This year is turning out to be a bad year for cholera. Major cholera outbreaks have erupted in Haiti, Pakistan, and in several African countries. Reports of all these outbreaks remind me of cholera epidemics in American history. In the 19th century cholera wasn’t as closely linked with disasters as it is today. Back then cholera was transmitted best by urban water systems, although it still swept through rural areas as well.
The 1850 federal mortality census gives us a glimpse at the cholera epidemic that struck Illinois during the summer of 1849. The American Bottoms region is the four counties in the St. Louis Metro East: Madison Co., St Clair Co, Monroe Co, and Randolph Co. It runs along the eastern shore of the Mississippi River from Alton to Kaskaskia. In 1849 the American Bottoms was mostly rural with a few good size towns (Alton, East St. Louis, Belleville, Cahokia). It is not hard to see the epidemic in a graph of deaths vs. months of 1849-1850.
In the mid-19th century summer was always the most deadly time of year in Illinois. The cholera epidemic was occurring against a backdrop of endemic malaria and typhoid fever, and high childhood morality. In 1849-1850, “fevers” accounted for about 15% of all deaths and cholera for nearly 40% of all deaths.
As bad as the epidemic looks in the graph above, census taker Levi Sharp knows that it was actually far worse than the numbers suggest.
Mr Sharp reminds us of the problems with the federal mortality census. Relying on survivors, neighbors or next tenants will miss a lot of people. In an era when children were not mandated to attend school, it is likely that there were a fair number of children who few people knew existed, especially in rural areas.
The shape of the outbreak in St Clair county looks similar to the rest of the American Bottoms.
Cholera reached the American midwest as part of the second global pandemic. It came and went without people understanding the cause of the epidemic. It will still be a few years more until Dr John Snow discovers the link between cholera and water in 1854.