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San Francisco plague of 1900–1904

The San Francisco plague of 1900–1904 was an epidemic of bubonic plague centered on San Francisco's Chinatown. It was the first plague epidemic in the continental United States.[1] The epidemic was recognized by medical authorities in March 1900, but its existence was denied for more than two years by California's Governor Henry Gage. His denial was based on business reasons, to protect the reputations of San Francisco and California and to prevent the loss of revenue due to quarantine. The failure to act quickly may have allowed the disease to establish itself among local animal populations.[2] Federal authorities worked to prove that there was a major health problem, and they isolated the affected area; this undermined Gage's credibility, and he lost the governorship in the 1902 elections. The new governor, George Pardee, implemented public-health measures and the epidemic was stopped in 1904. There were 121 cases identified, resulting in 119 deaths.[3][4]

San Francisco plague of 1900–04

1900

1900–1904

121

119

Much of urban San Francisco was destroyed by a fire in the 1906 San Francisco earthquake, including all of the Chinatown district. The process of rebuilding began immediately but took several years. While reconstruction was in full swing, a second plague epidemic hit San Francisco in May and August 1907 but it was not centered in Chinatown. Cases occurred randomly throughout the city, including cases identified across the bay in Oakland. San Francisco's politicians and press reacted very differently this time, wanting the problem to be solved speedily.[5] Health authorities worked quickly to assess and eradicate the disease.[6] Approximately $2 million was spent between 1907 and 1911 to kill as many rats as possible in the city in order to control one of the disease's vectors.[7]


In June 1908, 160 more cases had been identified, including 78 deaths, a much lower mortality rate than 1900–1904.[8] All of the infected people were European,[7] and the California ground squirrel was identified as another vector of the disease.[6] The initial denial of the 1900 infection may have allowed the pathogen to gain its first toehold in America, from which it spread sporadically to other states in the form of sylvatic plague (rural plague). However, it is possible that the ground squirrel infection predated 1900.[2][9][10][11][12]

Racism and discrimination lawsuit[edit]

Widespread racism toward Chinese immigrants was socially accepted during the initial time of the Chinatown plague in the early 1900s. Standard social rights and privileges were often denied to the Chinese people, as shown in the way landlords would refuse to maintain their own property when renting to Chinese immigrants.[55] The living conditions in the Chinatown community reflected the social norms and racial inequalities during that time for Chinese immigrants. Housing for the majority of Chinatown Chinese immigrants was not fit nor adequate for human living, but with scarce housing options and landlords unwilling to provide equal and fair housing, Chinese immigrants were left little option other than to live with such housing disparities.[55] Discrimination against Chinese Americans culminated in two acts, the quarantine of San Francisco's Chinatown, and the permanent extension of the Chinese Exclusion Act of 1882.[56] The extended quarantine of Chinatown was motivated more by racist images of Chinese Americans as carriers of disease than by actual evidence of the presence of Bubonic plague.[57]


San Francisco's quarantine measures were explicitly discriminatory and segregatory, allowing European Americans to leave the affected area, but Chinese and Japanese Americans required a health certificate to leave the city. Residents were initially angered as those with jobs outside of San Francisco were prevented from working. Few Chinese agreed to take the inoculation, especially after press reports on May 22, 1900, that people who did agree were experiencing severe pain from the untested vaccine. On May 24, 1900, with the help of Chinese Six Companies, they hired the law firm of Reddy, Campbell, and Metson. Defendants included Joseph J. Kinyoun and all of the members of the San Francisco Board of Health. The Chinese wanted the courts to issue a provisional injunction to enforce what they argued was their constitutional right to travel outside of San Francisco. On July 3, 1900, Judge William W. Morrow ruled that the defendants were violating the plaintiffs' Fourteenth Amendment rights. The ruling required that the same restrictions, if any, be applied to everyone no matter their ethnic group. The defendants did not have enough evidence to prove that the Chinese were transmitting the plague. Morrow agreed with the argument that if they were, the city would not have permitted them to roam the streets of San Francisco.[58]


