and Health Officer T. Dudley Ballinger of this city restrained Mr. and Mrs. Charles Peters…this afternoon ambulance orderlies carried away from the Peters home two-year-old William Peters, a victim of infantile paralysis. The child was taken ill yesterday afternoon, but after the case had been diagnosed by three physicians, the parents refused to permit the baby’s removal to the isolation hospital. When persuasion failed, Health Officer Ballenger called on the police for help… The parents insisted that the law had no right to take their child from them, and after a parley which lasted nearly two hours, two policemen held Mr. Peters while Mr. Ballinger and the other policeman restrained his wife. The child was then carried out.” (New York Times. “Parents Resist Policemen; Peters and Wife Overpowered and Baby Taken to Hospital,” 9 Sep 1916, p. 6.)

Oct 4: “Trenton, Oct. 4. – The state department of health lifted the quarantine which has been in force since the outbreak of the infantile epidemic. Children may now enter or leave New Jersey at will.” (Daily News, Frederick, MD. “New Jersey Lifts Quarantine,” Oct 4, 1916, p. 7.)

New York Overview

Massachusetts Health Department: The monthly breakout of reported cases of poliomyelitis in New York during the year is as follows: 10 in Jan, 6 in Feb, 5 in March, 9 in April, 16 in May, 345 in June, 4,054 in July, 5,773 in Aug, 2,201 in Sep, 643 in Oct, 122 in Nov, 39 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8.)

Wilson: “During the first five months of 1916 public health officials had little reason to worry about polio. Only seventeen cases of the disease had been reported in the boroughs of the city. However, early June saw a worrisome increase in polio cases, especially in Brooklyn, where six cases were reported by June 6. A house-to-house search of homes in the areas that were first affected uncovered a total of thirty cases that had begun in May or early June. By June 8, with six new cases and increased requests for laboratory confirmation of polio diagnoses, the Health Department realized that an epidemic might be underway. The official report on the epidemic later attributed the delay in recognizing the onset of the epidemic to physicians who delayed reporting their diagnoses of polio and to the difficulty of a correct diagnosis in the early stages of the disease. In the second week of June the Health Department increased their house inspections in affected areas and uncovered additional cases of polio. In addition, several mothers had brought their infants to a Baby Health Center in Brooklyn because their children had developed weakness and lameness in their arms or legs after having been ill for a few days. Given these additional cases, on June 17 the Health Department issued its first press notice on the rise in the number of polio cases in the city.” (Wilson. Polio. 2009, p. 11)

Offit on New York City: “During the week of June 24, 1916, polio claimed another 233 children…. On July 5 all movie theaters banned children under the age of sixteen. Three days later, carnivals, parades, public picnics, and excursions ceased, leaving the streets deserted. In the following week there were another 700 cases and 170 deaths from polio. The epidemic continued unchecked…. In the week of August 5 there were another 1,200 cases and 370 deaths. Dr. Robert Guilfoy had announced in July that one child died from polio every two and one-half hours; by early August it was every twenty-six minutes. By mid-August, polio had paralyzed 5,500 people and killed 1,500.

“Federal authorities, desperate to contain the epidemic, issued a regulation that no child could leave New York City without a certificate for interstate travel. Residents outside the city panicked. A self-appointed citizens’ committee of five hundred in Huntington, Long Island, entered every home in town looking for suspected cases of polio. Residents of Glen Cove, Long Island, threatened to kill the health officer and burn down the hospital after the arrival of several polio patients. Policemen in Hoboken, New Jersey, guarded every entrance to the city with instructions that no one could seek safe haven. At gunpoint, two policemen forced a family of seven to turn back; the family had given up their home in Brooklyn to move to Hoboken.

“Isolated and desperate for a cure, New York City residents tried everything. They ingested catnip, skullcap, lady’s slipper, earthworm oil, blackberry brandy, and the blood of frogs, snakes, and horses. Following a rumor about the wondrous powers of ox blood, parents showed up at East Side slaughterhouses with buckets. They hung charms around their necks made of pepper, garlic, camphor, and onions. A former state legislator sold cedar wood shavings to be worn around the neck ‘to protect the child from death and…prevent germs [and] insects from attacking the victim,’ and one man sold ‘Sol,’ containing sassafras and alcohol, to ‘cure infantile paralysis.’ Both men spent thirty days in jail for making false claims.

“Doctors, similarly desperate, injected adrenaline or fresh human saliva into the spinal fluid or took spinal fluid from infected people and injected it back under the skin. One physician, George Retan, claimed dramatic success with a technique that involved inserting a large hollow needle into a child’s back, draining spinal fluid, and at the same time infusing large quantities of salt solution into a vein. Retan reasoned that his technique washed poisons out of the nervous system. With wider use – when treatment killed more people than it saved – physicians abandoned the procedure.

“During the last three weeks of August, polio paralyzed 3,500 people and killed 900. Typically, polio killed 5 percent of its victims, but in New York City in the summer of 1916, for reasons that remain unclear, 27 percent of those infected died…. Children paralyzed by polio rarely recovered….

“By late September 1916 the number of new cases of polio finally declined, and New York City schools reopened. When the epidemic was over, polio had paralyzed more than 9,000 people and killed 2,400; most were children less than ten years old. It was the largest epidemic of polio ever recorded.“ (Offit 2007, pp. 7-9)

Chronological

Jan-May: “In the first five months of 1916, only 17 cases of the disease were reported, of which 8 were in Manhattan, 4 in The Bronx, 5 in Brooklyn and none in Queens or Richmond.” (NYC DPH. A Monograph on The Epidemic of Poliomyelitis… NYC…1916. 1917, p. 13.)

Beginning of the Outbreak: “Dr. Emerson said that a year ago the Baby Welfare Association notified the Health Department of six cases of infantile paralysis. Mothers had gone to the association and asked why their babies were so limp that they could not hold their bottles. The reason was that they were paralyzed. Dr. Emerson said it was quickly found that 114 more cases existed, but had not been reported. He urged that parents be instructed as to the necessity for reporting cases at once if they occur in the coming summer. “Our ignorance a year ago as to the control of the disease was complete,” said Dr. Emerson. “We obtained the advice we could and gave wide publicity to it. We stated to the public that there was a new and serious disease among us, and that we knew no way in which to control it. All doctors were urged to study the disease.” (Presentation by Dr. Haven Emerson, Symposium on Poliomyelitis, American Medical Association, NYC, in Municipal Journal “News of the Societies,” June 14, 1917, p. 803.)

May: Only five cases in the entire city had been reported to the Department of Health in May, and yet when we assign the cases, which were reported at later dates (discovered by the house to house visits of doctors and nurses of the Department in the section of Brooklyn first invaded, a thickly populated Italian section, bounded by Fourth avenue, Nevins, Carroll and Union streets), to the date when the first symptoms of sickness were ob¬served, i. e., to the date of onset of the disease in each case, wet find that in the month of May, 29 cases of poliomyelitis had their origin and were doubtless capable of spreading the disease to or through those with whom they came in contact.” (NYC DPH. A Monograph on The Epidemic of Poliomyelitis… NYC…1916. 1917, 13.)

June: “In June of 1916…a health crisis was reported in a thickly populated immigrant area of Brooklyn known as Pigtown. According to the newspapers, frightened Italian parents had approached local doctors and priests, ‘complaining that their child could not hold a bottle or that the leg seemed limp…and there had been a little loss of appetite and some restlessness.’ When the first deaths were confirmed a few days later, the Health Department had rushed dozens of investigators to Pigtown for a house-to-house inspection. The diagnosis was polio.” (Oshinsky 2005, p. 19.)

June 1-8: “To judge by the reports of physicians up to June 1st, there was nothing to excite suspicion that we were already at the onset of an epidemic. Within the first eight days of June, 6 cases were reported from Brooklyn, from which borough no cases had been reported up to this time in 1916…” (NYC DPH. Monograph…Epidemic of Poliomyelitis… NYC…1916. 1917, 13.)

June 8: “On June 8th [Thursday], when the homes of the 6 reported cases were found to be in a fairly circumscribed area [in Brooklyn], and when a notice was received from the research force of the Department laboratory that an unusual number of requests had, within the past few days been received, for positive diagnosis in cases of suspected poliomyelitis, orders were given to make an immediate and special investigation, by inquiry of physicians practicing in the area affected, and by instituting a house to house canvass for unreported and unrecognized cases.” (NYC DPH. Monograph…Epidemic of Poliomyelitis… NYC…1916. 1917, p. 14.)

June 15: “On June 15th, in addition to a number of cases discovered by visits of medical inspectors and nurses throughout the now obviously infected area of Brooklyn, several cases of recent paralysis were noted among the infants attending the Baby Health Station at 184 Fourth avenue, Brooklyn. The mothers of these children, all unaware of the existence of the disease or its communicable character, brought their babies to the doctors, com¬plaining that the child could not hold the bottle or that the leg seemed limp for the past few days, and there had been a little loss of appetite and some restlessness.” (NYC DPH. Monograph… NYC…1916. 1917, p. 14.)

June 17: “The first official announcement of the existence of an unusual num¬ber of cases of poliomyelitis in New York City (in the Borough of Brook¬lyn) was made in a press bulletin issued Saturday, June 17th, and published in the newspapers on the .following day. As in the case of all the press bulletins issued by the Department of Health, multi-graphed copies of this bulletin were sent to all the newspapers in the City, to the medical journals and to all the important news bureaus. This first bulletin called attention to the value of spinal fluid examinations in the diagnosis of poliomyelitis and announced that lumbar puncture and the laboratory examination of spinal fluid would be made free of charge by the Department of Health. At the same time a letter was sent to all the physicians in Brooklyn, calling attention to the existence of a group of cases of poliomyelitis in their borough, and asking for their co-operation in controlling the disease.” (NYC DPH. Monograph… NYC…1916. 1917, p. 15.)

June 20: NYC DPH assigned seven additional nurses “to search for unreported and unrecognized cases by an extension of the house-to-house visits, and the medical inspectors to visit the numerous cases now reported, to confirm the diagnosis made by the family physician and to examine suspects reported through many non-professional channels….

“The American Society for the Prevention of Cruelty to Animals was requested to take immediate measures to collect all stray cats and dogs found in the infected localities.

“The Department of Street Cleaning began active co-operation to give a special clean-up in South Brooklyn and to discontinue the use of burlap bags in the daily collection of rubbish.” (NYC DPH. Monograph… NYC…1916. 1917, p. 15)

June 22: Additional medical inspectors are assigned to assist in house to house visits. (NYC DPH. Monograph… NYC…1916. 1917, p. 15)

June 23: “On June 23rd, there were reported 48 cases, about half among Italian families, as compared with a total of 63 reported up to this date. Many of these were of considerable duration, their onsets having occurred even in the month of May, and almost all of them had either escaped recognition as poliomyelitis by the private physician or had not been under medical care. A further evidence that many cases had escaped detection for some weeks, and had been exposing others to infection for a considerable period, was presented by a leading orthopedic surgeon in Brooklyn, to whose dispensary class cases applied with already well developed deformities, fol¬lowing the acute onset of paralysis.” (NYC DPH. Monograph… NYC…1916. 1917, p. 15)

June 24: “On June 24th, in order to give immediate reply to many anxious inquiries and suggestions as to the part played by schools in the spread of the disease, a press bulletin was issued, pointing out the facts that 90 per cent. of the cases were in children under school age, that the cases were not, limited to any one school district or to children of the same classroom. The school term ended on June 30th. At the same time there was issued a special bulletin for parents, emphasizing the known facts which would be of service in preventing the spread of the disease in homes. The presence of the virus in the discharges from nose and throat, and bowels of infected individuals, the probability that atypical and non-paralytic cases were as dangerous and as numerous as the paralytic cases, and that little value or protection could be expected from the use of so-called antiseptic gargles and nose-sprays, were explained.” (NYC DPH. Monograph… NYC…1916. 1917, p. 15)

June 26: “New York, June 26 – Thirty-two new cases of infantile paralysis were reported from Brooklyn today, bringing the total number of cases to develop in the last 10 days up to 146. Many of the cases are in Italian families. The Department of Health has assigned 10 nurses and seven inspectors to the infected district.” (Boston Globe. “146 Brooklyn Babies Ill,” 6-27-1916, p. 8.)

June 28: “On June 28th the Board of Health met and passed resolutions requir¬ing eight weeks’ isolation instead of six weeks, and demanding immediate hospitalization of all patients for whom the following requirements could not be met :

Daily attendance of a physician.
Special attendant who must observe quarantine regulations, do no cooking, and avoid contact with other children of the house¬hold.
Special room for patient and attendant.
Screening of windows of patient’s room.
Separate toilet for the family.
Exclusion of food handlers from work.
Disinfection of bed linen of the patient and renovation of room occupied, after removal of patient.” (NYC DPH. Monograph… NYC…1916. 1917, p. 16.)

June 28: “New York, June 28 – Health Commissioner Emerson issued orders today to heads of all bureaus to turn every available man over to Dr. Simon Blattels of the Bureau of Preventable Diseases to assist him in the fight against the spread of infantile paralysis. Tomorrow there will be at least 20 department physicians and a large squad of nurses, sanitary inspectors and sanitary police at work in the infected districts, looking for new cases, supervising the care of cases reported and enforcing a strict quarantine. An alarming phase of the epidemic is its spread in Manhattan, where 29 cases have occurred since June 1. Nine were reported within the last two days, three today and six yesterday. Twenty-three new cases developed in Brooklyn making the total there 206.” (Boston Globe. “To Stamp Out Disease,” June 29, 1916, p. 12.)

June 29: “On June 29th the Queensboro Hospital was opened, thus giving imme¬diate relief to the Kingston Avenue Hospital, already crowded. By using the screened porches and obtaining accommodations for nurses in a neigh¬boring house rented for this purpose, it was found possible to accommodate as many as 112 children at a time, though the normal capacity of the hospital is 80 patients.” (NYC DPH. Monograph… NYC…1916. 1917, p. 17.)

June 30: “[On]…(June 30th), the Surgeon General of the United States Public Health Service was notified that an epidemic was under way, and the facts upon which this belief was based were given in full. The New York State Department of Health and the health officers of neighbor¬ing States, and of a few of the larger nearby communities were notified at the same time.” (NYC DPH. Monograph… NYC…1916. 1917, p. 15.)

June 30: “Health Commissioner Emerson has mobilized practically all the available forces of the Health Department to combat the further spread of infantile paralysis. Forty-nine new cases of the disease were reported yesterday and thirty-two cases the day before, making a total of 255 cases since the epidemic began. Most of them are in crowded parts of Brooklyn, although cases have been reported from all boroughs except Queens. Manhattan has twenty cases. So far there have been twelve deaths, eleven in Brooklyn and one in Manhattan.

“Dr. Simon Blatteis of the Bureau of Preventable Diseases has been put in charge of the fight against infantile paralysis and every available man in the Department of Health has been turned over to him. Other special department activities will be dropped until the epidemic is under control. Yesterday there were ten department physicians, ten nurses, and sixteen sanitary inspectors at work in the infected districts looking for new cases, putting into effect a strict quarantine of cases already reported, and attending the sufferers.

“Dr. Emerson does not fear that the disease will get beyond control. ‘We believe,’ he said, ‘that application of well organized sanitary measures will limit this outbreak. The Health Department cannot possibly carry out all measures necessary unless the people do their part and promptly report every case even remotely suspicious. Reports from janitors, neighbors, visiting nurses, as well as physicians will be welcomed. No names of persons making them are necessary. Our chief reliance must lie in complete and quick isolation of patients for not less than eight weeks, and on perfect cleanliness of the patient’s surroundings.’ A bulletin issued by the Board of Health says:

There is little doubt as to the transmissibility of the disease, either directly or through a third person. There is also some evidence that the disease can be spread by apparently healthy individuals who harbor the virus, although themselves immune.

The disease is eminently one of childhood, but adults are frequently affected, no age being immune. Children between 1 and 5 years are most susceptible. The disease occurs most frequently during the Summer months, from June to October, inclusive, which usually constitute the dry season; but the cases are reported every month throughout the year.

Acute poliomyelitis can occur in many different forms and in varying degrees of severity. The most frequent type is characterized by a sudden onset with fever, followed usually in from twelve hours to three or four days by a general or localized paralysis. *** Vomiting and convulsions occur frequently at the onset, but are not constant symptoms. Rather more significant may be considered the headache, restlessness, irritability, and sleeplessness which occur early in a large proportion of cases. However, some cases may be drowsy and stuporous.

“A special pavilion has been established in the Kingston Avenue Hospital, Brooklyn, where patients who cannot be properly isolated in their homes, or who are not otherwise able to command proper treatment, may receive attention of specialists.

“Dr.. H. L. Amoss of the Rockefeller Institute has been assigned to work with the specialists who are studying the outbreak in Brooklyn. A meeting of these experts will be held this afternoon at the Health Department. Tomorrow the Brooklyn physicians living in the infected areas will meet in the Polhemus Memorial Clinic under the joint auspices of the Health Department and the special poliomyelitis committee.

“As to the seriousness of the disease in Manhattan, Dr. Emerson said:

The situation in Manhattan is not encouraging. Most of the cases are confined to the crowded lower and upper east sides and follow the line of population. The epidemic of 1907 began similarly.

“Helen Elizabeth Downing, 14 years old, daughter of Walter Downing of 221 Webster Avenue, Brooklyn, died on Wednesday night of infantile paralysis on the eve of her graduation from Public School 134. According to the records of the Board of Health, she was the oldest child known to have died of the disease. The girl became ill on Saturday night. The diploma she was to have received was taken to the parents last night by one of her classmates.

“Dr. H. L. Amoss of the Rockefeller Institute explained last night that much can often be done toward successfully treating infantile paralysis, although no cure has been discovered. ‘Much depends upon the treatment,’ he said. ‘To say that there is no cure, although strictly true in the sense that there is no known antitoxin, would be likely to mislead, for many cases have completely recovered’.” (NYT. “All Unite to Check Infant Paralysis,” June 30, 1916, p. 8.)

July 1: “The Police Department, Street Cleaning Department, and the Society of the Prevention of Cruelty to Animals have been called upon, it was announced yesterday, to unite with the Department of Health, the Rockefeller Institute, and private physicians in a city-wide fight against the spread of infantile paralysis, which has recently attacked 302 children in the city, causing sixty-four deaths since the first of the year, forty-seven occurring since last Saturday, forty-two in Brooklyn and five in Manhattan. Italians living in crowded tenements have been the chief sufferers…..The rapid spread of the disease and its extraordinary record for fatality have stirred the Health Department to great activity. ‘The outbreak,’ said Dr. Emerson, the Health Commissioner, yesterday, ‘threatens to go beyond that of 1907, when there were 2,500 cases in the city. It is characterized by a high degree of virulence. Whereas in 1907 the mortality was approximately 5 per cent, the mortality in the present outbreak is probably four times as great. The Health Department records show that in the entire year of 1915 there occurred in the city only thirteen deaths from infantile paralysis. In 1914 there were thirty-four death, and in 1913, fifty-five.

“‘Everything possible is being done to combat the disease. The department has called the attention of the Society for the Prevention of Cruelty to Animals to the large number of cats which frequent many infected houses. The society has agreed to meet the situation promptly. The Department of Street Cleaning has agreed to devote special attention to the cleaning of the streets in the infected districts. The police are giving valuable assistance in enforcing city and Health Department regulations.

“‘Our method of fighting the disease is this: Whenever a case is reported in a block not previously affected, a house-to-house canvass of that block is made. In this way many unreported cases have been found. All cases are isolated at once, and, except where home conditions are equal to the accommodations of a hospital, the patient is removed to a hospital. Forty patients were moved today to the special pavilion at the Kingston Avenue Hospital, Brooklyn.

“‘The infected area contains many old tenements and garbage and ashes are deposited in the halls. It is reported that these areas are infested with cats and the garbage and ash piles draw flies. With the co-operation of the various departments these areas are being cleaned up.’

“The Commissioner added that nurses and other workers were being drawn from various branches of the Health Department and that he stood ready to divert many more from their regular occupations.

“Origin of the Malady.

“Concern over the spread of the disease has aroused interest in its origin, and the department has started its machinery of investigation. There was a report yesterday that the disease had been brought to America by Italian immigrants, and the Health Commissioner, upon hearing this, communicated with the Quarantine Station down the Bay. The report from there was that no cases had been noticed among immigrants and that Quarantine had no record of epidemics in any of the towns of Italy.

“Dr. Emerson, however, communicated with Surgeon General Rupert Blue, of the United States Public Health Service and requested him to ascertain through the consular service whether infantile paralysis was present in any Italian towns. Under ordinary circumstances, it was said, an answer should be received by cable within three or four days….

“State and city health authorities as far West as Illinois have been warned by the City Department to watch children coming from New York. No quarantine outside of New York has been declared, so far as is known, but other cities are expected to take due precautions.

“Attention of the public was called yesterday to the fact that in 1907 a number of adults died from the disease, so that grown persons, confident of immunity, might not take unnecessary risks. The oldest victim in the present outbreak was fourteen years of age.” (New York Times. “Infant Paralysis Starts a Cleanup,” July 1, 1916, p. 7.)

July 2: “Infantile paralysis continued to spread through the city yesterday, fifty-two new cases being reported to the Board of health for the twenty-four hours ended at noon. Of these cases, forty-three were in Brooklyn, eight in Manhattan and one in the Bronx. The total of cases for the year according to the department’s figures, is 350.

“The death rate also continued at about 20 percent, or four times as high as in the epidemic of 1907. There were twelve deaths yesterday, ten in Brooklyn, one in Manhattan and one on Staten Island. Fifty-nine children died of the disease during the week ended at noon yesterday, of whom thirty-six were boys and twenty-two were girls. By far the largest number of deaths occurred in Brooklyn, where fifty-one were reported. The number of deaths from the disease since the first of the year is seventy-five, almost all of which occurred in the month of June.

“All except two of the year’s deaths were of children under 10 years of age; nine were less than 1 year old; seventeen were between 1 and 2 years, and thirteen were between 2 and 3 years.

“In addition to combating the spread of the disease with all of the resources at his command, Dr. Haven Emerson, Health Commissioner, turned his energies yesterday toward his campaign of public education. He was assisted by Dr. Simon Flexner of the Rockefeller Institute, who addressed 100 physicians at the Polhemus Memorial Hall in Brooklyn, under the joint auspices of the Department of Health and the Special Poliomyelitis Committee appointed to assist in the fight against the disease.
Danger in Indoor Gatherings.

“Commissioner Emerson’s most frequently reiterated advice to parents yesterday was that they keep their children away from all crowds, especially indoor crowds. Infantile paralysis is conveyed in coughing and sneezing, and for this reason, Dr. Emerson said, a child carrying the disease may infect many others by coughing or sneezing in a crowd. The approach of the Fourth of July made the Health Commissioner especially apprehensive.

I would warn parents to keep their children away from others…The children should be kept out of moving picture theatres and other places of amusement. They should be kept away from church, picnics and all gatherings, especially indoor ones.

“Dr. Emerson also announced that inspectors of the Department of Health were investigating conditions in all grocery stores, fruit markets, and other places where edibles are sold in infected districts. He said that if any case of paralysis was found in the family of any vendor of foodstuffs the vendor’s place of business would be closed if the case could not be immediately removed to a hospital and all danger of infection removed from the place.

“The Health Commissioner also warned all persons against quack and advertised remedies and preventives of the disease.

