The 1924–1925 Minnesota smallpox epidemic was the deadliest outbreak of

smallpox Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) ce ...

in the U.S. state of

Minnesota Minnesota () is a state in the upper midwestern region of the United States. It is the 12th largest U.S. state in area and the List of U.S. states and territories by population, 22nd most populous, with over 5.75 million residents. Minne ...

. 500 people died—400 of them in the

Minneapolis–Saint Paul Minneapolis–Saint Paul is a metropolitan area in the Upper Midwestern United States centered around the confluence of the Mississippi, Minnesota and St. Croix rivers in the U.S. state of Minnesota. It is commonly known as the Twin Citi ...

metropolitan area. Almost 90 percent of the Twin Cities deaths took place in

Minneapolis Minneapolis () is the largest city in Minnesota, United States, and the county seat of Hennepin County. The city is abundant in water, with list of lakes in Minneapolis, thirteen lakes, wetlands, the Mississippi River, creeks and waterfalls. ...

Background

Smallpox comes in two varieties, one mild and one deadly (also called black, or virulent, or hemorrhagic.) In the late 19th and early 20th centuries, the relatively mild

variola minor Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) cer ...

type was common in Minnesota and killed few people. The deadly type appeared in scattered outbreaks, also killing relatively few. The worst period had been 1871–1872, when 273 people died, but since then the average had fallen to fewer than 15 deaths a year. People did not much fear it.

Outbreak

The first 1924 deaths took place in

Duluth, Minnesota , settlement_type = City , nicknames = Twin Ports (with Superior), Zenith City , motto = , image_skyline = , image_caption = Clockwise from top: urban Duluth skyline; Minnesota ...

, in January and were followed by more in Minneapolis in the last week of June. They raised little alarm. A few more people died over the summer. In the fall, when people began to huddle indoors, the disease spread: 27 died in October, 66 in November, and 149 in December. At the time, about 240,000 people lived in

Saint Paul Paul; grc, Παῦλος, translit=Paulos; cop, ⲡⲁⲩⲗⲟⲥ; hbo, פאולוס השליח (previously called Saul of Tarsus;; ar, بولس الطرسوسي; grc, Σαῦλος Ταρσεύς, Saũlos Tarseús; tr, Tarsuslu Pavlus; ...

and 410,000 in Minneapolis. Had the disease affected both cities' populations equally, there would have been 91 deaths in Saint Paul and 129 in Minneapolis. But at the end of 1924, 208 people had died in Minneapolis and only 12 in Saint Paul. Two factors explain the difference. First, Minneapolis had a higher population density. Saint Paul and Minneapolis were about the same size in area, but Minneapolis fit 170,000 more people into an equivalent space. It had more

flophouse A flophouse (American English) or dosshouse (British English) is a place that offers very low-cost lodging, providing space to sleep and minimal amenities. Characteristics Historically, flophouses, or British "doss-houses", have been used for ...

s, shelters, and boarding houses, all of which pressed sometimes sickly people into close quarters. In these conditions, the airborne smallpox virus spread quickly. Second, Saint Paul's

public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...

system responded more efficiently to the crisis. Its workers were better trained, and they acted more quickly to

quarantine A quarantine is a restriction on the movement of people, animals and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have been ...

victims and trace the sources of infection. Minneapolis public health officers, perhaps overwhelmed by the scope of their problem, acted less efficiently in training hospital workers, tracing sources of the virus, and warning schools, businesses, and families of danger when infection appeared. They also put smallpox victims in the public hospital, infecting new victims. Saint Paul officials isolated as many of the ill as they could in a "

pest house A pest house, plague house, pesthouse or fever shed was a type of building used for persons afflicted with communicable diseases such as tuberculosis, cholera, smallpox or typhus. Often used for forcible quarantine, many towns and cities had on ...

" far from the center of town. Minnesota state law blocked a sound public health response. An 1883 state law had required all school-age children to be vaccinated against smallpox. But in 1903, the legislature repealed that law and made compulsory child vaccination illegal. Although smallpox vaccination is almost 100% effective, public health officers had no power to make people protect themselves. They could recommend, but not mandate, the vaccine. Starting in November 1924, both cities launched free vaccination campaigns. Once the deaths mounted, the frightened public jammed the vaccination centers. As reported in the ''

Minneapolis Journal The ''Star Tribune'' is the largest newspaper in Minnesota. It originated as the ''Minneapolis Tribune'' in 1867 and the competing ''Minneapolis Daily Star'' in 1920. During the 1930s and 1940s, Minneapolis's competing newspapers were consoli ...

'', as many as 17,000 got their skin scratches in a single day. By mid-December 1924—according to public health officials—some 210,000 people in Saint Paul and 350,000 in Minneapolis had been vaccinated. December was the worst month; 129 people died in Minneapolis alone. But by then the tide had turned. The disease had carried off the most vulnerable before mass vaccination took effect. 88 people died in January 1925 and 30 in February (all in Minneapolis). By late summer, the epidemic had passed.

Toll

In the final toll, Saint Paul reported 855 smallpox cases and 38 deaths, suggesting a 4.4% death rate. Minneapolis reported many more cases, 1,430 cases and 365 deaths, indicating a death rate almost six times as high (25.5%). Another 101 people died around the state. Though occasional deaths took place into the early 1940s, smallpox as an epidemic never returned to Minnesota.

References

{{DEFAULTSORT:1924-1925 Minnesota smallpox epidemic 1924 disease outbreaks 1925 disease outbreaks 1924 disasters in the United States 1924 in Minnesota 1925 disasters in the United States 1925 in Minnesota 20th-century epidemics Health in Minnesota Disease outbreaks in the United States Smallpox epidemics Smallpox in the United States