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R&D Chronicles: The Navy’s Plight against the Typhoid Menace
Released: 12/14/2017

By André B. Sobocinski, Historian, BUMED


"Washing Day aboard U.S. Man 'o War." Postcard, ca. 1906. Courtesy of the Naval History and Heritage Command.  Scrubbing down and disinfecting ships were among the measures the Navy implemented to prevent the spread of diseases like typhoid fever.  But these sanitary practices alone were not full-proof safeguards against typhoid and in December 1911 the Navy adopted a compulsory anti-typhoid vaccine.



“Experience has demonstrated that the naval personnel even on shipboard is not entirely safe from food and water borne infection. . .”
~Surgeon General of the Navy Annual Report, 1908
 
***
 
After a century of advances in public health, water treatment, vaccine research and the advent of antibiotics, typhoid fever is far from the threat to the Navy it once was.   
 
Several generations ago this narrative was quite different.
 
Between 1900 and 1910 typhoid accounted for over 1,300 hospital admissions and some 100 deaths in the Navy.  In 1910 alone, there were 221 documented cases of typhoid in the service resulting in over 10,000 sick days.  The very same year the battleship USS Connecticut was so overrun with “the fever”  it was forced to abandon operations with its squadron.
 
For many, this archaic disease will forever be associated with an Irish immigrant branded by newspapers as the notorious “Typhoid Mary.”  Mary Mallon had for years served as a household domestic to a host of wealthy families in New York.  In addition to providing cleaning and laundry services, Mallon was known for preparing a special dish, home-made peach ice cream.  But little did her patrons know this delicacy came with an added dollop of disease.  As sanitation engineer George Soper would discover in 1907, Mary Mallon was a carrier of typhoid fever.
 
Like other enteric diseases typhoid is primarily transmitted by ingesting contaminated food or water containing harmful bacteria, specifically Salmonella Typhi. When typhoid manifests symptoms can include high fever, fatigue, stomach pains, skin rashes and loss of appetite; in the most severe cases internal bleeding—even death—will ensue. 
 
Typhoid was certainly no mystery to the Navy Medical Department in the early 1900s. The typhoid germ had first been identified by bacteriologists in the 1880s and tied to poor hygiene and sanitary conditions. Across the fleet, Navy physicians tried to safeguard crews by implementing sanitary measures like purification of drinking water, food inspection, regular cleaning of lavatories and kitchens, and instituting good hygiene practices (e.g.,  washing one’s hands, etc). 
 
But sanitation alone was not a full-proof safeguard against typhoid; and Navy Medicine sought new means for eradicating the menace, namely through vaccination.
 
The first anti-typhoid vaccine was developed by the British bacteriologist Dr. Almroth Wright in 1896 and would be used with great effectiveness to inoculate the British Army in the First Boer War (1899-1902).  Of the 5,475 soldiers inoculated against typhoid only 21 would be infected with the disease. 
 
Stateside, Maj. Frederick Russell, of the U.S. Army’s Medical Museum, would help improve the vaccine and begin administering inoculations in 1908.  Over the next four years over 400, 000 soldiers would be vaccinated against typhoid.
 
Per agreement between the Bureau of Medicine and Surgery (BUMED) and the Army Medical Museum dated June 3, 1910, the Army initially supplied the Navy with the vaccine “without requisition.”  First used at Naval Training Stations and aboard a limited number of ships, the vaccine was entirely voluntary.
 
Due to increasing demands and acceptance of its efficacy as a supplemental preventative, BUMED drafted and the Secretary of the Navy would issue Naval General Order 133,  December 1, 1911, making it mandatory for all officers and enlisted in the Navy and Marine Corps “under the age of 45” to be inoculated against typhoid. 
 
As Surgeon General of the Navy Charles Stokes would write, “The introduction of typhoid prophylaxis in the Navy was not instituted primarily as a humanitarian measure, but as a purely military procedure, in that it has been thoroughly tried out and has been proved efficacious in conjunction with our established sanitary measures to combat the invasion of typhoid fever.”
 
Within five months of the issuance of the general order, over 50,000 officers and enlisted were administered the vaccine.  The results would be immediate and telling.  Whereas in 1911 the Navy averaged about 19 cases of typhoid a month, this number dropped to a mere four cases the first month post-general order.
 
Through June 1913, over 80,000 sailors were inoculated with the full course of the vaccine ultimately ensuring that typhoid would be eradicated in the fleet and expeditionary forces.
Naval Medical Research and Development