AN INSECT-BORNE DISEASE — INFANT 

 PARALYSIS 



By C-E. A. Winslow 



NO branch of public health science has been more dramatic than the 

 progressive conquest of the insect-borne diseases. Up to 1898 

 malaria was a "bad air" disease, a mysterious miasm that crept 

 out at night from the swamps to seize on its helpless victims. Then the 

 Englishman, Ross, and the Italian observers, Grassi and Bignami, solved 

 the problem and the mystery resolved itself into a question of controlling 

 mosquito-breeding pools. When the American army of occupation went 

 into Cuba in 1898 yellow fever was raging. It had killed on the average 

 seven hundred and fifty men and women in the city of Havana every year. 

 Our administrators were at first helpless. The ordinary methods of sani- 

 tation served to control typhoid fever and smallpox and other diseases 

 whose causes were known. Yellow fever decreased from the high figures 

 of 1898 when the Havana hospitals were filled with soldier victims, but in 

 1900 it began to rise again. Then in March 1901, the American Army 

 surgeons, Reed, Carroll and Agramonte, heroes and martyrs of the war 

 against disease (for two of the three gave their lives to the cause) announced 

 the discovery that yellow fever too was carried by a mosquito of the genus 

 Stegomyia. With this basis for action the conquest of the disease was al- 

 most immediate. For 1901 there were eighteen deaths from yellow fever 

 in Havana and for 1902 and succeeding years, none. A few cases later 

 occurred in a little epidemic around the wharves in which the infection was 

 introduced from outside but the endemic scourge of the city for centuries 

 had been stamped out in a single year. So the discovery of each new dis- 

 ease germ and each new insect host has substituted effective measures of 

 control for helplessness and fear. 



The latest of the insect-borne diseases to yield up its secret is infant 

 paralysis or poliomyelitis. This infection, mild and obscure in its onset, 

 but not infrequently fatal and usually leaving its victims more or less per- 

 manently crippled, was entirely a mystery until four years ago. It is not 

 a new disease. In the light of modern knowledge it is clear that various 

 historical personages have suffered from it. In 1905 however, it assumed 

 a violent epidemic form in Sweden and quickly spread to this country, 

 appearing first in 1907 in the eastern coast cities and in 1908 in the Scan- 

 dinavian states of the Northwest. In connection with this disease I re- 

 ceived a vivid lesson in the helplessness that characterizes the prescientific 

 period of disease. It was in a little summer colony on the Massachusetts 

 coast, a colony of about twenty houses stretched out along a road through 

 the salt marshes. First a mild case occurred, not recognized at the time 

 but since thought to be infant paralysis. Then in rapid succession two 



