12-14-1867: Army Report of Yellow Fever Epidemic.
Source: Record Group 94. Records of the Adjutant General’s Office, 1780’s - 1917, Medical Records: 1814-1919. Reports on Diseases and Individual Cases, 1841-93, Papers Relating to Cholera, Smallpox, & Yellow Fever Epidemics, 1849-1893. Box 3 of 7. U.S. National Archives, Washington, D.C.
Report of a Board of Officers convened at Fort Jefferson Fla in pursuance of the following Order.
Head Quarters Fort Jefferson Fla
December 14th 1867
Special Order No. 233
A board of officers will meet on the 16th of December, or as soon thereafter as may be practicable to collect and report facts in relation to the epidemic of the year 1867, and to propose the proper means of avoiding any injury to the service by the appearance of disease in the Tortugas Islands, in future. The Board will not be limited in the field of examination or recommendation, and will take the evidence wherever it may be necessary.
Detail for the Board
Bvt. Major A.H. Smith, Capt. and Asst. Surgeon 1st Lieut Paul Roemer 5th Artillery, Actg. Asst. Surgeon Edward Thomas U.S. Army
By Order of Major George P. Andrews
(syd) Paul Roemer 1st Lieut 5th Arty
The board met December 16th 1867 in pursuance of the above order, all the members being present, and proceeded to collate evidence from persons present during the epidemic; from the records of the Post and of the Hospital; by personal inspection of the fort and the vicinity; and, as the result of these investigations respectfully reports as follows: the subject of these investigations consists of an Epidemic of Yellow Fever which occurred at Fort Jefferson, Dry Tortugas, Fla, beginning on the 19th of August and ending on the 14th of November, 1867, furnishing 270 cases and occasioning 38 deaths.
Fort Jefferson is in Lat. 24° 38’ N. and Long. 82° 53’ W. It is constructed upon a coral island, 3½ feet above the level of the sea. The island contains about seven acres, nearly the whole being occupied by the fort.
At the depth of two feet brackish water it is obtained. The only sources of procuring fresh water are the rainfall which averages 39.38 inches annually, and two condensers for evaporating sea water.
The present available surface of roofing would yield an average of 2,500,000 gallons. If the buildings now in process of construction were properly roofed the yield would be about an average of 3,500,000 gallons annually. There are ample cisterns. The condensers are capable of yielding about 6,000 gallons per day.
The facilities for supplying fresh meat to the troops are exceedingly defective. The cattle for beef are usually brought from the vicinity of Tampa, Fla, and are very inferior when purchased. They are then subjected to a passage of about seven days in the hold of a schooner. On arriving they are placed upon a small barrier island in the vicinity of the fort and fed upon dry forage to which they are wholly unaccustomed. By the time they are slaughtered, it is rarely that a full grown bullock will dress three hundred pounds. The supply of this meat wretched it as it is, often is deficient. When at the best, but three rations in 10 days to a man can be afforded, but it frequently happens that no fresh meat can be had for days at a time, on account of deficient transportation, and the difficulty of getting estimates approved in time to take advantage of the sailing of the chartered steamers. This is owing to the isolated position of the post and the infrequent and uncertain communication with the mainland.
The greater portion of the troops are quartered in the casemates which are very leaky and constantly damp. In that portion of the fort where the fever first appeared the walls are slimy and covered with a green mold. Notwithstanding these disadvantages the general health of the Post, in past years, has been remarkably good. From January 15th, 1866, to August 15th, 1867, the means ratio of sick per 1000 mean strength was 66.30. Among the prisoners during the same period the ratio was 70.10. The principal diseases have been intermittent and remittent fever and diarrhea. A considerable number of cases of “dengue” or “break bone fever” have occurred during the summers. Although but little actual sickness occurs, as a rule, yet the climate produces a remarkable deterioration of bodily strength. The Superintendant of the laborers in the Eng Dept states that it is customary in making up labor estimates to allow two men for the same amount of work as is performed by one man at the North; and that in practice these estimates always fall short, three men not accomplishing more work than one man is accustomed to perform in the northern States. A remarkable example of this effect of the climate occurred here a few days ago. A piano which was handled with ease by three men in New York required fourteen to carry it here, and they were obliged to put it down every few rods, and rest.
These being the general facts bearing upon the health of the garrison, the special circumstances which may have influenced the late epidemic, are the following:
Firstly and Chiefly - the prevalence of Yellow Fever in the West Indies, at Key West, and at numerous points along the Gulf Coast;
2nd The arrival in May and June of about 100 unacclimated recruits;
3rd An unusual fall of rain during the months of June, July, and August, amounting to 37.20 inches, within about two inches of the average fall for whole year;
4th A remarkably persistent wind from the S.E. commencing about the 20th of May and continuing almost without intermission until the 1st of September. This direction of the wind is very exceptional, it's course being generally from the N.E.;
5th The moat along two faces windward of the fort was in an unfinished condition, and had filled in to such an extent that the bottom was exposed at low tide. The stench at such times is represented as being very decided;
6th The connection of many of the privies with the sewers had become interrupted, and a great amount of filth had consequently accumulated in the vaults. Immediately preceding the outbreak of the fever an attempt was made to clean out these places, which attempt however was abandoned, as the resulting effluvia were so overpowering that the further prosecution of the work during the warm weather was deemed hazardous.
