Pox_ An American History - Michael Willrich [10]
Charlotte was in a state of turmoil. The physicians who examined the pesthouse patients disagreed about whether the cases were smallpox at all. At the request of the state authorities, Surgeon General Walter Wyman of the United States Marine-Hospital Service, the federal government’s civilian health corps, dispatched an officer to Charlotte. For Dr. Charles P. Wertenbaker, a surgeon in command of the service’s station in Wilmington, diagnosing smallpox was fast becoming a specialty. In the quasi-military argot of the corps, Wertenbaker held the rank of “passed assistant surgeon,” meaning he was a midlevel officer who had passed the service’s famously rigorous examination for promotion. He told the mayor of Charlotte that all four patients had smallpox. The quarantined inmates would almost certainly develop the disease, too. Instead of segregating suspects from patients, pesthouse officials had put suspects to work nursing the sick.7
To Wertenbaker’s eye, Perkins presented a “typical” case, in the “fifth day of the eruption.” But in an old man smallpox was especially cruel. Perkins died in the pesthouse ten days later. He was buried in a nearby woods, more than a hundred miles from home.8
The citizens of Charlotte had dodged a bullet, Wertenbaker announced in a bulletin issued by the state board of health to drum up support for vaccination. Had Perkins been stronger, “he would have come into the city; he might have stood next to any one in a crowd and infected him, he might have come in contact with one of your servants, and in this way sent the disease into your homes.”9
Dr. Henry F. Long learned the truth of these words. From the “seeds” of smallpox Perkins sowed at Mooresville arose the largest outbreak North Carolina had seen in years. An itinerant black preacher named A. B. Smoot unknowingly carried the disease from Mooresville to Statesville. More than sixty cases were eventually reported in Iredell County. It was anybody’s guess how many more people suffered, as Perkins had aimed to, in the privacy of their own homes. Dr. Long set up a hospital and detention camp in the woods outside Statesville. He hired the recovered Reverend Smoot to drive the ambulance wagon. When Long tried to organize a county-wide vaccination campaign, he ran up against fierce opposition, most of it “from the whites.” The city council gave Long power to vaccinate the citizens, with or without their consent. One state health official reflected, “The unreasoning prejudice of ignorance is extremely difficult to meet, and sometimes requires a resort to methods that are very obnoxious to Americans.”10
As the summer heat climbed into the Piedmont, the Iredell County epidemic of 1898 ran its course. But as Long put the finishing touches on his report, the fetid odor of smallpox, “insupportable and tenacious,” continued to haunt him. He was not going to escape that smell anytime soon. The North Carolina Board of Health, facing a widening epidemic in counties across the state, was about to create a full-time position for him: State Smallpox Inspector.11
The age of AIDS did not invent the notion of “Patient Zero.” Epidemics are dramatic events of cultural as well as scientific meaning, and the hunt for an outbreak’s first case has ever served needs and purposes other than those of medicine. One Alabama health officer reached all the way back to Genesis 3:15—the story of the serpent in the garden—to launch his narrative of the Greene County smallpox epidemic