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SMALLPOX
EPIDEMIC
It’s an emergency! A train from Toronto has just pulled into Bonaventure Station. The Pullman car conductor is sick. He’s coughing and running a slight fever. What’s more worrisome, though, its that he has blisters on his hands and face. The railway company’s doctor suspects that he has smallpox, a virus in the same family as chicken pox. Smallpox is much more dangerous, though, and spreads very quickly. There is an epidemic raging in Chicago right now, and the conductor was there not long ago. We must stop the virus from spreading in Montréal!
We need someone with a cool head, who will do what’s needed to protect Montréal.
Isolation
Dr. William Hales Hingston, Montréal’s former mayor (1875-1877), is a smallpox expert. In fact, he fought the disease during another epidemic between 1872 and 1875. He knows the virus well.
Smallpox is highly contagious and easily transmitted from one person to another. The virus enters the body through the mouth and nose. After an incubation period of 10 days, the victim starts suffering headaches, muscle pains, fever and chills. Blisters cover the whole body. The victim’s face swells and sores may appear in the mouth and nose and on the corneas. The symptoms usually disappear after eight days, and the skin heals, leaving scars. There is a very high risk of death, however, from the internal bleeding caused by smallpox.
What can we do to prevent an epidemic? Isolate the victim? If so, how?
- No, this person needs care and attention from his friends and family.
- Yes, in a special contagious disease wing at the hospital.
- Yes, at home, and quarantine his family with him.
Hospital
The nursing sister who greets the patient at the hospital should be informed immediately of his condition. Unfortunately, no one realizes how serious it is until the next morning, and the patient isn’t properly isolated until then. Pélagie, a young servant working at the hospital, catches the virus and gives it to her sister Marie.
She is quarantined at the hospital as soon as it is realized that she is sick, but it is too late. The virus spreads through the institution. Pélagie and Marie die several days later.
The authorities have two options:
- Send those patients who are not severely ill home, to prevent them from catching smallpox at the hospital.
- Re-open the small hospital for smallpox patients that was built during the 1872 epidemic, and transfer the smallpox patients there.
- Send patients home.
- Re-open the hospital for smallpox patients.
Send patients home
The virus has a 10-day incubation period. Some people are infected but show no symptoms. When they return home, they infect their families, and the disease spreads.
Montréal is at risk of an epidemic ...
Re-open the hospital for smallpox
The smallpox hospital was opened by the City in 1872, during the last smallpox epidemic, which lasted until 1875. The building is now quite run down. People don’t want to send their sick there!
In addition, the hospital is managed by laypeople, and this makes Catholics in Montréal uneasy. Families keep their sick members at home, and infected people continue to move about the city.
Montréal is at risk of an epidemic ...
Home
A City Board of Health officer is stationed in front of the home of another railway employee who has also come down with smallpox, to prevent the people who live there from leaving. But two people manage to slip out, taking the virus with them ... the disease spreads even more.
The City’s Health Committee, chaired by Henry Gray, meets and attempts to arrange free and voluntary public vaccination – but it runs into opposition.
Montréal doctors are divided on the question of vaccination. Many of them feel that vaccination will stop the epidemic from spreading; others think that injecting healthy people with the virus will make them sick.
In addition, even though vaccines were invented many years ago and have proved their effectiveness, the public still doesn’t trust them. Many people don’t understand how viral diseases are spread, and are afraid of vaccination. They also have a traditionally resigned attitude toward disease and death.
Alors, on vaccine ou pas ?
- Public vaccination
- No public vaccination
Vaccination
The Health Committee appoints new public vaccinators to provide free smallpox vaccinations to anyone who wants them. Doctors are also asked to report cases of smallpox.
Montréal’s poor and less educated residents reject the public health measures. Many simply refuse to be vaccinated!
French-language newspapers and some members of the city’s elite, including Doctors Alexander Milton Ross and Joseph Émery Coderre, throw fuel on the flames by openly opposing vaccination.
