Penn's Plagues

PHILADELPHIA, TUESDAY MORNING, MARCH 10, 2020

WHAT PAST PHILA. EPIDEMICS CAN TELL US ABOUT THE RESPONSE TO COVID-19

INTRODUCTION

OUTBREAK

RESISTANCE

ACTION

Philadelphia—

Introduction

Engraved for the London Magazine, The East Prospect of the City of PHILADELPHIA in the Province of PENNSYLVANIA

City of Philadelphia, Department of Records

Founded by William Penn in 1682 on the banks of the Delaware River, Philadelphia was, for a time, the largest city in America, the one-time U.S. capital, and later, an industrial powerhouse with the world's busiest freshwater port. It has shaped American ideals and established innovative firsts, engaged in trade and commerce from its central position in the urban northeast.

What superlatives remain for the City of Brotherly Love remind us of the city's rich history, its innovative cultural spirit, its commercial connectivity, and its expansive population.

Any city as old and large as Philadelphia has seen its share of plagues.

"On the 5th of August, I was requested by Dr Hodge to visit his child. I found it ill with a fever of the bilious kind, which terminated (with a yellow skin) in death on the 7th of the same month."

"... symptoms include extreme abdominal pain, violent diarrhea and vomiting, with parts of the intestines flaking off and being discharged as peculiar 'rice water.' Death comes rapidly from severe dehydration and shock in some forty to sixty percent of cases."

"As their lungs filled with rales the patients became short of breath and increasingly cyanotic. After gasping for several hours they became delirious and incontinent, and many died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth. It was dreadful business."

"16 per cent died... Within less than a day there was a rapidly rising fever associated with shaking chills... Chest pain often accompanied the cough and was frankly pleuritic in a third of the cases. Dyspnea, abdominal pain and gastrointestinal symptoms also occurred in many of the patients."

"Six patients had pneumonia... and one had necrotizing toxoplasmosis of the central nervous system. One of the patients with Pneumocystis pneumonia also experienced severe, recurrent, herpes simplex infection; extensive candidiasis; and cryptococcal meningitis."

COVID-19

2020

Once again, the city is gripped by a disease that threatens the health of its citizens. But everything old is new again—diseases that swept through the city in the past can show us that the measures taken and the reactions of today are not without precedent.

The novel coronavirus is not the same as the yellow fever, the influenza, or the cholera that has interred thousands of Philadelphians in the past. Not only is there a difference of biology, but the nuance of the politics and the economics, the actions of contemporary human beings engaged in self-preservation, greed, mourning, and community make this outbreak unique. But most of all, like all pandemics, this makes it a human story.

References

1. Centers for Disease Control (CDC). “Kaposi's Sarcoma and Pneumocystis Pneumonia Among Homosexual Men - New York City and California.” MMWR Morb Mortal Wkly Rep, July 3, 1981.

2. Fraser, David W. et al. “Legionnaires' Disease: Description of an Epidemic Pneumonia.” The New England Journal of Medicine, December 1, 1977. 10.1056/NEJM197712012972201

3. Rush, Benjamin. An Account of the Bilious remitting Yellow Fever, as it Appeared in the City of Philadelphia in the Year 1793. Philadelphia: Printed by Thomas Dobson, 1794.

4. Starr, Isaac. “Influenza in 1918: Recollections of the Epidemic in Philadelphia.” Annals of Internal Medicine, July 18, 2006. https://doi.org/10.7326/0003-4819-145-2-200607180-00132

5. Watson, William. “The Sisters of Charity, the 1832 Cholera Epidemic in Philadelphia and Duffy’s Cut.” U.S. Catholic Historian 27:4 (Fall, 2009): 1-16.