Perhaps you are wondering how epidemics influenced your family history. Obviously your ancestors survived, because you are alive today. For many of us deadly diseases such as typhoid, smallpox, cholera, yellow fever, measles, and polio are all diseases of the distant past. They have been eradicated or vaccinations have been found. However, our ancestors all lived with the ominous threat of disease. By understanding the diseases of their lifetimes, we will be better able to understand our ancestors and the circumstances they lived in. The repercussions of these diseases are important for family history research, especially here in the United States.

Disease was common in the large cities of Europe, where most early colonizers came from. The Black Death (or Bubonic Plague), of Medieval Europe was still in recent memory for most immigrants. It was just accepted that disease and premature death was part of life. Europeans brought many Old World diseases like smallpox, influenza, and measles to the New World. Many of these settlers had survived outbreaks in their homelands and developed immunities. However, the native American Indians had no previous exposure, and diseases decimated their populations. With their numbers weakened, Native Americas were unable to stop European immigrants from settling on their lands. Wars also decimated native populations. With Native American and European troops marching over colonial America, diseases traveled swiftly from colony to colony, country to country.

Part One: Smallpox

The first disease that we will examine is smallpox or Variola major. The disease was called smallpox because its surviving victims often had pox marks on the face or body, but the markings were smaller than those left by syphilis, which was commonly known as the large pox or French pox. The two diseases were often mistaken for each other until the 17th century.

In her book, Pox Americana, Elizabeth Fenn describes minutely the 32-day timeline of the Variola virus. She calls it a parasitic virus that consumes its host. Introduced by either touch or inhalation, Variola usually incubates in its new victim for 10-12 days before the first symptoms present themselves. At first, the victim may feel as if they have the flu with symptoms such as backache, headache, fever, and nausea. At this stage, the victim can contaminate others, yet not even know they are seriously infected. On about the 15th day a rash and eruptions appear on the skin. They eventually burst, then scab over. Sometimes victims developed internal sores that would cause them to bleed to death from various body openings, such as the eyes and ears. The entire process is full of immense pain and suffering. By day 30, if the victim is still alive, he or she is no longer contagious, though often scarred for life. The very young and the very old were the largest group of victims. In one study that Fenn recorded, there was a 29% mortality rate for children under one year of age, 8% for children 5-14 years, and 32% for adults over 45 years. The mortality rate was highest for pregnant women: 96%. Surprisingly enough, Variola could survive for long periods outside the human body. A blanket used on a victim, unwashed and stored away for years, can still contain an active virus. With statistics such as these, it is evident why smallpox was so feared in North American colonies.

The origin of the smallpox disease is uncertain, but John Duffy believes it came from Central Africa or India. Rhazes, a Persian scholar, who lived from 850-923 A.D, recorded the first accurately documented case. By the 15th and 16th centuries, Variola was affecting people worldwide. It reached the West Indies soon after Christopher Columbus, and in 1520 Spaniards carried it into Mexico. Duffy estimated the smallpox deaths in Latin America to be three million.

Just as explorers from Spain were carrying Variola to Mexico, the French were carrying it into Canada, and the English to the American colonies. This time period bustled with commerce and wars, both primary causes for smallpox epidemics. Fenn's work about smallpox focuses specifically on the years of 1775-82, the time of the American Revolution. Her claim is that the many military campaigns spread smallpox and killed more people than all the battles combined. As soldiers marched from one large city to another, they took Variola along with them, and no one was safe from the virus. Oftentimes diseases like smallpox and others were imported from abroad by crowded and filthy immigrant ships sailing from London or Liverpool. Sometimes these ships would stop in the West Indies for fresh fruit to prevent scurvy, where they would also pick up yellow fever and other tropical diseases. Major seaports were the primary dissemination points for diseases, especially smallpox. Once brought on land, Variola would spread again. Fenn estimates that for big cities, such as Boston and New York, smallpox epidemics happened approximately every five years, making it endemic to city life.

Lack of proper nutrition caused people to be physically weaker and more susceptible to smallpox. Duffy says malnutrition, especially scurvy, "paved the way for epidemic disorders." This is especially true for Native Americans. Fenn shows that many Native Americans died because of famine conditions and because their numbers were so decimated there were few left to care for the recovering victims of smallpox.

Even with such terrible consequences, Stephen Kunitz points out that while many European immigrants had higher mortality rates than people born in the American colonies, they tended to have lower mortality rates than those in their countries of origin. This perhaps was due to the distances between settlements in the colonies. According to Duffy, it was the geographic remoteness and smaller urban populations that spared early North American colonies from the many epidemics that raged throughout European cities. Apparently, if one worked and lived on a family farm in a remote part of a northern New England colony, one's chances of catching and spreading diseases like smallpox were greatly reduced compared to those of slaves working on southern plantations.