There is no preventive of the disease…and there is no cure. But – and this should be carefully remembered – parents can lessen the chances of their children catching the disease by proper precautions and a physician can give valuable treatment in any case. So my advice to parents is to observe the precautions and, if the disease makes itself manifest, to summon the family physician at once. Where there is no cure for infantile paralysis, treatment by nurses and physicians may often save life and will always improve chances of recovery.”

“Physicians Lending Aid.

Physicians have been urgently requested to report all suspicious cases to the Department of Health, and, as a rule, they are doing so regularly. When a case is reported it is often necessary to remove the patient to one of the isolated pavilions of a public hospital. Fortunately, we have had little trouble with parents about removals, and to those inclined to distrust hospital treatment I would say that the wards provided for infantile paralysis are not what are commonly feared as pest houses. They are all open, airy, sunny, cheerful rooms, where the children not only receive the best of care and attention, but where they have the advantages of absolutely sanitary and healthful surroundings not possible in many homes. Also parents should remember that when a patient is removed to a hospital the danger to others in the household and in the city is greatly diminished and, in many cases, avoided.

Parents should not resort to the use of drugs or chemicals on themselves or their children without the advice of a competent physician. I do not recommend the use of any antiseptics, as it is a physical impossibility to cleanse the mouth and nose of all germs. My suggestion is that the mucous membrane of the mouth and nose be washed frequently in boric acid or in a normal salt solution, that is, a solution of pure water and ordinary table salt in the proportion of one teaspoonful of slat to a pint of water. If the solution is stronger it may irritate the membrane. This salt solution or boric acid has no antiseptic quality, but simply cleanses the membrane of secreted fluids and foreign substances, thus giving it a better chance to maintain a healthy condition in which it may throw off germs.

“The general health should also be kept up. Keep the nose and throat clean, and the body up to par in health, and one will do more to prevent the disease than by using any chemicals.
Disease Picks Strong Children.

“One of the discouraging announcements of the day was made by Dr. Flexner in saying that infantile paralysis, according to all records, seemed ‘to pick the strong and well children in preference to the weak.’ ‘Vigorous health,’ said Dr. Flexner in Brooklyn, ‘seems to be no protection against the disease.’

“Dr. Flexner said that the disease may be spread by kissing, coughing and sneezing, and that flies often carried the disease. Dr. Flexner added:

The infectious agent enters the body chiefly, if not exclusively, through the mucous membranes of the nose and throat. Poliomyelitis, or infantile paralysis, affects chiefly, but not exclusively, young persons; it may and not infrequently does affect adults and to age is absolutely free of danger of infection.

“….Most of the cases reported in Manhattan are in the lower east side, the principal streets affected being Avenue D, Allen, Cherry, Clinton, Columbia, Delancey, East Broadway, Jackson, Ludlow, Madison, Monroe, Mulberry, Orchard, Rivington, Roosevelt, Second, Sixth, and others. The disease is not limited, however, to this section. Cases on the upper east side as far up as East 118th Street have been reported, and there are a few cases on Seventh Avenue and West Fifteenth, Twenty-fifth, and 100th Streets.

“There are three cases in the Bronx – on Third Avenue, Stebbins Avenue, and Fox Street. There are four cases on Staten Island, as follows: Tottenville, Central Avenue; West New Brighton, Conkins Street; Mariners’ Harbor, Central Avenue; Richmond, Elm Court. There are two cases in Flushing, as follows: Myrtle Avenue and Grove Street. The many Brooklyn cases are more or less scattered, the greatest number being among Italians.” (New York Times. “Day Shows 12 Dead by Infant Paralysis.” 7-2-1916.)

July 3: “Those in the Department of Health who have been assigned to fight the spread of infantile paralysis had no rest yesterday [Sunday], for the disease continued to claim new victims. Fifty-five new cases for the twenty-four hours ended at noon yesterday were reported, and although no record for deaths in the day was made public, it was said at the department’s offices, which were kept open despite the fact that it was Sunday, that the high rate of mortality which has marked the present outbreak had not been lessened. Of the fifty-five cases reported, forty-five were in Brooklyn, eight in Manhattan, and two in the Bronx.

“Report reached the city yesterday that Dr. Hermann M. Biggs, Commissioner of the State Department of Health, had taken energetic measures to prevent the spread of the disease to other towns and cities in the State. In orders issued yesterday, Dr. Biggs instructed the local health officers of Orange, Rockland, Putnam, Westchester, Nassau, and Suffolk Counties to report by telegraph every suspected case of infantile paralysis and to enforce the strictest quarantine of the patient. The health officers were also urged to give he widest publicity to the orders, and, in the event of anything threatening an epidemic, to issue special bulletins, so that the public in each locality might be informed of the danger.

“Dr. Biggs pledged the support of the State Department of Health in every possible way if an outbreak of the disease should occur in any place outside of the City of New York.

“Dr. Haven Emerson, Commissioner of the City Department of Health, warned residents of New York again yesterday of the dangers from the disease, and appealed to them to help the department in its work.

New York is in danger of being scourged with the worst epidemic of infantile paralysis in its history…You Citizens, however, can help us check the ravages of the disease and perhaps help in the saving of hundreds of lives by obeying a few simple rules. For instance, any illness of a child should demand immediate medical attention, and, the moment you note any suspicious signs of illness, segregate the child from the other members of the family until medical diagnosis has been made. Suspicious signs are fever, digestive upsets, lameness, or weakness in any joint….

The period of incubation has not been definitely determined. The time elapsing between the date of contact, direct or mediate, with a known case and the development of the disease has varied very much in different epidemics and in different cases in the same epidemic. The range is from two to thirty days, the average seven to ten days. The possibility of the abortive cases acting as carriers must be borne in mind, and also the fact that there are many authentic reports of cases in which the disease was in all probability carried by a third person.

There is no definite information as to the duration of the period of infectivity, i.e., the time during which a person ill with the disease is capable of transmitting it to others. Experiments on animals have shown, however, that the virus can persist in the nasal mucosa for many weeks, and even months.

“….It will be due as much to the cooperation of parents, the Health Commissioner said, as to the work of physicians and nurses when the disease is checked. As the disease is one of eh most contagious known, the Commissioner emphasized the fact that too much care could not be taken. He also impressed upon the public the terrible results of the disease. Not only is the death rate high – 20 percent in the present outbreak – but 70 percent or more of the children who do not die, Dr. Emerson said, usually are left paralyzed and crippled for life….” (New York Times. “State Now Fighting Infant Paralysis. Commissioner Biggs Sends Out Instructions to Officials of Six Counties. 55 New Cases in the City.” 7-3-1916.)

July 4: “New York, N.Y. (AP), July 4. – “Twenty-seven New York children have died in the last twenty-four hours in five boroughs of New York from an epidemic of infantile paralysis, according to Dr. Haven Emerson, the health commissioner, today. There are one hundred and ninety one cases in Brooklyn alone.” (Brownsville Herald, TX. “27 New York Babies Die of Paralysis.” 7-4-1916, p. 1.)

July 4: “With seventy-two new cases of infantile paralysis reported yesterday and twenty-three deaths in the forty-eight hours ended at noon yesterday, Health Commissioner Emerson yesterday afternoon definitely and drastically extended his efforts to prevent the spread of the disease. At his request the Commissioner of Licenses notified every motion-picture theatre in the city not to admit children under 16 years of age from July 5 until such time a the Board of Health declares the danger of an epidemic of infantile paralysis has passed. Also, at the request of the Commissioner of Health, the Police Department revoked fifteen of the fifty-one licenses which it had issued for neighborhood Independence Day celebrations in Brooklyn today.

“One of the last two attacks of the disease reported resulted fatally. Minnie Whitman, 11 months, of 146 Butler Street was stricken with the disease last night and was taken to the Brooklyn Hospital by Dr. Springfield. She died just after her arrival….

“Four cases of the disease were reported by the health officers of the Beacon (N.Y.) district, all of them discovered on Sunday. Two to the cases have already resulted fatally, and two other children are in such a serious condition it is feared they will die….The two children who have died…were between the ages of 2 and 3 years old.

“Yesterday’s action of the Commissioner of Licenses means, in all probability, that children under 16 years of age will be forbidden the motion-picture theatres in this city all Summer, for an outbreak of infantile paralysis beginning during the warm weather invariably lasts until cool weather comes, according to records of the disease. And Commissioner Bell of the License Department means to enforce his order strictly, according to his advice to the Department of Health. With each notice to motion-picture exhibitors to exclude children went the statement that violation of the order would be considered sufficient ground for the cancellation of the license of the offending theatre….The Department of Health has abandoned its own plans for free open air ‘movies’ for children in Manhattan, Brooklyn, and the Bronx, which were to have opened this month….
500,000 Leaflets Printed.

“As another step in the fight against infantile paralysis, the Department of Health yesterday had printed 500,000 leaflets, which will be distributed today throughout every district from which the disease has been reported. They read:

Infantile Paralysis (Poliomyelitis.)

Infantile paralysis is very prevalent in this part of the city

Keep your children out of the street as much as possible, and be sure to keep them out of the houses on which the Department of Health has put a sign.

The daily paper will tell you in what houses the disease is.

This is the disease which babies and young children get; many of hem die, and many who do not, become paralyzed for life.

Do not let your children go to parties, picnics, or outings.

If your child is sick, send for your doctor or notify the Board of Health….

“Commissioner Emerson and his lieutenants in he fight discussed yesterday a proposal for the police to compel every child in the city under 16 years of age to remain at home continuously for two weeks, and this measure would have been adopted, without doubt, had not the health officers feared any benefit in the fight against infantile paralysis would have been more than offset by the general disease and ill-health resulting from confining children. Also because of the dangers from the confinement of children the department decided yesterday not to quarantine every apartment and tenement house in which a case of paralysis might be found….

“The Board of Health has requested the aid of the Society for the Prevention of Cruelty to Animals in the Hamilton Ferry district, where the paralysis has been prevalent, in a round-up of stray dogs and cats. As a result, it was said last night, the number of animals destroyed in the society’s tank has increased from 300 to 450 a day.

“The health officials yesterday pointed out, first, that, while adults were usually immune to the disease themselves, they were not so always, and, second, that any adult might carry the germs, even if he himself escaped illness. A father, mingling in a crowd, it was said, might pick up germs from some affected child and give the disease to his own child by kissing. Because of this, Dr. Emerson has warned parents to avoid crowds as much as possible, and, above all, to enter the infected districts only in case of necessity.

Woman Dies of Disease.

“Three or four cases among adults have been reported to the Department of Health within the last few days, and only yesterday Mrs. Edward Ellis of Tottenville, S. I., who was 30 years old, died of what was certified as infantile paralysis by Dr. Walter Washington, her attending physician. She was ill but two days.

“Health authorities outside of the City of New York have made preparations to fight any appearance of the disease in their localities, but no outbreaks beyond the city have been reported, except that in Beacon and those in Nassau and Suffolk Counties of Long Island, where the officials, upon hearing of the cases, at once took steps to prevent a spread of the disease. According to local authorities, the disease will be less difficult to fight in rural communities than in the city, for the machinery of quarantine can be much more effectively applied where the population is not dense.

“Of the sixty-seven cases reported in this city in the forty-eight hours ending at noon yesterday, twelve were in Manhattan, twelve in Richmond, five in the Bronx, and one in Queens. In addition to this, unofficial reports said there were three new cases in Queens yesterday, two in Flushing, and one in Long Island City.

“There have been 460 cases of the disease in the city since the first of the year, most of them since June 1. Of these forty-nine have been in Manhattan and eight in the Bronx. The addition yesterday of five new cases to the three already reported from the Bronx indicated that the disease was making headway there.

“Since the first of the year there have been 101 deaths from infantile paralysis in the city, and, as there were only seventeen deaths before June 1, the rate at which mortality has increased is apparent. Dr. William H. Guilfoy, Registrar of the Bureau of Vital Statistics in the Department of Health, estimated yesterday that, in the last few days, there had been one death from infantile paralysis every two and a half hours. He added that this rate showed no signs of diminishing….

“Dr. Bertram H. Waters of the Department’s [Health] Bureau of Preventable Diseases, discussing symptoms of the disease, said yesterday:

It is not difficult to recognize typical cases. Here is a common picture. A child, previously perfectly well, complains of a little stomach trouble or diarrhoea. It is feverish, restless and irritable, and in the morning the mother finds that the child cannot stand, or, perhaps, that it cannot move its arms. Some of the victims thus attacked die withinnyt a day or two from paralysis of respiration. Others ultimately escape death, but are more or less crippled for life.

There are a great many cases, however, which do not run this typical course. In fact, a large proportion of cases do not show any paralysis at all. These are especially dangerous to the community, because they serve to spread the disease to others.

“Dr. Emerson announced yesterday that there were 153 cases in the Kingston Avenue Hospital in Brooklyn, and seventeen in the Willard Parker Hospital….” (New York Times. “Bar All Children From The Movies in Paralysis War. 7-4-1916.)

July 5: “New York, July 5. – The average of one death an hour was maintained today by the infantile paralysis epidemic, twelve children dying of the disease between 10 o’clock last night and 10 o’clock this morning. During a period of 18 hours there were 172 cases reported, of which 102 occurred in the last 24 hours in or near the seat of the epidemic in Brooklyn. In one Brooklyn hospital today there were 225 victims of the disease. The officers of the health department were besieged today by men, women and children who demanded medical advice. At one time those waiting for an audience with the doctors formed a line which extended for nearly a block…. Estimates made of the number of children who have been taken out of the city since the epidemic became serious, run as high as 50,000. Thus far, 524 cases of the disease have been reported to the board of health and 138 persons have died…. High mortality continued to be the striking feature of the epidemic and the death toll has reached approximately that of the entire epidemic of 1897, when 2,500 cases were reported.” (Brownsville Herald (TX). “27 New York Babies Die of Paralysis,” 4 July 1916, p. 1.)

July 5 Report: “Twenty-five deaths, 59 new diagnosed cases and 31 new suspected cases — this measures the 24-hour toll of infantile paralysis in New York, from 9 o’clock Monday night to 9 o’clock last night. The ravages of the disease reported to the Health Department yesterday exceeded those reported Monday night for both Sunday and Monday – 72 new cases and 23 deaths.

“With the spread of the disease, many thousands of children of well-to-do parents – 50,000 is considered a conservative estimate – have been sent out of New York. This has caused the New York State Health Authorities to issue strict orders that State Health Commissioner Biggs be notified by telephone immediately of the discovery of a case of infantile paralysis. The authorities in nearby States have taken similar precautions.

Day’s Toll of the Disease.

“This tabulation shows at a glance the situation as it existed last night:

Borough Deaths New Cases Suspects.
Manhattan 1 5 15
Brooklyn 24 48 15
Queens — — —
Bronx — — 1
Richmond — 6 —
Totals for day 25 59 31
Total of cases reported to date, 524.
Total deaths reported to date, 126.

“The disease continues most prevalent in Brooklyn, in the Italian quarter of the southern district of the borough, where the paralysis first appeared….” (NYT. “25 More Deaths From Paralysis. Fifty-nine New Cases…in Twenty-four Hours. Exodus of 50,000 Children.” 7-5-1916.)

July 6: “New York, July 6. – After a conference between W. G. McAdoo, secretary of the treasure, Mayor Mitchell, Health Commissioner Emerson and others, it was announced tonight that the United States Public Health service would co-operate with New York authorities to stamp out the epidemic of infantile paralysis which has cost the lives of 150 children. The federal aid, it was said, would be at once directed to tracing the origin of the disease. Additional cases reported since 10 a.m. today were 81.” (Beatrice Daily Sun, NE. “Dread Disease Raging,” 7 July 1916, p. 1.)

July 7: “New York, July 7.—One of the worst scourges since the bubonic, plague and yellow fever epidemics at New Orleans is sweeping New York. The entire Metropolitan district is now affected by an outbreak of infantile paralysis, which first occurred in Brooklyn. It has spread rapidly to the other boroughs, Manhattan, the Bronx, Staten Island and Queens, and is now making headway on Long Island and has appeared in New Jersey towns as far as Montclair. To date 101 deaths have been reported but this does not include, health officials say, probably scores of others which were improperly diagnosed. Within the last twenty-four hours sixty-seven new cases and twenty-three deaths were reported. Babies are dying at the rate of one every ninety minutes in the metropolis. The total number of cases now reported to health officers is 460. Of
the dead and affected several have been adults. The plague is making more headway every day.” (Daily Advocate, Victoria, TX. “Many Babies are Dying in New York,” 7 July 1916, p. 4.)

July 8: “New York, N.Y. (AP), July 8. – Although this is the hottest day since the beginning of the infantile paralysis epidemic, there were fewer fatalities from the disease. During 24 hours up to 10 o’clock the disease had killed 18 children, thirteen of these being in Brooklyn. Assistant Surgeon General W. C. Rucker of the United States public health service arrived today from Washington to confer with local health officials and direct those assigned to fighting the infantile paralysis epidemic. Health officials attached little significance to isolate cases in other parts of the state.” (Brownsville Herald, TX. “Fatalities in New York Less,” July 8, 1916, p. 1.)

July 8: “The work of checking infantile paralysis in the city is seriously handicapped, Health Commissioner Emerson said yesterday, by a shortage of nurses, doctors, ambulances, and Inspectors. At an afternoon conference held by Dr. Emerson and the physicians who have been assisting him in his work it was decided to appeal to the American Red Cross for nurses, but late last night Dr. Emerson announced that the appeal would not be made “at present.” He added:

We felt that, if we could arrange to have the cases cared for by the Red Cross doctors and nurses temporarily, so as to free out local doctors and nurses for the general work, it would be an aid.

But, on further considering the matter, I believe we shall be able to show it will not be necessary. We believe that it will be wiser to ask no outside aid at this time and that, with the offers of hospitals in the city to aid freely, which offers we expect to receive tomorrow, we will be able to take care of the situation and overcome the present difficulties of threatened overcrowding….

“The action of the conference, however, indicated the pressing needs of the situation. After advertising for three days for nurses and offering $30 a month and maintenance for any who might be accepted, Commissioner Emerson received applications from only thirty-one, and of these only one agreed to do the work required for the compensation offered. And Dr. Emerson said that he needed 150. He is also in great need of doctors, but his advertisement for interns at from $20 to $100 a month, with maintenance, had not received a single answer yesterday.

“From cities not in the environs of New York came reports yesterday of new infantile paralysis cases and measures against the disease. There was one death from the disease in Chicago yesterday, and the Finance Committee of the City Council appropriated $5,000 for the Health Commissioner to spend on precautionary measures. Three cases have been reported there….

“With 296 cases of infantile paralysis in the Kingston Avenue Hospital, in Brooklyn, 104 cases in the Willard Parker Hospital, in Manhattan, and new cases coming in at the rate of seventy-five to 100 a day, the Department of Health, although drafting every available employe to the work of fighting the disease, has been able to muster only an inadequate force….

“Commissioner Emerson also said that his work was suffering from a shortage of ambulances. He requisitioned ten automobiles from the city for use as ambulances, and will probably obtain more today. As the patients in the present outbreak are small children, any automobile can be used as an ambulance. Dr. Emerson also requested the Borough Presidents of Manhattan and Brooklyn to lend him some of the automobiles at the service of their departments. He promised to disinfect every automobile before its return, and guaranteed that they would not carry infantile paralysis to any one who used them.

Close Libraries to Children.

“At the request of the Health Commissioner all public libraries in the city issued notices yesterday that no child under sixteen would be admitted to their reading rooms until further notice. The children’s rooms in the various library buildings in the city have been closed, and it was said that children would not be admitted to the general reading or other rooms for adults.

“Simultaneously, Acting Police Commissioner Godley closed sixteen play streets in the city in infected districts. Also, the scheduled opening of twenty play streets today and of nineteen on Saturday was indefinitely postponed. The Health Commissioner has not yet requested the closing of any playgrounds and will not do so unless the spread of the disease makes such an action absolutely necessary. Park Commissioner Cabot Ward, while he has not closed the parks to children, yesterday placed restrictions upon their use, cancelled all arrangements for the usual Summer playground festivals, and directed that all recreational work in the parks be carried on in small units. He also ordered that all sand boxes in parks and playgrounds be emptied and disinfected, and said that sand boxes would not be used by children as play places until the outbreak of infantile paralysis had been controlled. The Commissioner further took steps to divert the money hitherto appropriated for sand to the purchase of oil to be used in coating the surfaces of playgrounds. This oil, the Commissioner said, would keep down dust and so probably aid in checking the spread of the disease. All buildings in the parks and playgrounds – gymnasiums, public baths, and comfort stations – were thoroughly cleaned and disinfected yesterday, and, the Commissioner said, will be the objects of special attention throughout the run of the outbreak.
The Federal Plans.

“The United States Public Health Service was quick to respond to Commissioner Emerson’s appeal of Thursday. Acting Surgeon General Glennan, in charge of the service, yesterday replied to the Commissioner’s telegram…’Cooperation requested in your telegram of July 6 will be immediately furnished….’
To Supply Screens to Poor.

“Emergency measures for fighting the infantile paralysis in the homes of the poor were adopted yesterday by the Executive Committee of the Charity Organization Society. Reports received by the committee from the fourteen districts of the society in Manhattan and the Bronx were that flies were numerous and screens scarce. The committee therefore voted to supply screens for the windows of houses in which children live. The committee also ordered its agents to make strict inspections of the homes visited by them, and to compel every possible sanitary precaution.

“For fear of spreading the disease through country districts and of infecting city children by bringing them together, the committee voted to postpone indefinitely all of its planned fresh-air outings, with one or two exceptions. Reports received by the committee were to the effect that persons in the poorer sections of the city had been thoroughly aroused to the situation and were zealously following the instructions of the Health Department as to cleanliness, keeping the children away from crowds, and reporting illness. Many others, incidentally, who had occasion to visit the crowded districts yesterday, reported the streets nearly deserted and the windows filled with children kept in-doors by parents.

“Nurses of the Society for Improving the Condition of the Poor reported that the children were being too much confined, but that they were doing all they could to see that the children got plenty of fresh air and exercise, without exposing themselves to risks. The society, it was announced, was continuing all its fresh air and country homes at full capacity, having 350 mothers an children at Sea Breeze, Coney Island; 120 mothers and children at Caroline Rest, Hartsdale, and 150 boys in the Summer camp at Southfields, N.Y. No children have been admitted to these and other places, it was said, without examination by physicians and nurses; all are under constant watchfulness, and none has been admitted from an infected house.

To Force Reporting of Cases.

“St. John’s Guild reported yesterday that all children entering its floating and seaside hospitals were carefully examined and that the society was working energetically among the poor of the city.

“The criminal law may soon be called upon to assist the Department of Health in its war. Infantile paralysis is a reportable disease and the department has the power to assume full control of any person suffering from it. Any one ignoring these facts, Dr. Emerson said yesterday, would be dealt with through the courts. He mentioned one case in particular. ‘There was a case of infantile paralysis in New York,’ he said. ‘which was not reported. The attending physician allowed the parents of the child to take it to New Jersey. Later these parents returned to New York and another physician attended the sick child, and permitted its parents to take it to Albany, where the case was discovered by the public authorities. I understand that that is the only case in Albany so far. The Albany authorities are sending me the names and data in the matter, and, if I have sufficient evidence, I shall officially proceed in the courts against the two physicians who violated the law in not reporting the case and in permitting it to leave the State.’

