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Contact Tracing in 1890s Helped Lessen Diphtheria Outbreak in Nova Scotia

If we didn't know exactly what contact tracing was before March 2020, we all do now thanks to COVID. Contact tracing is a powerful tool during an outbreak and according to Allan Marble, chair of the Medical History Society of Nova Scotia, the first example of contact tracing happened right here in Nova Scotia during the 1890s diphtheria outbreak which was killing hundreds of thousands of children all over the world, including 280 Nova Scotian children during this particular outbreak. Public health officials marked houses where children were suffering with this often fatal infection with red dots on a map of Halifax. The clip of the map was taken from CTV's article entitled The Forgotten Epidemic, Learning Lessons from Halifax's 1890 diphtheria outbreak.

The diphtheria outbreak in 1890 wasn't the first one in Nova Scotia, nor was it the most deadly. According to Marble, previous outbreaks of diphtheria killed more than 1000 Nova Scotian children. He said he found seven instances where parents lost 8 children in one month.

Most of us have no idea what diphtheria is thanks to a province wide immunization program starting in infancy. Diphtheria used to be the number one killer of children under 14 in Canada until a vaccine was produced in the mid 1920s. Diphtheria is a bacterial infection also known as "The Strangling Angel of Children". Basically the toxins cause a thick white patch to grow on the back of the patients throat, making it difficult to breathe and essentially suffocating the child to death in many cases.

Despite public health's successful use of contact tracing in the 1890s and the widespread use of the vaccine in Canada by the 1930s, in 1940 Halifax had a diphtheria outbreak so bad it became known as the diptheria capital of the world. Much as we are seeing now, many of the places in the world who are having large numbers of people contracting COVID and being hospitalized or dying are those places that are not adhering to lessons learned by public health during previous outbreaks, epidemics and even other pandemics. An alarming amount of people are in an anti-vaccination movement in general, even against infections like diphtheria, despite the vaccine being proven almost 100% effective. A large amount of the population in the USA, I think it is close to 50%, seem to say they will not take the COVID vaccine when it is available. The anti-vaccine movement of the 1920s-1940s, lead by Dr. William Duff Forrest, the Chairman of the Halifax Board of Health from 1925 to 1939 did not work out very well for his followers in Halifax. According to an article in the Halifax Examiner

Although inoculation existed and was practiced, it was a strictly voluntary process and in the initial stages of public acceptance. The situation was worse in Halifax than anywhere else in the Dominion, because the Chairman of the Halifax Board of Health from 1925 to 1939 had been Dr. William Duff Forrest (son of John Forrest, the former President of Dalhousie University), a firm, vocal and effective opponent of immunizations against disease and other innovations such as TB testing and the pasteurization of milk, in spite of ready acceptance in the rest of the province. During his tenure Halifax earned the unenviable reputation of “Diphtheria capital of Canada.”

There were 291 cases in Halifax in 1940, 640 in 1941, 633 in 1942, and 527 in 1944. Seventy people died in this period, all of them children

No wonder parents tried anything such as this recipe entitled Cure for Diphtheria to save their children from this horrible infection. This was taken from the Uniacke family material at the Nova Scotia Museum on the Nova Scotia Archives site. Transcribed below:

"Give a piece of green cauliflower about the size of a marrow fat pea, swallowing the saliva charged with it. Let it be retained in the mouth till it is dissolved. In another hour or so, give another and at the end of another hour, give a third; a fourth will not usually be required, but if it is, the cauliflower can be used 2 or 3 times more at a little longer intervals say 2 hours. To a child the cauliflower may be dissolved in alcohol. Add a little powdered sugar or rock candy and blow through a quill or tube into the throat."

IN MEMORY OF THE 280 Children Who Died during the 1890 Diphtheria Outbreak including:

Alice Walsh 6 years, 2 months died August 15, 1890

Osborne McLeod 5 years died August 19, 1890

Frank Duncan 7 years 3 months died August 23, 1890

Johanna Beck 2 years 8 months died September 8, 1890

Wilfred B King 8 years 8 months died September 9, 1890

Jessie E Ruden sibling 3 years 10 months died September 9, 1890

Daniel Ruden sibling 2 years died September 11, 1890

William Charles Garrett 3 years died December 3, 1890

Jenny Fox 16 months died December 13, 1890

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