Thursday, December 1, 2022

How The Sleeping Sickness Affected St. Louis Long Ago

Local newspapers published alarming stories during the Great Depression about a deadly “sleeping illness” — and it was a Washington University doctor that helped to identify the cause.

Fred Green, a man with a fever and a headache, arrived at St. Louis County Hospital on July 23, 1933. He fell into a coma quickly. The staff noticed that his neck was stiff. Within one week, he was dead. The symptoms were repeated by new patients, who began to appear in the same way. They had to be kept separate from each other. St. Louis Encephalitis was soon given the name.

This name is still used today. Six patients died from the virus out of nearly 100 cases reported in the U.S. between 2009 and 2018.

The human cost of the initial outbreak in St. Louis was far higher. Doctors reported more than 1,000 cases in St. Louis during the worst three months of 1933. Nearly all patients began with headaches and then developed a fever of 103 to 104 degrees. Their necks became stiff. Dr. John W. Eschenbrenner noticed that some patients were unable to communicate or keep track of time. He wrote, “Many of these patients that we have seen have a mask-like appearance with a staring gaze.” A minimum of 200 people died.

To investigate, military and federal experts arrived in St. Louis. Doctors realized that similar epidemics had been seen elsewhere in hot and dry conditions and that St. Louis was currently experiencing its fourth consecutive dry summer. One observer observed that the River des Peres became a common sewer and smelled “unusually bad.” It was also a breeding ground for mosquitoes. A U.S. Public Health Service expert said that you could drop a tumbler in the river to pull up a “living soup” of larvae.

Medical experts initially believed that mosquitoes were not the carriers. However, we now know that they are. What was the reason? As an assistant professor of pathology at Washington University School of Medicine Dr. Margaret Gladys Smith noticed the inclusion of bodies in patients’ cells. This strongly suggested that a viral infection was the cause. Smith became a pioneer in pediatric pathology and although she did not conquer St. Louis Encephalitis, her memory will live on. In her memory, the medical school gives an award to high-achieving female students.

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