A tragic incident makes the situation worse. Children in the Saint-Joseph orphanage are vaccinated under very dirty conditions. As a result, many of them fall sick – not with smallpox, but that is little comfort to the public. Protests grow, and the public vaccination campaign is cancelled.
Montréal is at risk of an epidemic ...
No vaccination
Houses in working-class neighbourhoods are packed closely together, increasing the risk of smallpox spreading. People there have not been immunized. They catch the virus and spread it as they move about the city, going to the market, work, church an public events like parades and demonstrations.
Montréal is at risk of an epidemic ...
No isolation
The Pullman car conductor returns home. As they try to care for him, his family and friends come down with the virus themselves.
The smallpox virus has a 10-day incubation period. Some infected people show no symptoms and don’t know that they are contagious.
People who have come into contact with infected people are now walking around the city and spreading the virus.
Information
An epidemic is sweeping Montréal. People from all walks of life are infected, and continue to spread the virus unknowingly. They are contagious during the incubation period, even before they notice any symptoms, and while they are sick. The Health Committee is battling the opposition of those doctors who are speaking out against vaccination and the public’s ignorance and fear.
People have to be informed about the disease and what has to be done to stamp it out:
- Every sick person must be isolated, and kept away from healthy people.
- Any objects he or she has touched must be sanitized or destroyed.
- Any form of public gathering must be avoided, for people in the crowd could be carrying smallpox.
How can we inform the public without creating a panic?
- Use the newspapers.
- Use public spokespeople.
- Panic is inevitable: Say nothing.
Newspapers
Newspapers are increasingly popular, but many workers, including a large number of French-Canadian Montrealers, are illiterate. On the one hand, the French newspapers downplay the severity of the situation, while on the other hand the English press blames the spread of the disease on French Canadians’ behaviour.
Anglophones criticize the Health Committee and blame the Board of Health for dirty conditions in the city, saying that it is incompetent. They think that by refusing to be vaccinated Francophones are contributing to the spread of the disease.
Meanwhile, life goes on. Workers have to earn a living, children play in the streets and women go to the market. People get together to celebrate special occasions ... and the disease continues to spread.
There has to be a way to limit the damage: to stop people from gathering and spreading the virus, and force them to comply with the public health measures ordered by the City. It’s risky, though, because this course of action goes against the will of half the populace. There could be riots! What should we do?
- Close public places and send out the sanitation constables.
- Clean up Montréal’s streets.
Spokesperson
Municipal officials are looking for a spokesperson with credibility among French-Canadian Montrealers. They call on the Catholic clergy, since French Canadians, who are the hardest hit by the epidemic and the ones the authorities really need to reach, are Catholic. They ask the Bishop of Montréal to intervene and speak to parish priests, to get them to stress the importance of prevention in their sermons. But it’s no use.
The public health authorities, for their part, avoid publicizing the epidemic – they don’t want to panic the public or harm the economy by frightening away trade and tourists.
Montréal’s economic elite, mainly English speaking, organizes and decides to take action. Employers demand that their workers get vaccinated ... or they will be fired.
Someone has to impose order and stamp out the epidemic sweeping the city: Stop people from gathering and spreading the virus, and force them to comply with the public health measures ordered by the City. It’s risky, though, because this course of action goes against the will of half the populace. There could be riots! What should we do?
- Close public places and send out the sanitation constables.
- Clean up Montréal’s streets.
Silence
The public still doesn’t understand what is happening. People go about their daily business and meet in the street, at work and in shops and markets. They gather to celebrate special occasions. The disease continues to spread.
The number of deaths is rising, and whenever people gather for funerals they spread the virus even more widely.
The lack of information is making the epidemic worse. The authorities no longer have a choice: they must clearly explain the situation to the public and outline the public health measures to be taken. How should they do this?
- Use the newspapers.
- Use public spokespeople.