Consequently, Kunitz states that in the 17th century, life expectancy in New England was higher than in Maryland; a trend which continued into the 18th and 19th centuries. For instance, in the early 19th century, death rates in New England were 18-25 per thousand and in cities like New Orleans and Savannah, 80-90 per thousand. Kunitz does not specify the race of these groups, but it is most likely those numbers are for whites only.

Other causes of smallpox epidemics were early attempts to inoculate or isolate people against the disease. Large cities usually quarantined ships with known carriers of disease. Eventually, quarantine laws were enacted. Sometimes a house was chosen outside of town in which infected individuals lived out their quarantine. Whole communities were often quarantined. As Fenn points out, these tactics sometimes worked. For example, in 1721, 900 of the 10,700 citizens of Boston fled to the countryside to escape the smallpox. The problem with such isolation methods was that those who fled the city often carried the disease into the countryside with them, thus spreading, rather than containing, the disease.

Inoculation was a technique that some colonists turned to. Also known as variolation, this technique was risky. Introduced to the Colonies in the 1700s, variolation required the patient to have a live virus - usually in the form of puss from an already-infected patient - inserted into a cut in the hand or arm. The patient eventually displayed symptoms of the disease, but milder, and mortality rates were lower. Unfortunately, variolation was expensive so only the upper classes could afford the procedure. Sometimes inexperienced and unqualified doctors, who did not encourage isolation for the newly inoculated, performed the procedure. Such carelessness often started epidemics when only a few cases were originally reported.

The consequences of such epidemics were horrifying, especially for native peoples and black slaves. Daniel K. Richter claims at least "twenty-five thousand Native people died on the Pacific Coast" because of smallpox, even before Lewis and Clark's famous expedition. And east of the Mississippi River, he calculates the Plains Indians population was decimated 75-95% by 1800. The disease destroyed entire Native American Nations. Fenn tells us that more African American and black loyalists died from smallpox than in the battles of the American Revolution. She describes the devastation this way; "With its first New World landfall, Variola gained access to millions of potential victims with no acquired immunity. It was as though a spark had landed in a forest laden with thousands of years of dried timber. The results were explosive; the consequences unspeakable". Fenn gives a conservative estimate of 130,658 deaths from smallpox during the years 1775-82. And not only were many lives lost, but schools, businesses, and governments all virtually shut down during smallpox epidemics. Life came to a complete and deathly halt during these Colonial epidemics.

Eventually Dr. Edward Jenner developed a vaccine for smallpox in 1796. Using cowpox, this procedure was much less painful and no side effects occurred. Today the World Health Organization considers the disease extinct.

But what can we learn from smallpox that will help us in our family history research? Fenn suggests that knowing about smallpox helps us to understand the peoples of Colonial America. She states, "While the American Revolution may have defined the era for the history books, epidemic smallpox nevertheless defined it for many of the Americans who lived and died in that time."

But more than that, we begin to understand the upheavals epidemics caused. Fenn puts it this way; "The movement of the virus from one human being to another shows us how people actually lived in the late 18th century. For despite the political, social, and racial boundaries of the day, people rubbed elbows. They lived side by side, they talked, they fought, they traveled, they traded, and in these daily transactions, they passed Variola on to one another." This virus gives us a glimpse of life in Colonial North America and we gain a better understanding of the world in which our ancestors lived.

Sources for this article:
Duffy, John. Epidemics in Colonial America. Baton Rouge, LA. Louisiana State UP, 1953.
Fenn, Elizabeth A. Pox Americana: The Great American Smallpox Epidemic of 1775-82. New York; Hill & Wang. 2001.
Kunitz, Stephen J. "Disease and Mortality in the Americas since 1700." Cambridge World History of Human Diseases. Ed. Kenneth F. Kiple. New York: Cambridge University Press, 1993. 328-334.
Richter, Daniel K. "The Imperial Virus." Common-Place April 2002. URL: http://www.historycooperative.org/journals/cp/vol-02/no-03/reviews/richter.shtml

See this chart for Smallpox in Colonial America.

Sources:
*Duffy, John. Epidemics in Colonial America. Baton Rouge, LA. Louisiana State UP, 1953.
- Fenn, Elizabeth A. Pox Americana: The Great American Smallpox Epidemic of 1775-82. New York; Hill & Wang. 2001.