“Dr. Emerson also told of another incident in which he had directed that a court summons be served upon parents. A case of infantile paralysis, discovered by a physician, was reported to the Department of Health, but before an official of the department reached the affected child the parents had removed it and refused to tell the officer where it was. They will have to make explanations in court, and in the meantime agents of the department fear that the child has been sent out of the State.

“A number of physicians have reported to the department that many ignorant parents resent the department’s coming into their homes, and that such parents have threatened to hide children if their cases were reported….

“Another example of resistance to the department came in the case of a Brooklyn woman, who protested against the forcible removal of her child to the Kingston Avenue Hospital in Brooklyn on the ground that the child did not have infantile paralysis, but would catch it from other children in the hospital. The case was a ‘suspected’ one, and as such was kept at the hospital for observation and was not placed in contact with positive cases.

“….Cats have been destroyed by the hundreds since the outbreak of the disease, it was learned yesterday. The S.P.C.A. and owners of the pets have ruthlessly done this work. Many parents have killed their children’s pets in fear that the animals might spread infection.

One Hundred Persons Arraigned.

“The police of Brooklyn yesterday arraigned more than fifty persons before Magistrate Nash in the Adams Street Police Court, charged with having no covers on garbage cans. The Magistrate imposed a fine of $2 in each case upon conviction, and warned the offenders that if they came before him again on the same charge he would deal more harshly with them.

“….George H. Bell, Commissioner of Licenses, made a tour of eh infected districts of Brooklyn yesterday and reported nearly all of the motion picture houses closed for the day. They opened last evening, but, according to reports, had small audiences and did not violate the order prohibiting the admission of children under 16 years of age. Motion picture men and organizations have petitioned the authorities to reduce the age limit to 14, but Dr. Emerson said that this could not be done at present. It is expected that Coney Island will be especially hard hit today and tomorrow by the order.

“…The number of new cases on Staten Island on Thursday was six [33 total cases up to then].

“….Motion-picture views, which will be shown at special matinees for mothers in the infected districts, will be presented to the Department of Health today by the Universal Film Company. The pictures were taken for the Animated Weekly Topical News at the Rockefeller Institute under the direction of an official of the institute, and in other places, with two Inspectors from the Department of Health. Included in the films are scenes showing affected districts, stricken children, sanitary precautions necessary, and how mothers may detect symptoms of paralysis. The pictures cost $4,700, which was paid by the Universal Film Company….

Soap, Water and Sunshine.

“…Dr. Emerson said yesterday that soap and water, sunlight and fresh air provided the best disinfectants against the disease. He said that, in every room where a case occurred, agents of the department had scoured the walls, floors and ceilings and had opened the room to sun and air….

“Since May 15, Dr. Emerson said, ninety immigrant Italians, including twenty-four children under the age of 10, had gone to live in Brooklyn, where the outbreak appeared, at about the date named. No symptoms of infantile paralysis were found among the Italians at Quarantine, but the Italian Consul has been asked to ascertain whether the disease was present in any of the cities from which the immigrants came.

“At a conference of Dr. Emerson and physicians at the Department of Health yesterday afternoon the subject of a general quarantine of the city was discussed, but it was decided that such a measure was impracticable….

8 New Cases in Suburbs. Some Places Have ‘Shotgun’ Quarantines Against New York.

“Infantile paralysis continued to spread outside of the city yesterday, and more stringent measures were taken in affected and threatened localities.

“Eight new cases of infantile paralysis in districts of the State outside of New York were reported to the State Health Department at Albany up to noon yesterday. This brought the total number of cases outside of New York up to forty-five. The new cases were reported as follows: Two at Yonkers and one each at Dutchess Junction, Warwick, Jasper, Hornell, Copiague, and Glen Cove. Other cases previously reported were: Hudson, 12; Beacon, 4; North Hempstead, 3; Farmingdale, 5; Copiague, 2; Albany, 2, and 1 each at Greenport, Jasper, Babylon, Hornell, Kingston, Amityville, Yonkers, Warwick, and Fishkill….

“The department [Health] today sent letters to Presidents of all railroads in the State requesting that special care be taken in disinfecting all cars that had carried children from New York. Local health officers were instructed today to see that glasses at soda fountains and other public gathering places were thoroughly cleansed and disinfected after use…..

“A ‘shotgun’ quarantine was being maintained in all affected districts, Dr. Overton said. Also the Long Island Railroad stations were being watched for afflicted children coming from New York City. The Suffolk County Medical Society has issued a bulletin giving advice to physicians and parents. Many schools, picnics, playgrounds, and amusement places have been abandoned.

“….Residents of Setaucket, L. I., fearful that fugitives from New York will spread infantile paralysis there, yesterday posed the following notice in many places throughout the village:

Warning. – We are informed that families from the infected parts of New York City and Brooklyn are offering high prices for rooms and houses here. While we sympathize fully with all who are suffering from this dread disease, infantile paralysis, we certainly should be very careful to whom we extend the hospitality of our village, that the dread disease many not make its appearance here.

“Other steps to exclude New Yorkers with children have been taken elsewhere.” (NY Times. “Paralysis Kills 22 More Babies in New York City; Death Total Now 187, and 87 New Cases Bring Number in City to 797. Libraries Bar Children.” 7-8-1916.)

July 10: “New units were added yesterday [July 10] to the great disease-fighting which the authorities believe will enhance its completeness and efficiency. Chief among the new forces probably was that of the city magistrates as a body, who were enrolled to back up the work of the police. The following letter, sent yesterday by Acting Chief City Magistrate Frederick B. House to every magistrate in the city, was the ‘call to arms’:

“Magistrate House’s Letter.

Gentlemen: The infantile paralysis epidemic in this community has passed the point of danger and has become a crisis. Mayor Mitchel, however, after a conference with certain of the heads of city departments, believes that this epidemic is within the range of control. To this end he has ordered the streets of the city to be thoroughly cleaned each day, and has directed the Police Department to rigidly enforce all city ordinances respecting uncovered garbage cans, the placing of refuse, garbage, and other filth in the public streets.

In enforcing these ordinances it is likely that the police will make summary arrests, and it is the earnest desire of the Mayor that the City Magistrates aid in this important work by imposing adequate penalties in these cases. The situation is critical; and all city departments are united in an effort to successfully meet it. Without full co-operation on the part of the City Magistrates the work of the other city departments will have little effect…..

In the absence of Chief City Magistrate McAdoo, I am asking you to join the Mayor and the other city departments in this important work. Very sincerely yours,

Frederick B. House, Acting Chief City Magistrate.

“Many Sanitary Code Cases.

“Even before receiving this letter the Magistrates evidenced appreciation of the responsibility devolving upon them and invariably imposed fines upon the many violators of the Sanitary Code brought before them. The keynote was sounded by Magistrate Patton in the Essex Market Court, an east side court….In all, 127 persons, most of them women carrying babies, were arraigned.

“611 Fined in Two Boroughs.

“In the Tombs Court Magistrate Marsh heard the cases of 148 persons charged with violating the Sanitary Code….In the West Farms Court 82 offenders were fined…and in the Jefferson Market Court 74 were fined….Altogether 611 persons were fined…in Manhattan and the Bronx yesterday for violations of the Sanitary Code, and, according to reports, a greater number were similarly punished in Brooklyn, with Queens and Richmond also making high records.

“These cases were the result of activity on the part of policemen, members of the Home Defense League, sanitary inspectors of the Department of Health, foremen of street cleaning gangs, and the private citizens. Acting Police Commissioner Godley testified to the part played by the Home Defense League… ‘The first call for the league was sent out on Saturday afternoon,’ he said, ‘patrolmen being instructed to notify such members of the league as lived on their posts. By 7 o’clock in the evening 5,000 leaguers had reported for duty. For hours these volunteers, accompanied by patrolmen, tramped the streets and poked into every conceivable place looking for violations of the sanitary code. And they made many reports, too, showing that they were on the job. One from the Amity Street Station in Brooklyn, found, hid in a cellar, bedding which had been recently used by a child suffering from infantile paralysis….

“The American Woman Suffrage Association announced yesterday that its entire city organization had volunteered to aid in the fight against the disease….

“Dr. Emerson Analyzes the Figures.

“Commissioner Emerson said yesterday that no case of infantile paralysis had been reported from any of the child-caring institutions in the city….The Commissioner said that his agents were also notifying out-of-town Boards of Health whenever suspicious cases were discovered to have left the city. Dr. Emerson also gave some statistics indicating that the deaths from infantile paralysis were chiefly in cases of children between one and five years of age, and that the death rate of the city as a whole had not been greatly increased by the present outbreak….

“The figures for Brooklyn, were the outbreak has been the most severe, were materially affected by the disease. In the week of July 10, 1915, there were only 92 deaths of children of less than five years of age in Brooklyn, but in the same week of this year there were 219 deaths….

“Dr. Emerson called attention yesterday to Section 87 of the Sanitary Code, providing that laymen must report cases of suspected infantile paralysis and other communicable disease to the Department of Health. Violation of the section, he added, might be punished, if the maximum penalty were imposed with a fine of $500 and one year’s imprisonment….

“`Shotgun’ Quarantines.

“Nearby counties and towns outside of New York, especially in New Jersey, took more severe measures against the immigration of children from Nee York. Many village authorities enforced ‘shotgun’ quarantines, turning back all children who approached from the direction of New York in either trains or automobiles….

“The quarantine against new York is not confined to New Jersey. Towns in the State yesterday adopted the embargo, among them being Poughkeepsie, where no suspicious persons were admitted, and a two weeks’ quarantine within the town was established or others….” (New York Times. “Arrest Hundreds in Fight to Check Infant Paralysis,” July 11, 1916, p. 1.)

July 11: “An increase of more than 100 percent in the number of deaths from infantile paralysis and a marked increase in the number of new cases in the five boroughs were reported by the Department of Health… Dr. Haven Emerson, Commissioner of Health, held a conference with Mayor Mitchel in the afternoon, following which the Mayor announced that he would call, for 11 o’clock this morning [12th] at the City Hall, a conference of heads of city departments who have been co-operating in the crusade against the disease, members of the Medical Advisory Board, and the best medical talent of the city….

“Mayor Issues a Statement.

“Following his conference with Dr. Emerson, the Mayor gave out a statement by him, addressed to the Health Commissioner, which read in part: ‘You have a disease concerning which comparatively speaking, little is known; and it has got to be fought in the light of the best knowledge that there is available….

“The increases in the number of deaths and number of new cases should occasion no undue alarm, according to Dr. Emerson, who said the fatalities from and spread of the disease had not been nearly so great as from other epidemics…Dr. Emerson pointed out that, during the epidemic of measles which ran from March to May last year, it was not unusual to have from 600 to 900 case of that disease reported each day, while mortality ranged from 20 to 50 per cent. ‘There were more lives lost and more permanent injuries from the epidemic of measles last year than will result from this outbreak of infantile paralysis,’ said Dr. Emerson. If the public mind should be thrown into a state of panic on account of the disease, Dr. Emerson fears that would speedily be reflected in an increased mortality rate among infants and children in the city, who would be cooped up unnecessarily when they should be out in the open, on playgrounds and elsewhere outdoors….

“The Commissioner has decided it would be wise to forbid the Italian Feast of Our Lady of Mount Carmel next Friday, Saturday, and Sunday, which usually brings large numbers of visitors from out of town to the Italian communities. The Commissioner held a conference with prominent Italian clergymen, and explained to them that the health authorities considered such a celebration at this time would be a grave source of danger, particularly because the scourge has made greatest headway among the Italian communities….

“824 Fined in Two Boroughs…for violations of the sanitary laws….

“S.P.C.C. to Take No More Children. As a result of the increase of infantile paralysis E. K. Coulter, Superintendent of the Society for the Prevention of Cruelty to Children, notified Acting Police Commissioner Godley that, at the direction of the Department of Health, that organization would not assume custody of children of less than sixteen years of age, when they were arrested by the police, but that they would, instead, be sent to the Municipal Lodging House. Acting Commissioner Godley suggested that the youthful offenders might be placed in care of the police matrons.

“According to Mr. Godley, there are 4,710 members of the Home Defense League members who are actively aiding the police in keeping children out of motion picture theatres….

“City Employees Give Up Vacations.

“Commissioner John T. Fetherston of the Street Cleaning Department announced that the employes of his department had agreed to give up their vacations in order to help fight the epidemic….

“Fifty Soda Fountains Closed.

“A list of thee streets in which new cases of the disease have appeared was issued by Dr. Bloduan, showing that in Manhattan the scourge has invaded Monroe, Essex, Ridge, Montgomery, East Seventeenth, East Sixth, East Thirteenth, East Houston, East Fifteenth, East Seventy-seventh, East Sixty-sixth Streets, and Amsterdam, St. Nicholas, Third, and First Avenues.

“Dr. Lucius P. Brown of the Bureau of Food and Drugs of the Department of Health has sixty-five Inspectors investigating conditions in stores and at soda fountains. They have closed fifty soda fountains and twenty stores because of unsanitary conditions, and have issued 113 summonses. Likewise they condemned 6,840 pounds of food, including for the most part milk, ice cream, and fruit….

The local health authorities received requests from both New Rochelle and Yonkers yesterday for a list of homes in which the disease had appeared. The Health Boards of these towns plan to turn back any person whom they suspect of infection.

“Warden George W. Kirchwey quarantined Sing-Sing Prison yesterday morning because he believed it was possible for visitors from New York and other infected communities to spread the disease among the 1,560 inmates. An extra guard was placed at the gates of the prison to turn back automobiles and pedestrians….” (NYT. “Paralysis takes lives of 32 more…,” 7-12-1916, 1.)

July 12: “Albany, N.Y., July 12.—Revised returns, made public tonight by the State Department of Health, record the existence of eighty-two cases of infantile paralysis in the State outside of New York City. During the day five new cases were reported at Gregfield, Saratoga County; Central Valley, Hudson, Cortland, and Utica.” (NYT. “N.Y. State Has 82 Cases,” 7-13-1916, 3.)

July 12: “Deaths from infantile paralysis reported in the city yesterday [July 12] were only one more than half the number reported the day before, and yesterday’s figures for the new cases showed a decrease of thirty-three, the records being: Deaths, yesterday, 17; Tuesday, 32; new cases, yesterday 162; Tuesday 195. Although Health Commissioner Emerson and his assistants were inclined to be encouraged by this comparison, they repeated what they had said before, that no reliable estimate of the advance or retrogression of the disease could be made from two days’ figures….

“No encouraging sign, however, is accepted by the city authorities as a justification for slackening up their warfare against infantile paralysis, and yesterday, as has been the case on every day for weeks, was marked by augmentation of forces and extension of the campaign. The conference of leading physicians summoned to his office by Mayor Mitchel was the chief development. The heads of city departments, who organized last Sunday to fight the disease, attended the conference. The physicians, who were present at the request of the Mayor, formed themselves into a Special Advisory Board, of which Dr. S. S. Goldwater, of Mount Sinai Hospital and former Health Commissioner, was made Chairman. This board will not supersede either the Standing Advisory Committee of the Health Department nor the special Physicians’ Committee appointed by Dr. Emerson to assist him; but its members will follow the progress of the epidemic, watch special cases, perform experiments, and observe conditions everywhere, with a view to making practical suggestions whenever possible….

In addition the board yesterday designated a subcommittee with the general purpose of assisting in the fight against the disease, and with the special purpose of studying and reporting to Dr. Emerson and the Mayor on two matters about which there is now general uncertainty. These special matters are:

“First—The question of carriers as it relates to the members of a family in which a case of infantile paralysis has occurred. The committee will devote itself to extensive and detailed field work in following the members of such families who have gone into other localities than those in which the disease originated, whether within the city or without, to determine, if possible, whether any cases in such new localities can be traced to the persons followed.

“Second, the committee will formulate a more succinct and simple statement than has yet been distributed of the known and hypothetical preventive measures and symptoms of the disease. This statement will be printed in many languages and distributed broadcast for the benefit of mothers, physicians, and others….

“Among those at the conference was Dr. John D. Robertson, Health Commissioner of Chicago, where there are a number of cases of infantile paralysis. He had come to New York to study conditions and methods….

“Following the conference at the City Hall the Mayor said that, in addition to the definite action taken, the physicians had discussed the methods of transmission of infantile paralysis, and that differences of opinion among them had been manifested.

“The suggestion was also made, said the Mayor, that all medical practitioners in the city be mobilized….The clergy of the city, added the Mayor, will probably be asked to help by explaining to their congregations what to do in suspicious cases, and by keeping a record of cases among the members of their churches.

“One aspect of the situation that has become serious, it was pointed out by Dr. Emerson, has been the effect of the disease on real estate values and returns in the city.

“Tenement Houses Vacated.

“The Health Commissioner said that in one sixteen-family tenement house, which had been occupied to capacity before the outbreak, two cases had occurred, and that every family vacated its apartment, except the two in which the cases appeared. This was a typical case, he said, and according to reports from real estate and rental agencies, the financial losses of those interested in houses in the affected districts would be heavy.

“The city Magistrates continued yesterday to impose fines upon violators of the sanitary code, and Acting Chief Magistrate House issued instructions to associates on the bench not to admit children of less than 16 years to their courts, except as legal matters made it necessary….

“340 Fined in Manhattan….”

“Because of the Health Commissioner’s warnings against crowding children together, postponements were announced yesterday for the joint outing of the Advocate, Holy Spirit, and St. Mary’s Episcopal Churches of the Bronx, scheduled for July 14, and for the annual excursion of All Saints Episcopal Churches in Bayside and Great Neck, L.I., planned for July 24. Following a conference of the Board of Directors of the National Daily Vacation Bible School Association yesterday, it was announced that all of the organization’s schools in the city would be closed this morning.

“John J. Gordon, who lives in Bath Beach, which has not been invaded by the disease, yesterday reported to Acting Police Commissioner Godley that an Italian suspected of coming from an infected neighborhood was traveling around Bath Beach and attracting great crowds of children with a portable merry-go-round. Although the Deputy Commissioner had no specific instructions from the Department of Health, and could not obtain them because the Department had closed for the day, he had the Italian instructed to leave the streets. He will confer today with Dr. Emerson concerning the advisability of prohibiting the activities of all such strolling entertainers….

“The Health Department authorities said that, in most cases, children were safer in New York than out of town…..

“Near-by Towns Tighten Quarantine.

“Dr. Emerson yesterday extended the co-operation between the local and out-of-town health authorities by providing the officials of other places with lists of addressed where cases in New York had occurred, and asking the officials to report to him any persons arriving from infected areas….Practically every town in Westchester, according to report, was rigidly quarantined against New York, and not only were the Hudson River ferries watched on the New Jersey shore, but a motor boat patrol was established by the Edgewater police to prevent fugitives from New York landing in New Jersey.

“Mrs. Finley J. Shepard, it was announced last night, has closed her sewing school at Lyndhurst and her playgrounds. She has decided, it was said, not to conduct any children’s excursions from this city during the Summer.

“The State Board of Health yesterday issued a statement from Trenton to the effect that a State quarantine against New York would not be declared, but in Jersey City, where one new case was reported, the Health Department ordered that all persons coming from Nee York into the city intending to remain for more than a day should be required to show a certificate from the New York Department of Health guaranteeing that they had not lived in an infected district….” (New York Times. “Noted Scientists Organize to Curb Infant Paralysis…, July 13, 1916, p. 1.)

July 12: “To the Editor of The New York Times: I was hardly seated in my parlor car chair on Monday on my way from New York City to Saratoga Springs when a young woman walked up to me and without a word of explanation or apology sprayed me with a vile-smelling disinfectant. Before I had time to protest she was half way down the car spraying everybody and everything as she passed. Two young men en route for Plattsburg were especially favored. Each of them was sprayed twice. When the entire car smelled like a hospital she returned to her seat opposite me, where her two little children were sitting. ‘Yes,’ she said, in answer to the question of the mother of a small boy, ‘I, too, am leaving town because of the epidemic and I am taking no chances.’ Again she squeezed the bulb of the atomizer and I buried my nose in my handkerchief. I.B.O., Lake George, N.Y., July 12, 1916.” (NYT. “Parlor Car Passenger Sprayed Her Neighbors with Disinfectant,” July 14, 1916, p. 10.)

July 13: “Rochester, N.Y., July 13.—An order barring children from New York City from the city playgrounds was issued today by Robert A. Bernhard, Superintendent of Playgrounds and Recreations, as a precaution against the exposure of Rochester children to infantile paralysis.” (New York Times. “Bar New Yorkers from Playgrounds,” July 14, 1916, p. 5.)

July 13: “Watertown, N.Y., July 13.—Dr. H. L. K. Shaw, head of the Division of Child Hygiene, New York State Heath Department, said today that he feared the spread of infantile paralysis in New York State would grow more serious. ‘I do not wish to be an alarmist,’ said Dr. Shaw, ‘but in all past epidemics the disease has become more virulent as the Summer progresses. August and September are the worst months, the high mark being reached in September usually.’

“Dr. Shaw spoke at a meeting of the Jefferson County Medical Society at Alexandria Bay. In the course of his talk he said that the disease could not be traced to the milk supply, and pointed out that Brooklyn and New York, where milk is pasteurized, had been the centres of the disease. He said that the only point of entry was the nose, and that it could not come through the mouth or the veins. Flies might be carriers, as well as human beings, he said. Dr. Shaw said that if a cord could be drawn around New York for two weeks an every child refused exit the epidemic could be stopped. ‘But there would be civil war if we did such a thing,’ he added. Dr. Shaw pointed out that the serious part of the disease was that no one can diagnose it until paralysis comes.” (New York Times. “Fears Malady Will Spread,” July 14, 1916, p. 5.)

July 13: “Certificates stating that the rightful holders were not suspected of being carriers of infantile paralysis were issued yesterday by the Department of Health to those who applied for them and were able to convince the authorities that they had not come into dangerous contact with the disease by living in infected houses, or in any other way. The certificates were issued from the department’s headquarters at 149 Centre Street and at each of the borough branch offices. Although the news that the department intended to begin the practice was not widely advertise, the number of certificates applied for and issued was large. No record of this number was prepared by the Health Department last night, but it was learned that during the day ninety certificates were issued at the Manhattan headquarters alone.

“Dr. Haven Emerson, Health Commissioner, said last night that the certificates served a threefold purpose. Those who received them, he said, benefited because it was probable that health and police officials outside of the city would not interfere with the travel or residence of holders of the certificates, whom they might otherwise turn back or quarantine…

“Dr. Emerson said the certificates were not passports which had to be accepted, and admitted that in some towns where absolute quarantine against New York had been declared the authorities might refuse to honor them, but he was sure that the holders would have less trouble with them than without them, wherever they might go….

“That the Federal Government would co-operate with local authorities in protecting communities against known and suspected carriers was learned here yesterday. According to an announcement from Washington, the United States Public Health Service notified all railroad and steamship lines leading out of New York to ascertain the name, home address, and destination of each child under 15 years of age leaving New York so that this information might be sent to the health authorities at the destination. The transportation companies were also warned against carrying any person suffering from the disease….”

“In addition to these measures related to the infantile paralysis carrier problem, the special committee of physicians appointed by the Mayor on Wednesday met with Dr. Emerson at the Health Department yesterday….This meeting of the committee lasted nearly two hours, and many important questions were discussed….The results of the meeting were made public late in the afternoon at the City Hall by Mayor Mitchel, who received a report from the committee through Dr. Emerson….