The Board then "attempted to sidestep the decision by instituting a quarantine order that avoided mention of race, but which was precisely drafted so as to encompass all of the Chinatown area of San Francisco while excluding white-owned businesses on the periphery of that area"; this effort was also struck down, with the court noting that the boundaries of the quarantine corresponded with the ethnicity of building occupants rather than the presence of the disease.[59]

Detailed history[edit]

1900[edit]

Upon the death of Wong Chut King, the San Francisco Health Board took immediate action to prevent the spread of plague: Chinatown was quarantined.[60] Health officials, in order to prevent the propagation of the disease, made the decision of placing Chinatown under quarantine, without any notice to the residents – targeting Chinese residents only. White Americans that were walking the streets of Chinatown were allowed to leave; everybody else was forced to stay.[60] Physicians were restricted from crossing into Chinatown to identify and help the sick. The Health Board had to approve whether or not any health official crossed into the quarantined area.[60] Due to lack of evidence that the cause of death of King was plague, the quarantine was removed the day after to avoid controversy.[60]


Kinyoun's lab confirmed the disease was bubonic plague and informed the Health Board right away. In an attempt to avoid a second controversial quarantine, the Health Board continued with a house-to-house inspection to look for possible plague infested households – disinfecting those that were thought to be at risk of infection.[60] Participants in the house-to-house examination were mainly volunteer physicians and residents. On the contrary, other residents did not support the inspection and argued that the disinfecting plan was not being done in good faith. Believing a second quarantine would be soon implemented, worried residents began to flee quietly and hide in friends' houses outside of Chinatown.[60]


As days passed, more dead bodies were reported and autopsies revealed the presence of plague bacilli, indicating that a plague epidemic had hit San Francisco's Chinatown, but the health board still was trying to deny it. The health board attempted to keep all the information regarding the outbreak secret by implementing strict regulations of what physicians could write official death certificates.[60] Nevertheless, newspapers published the news of the presence of bubonic plague in San Francisco to the entire nation, especially William Randolph Hearst's New York Journal which published a special plague edition.[61]


The official inspection and disinfection of Chinatown finally began, thanks to the monetary contributions of the supervisors of the volunteer physicians, policemen, and inspectors that participated in the actual disinfection campaign. The sanitizing of Chinatown began to show results as the death toll slowly dropped throughout the month of March and the beginning of April.[60] Towards the end of April, the corpse of Law An, a Chinese laborer from a village near the Sacramento River, was found in an alley in Chinatown. The cause of death of Law An was determined to be bubonic plague. After that, a few more Chinese residents that died suddenly were determined to be infested with plague bacilli. The fear that the bubonic plague was spreading intensified.[60]


The controversy of the vaccination program organized by Kinyoun with the help of Surgeon General Wyman spiked. The plan was to inoculate the Chinese residents with Haffkine's vaccine, a prophylactic anti-plague vaccine that was intended to provide some protection against the plague for a 6-month period. No one spoke about the side effects and that the vaccine was still not approved for humans.[60] Most Chinese residents refused and demanded the vaccine to be tested in rats first. At first, representatives of the Chinese community had agreed that inoculating the population with such serum could be a reasonable and safe solution, but soon after agreed with the rest of the Chinese population in that it was not ethical to try the vaccine in humans first. The representatives from the Chinese Six companies demanded the vaccination program to be eliminated as an option, and with much pressure and insistence from the Chinese community the vaccination program was halted.[60]

1901[edit]

Joseph J. Kinyoun was feeling the pressure of the public to clear his reputation. He summoned the help of U.S. Surgeon General Walter Wyman to bring someone from the outside to investigate Kinyoun's procedures. In December 1900 Wyman selected Assistant Surgeon General Joseph H. White to manage the investigation surrounding all of the Pacific Coast stations. White wanted to focus on how food was handled while being imported from China and Japan. Kinyoun tried to hinder these advances because he did not want to publicly admit that there was an outbreak. White made his appearance in January 1901. White and Kinyoun attended the autopsy of Chun Way Lung who was said to have suffered from gonorrhea. Wilfred Kellogg and Henry Ryfkogel conducted the autopsy and achieved respect from White by revealing that Lung had died from the bubonic plague. White concluded that Kinyoun's bacteriological confirmation could no longer be credible.[62]