Close public sites and deploy sanitation constables
Sanitation constables are roaming the streets of Montréal, posting yellow signs on the doors of smallpox-contaminated homes. Smallpox victims have to be taken by force to the smallpox hospital that the City has just re-opened. Anyone who refuses to comply with the City’s new health rules is fined and threatened with jail.
In working-class neighbourhoods, the people tear down the signs posted on the doors of contaminated homes; they drive off the sanitation constables with sticks and insults. When the Mayor, businessmen and newspapers all agree that public-health measures must be obeyed, riots break out!
On September 28, 1885, a crowd gathers, throwing stones and breaking the windows of pharmacies and the offices of doctors who perform vaccinations. They also attack City Hall. As the first shots are fired, the Mayor calls in the police. The rioting continues well into the night.
The epidemic runs its course ...
Clean Montréal's streets
Whole neighbourhoods in Montréal and neighbouring villages resemble an open-air dump. There is no running water, and no sewers. The privies are overflowing with human waste and garbage. Montréal stinks!
Municipal authorities remember the cholera epidemics that struck the city so hard in the past and are erupting elsewhere at this very moment. Cholera is spread mainly through infected food and water. The City rushes to clean up the streets, picking up garbage and waste littered everywhere.
But while people are worried about cholera, it is smallpox that is causing damage. It spreads from person to person. Lots of energy is invested in cleaning the streets, but smallpox calls for different forms of prevention.
The epidemic runs its course ...
The epidemic runs its course
The City of Montréal converts one of the provincial exhibition buildings into a clean and spacious temporary hospital for smallpox patients, guarded by the army.
Slowly, the disease fades away and the epidemic runs its course. The most vulnerable people have died. Everyone else has developed resistance to the virus or been vaccinated. Smallpox has struck all its potential targets in Montréal.
The result: 9,600 people came down with smallpox in 1885 in the administrative territory of Montréal, and 3,234 of them died. Out of a total population of about 167,000, some 2% of Montrealers perished. That’s not to mention the victims in neighbouring municipalities, including the village of Saint-Jean-Baptiste, where the smallpox epidemic was most deadly.
Could the disaster have been avoided?
- Go back to Day 1: See what you can do by making different choices!
- Successful crisis management
Successful crisis management
The City of Montréal created a committee to study the epidemic and draw lessons from it for the future. The main conclusions in its report were:
- People should have been vaccinated as soon as possible, even before the epidemic started. Then the first individual with smallpox could not have transmitted the virus so easily.
- Smallpox cases must be reported as soon as possible.
- Montréal should always have a hospital to handle contagious patients.
- Hospitalization should be mandatory for contagious diseases.
- The effectiveness and benefits of vaccination should be stressed to members of the medical profession and explained to the public.
- In a serious epidemic, with deadly consequences, vaccination should be mandatory.
Thanks for your help. We all did our best with the facts at our disposal. Let’s make sure it never happens again!
Pictures
Consolidated Engine No. 403, C. P. R. Pacific Division, BC, about 1887
A. B. Thom
About 1887, 19th century
Silver salts on paper mounted on card - Albumen process
18.4 x 23.5 cm
Gift of The Estate of Omer Lavallée
MP-1993.6.6.32
© McCord Museum
Mayor Honoré Beaugrand, Montreal, QC, 1887
Wm. Notman & Son
1887, 19th century
Silver salts on glass - Gelatin dry plate process
17 x 12 cm
Purchase from Associated Screen News Ltd.
II-82778
© McCord Museum
Grand Trunk Bonaventure Station
P186,S9,P84
Fonds Laurette Cotnoir-Capponi (BAnQ)
Sir William Hingston, Montreal, QC, 1886
Wm. Notman & Son
1886, 19th century
Silver salts on paper mounted on paper - Albumen process
15 x 10 cm
Purchase from Associated Screen News Ltd.