“Because the epidemic was hurting the business interests of the city, it was explained in the Mayor’s office, about four out of every five persons who wrote to the Mayor urged him to give as little publicity to conditions as possible. The Mayor replied, it was said, that he couldn’t suppress any fact of record relating to the outbreak….

“The total number of cases in hospitals yesterday…was 773….”

“The city magistrates continued yesterday to fine violators of the sanitary code brought before them…”

“Town Ousts Newcomers.

“The difficulty of parents with children in obtaining refuge in New Jersey was illustrated last night in the case of Pearly Gold, 3 years old, and her mother, who lived at…Putnam Avenue, Brooklyn, until two days ago, whey they went to Fallsburg, N.J. The child fell ill yesterday and the mother was ordered by the town authorities to return to New York with her. She did so, and upon her arrival at the foot of West Forty-second Street last night she was met by an ambulance from Polyclinic Hospital. The surgeon in charge suspected a case of paralysis and the child was removed to the Willard Parker Hospital.

“A family which arrived in Hoboken from Brooklyn yesterday was promptly sent back across the river by the health authorities….” (New York Times. “Department Issues Cards to Those in Infected Districts Free of the Disease,” 14 July 1916, p. 1.)

July 14: “Albany, N.Y., July 14.—Since the infant paralysis epidemic began in June 100 cases and eight deaths in sections of the State outside of New York City have been reported to the State Department of Health, according to official announcement tonight. Ten new cases and one death were reported during the day, official notification of the death being received from Claverack, Columbia County. The new cases reported were: One in Beekman, Dutchess County; three at Ossining, and one each at Florida, Coxsackie, Hartsdale, Roslyn, Kingston, and Rochester, Ulster County. The Coxsackie victim was reported as having been stricken with the disease in West Hoboken, N.J.

“Dr. Hermann M. Biggs, State Commissioner of Health, sent out today a circular of information to the health officers of the State as a further guide for them in their campaign for the prevention and cure of the disease. The new instructions would require boarding-house keepers, hotel managers, and other persons to notify health officers of the arrival of any children from infected districts. Dr. Biggs said that if unfavorable developments should result from failure of persons to make such report they would be held personally responsible.

“The instructions also urged health officers to see that glasses, dishes, spoons, and other articles used in public places were thoroughly disinfected after use. The officers were requested especially to inspect soda water fountains with a view to enforcing this ruling strictly.

“Department officials received a communication today from Health Commissioner Emerson of New York, stating that the city authorities would be glad to take back to New York any up-state cases which had originated there, and care for them in the city hospitals. It is not probable, however, that this course will be pursued, except in instances where the cases are located within easy automobiling distance of New York, because State officials do not believe it advisable to authorize the transportation of any infected persons in trains.” (New York Times. “N.Y. State Cases Total 100,” 15 July 1916.)

July 14: “Buffalo, N.Y., July 14.—The first death from infantile paralysis occurred here today. The victim was Violetta Wilson of Brooklyn, 3 years old, who came here a week ago to visit her grandparents.” (New York Times. “Brooklyn Child Dies in Buffalo, July 15, 1916, p. 16.)

July 14, NYC: “At a special conference of the Academy of Medicine, called at Aeolian Hall last night to inquire into the nature, manner of conveyance, and means of prevention of infantile paralysis, Dr. S. J. Meltzer of the Rockefeller Institute urged the treatment of all cases of this disease by intra-spinal injections of solutions of adrenaline. On the basis of experiments on monkeys, Dr. Meltzer has reached the conclusion that this method of treating the disease may prevent the spinal lesions which culminate in paralysis and death.

Dr. Meltzer’s was the only specific suggestion made as to a possible manner of curing the disease, and his remedy attracted considerable attention among the physicians present. Dr. Louis C. Ager, specialist on children’s diseases and one of the speakers of the evening, declared the proposed remedy was important and should be brought immediately to the attention of the public.

“In reading his paper to the large gathering of physicians and laity, Dr. Meltzer declared he had great faith in the adrenaline treatment because of the remarkable results it accomplished with monkeys which had been artificially infected with infantile paralysis. He conducted a long series of clinical experiments in this direction at the institute in conjunction with other physicians.

“`This procedure,’ said Dr. Meltzer, ‘may save live and in surviving cases it may reduce the extent of the final lesion. There is no danger involved. Monkeys stood as large a dose at 2 C.C. in a single injection. However, in human infantile paralysis, the injection should begin with a dose of .5 C.C. of adrenaline until more is learned about the effects’….

“`The chief mode of demonstrated conveyance of the virus,’ said Dr. [Simon] Flexner [another speaker] is through the agency of human beings. Whether still other modes of dissemination exist is unknown. According to our present knowledge, the virus leaves the body in secretions of the nose and throat. The conveyers of the virus include persons ill of infantile paralysis in any of its several forms and irrespective of whether they are paralyzed or not, and such healthy persons who many have become contaminated by attendance on or association with the ill. How numerous the latter class may be is unknown. But all attendants on or associates of the sick are suspect. These healthy carriers rarely themselves fall ill of the disease; they many, however, by the source of infection in others.

“The chief means by which the secretions of the nose and throat are disseminated is through the act of kissing, coughing, or sneezing. Hence during the prevalence of an epidemic of infantile paralysis care should be exercised to restrict the distribution as far as possible through these common means. Habits of self-denial, care, and cleanliness and consideration for the public welfare can be made to go very far in limiting the dangers from these sources.

“Dr. Flexner warned against the presence of flies, insects, and especially the stable fly, as possible carriers of the germ which causes infantile paralysis….

Dr. Ager has concluded that negro children are more or less immune and that the virus attaches itself more often to blondes than brunettes. As for treatment Dr. Ager declared that the only place to take care of these children was in the hospital, excepting in cases where adequate facilities could be provided in the home, and he urged the immediate removal to the hospital of all patients as soon as they manifest symptoms of the disease either in the abortive or more developed stage….” (NYT. “Offers New Cure in Fight Against Infant Paralysis,” 7-14-1916, p.1)

July 14: “Washington, July 14.—A number of surgeons of the Public Health Service were ordered to New York today to join the staff of the Federal surgeons cooperating with the local health authorities in combating infantile paralysis. The United States Health authorities are determined to prevent, at all hazards, the spread of the epidemic into the interior of the country. A general bulletin on the character, symptoms, and treatment of the disease has been prepared for wide distribution and especially in the large cities. Senior Surgeon Banks, whose station is Milwaukee, has been ordered to New York, and stopped here today for conferences with Acting Surgeon General Rucker and others of the Public Health Service. There has been a more than ordinary occurrence of infantile paralysis in Milwaukee in recent years, and Dr. Banks is regarded as a special expert in its treatment. Surgeon C. H. Gardner at Buffalo, Surgeon A. W. Freeman at Cincinnati have been ordered to New York for duty with the Public Health Service force now there….

“It is not yet regarded as imperatively necessary that there should be a quarantine declared against New York in order to protect adjoining States. There have been many appeals from local health authorities in the interior of the country for a quarantine against New York, and several railroads have telegraphed the Acting Surgeon General that they were apprehensive of trouble through tourist travel from the East. To save travelers from inconvenience on account of the restrictions which many cities and States have placed on the movements of children from New York, the Public Health Service today issued the following advice:

All persons accompanied by children under the age of 16 years who contemplate a journey which necessitates transit through New York City are advised to provide themselves with certificates stating their place of departure. If this is not done, inconvenience and even delay may result, as many cities, in the absence of proof, make no distinction between children actually residing in New York City and those who merely are in transit through that locality. These certificates should be secured from the Health Officer at the place of departure, and may be presented to any inspection officer as an evidence that the holder does not come from the infected district.

“The health authorities of Canada have been in close touch by wire today with the Public Health Service and delegates will be present to represent Canada at the conference to be held at Seattle to discuss the protection of the States of Washington, Montana, Oregon, Wyoming, and Idaho. Surgeon Magruder of the U.S. Public Health Service has been designated to represent the United States at the conference.” (New York Times. “More Experts Coming Here,” July 15, 1816, p. 16.)

July 15: “The New York Medical Journal in today’s issue minimizes the epidemic of infantile paralysis and intimates that its early seasonal onset this year is to be attributed to civic lassitude in the matter of cleanliness.

We intimated in our issue of July 8…that the present epidemic of infantile paralysis was by no means so terrible as the first newspaper reports made out. The disease has been with us annually for many years, and taken its toll of death and disability. It was always thought to be a hot-weather disease and usually invaded the city in August; it cam early this year, and after cool weather, and seems to have greatly impressed some one new either to office or to sources of publicity.

When we compare the results of our annul visitation of croup and diphtheria the latter with its post-diphtheritic paralysis, we are moved with difficulty to regard as serious the invasion of anterior poliomyelitis. Nature may have concluded that the legs of New Yorkers, especially in movements toward civic cleanliness, were becoming obsolete, and has therefore decided gradually to eliminate them.

The plague seems to have reached its height and to be already abating; but we hope that a lesson in cleanliness has been taught. Already myth has begun to hover about the attack; for example, the second submarine boat from Germany is to bring us a specific treatment, probably to heap coals of fire on our heads.

The Board of Health is reported to be working along with the Rockefeller Institute on a new serum. It was about time that the authorities awoke to a disease the treatment of which has not varied for over a quarter of a century.” (New York Times. “Sees No Cause For Scare,” July 15, 1916, p. 1.)

July 15: “Although yesterday’s reports of deaths from infantile paralysis and of new cases in the city showed an increase over the deaths and new cases of the day before, Health Department officials and others associated with them in the fight against the disease were encouraged and their work, and repeated that the outbreak gave no reason for public excitement.

“The fact that the day-to-day development of the disease had been more or less regular, they said, indicated that the city was not in danger of a sweeping scourge that would wipe out child-life in all quarters. Furthermore, they pointed out that, with the exception of some scattered cases, the disease had been confined to a few districts of the city where the contagion was already prevalent by the time the first cases came to the notice of the Health Department.

“Most of the 162 new cases yesterday were in Brooklyn….More than half the 31 deaths were in Brooklyn also….

“Health Commissioner Emerson, though confident there would be no immediate shortage of beds, went over his reports and found that six large hospitals in the city had not replied to his invitation to aid in the fight against the disease by supplying as many beds as possible. He submitted the names of these hospitals to the Mayor, who made them public and with them a letter addressed by him to each of the institutions. The institutions were: Flower Hospital, New York Hospital, Roosevelt Hospital, St. Luke’s Hospital, the Hospital for Ruptured and Crippled, and the Brooklyn Jewish Hospital. The Mayor’s letter was as follows:

Gentlemen: The Commissioner of Health has just placed in my hands a list of hospitals that have been invited to cooperate with the city in the care of cases of poliomyelitis. While on the whole there has been a gratifying response to the appeal of the department, I note that as yet no response has been received from your institution. It is desirable that the Health Department know as soon as possible the resources of the city for the work in question, and I would therefore ask for your early decision. I need hardly add that I hope this decision will be favorable. Very truly Yours

John Purroy Mitchell, Mayor.”

Before closing its article on Polio, it provided a sort of good news/bad news story using quotes from a paper by Dr. S. J. Meltzer of the Rockefeller Institute, before the Academy of Medicine the day before. The bad news was “in the discouraging fact that there is, at present, practically no treatment for poliomyelitis.” However, “It is important to bear in mind that the mortality in human infantile paralysis is generally not more than 25 percent.” (New York Times. “31 Die of Paralysis; 162 More Ill in City,” July 15, 1916, p. 1.)

July 16: “The idea of quarantining against New York because of the paralysis epidemic is as absurd as the shotgun quarantines against yellow fever in the South or against cholera, which used to be imported with the immigrants, and which followed river courses because the immigrants traveled on boats for lack of railroads in those times. The things to quarantine against were mosquitoes and the cholera germs in the immigrants’ baggage. Sanitation was the remedy, not prevention of intercourse. The proposed paralysis quarantine is preposterous because the proportion of cases is small compared with other dangerous diseases which attract less attention. There are many diseases equally communicable which are more numerous in their total of cases, and others, like croup and diphtheria, which are more deadly. Yet nobody thinks of quarantining against them, except locally, as a measure of sanitation rather than of prevention of intercourse.

“The lesson for communities which are drawing aside their skirts from contamination by contact with New Yorkers is the same as for New York itself, and that is, ‘clean up.’ A paralysis-stricken infant loses its threat in a clean community. Pity is more rational. It is unworthy of New York itself to lose balance over the disease, when it is considered how much worse diseases have been conquered, and how much higher a range of health the community enjoys than in the old days. The list of deadly diseases which have been prevented by vaccines and healed by serums is long. Smallpox and cholera and a long list of fevers are harmless comparatively as is shown by the lengthening expectation of life. And yet paralysis is thought as frightful almost as leprosy, that unconquered scourge of humanity.

“The epidemic has its uses as well as its threats. It strengthens the hands of those who have been as those crying aloud in the wilderness for purity of living conditions. How far we are from attaining that appears from the statement of Dr. Jenkins that our sewer basins are built to hold rather than to discharge their contents. The sewer catch-basins, therefore, act as settling or fermentation tanks, for the propagation of germs and toxins on a huge scale….

“The time to be frightened to some purpose was before the trouble, when those urging decency in community life were thought to be tiresome, and suspected of having sordid motives.” (New York Times. “Paralysis Hysteria (Editorial),” July 16, 1916, p. E2.)

July 16: “The new cases of infantile paralysis in the entire city yesterday were fewer by eighteen than on Friday, but the reduction was confined to Brooklyn and the Bronx and Manhattan. Queens and Richmond reported a greater number of new cases than in any twenty-four hours for many days. In Manhattan, especially, was the increase marked, the reports showing thirty new cases yesterday, against six on Friday. Queens had twelve new cases yesterday and eight the day before, and Richmond had eleven, against nine on Friday.

“In Brooklyn the decrease in new cases was decided, the figures being eighty-seven yesterday and 122 on the day before. The Bronx had four new cases yesterday and six on Friday. The total for the day in all five boroughs was 144 new cases, against 162 for the preceding day.

“The decrease in deaths for the five boroughs was from thirty-one on Friday to twenty-seven yesterday….According to figures made public by the Department of Health, there were 977 new cases of infantile paralysis in the city during the week just closed, and 552 new cases in the week preceding….

“That these figures showed an increased spreading in infantile paralysis in the city, Health Commissioner Emerson was, of course, not prepared to deny yesterday, but he said emphatically that the rate of increase was not such as to cause alarm and that, when the actual figures were compared with estimates of the number of healthy children in the city, it could be seen that infantile paralysis had, in fact, attacked a very small percentage of the juvenile population. Dr. Emerson added that he did not fear a sudden spreading of the disease or change from the steady and comparatively limited increase which usually marks the corresponding stage of all infantile paralysis outbreaks. The Health Commissioner was not alone in his belief that the figures gave to the population of New York City and neighboring towns no cause for panic. Officials of the United States Public Health Service and private physicians associated with the Health Department in the fight against the disease voiced opinions agreeing with Dr. Emerson.

“Those actively interested in the war against the epidemic were decidedly encouraged yesterday by the announcement that the Rockefeller Foundation had donated $50,000 to their cause and that Dr. C. E. Banks of the United States Public Health Service had arrived in the city from Milwaukee to take charge of the Government’s campaign to prevent the spread of the disease outside of the city.” (New York Times. “Rockefeller Cash to Fight Paralysis,” 7-16-1916, p. 1.)

July 18: “….Twenty-six deaths were reported to the Health Department for the whole city, as against 14 in the preceding twenty-four hours, making an increase in fatalities of nearly 90 per cent….

“Notwithstanding the increase Health Commissioner Haven Emerson, Deputy Health Commissioner John S. Billings, the Mayor, and the Police Commissioner agreed that there was no cause for alarm. Dr. Emerson showed a chart of the progress of the disease to prove that the ‘crest of the disease wave’ was slowly yielding, and that each cumulative surge of the epidemic was showing comparatively less force…. ‘I have no reason to change my belief that the outbreak is on the wane,’ said Commissioner Emerson…..

“Five additional surgeons of the United States Health Service arrived yesterday to assist in preventing the spread of the disease…. The five surgeons will report for duty at the railway stations in the work of issuing certificates to persons who are going out of the State…. ‘Persons traveling out of the State must first obtain certificates from the City Board of Health that the disease of infantile paralysis does not exist on their premises. These certificates must be obtained on the day of travel, if possible, or the day before at the furthest’….”

“Stricter Quarantine.

“Intra-city quarantine will also be more strictly enforced by the police. Dr. Emerson announced that policemen on quarantine duty would be required to make daily calls at houses where there was illness, to see that no children had been removed from the restricted dwellings. They will also see that cards on the doors are prominently displayed…..

“Police Commissioner Woods furnished figures to prove that the police were vigilant. He said there were 800 arrests a day before the outbreak, compared with 2,500 a day at present, the increase being due to violations of the Sanitary Code….

“The Yonkers Bureau of Health reported two deaths yesterday. They were the first due to the disease in that city. The two victims were Agnes Drinck, 13 months old…and J. Hartfelder, 11 months old…There are five cases in the contagious hospital. One case of infantile paralysis was reported yesterday at Mamaroneck.” (NYT. “Gain in Paralysis Due to a Holiday,” 7-19-1916, p3)

July 19: “Albany, July 19. — The suggestion that health officers in all up-State communities keep under observation for two weeks all children under 15 arriving from New York went out from the State Health Department today. Fifteen new cases and no deaths outside of New York were reported today, Kerhonkson, Rochester, in Ulster County; Gloversville, Claverack, New Rochelle, Glen Cove, West Babylon, Bedford, and Buffalo reported one each, and Yonkers six, making the up-State total 161.” (NYT. “Fifteen New Cases Up-State,” July 20, 1916, p. 11.)

July 19: “New York, July 19. – Despite efforts of business interests to minimize the epidemic of infantile paralysis now taking heavy toll, the figures issued by the health department today showed 30 more deaths and 142 new cased for the 24 hours ending at 10 A.M. Men in business lines which would be affected by a diminution in the number of visitors of New York have maintained that the ‘epidemic is a form of hysteria,’ but the health officials admitted today that their hope of immediately curbing the plague has gone a-glimmering. Yesterday’s figures showed 26 deaths and 121 cases. Today, therefore, the deaths increased by 4 and the cases by 21. The total of deaths is now 456 and of cases 2,317…. In four hospitals of the greater city, 805 cases are today being cared for. Hundreds of other patients are being nursed in their own homes.” (Daily News-Record, Harrisonburg, VA. “Infant Epidemic Grows,” 7-20-1916, p. 1.)

July 20, NYC: “There were twenty-eight new cases of infantile paralysis in Manhattan yesterday, against seven on the day before, and Health Commissioner Emerson admitted that the number was larger than he had expected. He had no fear, however, that the disease had got beyond possible control, and said there was no cause for alarm…

“Dr. Emerson believed the crisis had been passed in Brooklyn, for the number of new cases there yesterday was eighty-two, against eight-three on Tuesday, a considerable decline from a week ago….” (New York Times. “Paralysis Gains Only in Manhattan,” July 20, 1916, p. 11.)

July 21, NYC: “With 119 new cases of infantile paralysis in the city yesterday against 142 the day before, and with the number of cases in each borough about normal for the present period of the outbreak, Health Commissioner Emerson and his associates were strengthened yesterday in their belief that they were checking the spread of the disease. ‘Should the number of new cases decrease every day for a week,’ Dr. Emerson said, ‘we shall be justified in saying that we have the disease under control. As matters stand now we feel that we have the situation well in hand.’

“Dr. Emerson called special attention to the fact that in Brooklyn, where less than a week ago no surprise was caused when the number of new cases in a day was more than 100, there were only eighty-one new cases yesterday to compare with eighty-two on Wednesday and eighty-three on Tuesday. The Health Commissioner said these figures indicated that there was no acceleration in the spread of the disease in Brooklyn and were, therefore, evidence that the outbreak was being brought under control in the source and centre of its virulence….

“Notwithstanding Dr. Emerson’s advice parents continued yesterday to apply in increased numbers for certificates with which to leave town. On Wednesday 1,031 certificates were issued and 2,079 yesterday….

“No Law Requiring Cards.

“No Federal law nor any New York State or city law requires a certificate or card, but Dr. Banks pointed out that both were made desirable by the fact that practically every health officer outside of this city demanded them of arrivals from New York.

“The difficulties of travel, even with cards and certificates, were illustrated yesterday in the case of a resident of Ridgewood, N.J., who desires to go by automobile with his young son next Sunday to visit relatives on Long Island and to return on Monday. He learned from the health officials of Edgewater yesterday that if he landed there from the Fort Lee ferry, as he intended, he would be turned back unless he possessed a certificate, though he had only passed through New York in an automobile. He asked the Department of Health how to get a certificate and was told that no certificates were issued to persons passing through the city. Edgewater officials later said they would not accept a certificate from any Long Island physician, so the visit was abandoned.

“Dr. Emerson conferred with License Commissioner Bell yesterday on the petition of motion-picture exhibitors for permission to admit children in certain districts, and requested the License Commissioner to refuse the permission, at least until Aug. 1, which Mr. Bell did. Dr. Emerson also said he would not reopen the closed playgrounds and play streets until that date at the earliest….

“Many Police Volunteers.

“Police Commissioner Woods said yesterday that his call for twenty-five unmarried men from bicycle and motor-cycle squads to inspect quarantined homes brought 168 volunteers by noon, and that many others who had been off duty volunteered in the afternoon. Thirty-five were picked for the work.

“The activity of the police and Magistrates against sanitary code violators continued yesterday. Policeman Dunn of the Mulberry Street Station summoned twenty-five offenders yesterday. When Magistrate Marsh learned this, and also that Dunn had summoned more than 100 offenders since July 14, he complimented him….

“Dr. Emerson yesterday substituted nurses for policemen on many ambulances because, he said, the trained women were more successful in persuading parents to let their children go to hospitals. The nurse’s uniform and her sure manner create confidence, he explained.

“The complaint that flies had access to foods in the Washington Market was echoed yesterday concerning Jefferson Market by the Women’s Municipal League. Officials of the Health Department said last night that Inspectors would be sent to the markets at once. It was said that no law required the screening of the markets, but that the law did require all persons to screen or cover foods exposed for sale.

“After-Care Hospital.

“Following the suggestion of Miss Lillian D. Wald that immediate provision be made for after care of paralysis patients so that ill-effects may be minimized, the Directors of the Neustadter Foundation yesterday announced that they would establish a temporary convalescent hospital to be known as the Neustadter Home to accommodate fifty suffers after discharge from general hospitals. It is estimated to cost $40,000 to treat fifty patients for eight or ten months….

“Dr. Gustav Brown of the Health Department in Flushing will investigate today a report that Mrs. Annie Smith of Bayside was permitted to carry her four-year-old daughter Elsie, suffering from infantile paralysis, from Bayside to Flushing and back in crowded trolley cars. The child was taken to the Kingston Avenue Hospital yesterday.

“The total of cases in hospitals yesterday was 1,189…

“Hoboken’s Strict Quarantine.

“Despite drastic measures adopted by the authorities of New Rochelle, four cases and one death of infantile paralysis were reported there yesterday, all in the Italian quarter. The authorities believe the disease spread from a family of children who came from an infected district of Brooklyn two weeks ago, before the quarantine.

“There was a new case of the disease at Greenport, L.I., yesterday, and another at Amityville….”
(New York Times. “Day Shows a Drop in Infant Paralysis,” July 21, 1916, p. 18.)