Governor Gage refused to support the diagnoses that were verified by the competent Pasteurians in San Francisco. Kinyoun was starting to express his frustration and suggested that independent outside experts confirm that the plague was present. White agreed and passed this information to the surgeon general. Kinyoun desired that his reputation be restored and that his findings were valid so that he could continue to investigate plague cases. On January 26, Flexner, Novy, and Barker arrived in San Francisco. The three scientists were appointed to an official commission to prove if the plague existed.[62]


Gage reacted by sending a telegram to President William McKinley urging that the federal experts work with state health authorities. Gage's request was not granted because the federal government wanted the commission to be allowed to work independently. They would relay all of their findings to the treasury department and then forwarded to Gage. Flexner, Novy, and Barker scheduled an inspection of the sick and dead on February 6. The federal investigators split up the duties. Novy carried out bacteriological tests, while Barker accompanied by a Chinese interpreter visited the sick. By February 12, the team had studied six cases that all identified the characteristics of bubonic plague. This was confirmed by pathological and bacteriological data. Flexner, Novy, and Barker completed their investigation on February 16. They met with Governor Gage the same day and informed him of their conclusion.[62]


Gage was upset and accused them of being a threat to public health. Over the next few weeks Gage questioned the diagnoses and blocked the publication of the final report. He blamed the commission of being biased and influenced by Kinyoun. Finally the two senators for California proposed that Gage needed to engage in friendly cooperation with federal authorities. Gage sent representatives to Washington to reach an agreement for federal authorities to suppress their findings concerning the plague in San Francisco. The federal authorities agreed to these demands after Gage's representatives verbally pledged to manage a sanitary campaign in Chinatown. This would be done secretively under the guidance of an expert from the Marine Hospital Service This deal was designed to avoid impairing the state's reputation and economy. Surgeon general Wyman took the majority of the blame. He was accused of violating U.S. laws and breaking international agreements that required him to notify all nations that there was an existence of contagious disease. Wyman and President McKinley destroyed the credibility of the American public health in the eyes of the nation and abroad.[62]

1902[edit]

Countering the continued denials made by San Francisco-based newspapers, reports from the Sacramento Bee and the Associated Press describing the plague's spread, publicly announced the outbreak throughout the United States. The state governments of Colorado, Texas and Louisiana imposed quarantines of California – arguing that since the state had refused to admit to a health crisis within its borders, states receiving rail or shipping cargo from California ports had the duty to protect themselves.[52] Threats of a national quarantine grew.[63]


As the 1902 general elections approached, members of the Southern Pacific board and the "Railroad Republican" faction[64] increasingly saw Gage as an embarrassment to state Republicans. Gage's public denials of the plague outbreak were to protect the state's economy and the business interests of his political allies.[46][52] However, reports from federal agencies and certain newspapers continued to prove Gage incorrect. Other states were moving to quarantine or boycott California, and the powerful shipping and rail companies sought a new leader. At the state Republican convention that year, the Railroad Republican faction refused Gage's renomination for governorship. In his place, former Mayor of Oakland George Pardee, a German-trained medical physician, received the nomination. Pardee's nomination was largely a compromise between the Railroad Republican factions.[65]


In his final speech, to the California State Legislature, in early January 1903, Gage continued to deny the outbreak. He blamed the federal government, in particular, Kinyoun, the MHS, and the San Francisco Board of Health for damaging the state's economy.[46][52]

List of epidemics

Chinese boycott of 1905

Early Motion Pictures, Library of Congress

1902 Scene in Chinatown

PBS American Experience: Plague at the Golden Gate https://www.pbs.org/wgbh/americanexperience/films/plague-golden-gate/#part01