Typhoid!

Typhoid Epidemic

The next time you’re driving up Alpine Road, slow down a bit when you reach Hillbrook Drive and take a close look to your right.  A seasonal stream runs through a small gully there, surrounded by lush and wild vegetation.  Some water remains in it now, in puddles in some spots and flowing in others.  Redwoods, oaks, berry bushes and luxuriant poison oak shelter the neighborhood houses from the road.  A narrow trail wanders along between the creek and the road. Two rickety wooden bridges offer an opportunity to peer down into the streambed without risking the poison oak.

The creek crosses under Alpine Road at Hillbrook Drive in a big storm drain and continues along, edged by bags of concrete which eventually  give way to concrete-lined banks.    Who would guess that a dairy farm  situated right here in this peaceful, pastoral scene was the source of  a major typhoid fever epidemic in 1903?

Maximo Martinez willed this portion of his rancho to his son Antonio who in turn passed it on to his daughter Laura and her husband Pete Faber.  They moved into the Martinez home which stood by the tall redwood in front of the Portola Valley garage.  Pete was mostly interested in “gulching”, cutting and removing timber from his property.  So he leased about a thousand acres to four recent immigrants from the Azores for a dairying operation.  They would run the dairy and continue to provide milk to the distributor in Palo Alto who made regular deliveries around town.

Although the first cases of typhoid weren’t announced in Palo Alto until April, it began to spring up out in the countryside as early as December 1902.  It wasn’t until much later that the medical authorities understood what had happened.  A relative from San Francisco visited his Portuguese family near Page Mill and complained of being sick.  Eventually he died, as did three other members of the family he visited.  Other people from the Portuguese community who lived along Alpine Road had visited the family to help out and attend funerals.  More sickness and more deaths resulted.  The Perreira family of the dairy on Alpine were among those affected, although none of them died.  One San Jose doctor had diagnosed typhoid in one of the cases but had not reported it, so no one yet suspected that an epidemic was underway.

In April, doctors began diagnosing and reporting typhoid in Palo Alto and at Stanford..  The number of cases escalated rapidly, from 2 cases on March 31 to 18 on April 15.  According to the Palo Alto Board of Health report, issued in 1905,  236 people had been diagnosed with typhoid before the epidemic ran its course.  Few records were kept in the outlying districts such as Portola Valley, but the experts felt, in retrospect,  that many  typhoid cases outside the city were never recognized, either by doctors or by victims who never sought medical help.  At least twelve deaths resulted. The number was probably higher.

The population of Palo Alto and Stanford was then 4500.  There was no hospital closer than San Francisco,  so makeshift hospitals were set up at the YWCA, in private homes and in Stanford fraternity houses.  Doctors were few and worked day and night.  Nurses were recruited from San Francisco.  Generous citizens including Mrs. Stanford donated funds so that no one would be denied care.  (Leland Stanford Junior had died of typhoid in Italy in 1884.)

The detective work to find the source of the disease began.  The city water and sewers were found to be uncontaminated.  No pattern of  common vegetable consumption was detected.  No victims had consumed raw oysters or clams. Only one patient had eaten uncooked food.  But nearly everyone with typhoid was on the same milk delivery route.  The two dairies were tested.  It took a week for the  results to come back from a laboratory in San Francisco:  the Perreira dairy on Alpine Road was the source of the typhoid.

Sanitary arrangements for milk delivery in those days were appalling to our modern sensibilities.   The milk was transported in 3 gallon containers by horse drawn wagon about 8 miles to the distributor in Palo Alto.  The cooling system there was a wooden trough filled with water in which the milk cans were placed.  Once or twice a week the trough was emptied and scrubbed.  On the delivery route, the milkman dipped into the cans and poured the correct amount of milk into the customer’s pan.  The empty containers were picked up at the distributors, filled up with skim milk from a creamery, and returned to the Perreira dairy to feed hogs.

Conditions at the dairy were even more shocking.  The wooden floor of the dairy house was cleaned with a shovel.  Cobwebs and dust were everywhere.  Refuse from the outhouse, pigpen and kitchen drained, slid or had been dumped into the gully during a long, dry spell.  Heavy rains from January to April washed months of deposits into the creek, where they were collected by the slowing current at a small dam. This  water, contaminated with the typhoid bacilli, was diverted daily to the dairy house for washing milking utensils and delivery containers. It was a month before the contamination was confirmed and the dairy closed.

When the final count was taken, 98 1/2 % of the typhoid victims had used Perreira milk, even though this evidence of the cause hadn’t been obvious at first.  26% of the users of Perreira milk had contracted the disease.  The epidemic stopped when the use of Perreira milk ceased, although isolated cases and deaths continued throughout the summer.

The public had been made aware of  the need for improved public health conditions in a dramatic, painful and frightening way.  A State Dairy Inspector was appointed.  A permanent hospital opened in Palo Alto.  By May the water in the little creek along Alpine Road by Hillbrook Drive tested pure.  The dairy and the Perreiras were gone.

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