July 21: “Washington, July 21. – Five more Public Health Service surgeons were ordered to New York today to aid in the campaign to prevent spreading of infantile paralysis. Twenty experts of the service already are there….All leaves of absence have been canceled by the service on account of the imperative demand for surgeons. Assistant Surgeon General Rucker said today that, while the local authorities in New York seemed to have the situation pretty well in hand, the fight to prevent the disease from spreading to other parts of the country was just beginning.” (New York Times. “Rucker Sends More Doctors,” 7-22-1916, p. 16.)

July 22: “Further indications that the infantile paralysis outbreak was on the wane were contained, health officials said, in yesterday’s report of but eighty-one new cases for the entire city, the smallest number for a day since July 3, when there were seventy-three cases….

“In his report to the Department of Health, Dr. Bermingham said:….The routine treatment of all cases has been: Fresh air at all times; screening from flies; antiseptics for the throat and nose; frequent sponging of the entire body; strict attention to bowels; frequent changing of personal and bed linen; at least one quart of milk daily; regular doses of utropin; intra-spinal injections of adrenalin every six hours, and oxygen as indicated.” (New York Times. “More Gains Made In Paralysis Fight,” 7-22-1916, p. 16.)

July 22: “….The number of new cases yesterday brought the total for the Summer up to 2,527, or more than the 2,500 cases recorded in 1907. The total deaths to date yesterday were 519, making the death rte of the outbreak more than 20 per cent., which has marked the outbreak from the beginning. More residents are leaving the city. Against 1,031 health certificates issued to travelers on Wednesday and 2,070 on Thursday, there were 4,108 yesterday….” (New York Times. “More Gains Made In Paralysis Fight,” 7-22-1916, p. 16.)

July 23: “Thirty-nine deaths from infantile paralysis were reported in the city yesterday, and 135 new cases. This was a greater number of deaths from the disease than has occurred in any twenty-four hours since the beginning of the outbreak, and the new cases were more than on any day since last Wednesday.

“The borough reports of new cases tended to confirm what Health commissioner Emerson and others have been saying for several days – that the situation in Brooklyn was positively encouraging, while that in Manhattan had elements of uncertainty…. Health Department officials…added that the tendency in either case was not sufficiently pronounced to cause either unrestrained optimism or hysterical alarm….

“As serious in some ways as the disease itself, is the quarantine situation. With a daily increase in the number of towns taking sudden and drastic action against travel from New York, the city and Federal officials admitted yesterday that New Yorkers might soon find themselves practically imprisoned I the city, to the great inconvenience and disturbance of life both here and out of town. As in indication of the extent to which some health authorities were going, Dr. Charles E. Banks of the Public Health Service yesterday received a telegram from the Health Officer of New London, Conn., saying that New London, Norwich, Willimantic, and ‘way stations’ were closed to incoming New Yorkers….According to reports from Bridgeport, children from New York are absolutely prohibited from entering the city….Other reports were that parents with children alighting from trains at New London and other places had been told to leave town at once, and in some instances, it was reported, mothers with a number of young children were accompanied to the borders of towns and left alone in open fields….

“The situation became acute yesterday and on Friday because so many persons sought to leave town for the week-end. Hundreds of those who obtained health certificates, it was said, were turned back at their destinations, and returning boats and trains yesterday brought in numbers of disappointed travelers.

“According to the Department of Health report of yesterday, 5,225 certificates were issued in the day. This was the largest yet issued in twenty-four hours.

“While thoroughly appreciating the efforts of every community to protect itself, the physicians of the United States Public Health Service, stationed here, were severely critical yesterday of the more than futile measures taken in many communities. Dr. C. H. Lavinder, the expert of the Public Health Service in charge of the corps of surgeons studying the carrier problem, said:

‘The city which says that no one shall enter, and simply turns back all arrivals without provision for their protection, simply commits an outrageous act and does not protect itself.’

“….By order of the Board of Health, it was announced yesterday the Salvation Army’s Fresh Air Home at Long Branch, N.J. has been closed to mothers and children from New York City. The army had made provision for taking care of nearly 3,000 persons from New York’s tenement house districts….

“Mrs. Anna Henry…Brooklyn, has received a ‘Black Hand’ letter, threatening her life because she had been active in reporting infantile paralysis cases and violations of the sanitary regulations in the Italian colony of Brooklyn near Public School 91, at Albany Avenue and Maple Street, known as ‘Pigtown.’ Mrs. Henry is one of the nurses at a babies’ clinic in the public schools. She found and reported two cases of infantile paralysis, and wherever she has discovered unsanitary conditions she forced corrections. Mrs. Henry took the letter to the Snyder Avenue Police Station and Detectives…were assigned to the case. Also a policeman was detailed to meet Mrs. Henry every day at her home and accompany her about her work, for she said she had no idea of quitting….

“Dr. Oscar M. Leiser, Assistant Director of Public Education of the Department of Health, yesterday warned the public against the numerous quack remedies being sold. He said that a number of ignorant persons, believing that a bath in ox blood would protect them from the disease, had gone to slaughter houses with buckets to obtain the blood….

“Oyster Bay Bars Children.

“Fearing infantile paralysis in the Township of Oyster Bay, which includes the villages of Oyster Bay, Glen Cove, and other Long Island towns where many New Yorkers spend the Summer, Dr. William J. Burns, health officer of the township, yesterday issued orders that no child of less than 16 years of age be admitted to the township from the outside, and officers at railroad stations and automobile roads turned back many persons intending to enter with children. Dr. Burns said further that all children living in the township who had recently been away would be quarantined in their homes for two weeks. ‘And,’ continued the health officer, ‘we intend to effect a provisional quarantine of two weeks on all homes where there are children under 16 years of age….

“About 50,000 cats have been caught and killed by the Brooklyn police since the clean-up connected with the infant paralysis epidemic began. Practically no cats are to be seen in the streets now, except along the waterfront, where the residents have put up a fight, fearing that rats which may land from incoming ships may be more dangerous than the cats which now are there.” (New York Times. “39 Die of Paralysis; Highest Day’s Toll,” 7-23-1916, p. 7.)

July 24: “The Department of Health reported yesterday that it had issued a total of 6,072 certificates in the twenty-four hours preceding the publication of the report…. Scenes in railroad and steamboat terminals of the city yesterday were indicative of the numbers going away and of the numbers returning against their will….

“Couple Evicted from Home.

“It was also learned yesterday that at 10:30 o’clock on Saturday night Health Officer Stack of Hoboken had aroused a New York man and his wife, who were sleeping in their new home, and had compelled them to leave the city immediately. He took this action, it was said, because the man had applied to Dr. Stack for entrance into the city earlier in the day and had been denied. In the evening a policeman had detected a van moving furniture into the man’s new home, and had reported the matter to the Health Officer….

“Government boats leaving for Governors, Bedloe’s, and Ellis Islands yesterday refused to accept children for transportation….”

“Dr. Emerson [reported]… that there were 1,375 cases of infantile paralysis in the hospitals….

“Chatham, N.J., yesterday joined the towns enforcing quarantine against New York. To insure that no one enters the village who might be a carrier of poliomyelitis twenty women members of the Home and School Association will today begin guard duty at all trolley and railroad stations.” (New York Times. “Fewer Fatal Cases on Paralysis Rolls.” 7-24-1916, p. 16.)

July 24: “Oyster Bay, N.Y., July 24. – Colonel Roosevelt today began war on infantile paralysis in this section. The Colonel and about one hundred of the most prominent men and women of Oyster Bay met this afternoon at the Town Clerk’s office and mapped out a campaign against the disease.” (New York Times. “Roosevelt Fights Plague,” 7-25-1916, p. 20.)

July 25: “Decrease in the number of new cases, and increase in the number of deaths from the reports of Sunday, yesterday marked the progress of the outbreak of infantile paralysis in the city, but the measures employed to prevent further spread of the disease beyond the city were extended both within the city by the United States Public Health Service officials and in other communities by local health authorities.

“Dr. Charles E. Banks, who is in charge of the medical staff issuing certificates to persons leaving the city announced that henceforth no children of less than 16 years of age would be permitted to leave the city for interstate travel without both a Federal and a city Department of Health certificate…. ‘The inspection of children leaving the city for interstate travel,’ said Dr. Banks yesterday afternoon, ‘will be compulsory from now on, and all railroad and steamship lines have been notified to that effect. Ticket punchers at station and pier gates will be instructed not to pass any children who have tickets for points in other States unless the children show the Federal certificate, which, as in the past, will not be issued to any one until a Department of Health certificate has been obtained by the applicant.’….

“The New York, New Haven & Hartford announced that it had received the following from Montpelier, Vt.”

‘The Vermont State Board of Health orders that all children under 15 years of age to Vermont State points shall report within twenty-four hours of arrival at destination to physician, when they will be quarantined at their homes from contact with other children for two weeks.’

“….The New York Central Railroad and the Central Railroad of New Jersey both announced that they had received advices from the State health authorities of California that no person from New York would be admitted to any point in the State who did not have an authoritative health certificate. The same announcement was made by the New York Central for Toledo, Ohio, and Watertown, March, and Stittville, N.Y.” (New York Times. “New Federal Rules in War on Paralysis,” 7-25-1916, p. 20.)

July 26: “Thomas F. Freel, Superintendent of the Society for the Prevention of Cruelty of Animals at Twenty-sixth Street and Madison Avenue, said yesterday that the inspectors were working over time and collected 80,000 dogs and cats, of which 10 per cent. Were dogs, since July 1. All of these animals were disposed of in the lethal chamber. ‘Since the beginning of the alarm over infantile paralysis,’ the Superintendent said, ‘we have been receiving on an average of 800 requests a day for our men to call for unwanted domestic pets, mostly cats, in spite of the statement issued by Health Commissioner Emerson that cats do not carry the germs of the disease. Our men go out with motor ambulances at 7 in the morning and work until 1 o’clock the following morning and pick up a total of 3,700 animals a day….Many persons who became alarmed at the spread of infantile paralysis turned their cats out of doors immediately, and some who had dogs did the same, which is probably the reason why there are so many adrift in the streets this Summer….Mr. Freel said that rats and mice carry the germs of infantile paralysis, but that there was no evidence to show that cats had ever been germ bearers….” (New York Times. “72,000 Cats Killed in Paralysis Fear,” July 26, 1916, p. 5.)

July 26: “Infantile paralysis has taken a jump ahead in Manhattan, the Health Department report showing forty-two new cases in this borough in the twenty-four hours ended at 10 o’clock yesterday morning. The total of new cases in the city in the same period was 150, an increase of more than 68 per cent. Over the eighty-nine cases of the preceding twenty-four hours…. Although the figures were not as encouraging as he had hoped, Health Commissioner Emerson was not dispirited. His study of the onset charts, which showed the date of origin of cases, sustained his belief that the epidemic had begun to recede in Brooklyn, and, while not receding in Manhattan, was not running wild over the borough…. The committee [Rockefeller Foundation] has obtained much evidence that infantile paralysis is not spread by inanimate things – clothing, garbage, trash, &c. This, however, has not inclined the authorities to lessen their enforcement of sanitary regulations….

“As indicating the number of persons leaving the city with children, Dr. Banks said yesterday that at 3 o’clock his seventeen surgeons had issued 2,000 certificates. In many cases one certificate was issued for a family of several children. The Health Department yesterday issued 3,736 certificates….

“Now that patients are beginning to convalesce from poliomyelitis, the work of after-treatment is increasing in importance, and, realizing this, Dr. Emerson yesterday summoned representatives of orthopedic hospitals and departments to his office for a conference. It was agreed that many children would require orthopedic treatment for months or years, and it was recognized that hundreds could not pay for treatment. The representatives of hospitals at yesterday’s conference agreed to contribute the services of surgeons in all needy cases, and plans for paying for electrical treatment, braces, and other appliances were made, a number of representatives of city relief organizations offering to provide funds. The representatives of hospital and relief organizations at the conference organized a permanent committee to care for the after-treatment of children. Private institutions and individuals have already begun the work of raising money for this after-treatment. Among the announcements of such efforts yesterday one came from the Children’s Brace Fund for Infantile Paralysis Victims, organized by persons who have escaped the epidemic by going to the country….” (New York Times. “Paralysis Figures Rise in Manhattan,” July 26, 1916, p. 5.)

July 27: “The detailed figures for infantile paralysis…show that Tuesday’s high record of forty-two new cases in Manhattan was duplicated yesterday… Unsatisfactory reports also came from Queens, where twenty-five new cases were recorded…. Summing up the new cases, Dr. Emerson said: ‘Brooklyn has risen to its normal and Manhattan has failed to decrease, but I see no reason to fear that the epidemic has not reached its crest in Brooklyn or that it will sweep through Manhattan. There is no indication in science that the virus of poliomyelitis gains in strength after passing through numbers of persons, so that there should be no reason for increasing virulence. In some diseases the virus gains strength as it spreads, but not in poliomyelitis.’ Dr. Emerson repeated yesterday his appeal to citizens to consider the outbreak serious enough to warrant every preventive measure, but not to develop unreasonable fear of poliomyelitis, as if it were a devastating scourge….

“The Department of Health yesterday issued certificates [to travel] to 2,199 persons…

“There were 1,562 cases in hospitals yesterday…” (New York Times. “Paralysis Spread Near High Mark,” July 27, 1916, p. 18. )

July 28: “The Board of Estimate yesterday appropriated $2,000 at the request of Mayor Mitchel to bring between fifteen and twenty scientists and specialists from other cities to New York to join leaders of the medical profession here in the study of infantile paralysis….” (New York Times. “Scientists to Study New York Paralysis,” July 28, 1916, p. 5. )

July 29: “The forty-four deaths from infantile paralysis reported yesterday constitute the largest number in any twenty-four hours since the beginning of the epidemic….

“Dr. Banks yesterday held up Connecticut as showing the most unreasonableness and least consistency in its quarantine measures. ‘Some of the people up there,’ he said, ‘are acting like two-year-olds. One woman with no child was refused admission to three Connecticut towns, for example, because she had her cat with her’….

“The Department of Health…announced that it had issued 34,503 health certificates to persons wishing to leave New York and had refused 206 applicants.” (New York Times. “Paralysis Deaths Number 44 in Day,” July 30, 1916, p. 12.)

July 30: “New York, July 30. – A decided decrease in the infantile paralysis epidemic is shown by figures issued today covering the 24 hours ending at 10 a.m. During that period there were 13 deaths and 145 new cases were discovered in the five boroughs of the city, as compared with 44 deaths and 161 new cases during the preceding 24 hours. An inspection of the city’s hospitals today by Dr. Haven Emerson, health commissioner, disclosed that the number of beds in the institution is not sufficient, and Dr. Emerson announces that this situation would be remedied.” (Petersburg Daily Progress (VA). July 31, 1916, p. 6.)

July 31: “Albany, N.Y., July 31. – Fifty-three cases of infantile paralysis, the largest number since the outbreak of the present epidemic, were reported to the State Department of Health from points outside of the City of New York, in the twenty-four hours ended at 5 o’clock this afternoon. Health Department officials said, however, that the figures were not alarming, as many of the cases would have been reported yesterday if the local health officers had known that the department’s office was open on Sunday. Three deaths were reported in the same period. Up to tonight there had been a total of 436 cases and 42 deaths, not including those in the City of New York.” (New York Times. “Disease Spread in State,” Aug 1, 1916, p. 5.)

Aug 1: “….So successful has the treatment of poliomyelitis patients with serum of the blood of recovered patients seemed to the surgeons of the Willard Parker Hospital that the surgeons are now attempting to obtain as much serum as they can with the intention of treating all of the more than 300 patients in the hospital. The serum treatment has also been used to a limited extent in the Kingston Avenue Hospital I Brooklyn with encouraging results…. Thirty patients at the Willard Parker Hospital…had been inoculated with the serum, and it was upon the improvement in the condition of these that the physicians have based most of their hopes. One of those familiar with the treatment said yesterday: ‘The serum seems to be the only thing that offers any promise, and those who have used it have strong hopes of its efficacy. They are beginning to hope not only that it will cure many cases of poliomyelitis, but that, injected into patients not yet paralyzed, it will prevent paralysis’.” (NY Times. “Find Hope for Cure in Paralysis Serum,” 8-1-1916, p. 5.)

Aug 2: “Although no deaths from infantile paralysis were reported yesterday from the Bronx and Staten Island, the total of fifty-five in the other three boroughs was the highest recorded in the city in any twenty-four hours since the beginning of the epidemic. The number brought the total deaths from poliomyelitis since the first of June to within four of 900.” (New York Times. “55 Die of Paralysis in This City in a Day,” Aug 2, 1916, p. 4.)

Aug 2: “New York, August 2. – A series of investigations with the object of solving problems which have arisen from the epidemic of infantile paralysis in this city will be commence here tomorrow by several of the leading pathologists and bacteriologists of the country. Some of the out-of-town experts arrived here tonight. Dr. Simon Flexner, of the Rockefeller Institute for Medical Research, probably will preside at the investigations. When the physicians meet, it is planned to discuss thoroughly the nature of the epidemic and its progress. Then the doctors will be organized into committees to divide the work of investigation. Sessions will continue tomorrow and Friday, after which the physicians will take cultures of the disease to their laboratories and endeavor to find a specific remedy.

“I was announced tonight that thus far 38 persons classed as adults, all over 15 years have had the disease. One of the deaths reported today was that of the 4-year-old daughter of Dr. Thos. C. Chalmers, an attending physician in the Queensboro Hospital, where several cases have been treated. Forty-one children have died and 166 stricken in the greater city during the last 24 hours. The seat of the plague shifted to Manhattan borough today, and there were more deaths and new cases reported in that borough than at any previous time since the inception of the plague.” (Petersburg Daily Progress, VA. “Probe Infantile Paralysis in New York,” 8-3-1916, 1)

Aug 4: “The greatest number of new cases of infantile paralysis reported in any twenty-four hours were reported yesterday, on the day that a group of bacteriologists and specialists in disease prevention from New York and many other cities began their conferences in this city at the call of Commissioner Emerson…. One of the most interesting facts placed before the conference of specialists at the first meeting yesterday was that in the sparsely settled district of Staten Island there have been a great many more cases in proportion to population than in any other borough. The disease has so far attacked about one person in 500 on Staten Island, one in 750 in Brooklyn, one in 820 in Queens, one in 3,850 in Manhattan, and one in 4,180 in the Bronx…. Dr. Emerson said yesterday that these figures showed that the overcrowding and filthy conditions in some parts of the east side and elsewhere were not the main factor in spreading the disease…. Why the disease travels more rapidly in thinly populated regions is unknown. Dr. Emerson said the only supposition which had received much attention was that it might be spread faster in rural districts through the local distribution of food raised there. Another guess, he said, was that the dust of country roads might carry the disease-producing organisms more readily than the dust of city streets…. Another unexplained fact about the disease on Staten Island is that it is less deadly than elsewhere. Fifteen have died for every 100 cases reported on Staten Island, 21 in every 100 in Manhattan, 22 in the Bronx, 22 in Brooklyn, and 28 in Queens…. Dr. Emerson said the disease was undoubtedly increasing in this city at present, although not at so great a rate as indicated by the number of new cases. The increase, he said, for several days had been due partly to increased vigilance in reporting mild cases, which before had gone unreported.” (New York Times. “Paralysis Growth Passes…Record,” 8-4-1916, p. 7.)

Aug 4: “Albany, Aug. 4….The officials of the Health Department announced an order for the arrest of members of a family who had broken quarantine rules in Hop, N.Y.” (New York Times. “The Disease in this State…,” Aug 5, 1916, p. 16.)

Aug 6: “Albany, N.Y., Aug. 6. – A case of infantile paralysis at Deposit, N.Y., in a fresh air camp composed chiefly of New York children, today caused the State Health Department to order that the ninety-five children there be quarantined. Seven other cases of the disease and one death at Otisville were reported to the department today. These brought the total cases in the State outside New York City to 638, and the total number of deaths since the outbreak to 58….

“Officials of the [Westchester] Health Department last night criticized the New York Department of Health for ‘inefficient quarantine’ and alleged that the spread of the disease in Westchester had been due to families coming from Brooklyn. More than 1,000 automobiles were stopped and turned back yesterday when their drivers attempted to cross the line between Nassau and Queens Counties.” (New York Times. “Paralysis Invades a Camp,” Aug 7, 1916, p. 16.)

Aug 7, NYC: “In the city there have been about 5,000 cases of infantile paralysis, with a death rate of 22 per cent. But the figures which show how many die do not measure the full force and effect of the epidemic, for a majority of those who survive are deformed cripples during the remainder of their lives. Many of the patients are in our hospitals. Health Commissioner Emerson, a few days ago, predicting that there would be in all not less than 5,000 hospital cases, said that the deaths would be 20 per cent., and that ‘of the remaining 4,000 patients fully 2,000 will be in come manner paralyzed when they are discharged.’ In half, or 1,000, of these cases paralysis would be permanent, beyond cure, and the victims would need mechanical appliances. Continuous treatment might better the condition of the other half. And in his advice to parents of these hospital patients he urges them to place their discharged children under proper medical or surgical supervision for at least one year, and to procure treatment at some one of the city’s orthopedic hospitals.

“In their report the bacteriologists and pathologists who have been in conference here recommend immediate isolation of the patient, and say that ‘satisfactory isolation can be secured only in a hospital.’ More emphasis might well have been given to the fact that only in a hospital, for great majority of cases, can the patient who survives have the treatment which may prevent deformity.

“We are inclined to think that Commissioner Emerson’s estimate of 2,000 paralytic cripples out of 5,000 is not large enough. Some authorities would increase it by 50 per cent. It may be noted that of about 10,000 crippled patients treated last year at the largest of our orthopedic hospitals 3,000 had been made cripples by infantile paralysis. Our leading authority in the field of orthopedic surgery says many of these would have avoided the crippling deformity if they had been treated properly at the very beginning, during the first few weeks of illness. There are physicians who are not familiar with the treatment required. A large majority of patients can have it only in hospitals, and in these there should be a uniformity of practice, based upon the instructions of those whose eminence and ability are recognized.” (New York Times. “The Epidemic’s Cripples,” Aug 7, 1916, p. 8.)

Aug 7: “Albany, Aug. 7. Thirteen deaths from infantile paralysis and sixty additional cases of the disease were reported to the State Department of Health from various parts of the State, not including New York City, during the twenty-four hours ended at 5 o’clock this afternoon…. The department plans criminal proceedings against persons who have broken quarantine. One of the accused was a dentist of Hoboken, N.J., who was alleged to have broken quarantine at Hope, this State, and who was traced to Hoboken. The statures are being examined to see if he can be extradited…” (New York Times. “13 Die in New York State.” 8-8-1916, p. 18.)

Aug 7: “New York, August 7. – Infantile paralysis marched steadily along its devastating way today. The day’s figures were forty-four deaths and 145 new cases. Total cases to date number 5,164, and the total deaths 1,143. Nineteen deaths and sixty additional cases were reported to the State health department, breaking the daily record. State totals amount to 700 cases and seventy-one deaths. Delaware and Maryland today followed Pennsylvania in placing bans on children from infected districts.” (Daily News Record, Harrisonburg, VA. “Infantile Paralysis Continues to Spread,” Aug 8, 1916, p. 1.)

