Bubonic Plage in San Fransisco, 1900

The Bubonic Plague, also referred to as the Black Death, first struck San Francisco in 1900. This was the first plague epidemic to occur in the continental United States. Symptoms tended to mimic the flu—fever, chills, headache, weakness, and swollen lymph nodes. The origin of the transmission of the disease to the United States can be traced [in the late 1980s] back to a ship sailing from Hong Kong in the summer of 1899, in which two passengers were infected with the plague. Despite the fact that the ship never reached the San Francisco harbor, the disease reached California through rats that were onboard. The outbreak was discovered through the autopsy of a Chinese man by a public health official, which confirmed the results with a prominent bacteriologist. And although medical authorities reported the epidemic in March of 1900, the state's Governor denied the outbreak for a period of two years. This denial manifested from the fear of this booming city possibly being viewed as contagion-ridden, and therefore weak. It was similar to the dismissal of the 1906 earthquake, in which city officials and the media downplayed the magnitude of the quake to protect business interests. Chinatown, the center of the epidemic, was quarantined. There were 121 reported cases within San Francisco, as well as 5 outside, with 122 deaths. Most publications on the subject agree on this estimate of deaths.

In the Bubonic Plague that struck San Francisco in 1900, anti-Chinese sentiment shaped the political and public health response of surveillance, documentation, and quarantine of Chinatown. This response was paradoxical to the proper standards of social conduct; and prejudice informed the view on how the disease was transmitted, as well as its causes and possible ideas for prevention and treatment. Chinatown was viewed as useful but extremely disliked ghetto. While white property owners owned the majority of buildings in the district, the Chinese served as the backbone of San Francisco's servant class. Serving as the city's scapegoat for most problems, disease was almost exclusively blamed on the neighborhood. And at the time there had not been the discovery of the cause of the plague, so it became to be viewed as an "Asian disease."

On the Plague
The plague is thought to originate in China from the pathogenYersinia pestis. In the 14th century, the plague claimed an estimated 75 to 200 million lives, making it one of the most deadly pandemics in history. The strain of the plague that struck San Francisco derived from the third occurrence of the pandemic in China (1855-1859). Due to varied contemporary accounts, precise symptoms were difficult to define. The most commonly noted symptom was the appearance of buboes (swelling of the lymph nodes) in the groin or the neck and armpits. This was followed by fever and vomiting of blood. Most victims died within two to seven days of infection Contemporary research indicates the plague was spread through rat fleas, which tended to congregate in larger numbers in areas with greater amounts of waste.

On Racial Attitudes Towards the Chinese Immigrants
Even the prior to the plague, disease was often blamed on the Chinese. In the summer of 1876, there was an extremely sudden and severe outbreak of smallpox. By October, the epidemic had infected over 1600 citizens and claimed nearly 450 lives. Dr. John Meares, the newly appointed city health officer "blamed the spread and severity of the epidemic on the presence of 30,000 'unscrupulous, lying, and treacherous Chinamen' living in the heart of the city and their 'willful and diabolical disregard of our sanitary laws." Meares and his colleagues even referred to Chinatown as "the material manifestation of the alien within the modern American city." There was even a perception of Caucasian physical superiority over the "yellow" Chinese. The view was that the Chinese were more susceptible to disease due to their "inferior racial heritage" as well as weak vitality affected by diet and lifestyle. At the time, there was even a rhetoric that a diet rich in protein, namely from eating a large amount of meat, was critical for building resistance to disease. In contrast, eating rice led to physical weakness and a lower immunity.

On Public Health in San Francisco
Following an outbreak of cholera in 1850, San Francisco established its permanent health board to monitor conditions. The local health board was charged with "the duty to implement sanitary regulations and abate public nuisances." Dating back to it's creation is the prejudice of the health board against Chinatown and it's residents. Public health rhetoric involved a dramatic narrative style adopted by city inspectors. Despite the fact that similar unsanitary conditions prevailed in other neighborhoods, Chinatown was the primary target for criticism and blame. In 1854, a prominent health official, William Rabe, urged the investigation of Chinatown because of its alleged unhealthiness. This initial survey of the district took place in a climate of anti-Chinese bias, and returned with the designation of a city-wide health threat. This inspection set the pattern for more than half a century of biased monitoring and investigations. In the early 19th century, sickness were no longer viewed as inevitable occurrances but rather as an avoidable flaw. Strict regulation of the "body, conduct, and living environment" became a key method in the guarding against disease.

Causes
The anti-Chinese immigrant sentiment that predominated California, especially San Francisco, shaped and informed the response to the emergence of the plague in San Francisco. Many public health officials often blamed the Chinese and their "sub-standard of living" as the cause of the epidemic. Theories of germ transmission were just beginning to transition from dirty clothing and "foul and disgusting vapors" to bacteriological science at the beginning of the twentieth century. When considering solutions to facing the plague, suggestions included a mass removal of those in Chinatown and a subsequent move to Angel Island, as well as possibly burning the area to the ground. The public health response included several quarantines of the Chinatown area, experimental vaccines, fumigation of buildings.

