Med Journal October 2020 - Page 7

been threatened by violent deadly diseases . Since 1804 , the region had dealt with endemic malaria and typhoid fever . There had been recurring threats of smallpox , cholera , and yellow fever during the 19th century . These illnesses would appear unannounced and wreak havoc on parts of the populations . Prior to the 1860s , most of these illnesses were grouped together into fever illnesses ; the population and their physicians had very little idea as to the cause or how to deal with them . With the advent of the germ theory in the 1860 ’ s , this began to change . Even before the germ theory , quarantine was known to be a useful tool . “ Shot Gun ” quarantine was an unofficial but useful tool to prevent the spread of these disease processes . 1 Armed groups of men would stand guard at the entrance to a town and you were not allowed to enter if they didn ’ t know you .
By the late 1870s , state-wide temporary Boards of Health were created to help establish more widespread quarantine against yellow fever . In 1913 , the state of Arkansas created a permanent Board of Health , that eventually morphed into the Arkansas Department of Health . Between 1913 and 1918 , the head of the State Board of Health , Dr . Charles Garrison , began to establish the rules and regulations that would be used to protect the public ’ s health . A list of reportable diseases was established ; interestingly , influenza was not included on this list .
The new State Board of Health was active in remote counties before the epidemic of 1918 , but most of their efforts were
Camp Pike Hospital
aimed at smallpox immunization . Dr . J . W . Melton of Solcomb and Dr . J . M . Phillips were the unofficial county health officers and as early as 1916-1917 , they were instrumental in helping to carry out the State Board of Health mandated smallpox immunization policy for school attendance .
Another change in rural Arkansas that impacted the spread of any epidemic disease was the advent of the railroads . In the post-Civil War era , the rail systems began to create a spiderweb of train tracks across the state making even the most remote places in rural Arkansas accessible . With an illness like the flu that may have an incubation period of two or three days , this modern convivence became a two-edged sword . An asymptomatic person could board a train in Little Rock and hours later disembark in Paris , Arkansas ; soon , the flu had a foothold in a new town . Early in the epidemic , small towns as widespread as Carlisle , Newport , Wilmot , Stuttgart , Waldon , Subiaco , Paris , Hunter , and Dermott reported significant caseloads of flu . 2
The Flu Arrives The first area of the state to be affected by this wave of the flu was Camp Pike , located northwest of North Little Rock . Camp Pike was established in 1917 , and by September of 1918 there were 54,000 soldiers being trained at the post ; making it the second largest town in Arkansas . 3 , 4 Young soldiers crammed into over-crowded barracks provided a tinderbox for the rapid spread of the flu . By late-September , there were thousands of cases of
Electron microscope of H1N1 virus .
flu on the post , overwhelming the base hospital . 5 Despite , the dramatic rates of infections among the troops and high death rates , the U . S . Surgeon-General , Rupert Blue , said : “ There is no cause for alarm if precautions are observed .” 6
It is no surprise that in mid-September , Dr . James C . Geiger , the U . S . Public Health Officer in charge at Camp Pike in North Lit-
Volume 117 • Number 4 october 2020 • 79