Aug 8: “New York, August 8. – The infantile paralysis figures for today were fifty-two deaths and 183 new cases. The grand totals were 5,333 cases and 1,194 deaths. The mortality rate is gradually rising. It is now dangerously close to 25 per cent.” (Daily News Record (Harrisonburg, VA). “Nearly 25 Per Cent Dying of Infantile Paralysis,” Aug 9, 1916, p. 2.)

Aug 9, NYC: “….Deputy Health Commissioner Billings said yesterday he had been making a special effort to enforce the quarantine of children in families in which there was poliomyelitis, and that several persons responsible for violations of quarantine had already been summoned to court. Janitors of houses in which the diseases occur will be held responsible for enforcement of the regulations…” (New York Times. “Paralysis Cripples Glad to Aid Others,” 8-9-1916, p. 3.)

Aug 10: NYC: “Health Commissioner Haven Emerson announced yesterday afternoon that the opening of the public schools of New York City had been postponed because of the epidemic of infantile paralysis. The schools were to have opened on Sept. 11, and though the date when they will open has not been determined, those who conferred with Commissioner Emerson on the subject agreed, according to report, that Oct. 2 was the earliest possible date on which the school session might safely begin. At any rate, the schools will not open until the health authorities have positive evidence that the epidemic is dying, and some of them admitted yesterday that prevalence of poliomyelitis might continue in the city as late as Nov. 1. All of the 800,000 or more public school students of the city will be kept from their classrooms by the Department of Health’s decision, as both high and elementary schools re affected. It is practically certain that the opening of the parochial schools and private schools in the city will also be postponed, either by order of the Department of Health or by the voluntary action of their managers….

“At the request of the State Department of Health, Dr. Emerson yesterday issued and emphasized a warning to the public against going to the Catskill Mountains.

‘I have been advised…that conditions in Sullivan and Ulster Counties, especially in Fallsburg, Liberty, Hurleyville, and Ellenville, are so serious that the State Department of Health considers it a serious danger for more people to go into those regions…. My information is that conditions in many places in the Catskills are deplorable. When the epidemic began in New York thousands of frightened persons rushed to the mountain resorts with their children and they soon filled to overflowing all of the available accommodations. Of course, many of them took poliomyelitis with them and the disease soon broke out among the children. Conditions were splendid for its spread, and now the danger there is great… And I wish to warn the New York people in the Catskills that they must not send their sick children to the city. In some cases children have been shipped to the city in a dying condition, and not only have their deaths been hastened by this transportation, but the danger to the traveling public and to the community has been increased. These sick children have been brought in by the common carriers, and the managers of the transportation lines will be warned not to accept as passengers children suffering from suspicious ailments.’

“One Thousand Cribs Needed.

“Dr. Emerson said yesterday that the hospital service was suffering from a serious shortage of cribs. ‘We have bought all of the enameled iron cribs we can find on the market,’ said the Commissioner, ‘and still we have not nearly enough. We’ve been getting thirty or forty a day when we have needed 500. I therefore appeal to the public either to suggest some means whereby we can purchase cribs or to donate cribs not needed in homes. We want 1,000 cribs today’.”
“A Record Death Total.

“The number of deaths announced yesterday, 57, was the highest in any twenty-four hours since the beginning of the epidemic, and the 183 new cases equaled the unusually large number announced on Tuesday. Dr. Emerson, in commenting upon the day’s figures said that they were ‘not encouraging’.” (NY Times. “Schools to be Shut Till Epidemic Ends.” 8-10-1916, p. 1.)

Aug 10: “Albany, N. Y., Aug 10. – Failure to summon physicians quickly to attend cases of infantile paralysis is believed to be the cause of the increase of the disease on Long Island, Dr. F. M. Meader, Director of the Division of Communicable Disease of the State Health Department, said tonight. He asserted that in the up-State sections health officers were holding their own in the fight and successfully preventing the disease from spreading….” (NY Times. “Check the Disease Upstate. Epidemic on Long Island Due to Delay in Reporting Cases,” 8-11-1916, p. 5.)

Aug 11, NYC: “Dr. Emerson yesterday complimented Mayor Mitchel on resisting ‘tremendous pressure’ brought by real estate dealers and apartment house owners who wanted the seriousness of the epidemic minimized. Some of the proprietors of high class apartment houses, said the Commissioner, had sought in vain to keep the infantile paralysis placards from their infected premises….” (New York Times. “Cases of Paralysis Brought Into City,” Aug 11, 1916, p. 5.)

Aug 11: “Albany, N.Y., Aug 11. – Officials of the State Health Department expected tonight that by tomorrow they would have completed a list of fairs and meetings at which attendance by children of less than sixteen years of age will be forbidden because of the epidemic of infantile paralysis. The department, it was said, also would instruct health officers rigidly to enforce its orders of today that children be excluded from such gatherings in districts where the disease was prevalent. Department officials said that the order would apply to the State fair to be held at Syracuse.” (New York Times. “To Bar Children From Fairs. State Health Officials Adopt a New Paralysis Epidemic Rule,” Aug 12, 1916, p. 16.)

Aug 13, NYC: “New York, August 13. – AN encouraging and altogether welcome drop in the number of infantile paralysis cases and deaths was recorded by the Health Department today. The number of new cases in the greater city was 141 against 167 on Saturday – a decrease of twenty-six. The number of deaths was fewer by twenty – a drop from forty-two on Saturday to twenty-two today. This decrease affected every borough except the Bronx, where there were twenty-one new cases – four more than Saturday.” (Petersburg Daily Progress (VA). “Decrease in Cases of Paralysis,: Aug 14, 1916, p. 5.)

Aug 13: “To the Editor of the New York Times: If it is true, as some medical authorities assert, that infantile paralysis can be carried by an adult who is in good health, why should not adults as well as children, before being allowed to leave an infected area, be required to show certificates to the effect that they have not come in contact with the disease? This would prevent the recurrence of a case like that mentioned in the day’s paper of a woman who had recently lost five children by infantile paralysis going to stay in some rural district where she carried the disease to thirty little children.

“In connection with adults carrying the disease, is there not a risk in the proposed house-to-house inspection in New York City? Personally I should resist strenuously any visitor who desired to approach my well child after he had examined innumerable other children in an infected area.” (New York Times. “Adult Carriers of Disease,” Aug 13, 1916, p. E2.)

Aug 14: “Fifteen families in a tenement house [in]…Brooklyn, were quarantined last night because…one of the tenants refused to permit the health authorities to remove to a hospital his three-year-old son…said to have infantile paralysis. The father insisted that two physicians had told him the illness was not infantile paralysis. The entire tenement house was isolated until the boy is either moved to a hospital or to some private institution.” (New York Times. “15 Families Quarantined,” Aug 14, 1916, p. 18.)

Aug 15: “Indications that the epidemic of infantile paralysis was on the decline were seen by Health Department officials in yesterday’s reports of new cases and deaths. A suggestion that the epidemic might be halted altogether and that children who had not yet contracted the disease might be immunized by injections of serum made from the blood the their parents, regardless of whether the parents have had poliomyelitis, was offered by Dr. Abraham Zingher of the Willard Parker Hospital…. The theory on which the recommendation was based is that in the blood of adults there are antibodies or elements that make them immune, and that if serum made from the blood of adults be put into the blood of children they, too, may be made immune. Many scientists have suggested that the ordinary adult was immune to poliomyelitis because most persons now grown had the disease in some unrecognized form when children….

“Yesterday’s reports of new cases of infantile paralysis listed only ninety-five, the lowest number in any twenty-four hours since July 24, when there were eight-nine….” (New York Times. “Suggests Serum For All Children,” Aug 15, 1916, p. 18.)

Aug 17, NYC: “New York, August 17. – there were 121 new cases of infantile paralysis in Greater New York today. The deaths numbered thirty-two. This was a slight decrease from Wednesday when the figures were 133 and 34, respectively. The total number of cases to date is 6,774 and the deaths are 1,539.” (Daily News Record (Harrisonburg, VA). “Fewer Infants Die,” Aug 18, 1916, p. 6.)

Aug 25: “Although the 109 new cases of infantile paralysis reported in the city yesterday were 22 fewer than those reported on Wednesday…the epidemic took a spurt in Manhattan where there were 59 new cases, the highest number ever reported in the borough in twenty-four hours….Health Commissioner Emerson was not discouraged, and continued to believe that the epidemic was receding….

“Dr. Joseph F. X. Stack, Health Commissioner of Hoboken, yesterday issued a statement saying that, in his opinion, many children not suffering from infantile paralysis had been rushed to contagious-disease hospitals in New York City and elsewhere on false suspicion and had contracted the disease in the hospitals….” (New York Times. “Want Blood of 1,000 in Paralysis Fight,” Aug 25, 1916.)

Aug 25: “Out of more than 1,700 cases of infantile paralysis reported to the State Department of Health there have not been to exceed half a dozen wrongfully diagnosed. All suspected cases have been places under surveillance until determined one way or the other. The State Department has sixteen diagnosticians in the field….” (New York Times. “100 More Ill; 2 Die in State.” Aug 26, 1916.)

Aug 26: “Health officials hope – and some of the more optimistic believe – that infantile paralysis has made its last high record in this city and that, from now on, daily reports of new cases and deaths will decrease steadily until there is nothing more to report. Several Department of Health and United States Public Health Service officials, including Senior Surgeon Charles E. Banks, agreed yesterday in predicting that in one month from yesterday, that is, by Sept. 25, the date tentatively fixed for th opening of the schools, the epidemic stage of the disease would be over. The ninety-four cases reported yesterday…made a low record…. With the end of the epidemic in sight, the officials were led to make forecasts. They expected the total number of cases to exceed 10,000, and said that about 2,500 children would be left by the disease in such condition as to need braces, while at least 3,000 other children would be crippled, but with chances for complete or nearly complete recovery. The death would number about 2,500, it was predicted….” (New York Times. “End of Epidemic Believed at Hand,” Aug 26, 1916.)

Aug 26: “Dr. Emerson said that, in trips to nearby New York communities, he had found that many rural physicians and health officers reported only those cases in which there was visible paralysis and ignored many in which there was no paralysis. ‘In following this practice,’ the health commissioner said, ‘authorities not only expose their localities to the danger of infection, but make it appear that they have a fewer number of cases than actually are present’….

“Deputy Police Commissioner Godley will make an inquiry into the charge of Mrs. Jennie Dasnoit…Brooklyn, that three policemen forcibly took her nephew from her to the Kingston Avenue Hospital. Dr. Emerson said the child was convalescent from infantile paralysis, and had been removed to the hospital because Mrs. Dasnoit would not observe the quarantine regulations….” (New York Times. “3,936 Cases in Hospitals Here,” Aug 26, 1916.)

Aug 27: “Public and private armed forces opposed each other list night and the night before at Woodmere, L.I., where wealthy Summer residents of Rockaway Peninsula have built an isolation hospital for infantile paralysis patients. Deputy Sheriffs, acting in the name of the health officers of the town of Hempstead and the village of Woodmere, were present to prevent the entry of any paralysis cases, and with the deputies on both nights were crowds of persons living in Woodmere and vicinity who had threatened to burn the hospital. Private detectives were on hand to guard the property against attack. The present situation developed from the efforts of the Committee for the Control of Infantile Paralysis on the Rockaway Peninsula to provide scientific medical treatment and adequate housing of poliomyelitis patients. The Chairman of this committee is J. Howes Burton, who is identified with the Save New York Committee, and associated with him are members of the Rockaway Hunting club, the Woodmere Club and the colony of New Yorkers spending the Summer at Cedarhurst and other villages on the peninsula…. But before the hospital was completed the residents of Woodmere had stirred themselves. The committee maintained that it had selected a site for the hospital on a neck of land almost entirely surrounded by water and nearer the large estates, where there was no congestion, than the homes of the citizens of Woodmere. The citizens, however, resented the idea of receiving infantile paralysis patients in their village, and, according to report, they were aided and abetted by a number of Summer residents, whose estates are from one to two miles from the hospital.

“Citizens Hold Mass Meeting.

“The protest of citizens was voiced at a mass meeting held on Thursday night. Mr. Burton was hooted down when he attempted to induce those at the meeting to permit the use of the hospital. As the building was on private property the citizens could not stop its construction, but they made their influence felt on the Town Board of Woodmere, on Dr. A. H. Beaman, health officer of Woodmere, and on Dr. H. M. Phipps, Health Officer of Town of Hempstead. The result was an order that no infantile paralysis cases should be sent to the hospital except such as had their origin in the villages of Woodmere and Hewlett. There is only one case in Woodmere and none in Hewlett, so the hospital, as matters stand now, has been built for a single child who will be moved into it today. There are about six other cases on the Peninsula, three in Inwood, which cannot be taken to the hospital. Because the populace feared an attempt would be made to take the six cases to the hospital on Friday night, they gathered about it, some 500 or 600 strong, and threatened to burn the buildings. The committee employed half a dozen detectives from New York to guard the property, and last night this force was increased to twenty. Deputy sheriffs joined the crowd about the hospital and barricaded the approaches with rakes and other implements to prevent the dashing in or out of automobiles. The deputy sheriffs threatened to shoot any one who attempted to take a patient into the hospital, and the detectives threatened to shoot any one who attempted to approach the buildings without permission.

“Franklin B. Lord, Jr., one of those who contributed to the erection of the hospital, went to Albany yesterday to consult about the situation with Governor Whitman and a representative of the Attorney General’s office arrived in Cedarhurst to make an investigation. Members of the committee said an effort would be made to have the State Board of Health open the hospital for the use for which it was built. It was also said an effort would be made to have the local health officers removed. ‘The health laws of the State,’ Mr. Burton said, ‘should be devised so as to prevent petty politicians holding positions as health officers in small towns and hindering the work of the State Board of Health, which came into the field only to co-operate with the physicians in a serious effort to stamp out the epidemic.

“While matters in Woodmere remain unsettled, the three patients in Inwood are being cared for in tents erected since noon yesterday on the property of the Nassau County Industrial School, a Russell Sage Institution, and the other cases of the peninsula are in their homes in congested districts…” (New York Times. “Threaten To Wreck Paralysis Hospital,” Aug 27, 1916.)

Aug 28: “Hundreds of parents yesterday visited their children in Willard Parker Hospital, Sunday being the only day of the week on which visiting is permitted, except in cases of imminent death.” (NYT. “Paralysis Fighters Expect a Rest Soon,” Aug 28, 1916.)

“Oyster Bay [L.I.], Aug. 28. – The corruption of men and microbes by the millions of John D. Rockefeller and Andrew Carnegie, and the gullibility of Col. Theodore Roosevelt are responsible for the ‘causeless hysteria and the needless hardships of the alleged infantile paralysis epidemic,’ according to townsmen of Oyster Bay who met today in tumultuous assembly and adopted resolutions expressing their angry opinions. The meeting began with a session of the Town Board, at which Dr. W. E. Caldwell of the State laboratory at Roslyn, and Dr. William J. Burns, Health Officer of Oyster Bay, appeared to give information concerning the epidemic. The doctors had difficulty in sticking to their subjects because of interruptions by irate fathers who wanted to know why their children had been snatched away to the isolation hospital when they were not suffering from infantile paralysis. The citizens seemed to be especially incensed because of the health regulation permitting the forcible removal of children to the hospital and a recent incident when it took the authorities and strength of four deputy sheriffs and two physicians to get a child from its father to the hospital was emphasized as an especially flagrant offense against the freedom of the community.

“Drs. Caldwell and Burns finally left the meeting in the hands of Joseph Steinert, Chairman of the Town Board, who was powerless to preserve order, and left himself within a short time, followed immediately by the members of the board. Then the townsmen took charge of the meeting. They elected Colonel Henry M. Bennett Chairman, and appointed a committee to draw up resolutions representing the opinion of those present. The resolutions were adopted, and will be presented to the Town Board when it comes back to its hall, with the demand that the regulation governing the removal of children to hospitals without the consent of parents, except in cases where the parents are unable to provide proper care, be repealed….” (NYT. “Expects Epidemic to End by Sept. 15,” Aug 29, 1916.)

[A few days latter, the NYT published a Letter to the Editor, in sympathy with the citizens of Oyster Bay from Dr. Wm. W. Trent, a NJ physician:

I have read with interest the account of [the Oyster Bay] meeting. We, here, are in the same condition as you are in Oyster Bay. I have from the start contended that it was all wrong, and that the people were worked up into a ‘panic’ and was told publicly by the Health Officer (a brother physician), that I was a ‘disgrace to the profession’ for the stand I took. It took about three days and three physicians to decide that a boy suffering with the toothache did not have poliomyelitis. I am disgusted with some of the medical fraternity. (New York Times. “Paralysis Forecast Cut by 1,000 Cases,” Sep 4, 1916.)
¬¬¬¬¬
Aug 29: “For the first time since the disease assumed epidemic proportions, there were more patients discharged from hospitals yesterday as recovered than were admitted, thirty-nine being discharged and thirty-sic admitted….

Aug 29: “Physicians in Yonkers are watching the results of a treatment of vaporized turpentine being used on six cases in the isolation hospital there….” (NYT. “Expects Epidemic to End by Sept. 15,” 29 Aug 1916.)

Aug 30: “….Dr. Charles E. Banks, senior surgeon of the United States Public Health Service, said yesterday that he expected to be able to discontinue the issuance of certificates for interstate travel by Sept. 15, when, he thought, the progress of the disease would be limited to ten new cases a day…. Since the beginning of the epidemic 40,000 Federal certificates have been issued to children, and 18,000 to adults. The [NY] Department of Health has issued 109,613 certificates….

“The death rate for the epidemic to date is 23.9 per cent., which is higher than was the rate for the State outside of the city at the end of July, this having been approximately 10 per cent….

“Of the 7,904 cases of poliomyelitis in the city to date, only slightly more than 1 per cent., or 94, were among persons more than 16 years old. Of these 48 were women and 46 were men…. The oldest patient reported was a man of 52 years in Brooklyn. The statisticians of the Health Department have not tabulated the deaths among these cases, but Dr. Emerson said that the poliomyelitis mortality rate for adults was about 40 per cent….” (New York Times. “Look For Schools to Reopen Sept. 15,” Aug 30, 1916.)

Aug 31: “The College of the City of New York and Cornell University in Ithaca have postponed their openings two weeks because of the epidemic of infantile paralysis….”(New York Times. “Paralysis Defers College Openings,” Aug 31, 1916.)

Sep 1: “August…will…[be] the worst month of the epidemic. In June there were 313 cases and 63 deaths, in July 3,457 cases and 779 deaths, and in August 4,004 cases and 1,082 deaths.

“Health Commissioner Emerson said yesterday that he would permit the motion-picture theatres and other places of amusement to admit children more than 12 years old on and after next Monday, Labor Day…” (NY Times. “Movie Ban Modified as Paralysis Wanes,” Sep 1, 1916.)

Sep. 3: “The fifty-one new cases of infantile paralysis reported yesterday constituted a hopeful beginning for the new week, in the opinion of Health Department officials…. The officials are beginning to hope that their prediction of 10,000 cases for the epidemic will not be fulfilled. If the present decline continues, the total of cases for the epidemic, according to estimates, will not be much more than 9,000. The 8,197 cases to date, however, make this epidemic of the disease the largest ever recorded, and the 1,988 deaths give it one of the highest mortality rates on record….” (New York Times. “Paralysis Forecast Cut By 1,000 Cases,” Sep 4, 1916.)

Sep 4: “For the first time since the beginning of Summer children of the city yesterday enjoyed themselves without felling the inhibition of the Health Department in nearly everything they wanted to do. The restrictive measures prescribed by Health Commissioner Emerson were not abrogated, but were modified. A throng of 50,000 children who had to forego picnics, festivals, and all merry-making in crowds were permitted yesterday to enjoy Labor Day in the parks and playgrounds under the direction of the Bureau of Recreation of the Department of Parks. Thousands of others went out of the city on excursions, doctors and nurses examining them first and requiring them to wash their faces and hands….” (New York Times. “Let Children Romp as Epidemic Wanes,” Sep 5, 1916.)

Sep 4: Poughkeepsie, N.Y., Sept. 4. Vassar College’s opening has been postponed two weeks because of the infantile paralysis epidemic, it was announced.” (Daily News (Frederick, MD). “Plague Postpones Vassar Opening,” Sep 4, 1916, p. 7.)

Sep 5: “Oyster Bay, N.Y., Sept. 5. – The Town Board of Health lifted the stringent infantile paralysis quarantine tonight after the Citizens Committee, organized to fight it, presented the resolutions adopted by the citizens last week condemning John D. Rockefeller, Andrew Carnegie, and the ‘medical bandits’ for the ‘reign of terror.’ They were read to the accompaniment of great applause. Colonel Henry M. Bennett, Chairman of the Citizens Committee, produced witnesses and affidavits showing cases wherein children had been rushed to isolation hospitals and homes shut up when it later developed that a child was suffering with nothing more serious than teething. He also showed that physicians were unable to agree on many of the cases which had been quarantined.

“Dr. George A Draper, formerly with the Rockefeller Institute and now a Deputy State Health Commissioner at Roslyn, defended his profession and entered into a long technical explanation of infantile paralysis. He asserted that Bennett was ‘grossly slandering the physicians,’ and added that simply because a child was not paralyzed did not indicate it did not have the disease. For that reason, he maintained, it was necessary to enforce a strict quarantine. In telling the history of the disease, Dr. Draper asserted that it had just been proved that adults could carry the disease in their throats and noses. This was another good reason why a strict quarantine should be maintained, he said. “Then what protection have we from the physicians who go from house to house”? demanded an irate farther whose child had been taken away. ‘They do not disinfect themselves and they can carry it into houses where the children are all right.’ Dr. Draper said that this was a serious phase of the situation, but said that generally the physicians kept out of the ‘cough or speech-line’ of the patient.

“Bennett started the excitement by accusing the city and State Health Departments of being the ‘main instigators of the propaganda to terrify the people for financial profit.’ He read letters from physicians in various parts of the country upholding his attitude, and read from several medical journals to show that the physicians had become hysterical. He then produced a number of fathers who told of the way in which their children had been removed, their homes quarantined, and of the discovery later that the child did not have infantile paralysis.

“When the board finally adopted the resolutions lifting the quarantine there were cheers. ‘We have finally got the authorities back to a common horse sense view of the situation’ said Bennett.” (New York Times. “Oyster Bay Lifts Poliomyelitis Ban,” Sep 6, 1916, p. 20.)

Sep 5: “The forty-three new cases of infantile paralysis reported yesterday, continuing the low average of the last few days, led Department of Health officials to predict with confidence that the public schools may open safely on Sept. 25, the date tentatively fixed. United States Public Health Service surgeons said also they expected to discontinue their certificate service and leave town within ten days….” (New York Times. “Paralysis Workers See End of Labors,” 9-6-1916.)

Sep 7: “`The epidemic is evidently fast burning itself out. There seems to be every prospect of conditions again reaching normal within the next two weeks.’ Health Commissioner Emerson thus expressed his optimism yesterday…. ‘There is every prospect of having lower general death rate in New York City this year than ever before. In view of the outbreak of grip last January, and especially in view of the 2,000 deaths from infantile paralysis this Summer, this is a remarkable showing and indicates that after all New York is a pretty good town to live in’….

“Carlisle Norwood, a lawyer, yesterday filed a mandamus requiring the Department of Health to remove infantile paralysis placards from an apartment building at Madison Avenue and Sixty-eighth Street, owned by him. The placards, which state that there is a case of poliomyelitis in the house, were put up on Aug. 30, according to an affidavit filed by Mr. Norwood, ‘at the very height of the renting season.’ ‘Immediately,’ continues the affidavit, ‘it became impossible to interest prospective tenants in apartments in the building. The business of a drug store and a grocery in the building has been practically ruined, and even the hall-boys and the janitor threaten to leave’.” (New York Times. “Expects Epidemic…End…2 Weeks,” 7 Sep 1916.)