On the 19th of August the first case of Yellow Fever occurred. The patient was a member of Co K’s 5th Arty then quartered in casemates on the south side of the fort overlooking the unfinished portion of the moat previously referred to. On the 20th the second case occurred, also from Co “K”, while quartered in the same locality. The next three cases were also from this company. On the 25th the Schr. Matchless arrived from Tampa, having on board a case of Yellow Fever. This was the six case. The patients had all been removed to the Hospital on the east side of the fort, in the immediate vicinity of which Co “L” was quartered. On the 23rd Co “K” was removed into casemates on the east side of the fort adjoining Company “L.” On the 25th the disease broke out in the latter Company. It next appeared among the servants in the officers quarters. Co “I” quartered in the barracks adjoining the Hospital was then attacked. Co “M” on the north side of the fort escaped for nearly three weeks, when on the 7th of September 30 cases occurred in the company.
In addition to the above there were 58 cases of relapse, making in all 270 cases.
On the fourth of September Co “L” was removed to Bird Key three quarters of a mile from the fort. After the removal none were attacked, except those whose duties called them to the Post.
On the 1st of September a Hospital was established on Sand Key, two miles from the fort. A small building capable of accommodating about ten patients was already on the island, having been erected some years before as a smallpox hospital. Three hospital tents were added. Twenty six patients were treated at this place, all of whom had taken the fever before they were sent from the fort. Seven died.
On the 5th of September Bvt. Major J. Sim Smith, Asst Surg., the Medical Officer of the post, was taken sick. He died on the 8th. During his illness Dr. Mudd, a prisoner, was placed in charge of the hospital by the Commanding Officer and rendered faithful and efficient service until the arrival of Dr. Whitehurst from Key West, September 7th.
On the 8th of September Co “K” was removed to Loggerhead Key and encamped. On the 21st Co “L” was for greater convenience transferred to the same place from Bird Key. But one case occurred at Loggerhead, while the disease continued to rage with unabated severity at the Fort. This encampment was continued until the close of the epidemic. The supply of provisions & water was derived from the Post.
The disease reached its height about the 20th of September, and gradually declined until about the last of October, the last case occurring the 14th of November.
The total number of cases of officers, soldiers, citizens, and prisoners, amounted to 270. The number of deaths was 38. The mortality among the recruits coming from the North who had been here but a few months previous to the outbreak of the fever, was in every instance very much greater than among those who has spent a winter here.
Of the 54 prisoners at the Post, 44 had been here upwards of a year. Of these one died or 3.33 percent. Of the other ten prisoners who had been here but a few months, one died making 10 percent.
Of the men detailed as cooks and nurses in the Hospital, not one escape disease: - four died.
The facts which have been presented to the Board lead them to concur in the following recommendations:
1st That unacclimated troops should never be sent to this Post except to arrive in the months of November, December, and January;
2nd That care should be taken to have always at least one company of thoroughly acclimated troops at the Post, to act as cooks and nurses, and to perform fatigue duty in the event of an epidemic of Yellow Fever;
3rd That the barracks be finished and the men removed from their present damp and unhealthy quarters in the casemates;
4th That the sea wall be completed as soon as possible and the moat dredged so that the bottom will not be exposed at low tide;
5th That the connecting sluices between the privies and the sewers be opened, and if necessary enlarged, and the outlets of the sewers be carried across the moat so they may discharge outside the sea wall and not as at present into the moat;
6th That the temporary wooden buildings in the interior of the fort be removed;
7th That the Post Hospital should not be erected on the site contemplated in the original plan; viz. within the Fort between the officers quarters and the barracks, but outside of, and to the leeward of the Fort, where there is a very favorable ground for that purpose. As proposed in the original plan the hospital, besides being in the closest proximity to the quarters of the officers and men, would be enclosed on three sides by lofty structures which would completely shut out a free circulation of air;
8th That a supply of ice sufficient to provide for its liberal use in case of sickness be furnished before the approach of summer. There is a well constructed ice house here capable of holding 200 tons;
9th That in the event of the reappearance of Yellow Fever in the vicinity the requisite means be on hand to construct summer quarters for the troops on one of the neighboring Keys;
10th That a small steamer should take the place of the schooners now in the employ of the Q.M.D. in order that prompt communication may be had with the mainland and the procuring of suitable supplies be facilitated;
11th That at least during the summer there be two Medical Officers at the Post, and two hospital stewards;
12th That the fact a grave cannot be dug to a greater depth than 1½ or 2 feet without filling in with water renders a proper interment of the dead, in the ordinary manner, difficult if not impossible. It is therefore recommended that vaults be built above ground having separate cells, each of which should be large enough to contain one coffin. These cells can be hermetically sealed, and the remains of the dead, it is believed, be better preserved for removal afterwards by relatives or friends. We would also add in the recommendation that Loggerhead being the most desirable Key for the location of barracks should have erected upon it one of these vaults to contain not less than twenty separate cells, for the reception of the remains of those dying there, and Long Key 1/4 mile distant from the fort should have another to contain not less than thirty cells in which to deposit the dead from this place. The Commanding Officer states that these vaults can be easily and cheaply constructed.
In conclusion, we would say that of the origin of the disease that not much can be determined with certainty, but it appears, from all the evidence we have been able to collate, reasonable to believe that it originated here, - was caused by deficient and bad drainage, and the consequent accumulation of a great quantity of decomposed animal and vegetable matter, - was aggravated, in all probability, by damp & unhealthy quarters, and the unusually great amount of moisture in the months of June, July, and August, last.
The exemption of the troops at Loggerhead would seem to indicate that the poison was confined within the limits of the fort, and, at the same time, to throw some disproof upon the commonly advanced theory that this disease is wafted by the wind.
A.H. Smith, Capt & Asst. Surgeon, U.S.A.
Paul Roemer, 1st Lt. 5th U.S. Arty.
Edward Thomas, A.A.Surg. USA Recorder