II-80533.1
© McCord Museum
Unidentified group
John Henry Walker (1831-1899)
1850-1885, 19th century
Ink on paper on supporting paper - Wood engraving
8.2 x 9.6 cm
Gift of Mr. David Ross McCord
M930.50.5.492
Hotel Dieu Hospital, Montreal, QC, about 1865
Anonyme - Anonymous
about 1865, 19th century
Silver salts on paper mounted on card - Albumen process
8 x 5 cm
Gift of Mr. David Ross McCord
MP-0000.1764.2
© McCord Museum
Houses for Mr. Meredith, corner of Barré and Aqueduct Streets, Montreal, QC, 1903
Wm. Notman & Son
1903, 20th century
Silver salts on glass - Gelatin dry plate process
20 x 25 cm
Purchase from Associated Screen News Ltd.
II-146722
© McCord Museum
Hospital for smallpox patients
Library and Archives Canada
Poor Montréal neighbourhood (Old Montréal): the Friponne house (former warehouse under the French Regime). Probably after an original by A. Henderson, 19th century / Reproduction by Edgar Gariépy.
Archives de la Ville de Montréal (Fonds BM42, G2675)
Houses for Mr. Meredith, Montreal, QC, 1903
Wm. Notman & Son
1903, 20th century
Silver salts on glass - Gelatin dry plate process
20 x 25 cm
Purchase from Associated Screen News Ltd.
II-146359
© McCord Museum
Henry Gray
Fraser-Hickson Institute Fonds
Dr. A.M. Ross, an opponent of vaccination
Archives de la Ville de Montréal
Coderre, J.E.
Fraser-Hickson Institute Fonds
Allegory
John Henry Walker (1831-1899)
1850-1885, 19th century
Ink on paper on supporting paper - Wood engraving
16.4 x 15.8 cm
Gift of Mr. David Ross McCord
M930.50.2.245
© McCord Museum
Riot
John Henry Walker (1831-1899)
about 1870, 19th century
Ink on paper on supporting paper - Wood engraving
7.8 x 10.2 cm
Gift of Mr. David Ross McCord
M930.50.6.33
© McCord Museum
Vaccinate!!
Propaganda opposing vaccination, by A.M. Ross
University of Toronto Library
J. B. Mailloux, Wood & Coal, Barré St., Montreal, QC, 1903
Wm. Notman & Son
1903, 20th century
Silver salts on glass - Gelatin dry plate process
20 x 25 cm
Purchase from Associated Screen News Ltd.
II-146360
© McCord Museum
Market day, Jacques Cartier Square, Montreal, QC, about 1890
Wm. Notman & Son
About 1890, 19th century
Silver salts on glass - Gelatin dry plate process
20 x 25 cm
Purchase from Associated Screen News Ltd.
VIEW-2421
© McCord Museum
The Best Preventive Known for Smallpox, Dr. Morley’s Standard English Remedy
Fraser-Hickson Institute Fonds
City Hall,
Montreal, QC, about 1878
William Notman (1826-1891)
VIEW-807.1
© McCord Museum
Smallpox riot
Harper’s Weekly
Montreal's Night-Mayor on his Ghostly Rounds (Dedicated to the Board of Health)
Henri Julien
1875, 19th century
Ink on paper - Photolithography
40 x 28 cm
M992X.5.82
© McCord Museum
Montreal. St. George (Mayor Hingston) and the dragon (small pox), 1876
Henri Julien
1876, 19th century
Ink on newsprint - Photolithography
39.9 x 27.7 cm
M993X.5.1135
© McCord Museum
City Council of Montreal, QC, composite, 1885, copied 1887
Wm. Notman & Son
1887, 19th century
Silver salts on glass - Gelatin dry plate process
20 x 25 cm
Purchase from Associated Screen News Ltd.
II-85064
© McCord Museum
Memphis
John Henry Walker (1831-1899)
1878, 19th century
27.3 x 25.4 cm
M991X.5.795
© McCord Museum
The Mayor and the Board of Health
Henri Julien
1877, 19th century
Ink on newsprint - Photolithography
37.5 x 28.6 cm
Gift of Mr. Colin McMichael
M988.182.142
© McCord Museum