Sep 8: “Although Health Department officials were disappointed that there were eight more new cases of infantile paralysis yesterday than on the day before, they were not discouraged and repeated their prediction that the epidemic would be over in two weeks. So confident was Deputy Health Commissioner John S. Billings that the disease would soon be stamped out that he notified Police Commissioner Woods that considerations of public health required no restrictions upon the Coney Island Mardi Gras, which will attract crowds of children all next week….” (New York Times. “Paralysis Up Again – Due to Hot Weather,” Sep 8, 1916.)

Sep 9: “Oyster Bay, Sept. 9. – The lifting of the infantile paralysis quarantine regulations by the Town Board early this week, at the demand of certain citizens, has aroused resentment among the medical profession and many citizens who shared the opinion that the quarantine should have been maintained until all danger had been passed…. Among the most emphatic opponents of the element who desire the quarantine lifted is Dr. William J. Burns, Health Officer of the township. He is supported by the physicians and many citizens, and it is probable that at the next meeting of the Town Board of Health he will ask that the quarantine rules be again put in force until such a time as it is ‘safe’ to remove them. ‘On the day the quarantine was lifted,’ said Dr. Burns today, ‘I reported eight new cases of infantile paralysis. Since that time there have been six new cases….” (NYT. “Oyster Bay Row Still On; Health Officer and Citizens Seek Quarantine’s Restoration,” 10 Sep 1916.)

Sep 12: “there are still more than 5,000 children suffering from the disease in hospitals or in their homes….

“At the Department of Health yesterday afternoon statisticians completed a survey of the paralysis cases by age groups. Of the 7,496 cases under consideration, 751, or 10 per cent., were found among children under 1 year of age; 5,662, or 75.5 per cent., among children between 1 and 5 years; 812, or 10.8 per cent., among children from 6 to 10 years; 142, or 1.9 per cent., among children between 11 and 15 years, while 1`29, or 1.7 per cent., among persons of more than 16 years of age. Children between 2 and 3 were most often the victims. There were 1,714 of these. Of children from 1 to 2 years old, 1,541 were victims, while those from 3 to 4 years numbered 1,278. Children from 4 to 5 years of age numbered only 618.” (New York Times. “Paralysis Shows a Slight Advance,” Sep 13, 1916.)

Sep 13: “Sep 13: ….Rufus L. Perry, a lawyer representing Mrs. Rose Zimmerman of…Brooklyn, yesterday obtained a writ of habeas corpus from Justice Kelby in the Supreme Court of Brooklyn, requiring the production in court today of Mrs. Zimmerman’s two-year-old son, Lester, who has been in the Kingston Avenue Hospital since Sept. 1 as a sufferer from infantile paralysis. In an affidavit accompanying the application for the writ, the mother set forth that several competent physicians had said that Lester never had the disease, and that, shortly before the illness diagnosed as poliomyelitis by an inspector of the Department of Health, the boy ate peanuts, tomatoes and green apples, which made him sick.” (New York Times. “Paralysis Drops in Every Borough,” 14 Sep 1916.)

Sep 17-23: “The Infantile Paralysis Epidemic. – During the week ending September 23, the number of new cases of infantile paralysis has shown a considerable decrease. Whereas during the previous week the number of new cases reported daily ranged between thirty and forty, during the week just passed they averaged below thirty. September 22, there were only twenty cases reported, with six deaths. The total number of cases to date is 8,861, with 2,226 deaths. The number of cases in the state outside the city of New York has shown a similar decrease. – A conference was held in the office of the mayor between Dr. Haven Emerson, commissioner of health, and William G. Wilcox, president of the board of education, for the purpose of reaching a final decision as to the advisability of opening the schools on September 25, in view of the fact that the parents’ association had made a vigorous protest against this step during the week. It was decided that the children would not be exposed to danger in coming together in the schoolroom. No children or teachers from infected houses will be permitted to enter the schools. – The brace fund has reached about $40,000 and the goal now set is $50,000. It is said that this will be none too much, as there will be about 5,000 cripples to be cared for.

“The Communicability of Poliomyelitis. – A recent Bulletin of the department of health publishes a preliminary study of 7,000 cases of infantile paralysis with reference to the number of cases of the disease occurring in a family. There was only one case in a family in 6,521 instances; there were two cases in a family in 205 instances; three cases in one family. It is pointed out that this does not answer the question as to the communicability of the disease, for it might be possible that in a large percentage of the families included in this study there was only one child. It is hoped that further study will throw more light on this subject by including in the figures the number of children exposed in a family. Another group of figures which takes into consideration 7,496 cases of infantile paralysis shows that 751, or 10 percent, were found among children under 1 year of age; 5,662, or 15.5 percent, among children between 1 and 5 years of age; 812, or 10.8 percent, among children between the ages of 6 and 10 years; 142, or 1.9 percent, among children between the ages of 11 and 15 years, while 129, or 1.7 percent, occurred among persons more than 16 years of age. Children between the ages of 2 and 3 years were most often the victims; there were 1,714 of these. Of children between 1 and 2 years old, 1,541 were victims, while those from 3 to 4 years numbered 1,278; from 4 to 5 years the number was only 618.” (Journal of the American Medical Assoc.. “Medical News,” Vol. 67, 9-30-1916, p. 1028.)

Sep 22: “New York, Sept. 22. – The epidemic of infantile paralysis in this city was declared tonight by health department officials to be at an end. Members of the department will start on their vacations beginning tomorrow. Instructions were given today to the 497 nurses, one of whom will be present in each school on opening day, to refuse admittance to any child who may have lived in an infected house, this rule also will be applied to teachers.” (Salt Lake Tribune. “Paralysis Invades Richmond School,” Sep 23, 1916, p. 13.)

Sep 29: “Officials of the Health Department resented yesterday a published story that vaccination was a cause of infantile paralysis. The story came from the Anti-Vaccination League’s Headquarters in Philadelphia, and quoted at some length the Secretary of the league, Porter F. Cope….” (New York Times. “Vaccination Theory of Paralysis Denied,” Sep 29, 1916.)

Sep 30: “In spite of the fact that the number of new cases of infantile paralysis reported yesterday was the same as that for the day before and also last Tuesday, the New York health authorities are not worrying about the epidemic’s growing any worse. Commissioner of Health Emerson said yesterday that New York had had its share of the disease, but that it came out of the epidemic with fewer cases per capita than most of the other places which were visited.” (New York Times. “Trace Paralysis Spread to an Adult,” Sep 30, 1916.)

Oct 3: “More than 200,000 pupils who had registered for attendance in the schools this Fall were not in attendance on Sept 27, according to figures published by the Board of Education yesterday. It was supposed that the infantile paralysis scare kept many of these away…. There were 26 new cases of infantile paralysis and 14 deaths due to the disease in the last two days according to the Health Department’s report issued yesterday…. Six deaths were reported Sunday and 8 yesterday…. Florida lifted the ban it had placed on travelers from New York on Sept. 30, Pennsylvania lifted it yesterday and New Jersey will do so today, according to Federal health officials. Members of the Government corps of research workers sent here under Dr. C. H. Lavinder to study poliomyelitis have figured out mathematically that by Nov. 15 there will be only ten cases of infantile paralysis to be reported a week. The entire corps are unanimous in declaring that poliomyelitis as an epidemic has passed….” (New York Times. “200,000 Children Stay From School,” Oct 3, 1916.)

Oct 4: “Federal inspection of interstate travel originating in New York City, which was started last July at the height of the poliomyelitis epidemic, was discontinued yesterday, the United States Health authorities being convinced that the epidemic here was over. Dr. Charles E. Banks, in charge of the work of inspection in New York, made the announcement after he had received instructions from Surgeon General Blue in Washington. Yesterday’s new cases of infantile paralysis numbered twelve, and eight deaths due to the disease were reported…. The total number of cases is now 9,063, and there have been 2,308 deaths.” (New York Times. “Federal Inspection of Paralysis Ends,” Oct 4, 1916.)

Oct 4-14: “New York. State Plans After-Care of Infantile Paralysis. – Dr. Dinsly R. Williams, Albany, deputy state commissioner of health, has announced a comprehensive plan for the after-care of infantile paralysis patients. He announces that Dr. Robert W. Lovett, Boston, will cooperate with the state health department, and that clinics will be held in various places throughout the state where persons who have had the disease may come for advice and treatment….

“New York City. Federal Inspection of Infantile Paralysis Ends. – The federal inspection of interstate travel, which was instituted last July in this city, was discontinued October 4. The number of new cases in infantile paralysis reported on that date was twelve, with eight deaths. That represents a fair average of the number of new cases reported each day during the week.”

“Quack Preventives and ‘Cures’ for Infantile Paralysis. – The department of health has succeeded in obtaining jail sentences and substantial fines as penalties in the case of two persons who attempted to exploit ‘cures’ for poliomyelitis in this city. The first of these was a Mr. Frooks who made and sold amulets to be worn around the neck as a protection against infantile paralysis. An analysis made by the department of laboratories showed that the amulet consisted of a cotton bag containing cedar shavings. The court found Frooks guilty and sentenced him to thirty days in jail and a fine of $250. James T. Manchester was also sentenced to thirty days in jail for having manufactured and sold a preparation called ‘Sol’ which was represented as being a cure for infantile paralysis, consumption, rheumatism and other ailments. This preparation, on analysis, was found to consist essentially of capsicin, sassafras and alcohol.

“Supreme Court Upholds Health Department. – Considerable newspaper publicity has been given the case of Mrs. Anton Anderson, Jamaica, whose 19-months-old son was forcibly taken to the Queensborough Hospital for Contagious Diseases by officers of the health department. The diagnosticians of the health department stated that the child had infantile paralysis, while a private physician differed in regard to the diagnosis. The mother applied for a writ of habeas corpus and the case was taken to the supreme court, where it was dismissed, Judge Garretson holding that the board of health, in safeguarding the public health, is ‘clothed with discretionary powers,’ and that it exercised these properly in forcibly seizing the child. He vindicated Mrs. Anderson, however, stating that she had shown a commendable readiness to comply with the law until confused by conflicting medical opinions. The child was remanded for the full period of quarantine, eight weeks.” (Journal of the American Medical Association. “Medical News,” Vol. 67, 10-14-1916, pp. 1170-71.)

Oct 17-21: “New York. State Clinics for Poliomyelitis Cripples. – The first clinic for the after-care of cases of poliomyelitis was opened, October 17, at White Plains. Dr. Robert W. Lovett, Boston, will examine each patient and direct the treatment. Later it is planned to hold clinics in other parts of the state. Over thirty patients were examined the first day of the clinic. Clinics were held at Mount Vernon and Port Chester, October 18, in North Tarrytown, October 20, and at Yonkers, October 21.” (Journal of the American Medical Association. “Medical News,” Vol. 67, No. 18, 10-28-1916, p. 1311.)

Oct 20: “New York, Oct. 20. – Not a single death from infantile paralysis in the entire city was reported yesterday, for the first time since June, when the epidemic began. Total deaths since then were 2375. Six new cases were reported.” (Daily News (Frederick, MD). “No Paralysis Deaths in New York,” Oct 20, 1916, p. 3.)

North Carolina

Aug 17: “Mrs. C. P. Chapin, twenty-four years old, died of infantile paralysis at Greensboro, N.C., after an illness of less than forth-eight hours. She was a native of Philadelphia and recently returned to Greensboro after a visit to New York and New Jersey points.” (The News (Frederick MD). “Paralysis Makes High Record,” 17 Aug 1916, p. 1.)

North Dakota

The monthly breakout of reported cases of poliomyelitis in North Dakota for the year are as follows: 2 in Aug, 16 in Sep, 6 in Oct, 4 in Nov. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in Massachusetts. 1919, p. 8.)

Ohio

“The monthly breakout of reported cases of poliomyelitis in Ohio for the year are as follows: 8 in Jan, 10 in Feb, 7 in March, 6 in April, 2 in May, 7 in June, 100 in July, 177 in Aug, 147 in Sep, 63 in Oct, 7 in Nov. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p8.)

“Toledo, July 19.—The first adult case of infantile paralysis in Toledo was confirmed last night by City Epidemiologist C. S. Mundy after several physicians had diagnosed the ailment. The victim is Mildred Gallagher, 21 years old. There are now seventeen confirmed cases in the city.” (New York Times. “An Adult Case In Toledo,” July 20, 1916, p. 11.)

Oklahoma

The monthly breakout of reported cases of poliomyelitis in Oklahoma for the year are as follows: 1 in May, 3 in June, 12 in July, 10 in Aug, 8 in Sep, 13 in Oct, 2 in Nov. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8.)

Newspaper

Nov 30: “Tulsa, Okla., Nov. 30. Fourth case of infantile paralysis, that of the 14-months-old infant of Charles Hartshorn, a farmer living four miles northeast of Tulsa, ahs been discovered here. The child is in a critical condition.” (Muskogee County Democrat (OK). “Infantile Paralysis Again,” Nov 30, 1916, p. 1.)

Oregon

The monthly breakout of reported cases of poliomyelitis in Oregon for the year are as follows: 1 in March, 1 in April, 5 in Sep, 26 in Oct, 4 in Nov 1 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8.)

Newspaper

Dec 8: “Milwaukee, Ore., Dec. 8. – Public schools were ordered closed here as a precaution against the spread of infantile paralysis. One child, a 7-year-old girl, was stricken with the disease while on her way home from school yesterday. Several other cases have been reported in the town and vicinity recently. The order closing the schools was issued after a conference of physicians with the school board.” (Oakland Tribune. “Schools Are Closed to Check Paralysis,” 12-9-1916, p. 24.)
Pennsylvania

Levenson: “….Pennsylvania posted more than 1,000 men to guard 900 miles of state border, monitoring highways, railroads, ferries and bridges to prevent children under 16 without a good-health certificate from entering the state. Samuel G. Dixon, state commissioner of health, ordered all public, private and parochial schools closed during September for students under 16. Densely populated boroughs took additional actions on their own as local school boards decided to keep the public schools, which were to reopen in early September, completely closed.

“In August, the Doylestown Town Council appropriated $1,000 to enforce a quarantine ordered by the borough’s Board of Health, which exercised authority over public health matters. Doylestown went under strict quarantine at 12 o’clock on Wednesday, with twenty-two guards placed at the entrances to the borough to inspect every trolley car, automobile, wagon or other vehicles, and if they carry children under sixteen years of age to require them to show a clean bill of health before being allowed to stop in the town, or compel them to continue through the borough without stopping,” reported the Doylestown Daily Intelligencer.

‘Resident children will be permitted to go out of the town and remain for four hours only without a permit. It is urged, however, upon all parents to keep their children home, and it is especially urged that they do not allow their children to visit any amusement parks or gatherings of children where they may become liable to infection or become carriers of the contagion…’

“The Intelligencer also reported: ‘Langhorne Manor has instituted a very drastic quarantine and Yardley has four guards to keep children under sixteen years out of that borough.’….

“In Hatboro, ‘it was decided to have Officer Winner watch all incoming and outgoing trolley cars. The trains will be watched by Health Officer Jarrett,’ the Public Spirit reported in early September. ‘Children entering the borough will be required to show a health certificate, and will only be allowed to stay under certain conditions. Motorists and wagon drivers also will be under observation. Hatboro so far has not had any cases of infantile paralysis and hopes to escape the contagion by taking due precautions.’

“Other precautions: To combat the spread of polio, Bristol Borough in August began collecting garbage daily, with a special collection at 7 p.m. from ‘infected houses,’ the newspaper stated….

“By the end of September, the polio epidemic had subsided in Pennsylvania. The state and localities lifted their quarantines, and children went back to school on Monday, Oct. 2. It was up to each school board whether to make up the lost month of classes….

“Pennsylvania recorded 1,360 polio cases, including 324 deaths, in the summer of 1916. New York City had 8,900 cases with 2,448 deaths, according to a historical account. Approximately 6,000 people nationwide — mostly children — died from polio in 1916, making it America’s worst polio epidemic….” (Levenson, Edward. “Polio outbreak threatened Bucks, Montgomery counties at the beginning of 20th century.” Phillyburbs.com. Sep 2013.)

MA Health Dept.: Monthly breakout of reported cases of poliomyelitis in Pennsylvania for the year are as follows: 5 in Jan, 5 in March, 2 in April, 3 in May, 7 in June, 93 in July, 681 in Aug, 750 in Sep, 419 in Oct, 98 in Nov, 28 in Dec. (MA Health Dept. 1916 Infantile Paralysis Epidemic… 1919, p. 8.)

Chronological

June 22: “Fred Sutter, aged nearly 19 years…of Covode, died on Thursday as the result of illness produced by an attack of infantile paralysis. He had been in poor health since his youth.” (Indiana Progress (PA). “Fred Sutter,” June 28, 1916, p. 1.)

July 11: “Altoona, Pa., July 11. – Two cases of infantile paralysis were reported here today.” (San Antonio Light (TX). “Two Cases at Altoona,” 11 July 1916, p. 1.)

July 21: “Harrisburg, Penn., July 21. – Three new cases of infantile paralysis were reported to the State Department of Health today, making forty-two since July 1, and Commissioner of Health Dixon notified the Lehigh Valley Railroad to discontinue excursions for children to Coney Island. ‘I beg to notify you that such excursions will have to be discontinues at once owing to the malignant type of extended epidemic of infantile paralysis in New York City.’ Wired the Commissioner. ‘If these excursions are continued by railroad companies, the State will have to quarantine all children up the age of 16 years entering the Commonwealth from New York State’.” (New York Times. “Bans Excursions to Coney Island,” July 22, 1916, p. 16.)

Aug 9: “Philadelphia, Aug. 9. – Efforts of the Pennsylvania health authorities to enforce a rigid interstate quarantine against possible cases of infantile paralysis, it was said, were being nullified by the lax methods of officials in adjoining States, some of whom were said to be issuing health certificates to all who applied without making an investigation. Dr. Samuel G. Dixon, State Health Commissioner, declared that ‘if the Camden (N.J.) authorities continue the promiscuous issuance of the certificates’ he probably would be forced to order the Pennsylvania Inspectors not to honor any certificates issued by the Camden Department of Health. Three deaths from the disease and thirteen new cases were reported here during the last twenty-four hour period, making a total of twenty-six deaths since July 1 and 105 cases. Eight new cases were reported in the State outside of Philadelphia, increasing the total to ninety-four.” (New York Times. “Calls Jersey Officials Lax; PA Health Commissioner,” Aug 10, 1916, p. 5.)

Aug 15: “Philadelphia, Aug. 15…. Ten new cases of the disease have been reported to the state board as follows: Ursina, Somerset county, three; and one each in Marietta, Washington county; Lopez, Sullivan county; McKeesport, Allegheny county; Askaban, Luzerne county; Donora, Washington county; Bristol, Bucks county, and Middletown township, Bucks county.” (The News (Frederick MD). “Paralysis Gets More Victims,” Aug 15, 1916, p. 1.)

Aug 15: “Philadelphia, Aug. 15. – State and municipal health officers are at loggerheads here today over the use of the blood serum treatment for infantile paralysis. Chief Inspector Cairns, of the Bureau of Health, has a supply of blood serum on hand which he declares he will distribute for use among sufferers of the dread malady today. He points to the excellent results obtained in New York by this method. On the other hand, Dr. Samuel G. Dixon, State health commissioner, disagrees and has urged in vain that blood serum shall not e put to use in Pennsylvania. The cure, he says, is liable to prove more harmful than the disease.

“Six deaths and seven new cases are the toll of the infantile paralysis for the 24 hours ended at 9 a.m. today in this city, according to official bulletins from the Health Department.” (Frederick Post (MD). “At Odds Over Cure,” Aug 16, 1916, p. 2.)

Aug 18: “Pittsburgh, Pa., Aug. 18. – A rigid quarantine against children under sixteen years old entering the state without medical certificates showing them to be free from symptoms of infantile paralysis was inaugurated throughout western Pennsylvania. Beginning Thursday midnight all trains from the north, south and west making their first stop in the state at Pittsburgh were met by representatives of the state department of health, and all children without certificates were forced to turn back. Inspectors were also stationed at various points in Pennsylvania near the West Virginia and Ohio boundaries, where railway and interurban lines enter the state, to enforce the quarantine.” (The News, Frederick MD. “Quarantine in Western PA,” 19 Aug 1916, p. 1.)

Aug 19: “Harrisburg, Pa., Aug. 19. – New cases of infantile paralysis were reported from Elco, Washington county; Wilmore and Ebensburg, Cumbria County, and Easton.” (The News, Frederick MD. “Plague Still Spreads in PA,” 19 Aug 1916, p. 1)

Aug 22: “Philadelphia, Aug. 22. Four more deaths from infantile paralysis and ten new cases were reported here….

“Another case in the vicinity of Norristown was reported to Health Officer Bare, of Bridgeport. The patient is Anna Monlangan, three years, of Upper Merion. Four deaths and ten cases were reported here Sunday.

“William Vandegrift, thirteen months old, son of Herbert Vandegrift, Conshohocken, died of paralysis. This is the third death in Conshohocken….

“Virtually every Sunday school was closed to children under sixteen. Many churches observed a similar precaution.” (The News, Frederick, MD. “Infant Plague is Unchecked,” 8-22-1916, p. 1.)

Aug 31: “Philadelphia, Aug. 31. Six children died from infantile paralysis in this city. One death of a Philadelphia child was reported in Atlantic City. Eight new cases were reported in this city, and the brother of the Atlantic City victim was also stricken.

“Dr. Samuel G. Dixon, state health commissioner, issued an order from Harrisburg ordering all schools in the state to remain closed until September 29. His previous order postponed the opening of the schools until September 18. In the new order children under sixteen are barred from Sunday schools, moving picture theatres and other places of public entertainment until September 29. In this city the public schools will remain closed until October 2.”

Sep 1: “Summary of the Virginia Quarantine Regulations Against Infantile Paralysis….The quarantine applies to the States of New York, New Jersey and Pennsylvania…It applies to persons traveling in every fashion…train…boat…motor car…carriage…on foot…The quarantine does not apply to persons over sixteen years of age….

“Persons of any age suffering from poliomyelitis or any other contagious disease are prohibited by State and Federal laws from traveling in any train, boat, or by public carrier,” (Daily News Record, Harrisonburg, VA. 9-1-1916, p. 5.)

Sep 2: “Chambersburg, Penn., Sept. 2. – A riot took place this evening at St. Thomas, about seven miles from here, because the health officers, who had been sent there to enforce the quarantine for infantile paralysis, attempted to exclude children under 16 from grounds where an ox roast was being served. Two Deputy Sheriffs were badly beaten and a score of the mob received injuries.

“Robert Walker, State Health Officer, arrived at the grounds early this morning and discovered that several children under 16 had already been admitted. He ordered the parents to take the children away, but a number refused. The Sheriff and nine deputies were dispatched at once from Chambersburg to aid the Health Officer. One of them was attacked and when he attempted to defend himself a riot started. The officers were badly beaten, two being in a serious condition. More deputies were sent from here. At a late hour tonight the fighting was still in progress, but the deputies had the mob under control.” (NYT. “Mob Riots Over Paralysis,” Sep 3, 1916.)

