1906 Earthquake & Fire
The earthquake and fire set the stage for unprecedented threats to the public's health. Half of the population was homeless. The water supply was cut off; the sewers were broken. There were no sanitary conveniences of any kind. People were camping in vacant lots, in parks, and amid the ruins. Dead horses and other animals had to be disposed of, garbage was accumulating, and large quantities of food were no longer fit for consumption. For the first month, Dr James Ward, President of San Francisco's Board of Health, and Lieutenant Colonel George Torney, head of the Presidio's medical department [and ultimately surgeon general], shared responsibility for restoring sanitation. Their work was guided by a sanitary commission with health representatives from the city, the state, the Army, and the U.S. Marine Hospital Service (forerunner of the Public Health Service, the Centers for Disease Control, the National Institutes of Health, and others). Provision was made for the re-establishment of the water supply, and for the construction of latrines. Thanks to the Army and the many volunteers who worked with the Department of Public Health and the Department of Public Works, most of what needed to be done to restore sanitary conditions was quickly accomplished. The City was divided into sanitary districts that were inspected constantly. The Army assisted in the creation of twenty large camps spread throughout the City, most of which remained in operation for at least a year.
The prompt creation of sanitary living conditions for so many people was unprecedented. During the wars of previous centuries, before the scientific understanding of disease that was beginning to be established by 1906, more soldiers were lost to camp diseases than to battlefield wounds. Nevertheless, despite constant worry about the possibility of typhoid and other infectious diseases, an outbreak of typhoid fever [CDC] did occur. Before the earthquake and fire, there had been fewer than 15 typhoid cases per month in San Francisco. There were 60 cases in May, 35 in June, 158 in July, 129 in August...[no data for September], then 40 in Oct, fewer than 50 in Nov, fewer than 40 in Dec, and then a marked decrease every month thereafter [see bar graph].
These cases were traced to transmission by flies, which carried filth from uncovered latrines that were in close proximity to the shared food kitchens. The latrines were screened, darkened, and disinfected. New sanitary policies were established and publicized.