Cholera, Corona, and Cruising in the Time of Pandemics

One of the dominant news stories in early 2020 has been the outbreak of the corona virus, which first appeared in Wuhan, China, but has shown the hallmarks of erupting into a global pandemic. The availability of modern air travel, coupled with the rapid transmission of information through social media networks, has magnified the fear that naturally occurs with the appearance of a new biological threat. Although the exact nature of Corona and its transmission to new hosts remains the subject of fervent examination, the effects of such the new illness are already being played out on a global scale. New cases of the illness have been diagnosed around the globe, and accompanied with massive attempts to quarantine and contain it. The level of panic is demonstrated by the refusal of five nations to accept a port call by Holland America’s MS Westerdam, despite the fact that no passengers have been confirmed to carry the virus. The Japanese government quarantined a different cruise ship, Diamond Princess, in the port of Yokohama, holding 3,700 passengers and crew in a confined location. As of February 13, at least 218 had tested positive for the corona virus.

Fear in the face of spreading illness is nothing new—one need only recall the panic associated with small outbreaks of ebola to realize that the fear is often much larger than the threat demands. But there are times when such a fear is absolutely in order—such as the 1832 cholera outbreak in the United States. Cholera was endemic to the Indian subcontinent—but in the early 19th century, a new variant, caused by the bacterium Vibrio cholerae, began to spread beyond its traditional home and following the movement of armies throughout the region. Cholera, which can be transmitted through the ingestion of contaminated water or certain foods, causes severe diarrhea and vomiting, leading to acute dehydration and often death. The actual means of transmission were unknown at the time, but it was clear that the virulent disease represented a deadly threat to anyone who came into contact with infested people.

In 1831, a wave of cholera spread through Europe, killing substantial portions of the population in virtually every country. By the following year, it had crossed the Atlantic, carried by immigrants fleeing from its effects in Europe, and for two years, outbreaks ravaged every city of the United States. Quarantine measures, first created for plague outbreaks, might have offered some protection against the spread of cholera—but they were opposed by the merchant class as they devastated the local economy. As such, the cholera outbreaks followed entirely predictable pathways, particularly along the river networks, and proceeded to devastate the urban populations encountered. As many as half of all cholera sufferers died from the disease, many within a few hours of the first appearance of symptoms.

A separate fear also permeated the United States in the early 1830s—the fear of Native American populations in the west attacking frontier settlements. In 1832, the villain of choice was Black Hawk, whose small warrior band operated in Iowa, Illinois, and Wisconsin. To combat the threat his army offered, Major General Winfield Scott collected nine companies of artillery and infantry, along with the entire graduating class from West Point, and placed them on four river steamers, to travel across the Great Lakes and attack Black Hawk’s forces. At Detroit, two of the men with Scott were diagnosed with cholera, and both died within a day. The contagion soon appeared on all of Scott’s steamboats, with hundreds of men dead and dying from the outbreak. Scott’s forces moved to Fort Gratiot, forty miles north of Detroit, where he hoped to contain the outbreak. Instead, dozens of Scott’s men deserted and fled into the woods near the fort, hoping to save themselves, but it was too late—they had already been exposed to the bacterium. Almost none of the deserters were ever seen alive after that time, although local citizens found evidence of their corpses having been devoured by wolves and wild hogs.

Scott’s force pressed on to Chicago, where his ships were refused permission to dock. They stayed at anchor within sight of the city, and as men died from the disease, their bodies were weighted and tossed into the lake. The water in the vicinity was so clear that the remaining men on ship reported they could see the bodies of their dead comrades, swaying in the currents at the bottom of the lake. This macabre sight did nothing for morale among the troops, and the outbreak continued unabated.

Throughout the entire episode, Scott remained calm and collected. He personally ministered to the sick and dying, applying what remedies he could, and never showed any signs that he feared being struck down by the same malevolent force. He also ordered strict disciplinary measures. Believing that intemperance led to the men being vulnerable to cholera, Scott ordered that any soldier found in a condition of intoxication would, “as soon as his strength will permit, dig a grave…large enough for his own reception as such grave cannot fail to be wanted for the drunken man, or some drunken companion.” In the end, Scott and a small staff finally managed to reach Pairie du Chien, Wisconsin, on August 7, 1832—six weeks after he started his disastrous movement. Upon arrival, he discovered that Black Hawk’s army had been destroyed four days prior, at the Battle of Bad Axe.

The cholera and corona outbreaks have one major factor in common—both diseases spread in the face of every effort at containment. Even two centuries after the cholera outbreak, we have not learned effective means to counter the movement of infected persons, who may not know that they are carrying a deadly disease. We have also never managed to contain human greed—if there is a profit to be made by defying a quarantine, it’s almost certain that someone will attempt to collect that profit, regardless of the risk to themselves or others. And governments will continue to pursue ineffective means of protecting their citizens, if only to demonstrate that “something is being done” in the face of danger. Unfortunately, pandemics are a fact of life—bacterial and viral causes continue to evolve, and the means to counter their effects are always a few steps behind. Corona will not be the last pandemic to threaten the public health—and like previous contagions, defending against it will not be assisted by giving way to panic.