Sep 11: “Harrisburg, Penn., Sept. 11. – Today’s reports of infantile paralysis cases increased the total reported since July 1 to 1,149, which is more than the total reported during the outbreak of 1910. Of the cases reported, 658 came from Philadelphia. ‘There have been 288 deaths from the disease in the State. Nineteen cases were reported today from Philadelphia and 27 from other points in the State.” (New York Times. “658 Cases in Philadelphia,” Sep 12, 1916.)

Sep 16: “Pennsylvania….Infantile Paralysis. – From July 1 to September 16, 1,278 cases of infantile paralysis have been reported to the state department of health, with 307 deaths. Of these cases, 719 were reported from Philadelphia and 559 from other parts of the state. The state commissioner of health announces the opening at Rosemont of a new hospital for the treatment of acute cases of infantile paralysis.” (Journal of the American Medical Association. “Medical News,” Vol. 67, 9-30-1916, p. 1028.)

Sep 16: “Virginia Will Bar Children from Infected States. – All Pennsylvania Railroad trains carrying children under 16 years of age from New York, Pennsylvania and New Jersey into the state of Virginia are liable to be quarantined as a result of a conference in Philadelphia, September 16, between the officials of the railroads and Dr. Roy K. Flannagan, assistant state health commissioner of the state of Virginia. Dr. Flannagan visited Philadelphia to determine why New York, Philadelphia and Norfolk trains carry children in violation of the rules placed in effect, August 25. He stated that 50 percent of the cases of infantile paralysis in Virginia today came from the North, some from New York and some from Philadelphia.” (Journal of the American Medical Association. “Medical News,” Vol. 67, No. 14, 9-30-1916, p. 1029.

Oct 2: “Pennsylvania. State Quarantine Lifted. – Dr. Samuel G. Dixon, state health commissioner, on October 2, lifted the quarantine that has been enforced for the last sixty days to prevent entrance into Pennsylvania of children under 16 years of age. Under the direction of Dr. Dixon more than 1,000 men have been engaged in watching over 100 miles of border. It has been, it was admitted, the most effective and far reaching measure of its kind ever instituted in this state. Cool weather is putting an end to the epidemic and makes quarantine no longer necessary, according to the statement of Dr. Dixon. (Journal of the American Medical Association, “Medical News,” Vol. 67, No. 16, 10-14-1916, p. 1171.)

Oct 4: Pennsylvania lifts its quarantine against the movement of children of NJ into PA. (JAMA, “Medical News,” Vol. 67, No. 16, 10-14-1916, p. 1171.)

Oct 5: “Until October 5, the health reports show that 1,163 cases of infantile paralysis had been reported, beginning with July 1, Eight hundred and seventy-six of these occurred in Philadelphia. Since July 1, 414 deaths have occurred throughout the state from this disease.” (JAMA, “Medical News,” Vol. 67, No. 16, 10-14-1916, p. 1171.)

Oct 12: “Pennsylvania….Paralysis Bar Up Again. – Public schools, Sunday schools and moving picture places have been closed in Norwood, Delaware County, following the discovery of a case of infantile paralysis in that town….Three new cases were reported in Philadelphia, October 12. Four new cases were reported in districts outside of Philadelphia, October 12, making a total of 1,722 since July 1. The list includes 905 in Philadelphia.” (Journal of the American Medical Association. “Medical News,” Vol. 67, No. 17, 10-21-1916, p. 1237.)

Oct 20: “Philadelphia. Infantile Paralysis Report. – Since July 1 and up until October 20, there have been 946 cases in Philadelphia, with 282 deaths. An organization known as Lovers of Children collected $1,347 to buy braces and other necessaries for convalescents.” (Journal of the American Medical Association. “Medical News,” Vol. 67, No. 18, 10-28-1916, p. 1312.)

Rhode Island

The monthly breakout of reported cases of poliomyelitis in Rhode Island for the year is: 1 in March, 2 in April, 3 in June 39 in July, 55 in Aug, 76 in Sep, 44 in Oct, 13 in Nov, 4 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, 8.)

July 10: “Newport, R.I., July 10….All children coming from New York are subject to inspection and a watch will be kept over them for several weeks after arriving.” (New York Times. “Paralysis Takes Lives of 32 More…,” July 12, 1916, p. 1.)

South Carolina

The monthly breakout of reported cases of poliomyelitis in South Carolina for the year is: 1 in Jan, 1 in May, 20 in July, 58 in Aug, 24 in Sep, 13 in Oct, 6 in Nov. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8.)

South Dakota

The monthly breakout of reported cases of poliomyelitis in South Dakota for the year is: 1 in June, 10 in July, 23 in Aug, 36 in Sep, 20 in Oct, 10 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic in MA. 1919, p. 8.)

Tennessee

The monthly breakout of reported cases of poliomyelitis in Tennessee for the year is: 29 in June, 18 in July, 21 in Aug. (MA Health Dept. The 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

Texas

The monthly breakout of reported cases of poliomyelitis in Texas for the year is: 6 in June, 22 in July, 25 in Aug, 19 in Sep, 6 in Oct, 1 in Nov, 7 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

July 11: “Dallas, Tex., July 11. – The first case of infantile paralysis in this city since May, last, was reported to the health authorities today.” (San Antonio Light (TX). “One Case Reported at Dallas,” 11 July 1916, p. 1.)

Aug 14: “San Antonio, Aug. 14. – A meeting of the State Board of Health was being held here today for the purpose, among other things, to take concerted action to prevent the spread of the 26 cases of infantile paralysis reported to the board during the past month from 16 counties in Texas. Incidental to this meeting, country and city health officers throughout the state will be sent a set of rules to be followed when a case of paralysis is found. Individuals will be cautioned to keep their premises in a sanitary condition. Strict quarantine should be maintained in all cases, the bulletin says, and it is advised to limit the movements of children under 15 years of age to place affected or unaffected, as the case may be.” (Daily Bulletin (TX). “To Prevent Spread of Infantile Plague,” Aug 14, 1916, p. 1.)

Utah

The monthly breakout of reported cases of poliomyelitis in Utah for the year is: 5 in Jan and 5 in August. (MA Health Dept. The 1916 Infantile Paralysis Epidemic…. 1919, 8.)

Sep 16: “Sep 16, Salt Lake: “Report that Helen Yeiter, 2 years of age…of Woods Cross, has developed a case of infantile paralysis was made to Dr. T. B. Beatty, state health commissioner, yesterday. Checking on the case, Dr. Beatty learned that the child has not been out of the state and has had no chance of contact with anyone coming into the state. For these reasons he is inclined to believe that the case is a sporadic one, having no connection with the eastern epidemic, but such as have occurred from time to time in the state in the past and have been successfully handled by isolation and quarantine.” (Salt Lake Tribune. “Infantile Paralysis Reported to State,” Sep 16, 1916, p. 14.)

Oct 1, Salt Lake: “A case of infantile paralysis was reported to the authorities yesterday. Claudius Apdale, aged 5 years, living…near the surplus canal, was stricken with what is called infantile paralysis. Te was taken to the county hospital at 5 o’clock last evening and placed in the isolated contagious ward.” (Salt Lake Tribune. “Has Infantile Paralysis,” Oct 1, 1916, p. 28.)

Oct 8, Salt Lake: “An increase of contagious diseases is shown in the weekly report of the city board of health. There were fifty-three cases reported during the week. Measles, with thirty-two cases, has increased over last week. Scarlet fever shows thirteen cases; diphtheria, three cases; chickenpox, two; typhoid fever, two; infantile paralysis, one.” (Salt Lake Tribune. “City Health Board Issues Its Report,” Oct 8, 1916, p. 27.)

Vermont

Caverly: “There were 64 cases of this disease recognized in Vermont during the year 1916…most of these cases…belonged probably to the outbreak which invaded New York and adjoining states from the severe epidemic which had its focus in Brooklyn.

“The earliest cases in Vermont appeared in Arlington, Pawlet, Poultney and Woodstock during the last of August. One case, in which the diagnosis was somewhat doubtful, had occurred in the town of Underhill on June 28. The real epidemic, however, started in Arlington, August 20. This was a late date for the epidemic occurrence of this disease, even in Vermont, where it has usually occurred rather later than in neighboring states. Four of the eight cases which occurred in Vermont during the last ten days of August were in this town. Three of these cases occurred in one family. Fourteen days previous to the first case, the father of the children had made a two days’ trip through parts of Connecticut, Massachusetts and New York by automobile. The second and third cases in this family developed four and six days after the first. The fourth case in the town of Arlington occurred in a family, in which the grandmother of the child had been in contact with the father of the three children previously mentioned, eleven days before this fourth child was taken sick…..” (p. 144)

“Cases of the disease, widely scattered, occurred in various parts of the state through September and October. Grand Isle in Lake Champlain, a sparsely settled island, had the most pronounced epidemic focus observed. These cases began about September 20….” (p. 145)

Cases by Age, Vermont, 1916
4 and under 5-9 10-19 20-29 30-39
22 24 13 5 0 (p. 146)

“The percentage of young children in our Vermont epidemics has been very low as compared with urban outbreaks. The number of children under five years of age in this epidemic was 22. This is 34.3 per cent of the whole number of cases; in 1914, of 304 cases, which occurred in the state, 38.1 per cent were under five. These figures are remarkably low, when compared with the figures for Greater New York in this 1916 epidemic. Of 9,345 cases in that epidemic, 77.3 per cent were under five years of age; and of 1,081 cases in New York State, outside of New York City, the same year, 50 per cent were under five….. These figures suggest the question whether there may be something in urban life that increases the susceptibility of young children to this disease.” (pp. 146-147)

Distribution by County
Addison 3
Bennington 10
Caledonia 2
Chittenden 8
Franklin 1
Grand Isle 14
Lamoille 1
Orange 4
Orleans 1
Rutland 16
Washington 1
Windham 1
Windsor 2
Total 64 (p. 147)”

Results
Paralyzed cases who survived numbered… 32
Died… 12
Fully recovered, including abortive cases… 19
Died in another state… 1 (p. 148)

Monthly Distribution, Vermont, 1916.
Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec
3 2 —- —- —– 1 — 11 20 22 2 3 (p152)

“….It will be noted by reference to the accompanying map [omitted; on p. 156 in Caverly] that most of our Vermont cases were clustered in towns close to the New York State border.” (p. 155)

Management of the Outbreak in Vermont

“From long and varied experience with this disease, we had reason, in Vermont, to anticipate cases, when the very serious outbreak in New York City began to show itself the latter part of June. On July 6, the Board adopted the following regulations relating to children from Greater New York City:
Vermont State Board of Health
Quarantine of Children from New York City

Infantile Paralysis (Epidemic Poliomyelitis) is prevailing to an unusual extent in the city of Greater New York.

Families in that city in which there are children will naturally take such children as far as possible into the country. The State of Vermont has unusual reasons for taking extraordinary precautions against this disease. Infantile Paralysis is generally recognized as a contagious disease and one that may be spread innocently by persons who have no clinical symptoms, in other words, by “abortive cases” or “healthy carriers.” The State Board of Health of this State deems it reasonable under the circumstances to make the following rules and regulations; therefore under the authority of Section 5419 of the Vermont statutes, the following rules and regulations are promulgated:

1. No child under the age of fifteen years shall reside in this State for a period of more than twenty-four hours without being reported by an attendant, parent or guardian to the Health Officer of the town or city where such child is, provided such child has been in the city of Greater New York since the 20th of June, 1916.

2. It shall be the duty of every housekeeper, manager or proprietor of every hotel or boarding house where such child is domiciled to immediately report such child, giving the name and age to the Health Officer of his city or town.

3. Every such child shall be subjected to quarantine for a period of two weeks from the time such child was last in the city of Greater New York.

4. The Health Officer of every town and city to whom such a child is reported shall immediately serve a written notice upon the head of the family in which such child is; this written notice shall contain a copy of these regulations and an order signed by such Health Officer requiring such child to remain on the premises in which it is at that time for the specified time of two weeks after last leaving the city of Greater New York.

5. Each Health Officer to whom such child is reported shall require of the attendant, parent or guardian of such child, a certificate in writing, duly signed by a legal practitioner of medicine, certifying that the nose and throat of such child has been thoroughly washed with a solution of a teaspoonful of common salt in a pint of water, once a day for a period of three consecutive days before the premises are released from quarantine.

6. No child under fifteen years of age shall enter any house so quarantined.

7. A placard containing the word “Quarantine” shall be sufficient evidence to all persons that the premises are quarantined for the purpose of these regulations.

Nothing in these regulations shall be construed to prevent other members of a household in which there is a child as above described, who has left the city of New York since June 20, 1916, from attending to their usual occupations.

The owners, managers or proprietors of hotels and boarding houses may place no restrictions on attendants or guests in their hotels or boarding houses further than the strict isolation of any children as above described from New York City, provided such children are isolated to the satisfaction of the local Health Officer and their noses and throats irrigated as specified.

Each Health Officer will see that a copy of these regulations with which he is furnished is conspicuously displayed in at least three public places in his town or city.

These rules and regulations will remain in force until further notice.

Per Order Vermont State Board of Health.
Charles F. Dalton, M.D., Secretary.
Adopted July 6, 1916. (pp. 157-159)
….
“On account of the occurrence, during the latter part of August, of cases in the four southern counties of the state, the Board adopted the following regulations with regard to fairs, the annual Rutland Carnival, theatres and picture houses:

Vermont State Board of Health
Regulations Adopted in Regard to the Attendance of Children at Public Gatherings

In accordance with the Vermont Statutes, the following rules and regulations are hereby promulgated by the State Board of Health:

1. All children under fifteen years of age shall be excluded from all fairs. The Rutland Carnival, so-called, shall be abandoned unless effective measures can be taken, satisfactory to the local board of health, by which children under fifteen years of age can be excluded from all public functions, both indoors and out.

2. All motion picture houses and theatres in Rutland, Bennington, Windham and Windsor Counties shall exclude children under fifteen years of age from all entertainments.

3. In towns in which there are one or more cases of infantile paralysis, all children under fifteen years of age may be excluded from all public gatherings, including churches and Sunday schools, in the discretion of the local board of health.

These rules and regulations shall remain in force during the month of September, 1916.

By Order of the State Board of Health.
Charles F. Dalton, Secretary.
Adopted August 31, 1916. (p. 160)

(Caverly, Charles S., M.D. “Infantile Paralysis (Poliomyelitis) in Vermont 1916-1916.” 1924.)

MA Dept. of Health: The monthly breakout of reported cases of poliomyelitis in Vermont for the year is: 3 in Jan, 2 in Feb, 1 in June, 11 in Aug, 20 in Sep, 22 in Oct, 2 in Nov, 3 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

Virginia

Jan-Dec: The monthly breakout of reported cases of poliomyelitis in Virginia for the year is: 14 in Jan, 10 in Feb, 12 in March, 9 in April, 15 in May, 10 in June, 24 in July, 44 in Aug, 64 in Sep, 49 in Oct, 46 in Nov, 14 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

July 28, Petersburg: “The order promulgated by the State Health authorities making infantile paralysis a ‘reportable’ disease, has already been put into operation by Dr. Martin, the head of the local health department. Physicians are, therefore, required to hereafter report all cases of infantile paralysis. Dr. Martin informed the Progress today that there are no cases of infantile paralysis in Petersburg at the present time, but he could not guarantee there would be none….” (Petersburg Daily Progress, VA. “Drs. Must Report Paralysis,” 7-28-1916, p. 1.)

Aug 2: “A case of infantile paralysis is reported in Dinwiddie, and another in Prince George, between Hopewell and Petersburg. It the latter case the house has been quarantined.” (Petersburg Daily Progress (VA). “Probe Infantile Paralysis in New York,” Aug 3, 1916, p. 1.)

Aug 23: “Richmond, Aug. 23. – A strict quarantine against all districts in which infantile paralysis is prevalent was proclaimed by State Commissioner Williams, effective August 25. Guards will be placed at all railroad and steamship entrances to the state.” (The News (Frederick MD). “Virginia Inaugurates Quarantine,” 23 Aug 1916, p. 1.)

Aug 30: “Richmond, August 30. – One death, another new case of infantile paralysis reported [at Marion], and the suspected case in Carolina County being definitely diagnosed s the disease, were the developments in the poliomyelitis situation in Virginia yesterday. This brings the total number of victims of the disease in the State to nineteen. The death reported was that of a five-year-old boy at Tyreanna, a village five miles east of Lynchburg…. Dr. Brumfield went to Marion from Caroline County where he had gone to diagnose a suspected case at Sparta. He found it to be a real case of infantile paralysis, the child affected being…[an] infant three years old.” (Daily News Record, Harrisonburg, VA. “Case of Infantile Paralysis at Marion,” 8-30-1916, p. 3.)

Sep 1: “Summary of the Virginia Quarantine Regulations Against Infantile Paralysis.”

“The quarantine applies to the States of New York, New Jersey and Pennsylvania…It applies to persons traveling in every fashion…train…boat…motor car…carriage…on foot…The quarantine does not apply to persons over sixteen years of age….

Sep 23: “Richmond, Va., Sept 23. – Barton Heights, a residential suburb, was thrown into a panic when a six-year-old child…who has being going to the public school for several days, died of infantile paralysis. The news spread rapidly and mothers rushed to the school to remove their children. The school was closed and primary pupils placed in quarantine.” (Daily News (Frederick, MD). “Close School When Pupil Dies,” Sep 23, 1916, p. 7. )

Nov 14: “Fredericksburg, Va., November 15. – Two children of Mr. and Mrs. Harry Marchant of Middlesex county are ill with infantile paralysis.” (Daily News Record (Harrisonburg, VA). “Infantile Paralysis near Fredericksburg,” Nov 16, 1916, p. 4.)

Washington

The monthly breakout of reported cases of poliomyelitis in Washington for the year is: 1 in Feb, 1 in June, 6 in July, 3 in Aug, 5 in Sep, 4 in Oct, 6 in Nov, 3 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

West Virginia

The monthly breakout of reported cases of poliomyelitis in West Virginia for the year is: 2 in March, 3 in April, 5 in July, 13 in Aug, 18 in Sep, 18 in Oct, 4 in Nov, 18 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

US PHS: “On request of the commissioner of health of West Virginia…Asst. Surg. J. P. Leake was detailed on January 4, 1917, to investigate an outbreak of poliomyelitis at Elkins, W. Va…. A house-to-house canvass of the city was made to discover abortive and unreported cases of poliomyelitis. This is the first time that a community so large as Elkins (7,000 population) has been surveyed for this purpose by physicians having experience in the disease….The virus of the disease was preserved for purposes of comparison with the virus of other epidemics….the epidemic took place in the winter….”

Aug 19: “Morgantown, W. Va., Aug 19. – Quarantine was established against children under sixteen years of age entering West Virginia from Pennsylvania, New York and New Jersey. Uniformed policemen inspected all trains, and turned back those who did not have health certificates.” (The News, Frederick MD. “West Va. Quarantine Against Penn.,” 8-19-1916, p. 1.)

Sep 22, Beckley: “Two more cases of infantile paralysis were discovered in different families on the hill near Glen Morgan by D. W. H. Cunningham last week. Dr. K. M. Jarrell, of this city, was called into consultation and the patients placed under quarantine. The cases are thought to be sporadic and to have no connection with the epidemic causing so much suffering in other states.” (Raleigh Herald (Beckley WV). “Two More Cases,” Sep 22, 1916, p. 3.)

No Date, Fairmont WV: “All public meetings in Elkins, Grafton and Fairmont have been suspended by the health authorities, because of an epidemic of infantile paralysis which to the present has developed forty-nine cases and caused nine deaths in the three towns. The public schools here are closed and all children under sixteen years are permitted to go on the streets only when absolutely necessary.” (Municipal Journal, “Infantile Paralysis in West Virginia,” Jan 25, 1917, p. 108.)

Draper: “According to the still unpublished report of the Department of Health of West Virginia, the first case in this epidemic started at Elkins on August 29th; the second case appeared September 9th and the third case October 10th. The disease took epidemic proportions about December 10th. The total number of cases reported was 39 paralyzed and 35 non-paralyzed. The epidemic in the neighborhood of Grafton covered a period between December 10th and Feb. 12th [1917]. In this there were 22 paralyzed, 6 non-paralyzed and 6 deaths. The first case in Fairmont was on January 6th; the total paralytic cases were 15 and 3 deaths.” (Draper 1917, 18-19.)

Wisconsin

Jan-Dec: The monthly breakout of reported cases of poliomyelitis in Wisconsin for the year is: 2 in Jan, 1 in Feb, 2 in April, 2 in May, 4 in June, 20 in July, 174 in Aug, 163 in Sep, 87 in Oct, 19 in Nov, 9 in Dec. (MA Health Dept. The 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

Sep 27: Up to date there have been 300 cases of infantile paralysis in Wisconsin and thirty deaths. While there is nothing really alarming, in these figures, as they are small compared with the total population, they nevertheless suggest a problem of no little seriousness and importance. It is the opinion of medical experts that the present epidemic of this much dreaded disease may continue for some time before it is effectively checked, and they anticipate it may be worse next year than it has been this year. This means that worry and apprehension are likely to grow and spread, and perhaps culminate in a feeling of genuine alarm. It is highly unfortunate, of course, that medical science has not yet been able to solve the problem of controlling and checking this scourge, and much to be hoped this problem soon may be mastered. Pending that time, however, it behooves both physicians and the public to be vigilant in detecting cases of this disease immediately it appears, and prudently careful in preventing further spread of the contagion so far as possible. Also, there are certain precautions to he followed to minimize the danger, and this information should be spread by physicians and carefully observed by the people. A serious and extensive outbreak of this disease would be nothing: short of a public calamity, and everything possible should be done to prevent an unfortunate experience of this character.” (Daily Northwestern (Oshkosh). “Infantile Paralysis in Wisconsin,” Sep 27, 1916, p. 6.)

“Sep 29, Sheboygan: “Another, the fourth case of infantile paralysis in Sheboygan, was discovered Thursday evening when Joe…3 years-old…was taken to a local physician for treatment. The physician immediately diagnosed the case as one of infantile paralysis and summoned Dr. H. C. Reich, city health officer, who confirmed the diagnosis, removed the child to his home and placed it under strict quarantine.” (Sheboygan Press (WI). “Another Case of Infantile Paralysis,” Sep 29, 1916, p. 1.)

Sep 30: “Poliomyelitis in Wisconsin. – According to the records of the state board of health, 318 cases of infantile paralysis had been reported in Wisconsin up to September 30.” (Journal of the American Medical Association. “Medical News,” Vol. 67, No. 17, 10-21-1916, p. 1237.)

Dec 9, Green Bay: “Green Bay – Infantile paralysis claimed another victim in Brown county when the 9 months’ old child of John McCabe, Depere, succumbed after being ill about three weeks.” (Stevens Point Daily Journal, WI. “Is Victim of Paralysis,” 12-9-1916, p. 5.)

Dec. 31, Madison: Two cases of infantile paralysis were reported of infantile paralysis in Madison for the year. (Wisconsin State Journal, Madison. “City Grows and Work of Health Board Increases,” 12-31-1916, p. 33.)

Wyoming

Mar-Dec: The monthly breakout of reported cases of poliomyelitis in Wyoming for the year is: 1 in March, 2 in Oct, 2 in Nov, 3 in Dec. (Massachusetts Dept. of Health. 1916 Infantile Paralysis Epidemic…. 1919, p. 8.)

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