COVER

Plagues of the past

GLEN ALLEN November 18 1985
COVER

Plagues of the past

GLEN ALLEN November 18 1985

Plagues of the past

COVER

But Lord! How everybody's looks, and discourse in the street is of death, and nothing else. The town is like a place distressed and forsaken.

— Samuel Pepys, Aug. 30, 1665.

Many years and many epidemics later, those notes on the Great Plague of London by the English-speaking world’s best-known diarist invite chilling parallels with Acquired Immune Deficiency Syndrome, the scourge of the 1980s that has rampaged from the heart of Central Africa onto the streets of cities around the world. Despite the extraordinary advances of medical science in this century, AIDS reminds modern man that epidemics are part of the human condition—dooming him time and again to blind and primitive fear, distrust of his neighbors, rumor and misinformation as well as the inexorable toll of death which the plague visits upon its victims.

In its short history Canada has ex-

perienced eight diseases similar in their urgency to AIDS. But smallpox, tuberculosis, cholera, syphilis, typhus, leprosy, Spanish influenza and polio each ravaged many more people than AIDS has yet touched. Some epidemics ultimately brought benefits including medical discoveries and public health planning. But all of them have been marked by what Queen’s University medical historian Dr. Anthony Travill calls “a plague mentality—a fear of the unknown whose size is inversely related to the amount of knowledge we have about the disease.” And often that fear preys on victims and those associated with them as mercilessly as the disease itself. Said Travill: “Deep within us we all have a feeling of xenophobia—since we cannot blame ourselves we have to blame others.”

Killer: An outbreak of smallpox killed 3,000 people in Quebec City alone in 1702; typhus killed more than 5,000 at a single St. Lawrence River quarantine station a century later; and tuberculosis was a major killer at the

turn of the century. But the disease that frightened more Canadians than any other in the country’s early years was cholera. It was a hideous, incurable disease of mysterious origin that baffled medical science and created panic in the population. There were four epidemics of cholera between 1832 and 1854 which killed about 50,000 people in Ontario, Quebec and the Maritimes. Said University of Saskatchewan medical historian Geoffrey Bilson: “There are striking similarities to AIDS in that there was uncertainty as to how many would die from cholera. There was also a prevailing morality that there were some groups more likely to contract cholera than others, specifically those who lived immorally, the poor and the French Canadians.” But just as AIDS is no longer characterized as “The Gay Plague,” Bilson added that “the moral argument faded once the middle and upper classes began to keel over.”

Other aspects of the 19th-century plague bear a striking resemblance to

AIDS. Doctors were unable to explain it, and it was carried by healthy people who infected others by contaminating water supplies. Bilson says that victims had sentenced themselves to the disease by intemperance, fear, poor diet or fatigue. They suffered incessant diarrhea and usually became dehydrated, turned blue and died. Said Bilson: “Many Canadians ran away from the cities to the country, others sealed themselves in their homes.”

Fear: In a study of the cholera epidemics, Bilson wrote that “the efforts of government to deal with the disease took place against a background of fear that could erupt into riot or rebellion.” Immigrants were quarantined, the sick with the well, so that all became exposed to the waterborne bacteria, cholera vibrio. Those who fell ill in the cities were herded together into makeshift cholera hospitals which often become targets of public hostility. An angry crowd of 2,000 burned down one hospital in Quebec City and others were destroyed in Prince Edward Island and London, Ont.

A shorter-lived epidemic of Spanish influenza killed 30,000 Canadians in the two-year period following the end of the First World War, half the number of Canadian soldiers who died in the war. One in six Canadians fell ill, so many that telephone companies were paralysed by the number of calls being made by homebound customers. The disease did not come from Spain. According to Concordia University historian Janice Dickin McGinnis, the country was probably blamed because,

not being involved in the war, its press was not censored and therefore its epidemic was publicized earlier. In fact, it was brought home by soldiers who had suffered poor sanitary and nutritional standards in Europe, and in a matter of months it spread from Newfoundland to the Queen Charlotte Islands in British Columbia.

Futile: Again, quarantineproved futile. People who took precautions against infection fared no better than those who did not. Many churches, dance halls and theatres were closed, and unprecedented numbers of orphans crowded children’s shelters. But there was one positive result: the building of Canada’s modern health care system. Wrote McGinnis: “No one wanted to be caught so short again.”

Of all diseases mentioned in connection with the AIDS epidemic, leprosy (also called Hansen’s disease, after the Norwegian doctor Gerhard Hansen, who discovered the leprosy bacillus in 1874) evokes the most emotional responses, mainly because of the long history of persecution associated with it. First diagnosed in Canada in 1815, it was widespread in Europe and Asia for seven centuries. Its victims were invariably the targets of prejudice, kept apart from society and used as scapegoats for imagined evils. In some societies lepers were led to a high cliff and simply pushed off. But as with AIDS, much of the fear was unjustified, because the disease is usually spread through long and intimate contact. At one point there were 100 active cases in Canada (now there are 11, according to the federal government’s communicable disease office).

The disease is now controllable through sulfa drugs. But the ancient attitudes survived in Canada until the 1950s, when the government began treating lepers in two Canadian leper colonies—one at Tracadie,

N.B., another at Bentinck Island near Victoria.

Before the spread of AIDS the most-feared sexually transmitted disease in Canada was syphilis. Like AIDS, it was incurable—until the discovery of penicillin in 1928—and it often caused insanity and death after a long period of incubation. The means of infection and long incubation made it “a clear analogue to AIDS,” according to University of Chicago historian Wil-

liam H. McNeill, author of Plagues and People. In addition, the moral stigma surrounding syphilis was strikingly similar to that which now surrounds the victims of AIDS. Public health officials are concerned that a backlash against AIDS sufferers could drive the disease underground and make it even more difficult to curtail.

Recently, the threat of uncontrollable epidemics has usually been allayed by the reassuring intervention of modern medicine. Most Canadians over 40 remember the poliomyelitis scare of the early 1950s. In 1953, 481 Canadians died and thousands more were left handicapped by its effects. Some children were quarantined in their backyards, parents kept others away from school, and swimming pools were closed. But the panic was short-lived, eased by the vaccine invented by Dr. Jonas Salk in 1954. So was the public alarm that arose following outbreaks in 1976 of the mysterious and fatal legionnaires’ disease, which doctors quickly learned to control with the antibiotic erythromycin.

Lepers: No such breakthroughs are currently in sight for the sufferers of AIDS. And to them the prospect of the kind of social isolation that has characterized such diseases throughout history is almost as frightening as the disease itself. But the human consequences of creating a class of modern lepers are well illustrated by the last lepers to be kept in isolation in Canada. In 1948 a Maclean's writer visited Bentinck Island to interview its last three inmates. They were surrounded by the graves of 10 who had already died and together formed a portrait of devastating loneliness. One middleaged woman, who had contracted the disease while serving as a missionary in Africa, was subsisting on the $50 g annual pension given 5 her by the federal i government. She wrote articles for the newsletter of the mainland church she could not attend and composed letters to friends that had to be fumigated for 12 hours before being delivered. “Some acquaintances will not even visit my family because I am here,” she said. “It is being cast out that hurts.”

-GLEN ALLEN with JUNE ROGERS in Toronto

JUNE ROGERS