Although the first quarantine was lifted within 60 hours, another took it's place. Initially, it was a "penetrable quarantine" made up of flimsy ropes. But the second time it was reinforced by wooden fence posts and barbed wire. Many residents of Chinatown were confused by the quarantine, and did not believe that the plague was connected to themselves. Instead, it was thought that "it arose from poisonous vapors generated in the soil by seasonal changes." Another attempt to understand the plague was the tests with inoculating the Chinatown population with an experimental plague vaccine. This effort failed due to the public discovery that the vaccine was poisonous, and the riots that followed. Lastly, there was sporadic fumigation of certain buildings in Chinatown. Due to public denial and pressure from the media, the public health response was extremely weak. This weak public health response highlights how the handling of the plague was completely paradoxical to the standards of social conduct. If the plague had affected a wider range of citizens in San Francisco, there would have been a coordinated and concerted effort to prevent the spread and pressure to find a treatment more immediately. In fact, this was the case for the second outbreak following the 1906 earthquake, when the plague was spread out across San Francisco rather than being concentrated in Chinatown.
 * "On Wednesday, March 7, 1900, Chinatown’s early risers, including cooks, waiters, servants, and porters heading for their jobs outside the district, discovered that ropes encircled the space between Broadway and California, Kearny and Stockton streets. Two policemen on every corner demanded that everybody turn around and return to their homes."

For two years, California's governor Henry Gage publicly denied the existence of the plague in San Francisco, despite official confirmation by public health officials and the consultation of national experts. On June 14th, Gage released a statement denying that there was any plague in "the great and healthful city of San Francisco." In fact, Governor Gage even sent a telegraph to Dr. J. H. White, from the Surgeon Marine Hospital Service located in Sacramento, stating that there had been no request for Federal officials to investigate within the city of San Francisco and declining the action of Dr. White assuming control of State health affairs, as well as the continuation of secret and hidden investigations. In the letter he states, "Your mere suspicion from the improved health of the Chinese district that the sick are being removed from San Francisco, is not only unwarranted as a conclusion, but I know it be unfounded in fact." The media was complicit in this denial of the plague in San Francisco. Three prominent San Francisco newspapers gave no coverage on the plague, and reported that the city was doing extremely well. In addition to the denial of the outbreak, Governor Gage publicly condemned Dr. Kinyoun (the city's leading quarantine officer), telling the press that he had imported cultures of the bubonic plague bacteria to his lab on Angel Island, and even suggested that by spilling it he had created this catastrophe himself. Even death certificates of those who succumbed to the plague often read "typhoid pneumonia" as cause of death.
 * "In San Francisco, the century goes out brilliantly," wrote the Call's publisher, John D. Spreckels. "All kinds of trade report a good movement at profitable prices. The export trade of the port was never better...the Orient keeps the ships and the shippers busy...there is a general feeling of confidence in...1901."
 * "Now plague is powerless before its wonderful remedies. There is no danger for San Francisco.” –San Francisco Examiner (February 4, 1900)

Memory/Legacy
Pressure from other states--Colorado and Utah namely--threatening to institute commercial quarantines against California if it continued to refuse to address the public health crisis occurring within it's borders, as well as the replacement of Gage on the ballot for Governor with a practicing physician, signaled the beginning of a more unified and practical response to the plague. Such a commercial quarantine never occurred. The final push came in 1903 when, after a convention of the state's boards of health, there was the possibility of a military quarantine being placed over California if the disease continued to be publicly denied. The business community rushed to declare a public health crisis in San Francisco, and urged for action from Governor Pardee. By the end of 1904, the plague was considered to be suppressed and no longer a public health to the city or state.

Despite the deeming of the plague as "eradicated" in 1904, resurgence of the disease occurred after the 1906 earthquake. Due to the piles of garbage and waste, rat fleas [the carriers of the plague] multiplied and within a year of the fire, there were 159 reported cases. The push for the designation of eradicated occurred primarily because of three reasons--(1) the continued efforts to truly eradicate the disease were strongly opposed because it hurt business and trade, (2) there was an absence of new cases in humans, and (3) lack of adequate epidemiological information. In contrast with the response to the initial outbreak of the plague in San Francisco, the second outbreak, which had an increased number of cases and wider range of social classes affected, was immediately recognized and the respone focused less on race and more on indiscriminate treatment. Although this was partially due to the scandals associated with former Governor Gage's denial and subsequent lack of an adequate public health response, this improved reaction can be primarily credited to the fact that it was not concentrated in Chinatown.