On September 12, 1909, Seattle health officials report an outbreak of typhoid fever, later associated with the contamination of drinking water at the Alaska-Yukon-Pacific (A-Y-P) Exposition, on the campus of the University of Washington. Officials do not pinpoint the cause of the outbreak until after the exposition ends in mid-October. By the end of the year, 511 people -- including about 200 A-Y-P visitors -- will be sickened by the disease, and 61 will die.
Fit to Drink
Typhoid fever is transmitted primarily by the consumption of water or food that has been contaminated with human fecal matter. Its incidence in Seattle decreased dramatically after 1901, when the municipal water system was connected to the pristine Cedar River in the Cascade Mountains. Previously, the city had drawn most of its water from Lake Union and (after 1886) from Lake Washington; both served as repositories for sewage as well as sources of drinking water. Cedar River water was untainted by sewage, but the new system’s capacity was quickly outstripped by population growth. Certain neighborhoods, including the University District, remained reliant on lake water.
In January 1908, the city council authorized a bond measure to build a second pipeline from the Cedar River. Fair officials worried that it wouldn’t be completed by the opening of the exposition in June 1909. John W. Roberts, an A-Y-P lawyer, urged that bonuses be offered to the contractors as an incentive for faster work. Without the second pipeline, he said, "not only [will] some citizens of the city actually suffer for water, but there will be no city water for the fair" (Seattle Post-Intelligencer, May 5, 1908).
Adding to the sense of urgency, in late May 1908 a steam shovel accidentally pierced the existing pipeline, a 42-inch wooden conduit that normally delivered 23 million gallons of Cedar River water to Seattle each day. City officials called for strict rationing while the break was repaired. By June, water was flowing again and reservoirs at Volunteer and Lincoln parks were replenished. However, Dr. J. E. Crichton, newly appointed health commissioner for the Department of Health and Sanitation, warned that bacteria levels in a third reservoir, on Beacon Hill -- still fed by water from Lake Washington -- were so high that the water was "not fit to drink."
Construction of the second pipeline began in August. The work did not proceed smoothly. Among other problems, one of the workmen on the project died in October of what was later diagnosed as typhoid. The death led to an investigation by Crichton and a team of nearly 20 inspectors and others from the health department. They found that the 150 or so men working on the pipeline were living in camps close to the river, not using outhouses sited a safe distance from the river, not properly disposing of garbage, and otherwise violating rules intended to safeguard the purity of the water supply. Work was halted while the camps were relocated outside a 1,000-foot barrier from the river, outhouses constructed, and rubbish hauled away.
"All of the quarters of the men working in the camps were disinfected," the Post-Intelligencer reported. "To the quarters of the man who died of typhoid special attention was given." The paper quoted Dr. F. S. Bourns, chief medical inspector, as saying he was convinced that the worker, a man named Ole Staten, had not contracted typhoid at the camp; and besides, refuse from that camp would drain into Snoqualmie River, not the Cedar River. Bourns concluded that the city’s water supply had not been contaminated, but "the steps were taken none too soon" (October 11, 1908).
Plumbing Mix-up at A-Y-P
By the time the fair opened on June 1, 1909, the city council had approved a special contract to provide drinking water from the Cedar River. The first water from the new pipeline was delivered to the fairgrounds three weeks after the opening. The council had stipulated, however, that pumps from Lake Washington be kept available to supply water for irrigation and fire protection if needed. In late July, exposition managers were told to start pumping from the lake again. L. B. Youngs (1860-1923), water department superintendent, said the A-Y-P was draining more than one million gallons of water a day from the city system, and as a result, the water pressure was so low that faucets sometimes ran dry elsewhere. Harry Bringhurst, city fire chief, said the low water pressure was a threat to fire protection.
Unknown to the health department or to fair officials, lake water ended up in the pipelines meant to supply drinking water at the A-Y-P., at a time when tens of thousands of people were visiting the fair each day. One of the visitors was Mrs. W. H. Twombly of South Park, the daughter of a Rainier Valley dairyman. She was hospitalized in early August with what was later identified as typhoid fever. She was recovering when her young daughter, Gertrude P. Twombly, also became ill, at the home of her grandfather, Adam Boehm, the dairyman. A second child in the Boehm family was stricken, and then a third. Within two weeks, nearly two dozen of Boehm’s neighbors and customers were sick with typhoid.
City health officials did not become aware of the outbreak until early September. Health commissioner Crichton initially insisted it was a local problem, caused by lack of sanitation at the Boehm dairy. "Seattle is not afflicted to any serious degree with typhoid fever," he said. He also blamed two local doctors who had treated members of the family and not reported the disease. He promised to have them arrested. "If all cases of contagious diseases were promptly reported, we would be free of epidemics," he said.
The health department found 14 cases of typhoid among the 50 customers of Boehm’s dairy, in Hillman City. The dairy was closed. Crichton mistakenly believed that the disease was transmitted by flies attracted by unsanitary conditions. Once the "filth" was removed, no further controls would be necessary. "The place swarmed with flies," he said. "The source of infection is plainly proved to be the cesspool at the Boehm home, and the means of carrying the disease between the shallow cesspool, where the sick room sewage was thrown, and the milk cooling in the open air, was the housefly" (Post-Intelligencer, September 12, 1909).
In October, 140 new cases were reported. Crichton continued to diminish the significance of the reports. More than 40 of the cases had been "shipped into the city," he said; they were "of outside origin," involving visitors, not residents. He felt it was "unfair" to Seattle’s civic reputation because "These patients are sent to local hospitals for treatment and thus the record counts against the city just as much as the cases originating here" (Post-Intelligencer, December 2, 1909).
It was not until the end of the year that Crichton and his colleagues realized that some of the people who visited the fair had been sickened by the contaminated water they drank there. The fair closed on October 16. The incubation period for typhoid is ten days. Only 46 new cases were reported in November and none in December. Meanwhile, the second Cedar River pipeline went into operation, providing an additional 45 million gallons of safe drinking water a day to meet the needs of a growing city.
A total of 511 cases were reported during what turned out to be the last significant epidemic of typhoid in Seattle, a morbidity rate of 191 per 100,000 people. About 200 of the victims had visited the fair; 21 worked or lived on the fairgrounds. Sixty-one people died; an estimated third of them were tourists. In comparison, 292 people were sickened by typhoid in Seattle in 1908, a morbidity rate of 117 per 100,000, and 51 people died. Both morbidity and mortality from typhoid declined dramatically in the year after the fair. By the 1940s, the disease was almost unheard of.
Seattle’s health officials learned important lessons from the 1909 outbreak. As Reimert T. Ravenholt, former epidemiologist with the Seattle-King County Health Department, pointed out in a 1964 study, the health department demonstrated new understanding of the connection between drinking water and disease in November 1911, when the original Cedar River pipeline broke again. Advertisements and circulars instructed people to boil drinking water or treat it with chlorine. Messengers delivered packages of chloride of lime to dairymen, with orders to use it in washing their milk cans. Lake Washington water was pumped into the water mains temporarily, but when the Cedar River line was restored, the lake water was flushed out thoroughly. There were no cases of typhoid.