Editor’s Note: In the winter of 1924-25, oysters exposed to polluted water were responsible for a typhoid fever epidemic that spread to New York, Chicago, and Washington, D.C.   It was the deadliest outbreak of foodborne illness in U.S. history,  As part of a periodic series on historic outbreaks, Food Safety News recounts the typhoid fever epidemic that killed 150.

The deadliest outbreak of foodborne illness in U.S. history killed 150 of the estimated 1,500 sickened with typhoid fever. The Atlantic Seaboard oyster industry was responsible and it, too, would pay a high price.

Typhoid fever is a bacterial disease, caused by Salmonella Typhi. It is transmitted by ingesting food or drink contaminated by the feces or urine of infected people.

Twentieth Century medicine helped prevent the fatality rate in the 1924-25 epidemic from going even higher. Before 1900, death rates during typhoid outbreaks were known to hit 30 to 40 percent.

The 150 who died in the deadliest outbreak might have been sick as many as three weeks, when they possibly would have been delirious or lying motionless from exhaustion, eyes half closed in what is called “the typhoid state.”  

After the ordeal of high fever, bouts of diarrhea, rash, abdominal pain, sore throat, headaches and weakness and fatigue — death might have been welcomed.

The Oyster Industry

Before 1925, the East Coast’s oysters were on a lofty perch. Oystermen were taking in $14 million a year, an amount that would today translate into nearly $200 million. Collecting and processing 73,000 tons of oysters kept 67,000 gainfully employed.

Oysters were loosely regulated. States had jurisdiction over the oysters coming out of their waters. Only when oysters were moved in interstate commerce did federal authority come into play.

The oyster-borne typhoid epidemic occurred without warning. “Late in the winter of 1924, simultaneous outbreaks of typhoid fever were noted in Chicago, New York, Washington and several other cities,” according to  a report by the 1954 National Conference on Shellfish Sanitation.

“In all, 1,500 cases of typhoid fever and 150 deaths were reported.  A comprehensive epidemiological investigation implicated fresh oysters as the vehicle responsible for the outbreak,”  said the report, written almost 30 years afterward.

A key phrase in the report was “deaths in excess of normal incidence for the disease.”  That’s because during the 1920s, according to the National Institute of Health, 100 out of every 100,000 people in the U.S suffered from typhoid fever.

By the 1950s, the incidence of typhoid in America was just 1.7 per 100,000. The difference was that by the 1950s, indoor plumbing and public sewers were the rule. The day when a certain level of typhoid and the occasional outbreak was accepted was over.

But in that winter of 1924-25,  the era of being almost typhoid-free was still a generation away. The epidemic was fought as separate outbreaks in the cities of Chicago, New York and Washington.

Public Health Notices

It was the first time that radio joined with newspapers to carry public heath warnings. Some oystermen blamed the new broadcast medium for causing hysteria that wrecked their industry.

City health commissioners were the key players in the public health arena. Chicago’s health commissioner traveled to Maryland at his own expense after being invited by the governor of Maryland so he could personally examine oysters coming out of Chesapeake Bay.

Oysters up and down the Eastern Seaboard, then plentiful, were all suspect. It was not until Feb. 10, 1925 that the New York Times was able to report that the “typhoid oysters” were from West Sayville on Long Island.   

“The main factor in the spread of typhoid fever in New York, Chicago, and Washington was oysters distributed by one company operating near West Sayville, NY,” in the opinion of the Public Health Service.

After the source was identified, Walter Bensel, chief executive officer of the New York Department of Health, said oysters from other major growing areas were safe, but there was no way to quickly restore consumer confidence.

“Seldom has the tremendous power of public health manifested itself so drastically as during the generalized typhoid excess of last winter, when the oyster industry suffered a loss of millions of dollars at the hands of public health authorities,” the American Journal of Public Health reported. “While it is conceded that life and health take precedence over other considerations, and although no one would question their power, a grave responsibility rests upon health officials in the exercise of such authority.”

The journal found that for years little attention had been paid to sanitary protection and distribution of shellfish.  A manual published in 1920 — “Standard Methods for the Bacteriological Examination of Shellfish” — had not gotten enough attention.

After the epidemic, states adopted laws to regulate the oyster business and public health officials held a major conference in Washington devoted to the subject.

“One of the practices of the past that is known to be dangerous is the ‘drinking’ or ‘floating’ or ‘fattening’ of oysters,” the journal stated, explaining that “the oysters grow in salt water. After being removed from the beds, it has been the custom to put them in brackish water, often near to cities, where pollution with sewage may exist.”

“The oysters take up the water, become whiter in color, plumper and perhaps more attractive looking, but if the water is polluted, they take in the germs which may be present in sewage,” it continued.  “The new laws, as far as they have been proposed, prohibit this practice.”

The journal also praised the Public Health Service for doing “many things for the benefit of the consumer and the oyster business.” States apparently decided they needed the federal government  to coordinate shellfish sanitation. After 1925, the Shellfish Sanitation Section of the Public Health Service stepped into a leadership role.

It keep track of state-certified shellfish shippers, conducted research and provided advice in a program that included oysters, clams and mussels.The shellfish sanitation control program ended major outbreaks of oyster-borne typhoid.

Finally, the 1924-25 epidemic was the first time an outbreak of foodborne illness captured nationwide attention. It would not be the last.