Medicine and Disease in Canada: The Smallpox Epidemic

As news of the Ebola outbreak in West Africa continues to grip the world, fears in North America are on the rise after two nurses were infected while treating a patient at Presbyterian hospital in Dallas, Texas. Thus far, the viral hemorrhagic fever has claimed around 4,500 people, mostly in Liberia, neighbouring Sierra Leone and Guinea, and this recent news out of Dallas adds to concerns because the virus eluded the precautions of top US health officials. In Canada, the government announced that it will commit an additional $35 million to the World Health Organization, the United Nations and humanitarian aid groups working the effected regions. These funds will provide necessary health equipment such as mobile labs, and will contribute to an increased international effort and containment strategy to help local authorities in the effected African regions limit the spread of Ebola. While Clio’s Current is certainly not in a position to comment on the dangers of Ebola or the potentiality of an outbreak in Canada, we can provide a snapshot of one disease that has left a historical footprint on our nation.

During the late nineteenth century a smallpox epidemic swept through the British Columbia coast, claiming the lives of many Aboriginal peoples who lived in Tsimshean village communities. The exact number of deaths remain unknown, but the village of Metlakatla was partially able to withstand the scourge of the disease. In 1862 an Anglican minister, William Duncan, settled at Metlakatla in hopes of bringing Christianity to the region. At the time, Metlakatla was one of the seven small Tsimshean village communities in British Columbia. Shortly after Duncan arrived the smallpox epidemic surged through the surrounding villages, but the inhabitants of Metlakatla were left almost uninfected. Duncan claimed the medical phenomenon was a sure sign of religious intervention and of God’s want for Metlakatla to thrive as a Christian community. As part of this process, Duncan provided the Indigenous community of Metlakatla with medical aid that originated from the Church Missionary Society of England. The extent to which this aid helped to prevent the spread of smallpox remains unclear, but Metlakatla seems to have had more medical supplies than were provided to surrounding villages by the Hudson’s Bay Company or any local governing bodies.

The origin of smallpox is unknown, but the virus presumably evolved from wild animals. It was seemingly unknown to the ancient Greeks and Romans, and is believed to have first passed from Hindostan – also the birth-place of cholera – to Arabia and regions bordering on the Red Sea. It travelled slowly westward, striking England at the close of the ninth century. From Europe it passed to Mexico in the early sixteenth century, causing more deaths than all other predominant diseases of the era combined. Many changing patterns of human migration, warfare, and commerce carried the disease for thousands of years, and by the seventeenth century occurrence turned to epidemic. Mortality rates were usually between fifteen and twenty-five per cent, but during some epidemics forty per cent of infected persons died.

Usually contracted through the upper respiratory tract, the smallpox virus may also be transmitted by clothing, blankets, or other materials of human contact. During an incubation period that lasts about twelve days, the virus spreads to the internal organs and multiplies very quickly. After virus particles are released into the bloodstream, signs of illness begin with fever, aches, sneezing, nausea and fatigue. Within a week the patient begins to excrete pus and suffers from delirium due to high fever and a putrid, stifling odour. Septic poisoning, along with scaring, blindness, and deafness were not uncommon complications. The worst form of the disease, known as black or hemorrhagic smallpox, was almost always fatal. 

The story of Metlakatla certainly has colonial undertones, and it would be imprudent to suggest that Duncan and his missionary aid provided the Indigenous population of the community with a medical advantage. At the time the epidemic swept through the coastal regions of British Columbia, it was not uncommon for people to refuse vaccination. Indigenous populations in the Tsimshean villages were seemingly forced to build trade relationships with established colonial governments, but negotiations were largely unfair. Distrust in trade was not uncommon, nor was it uncommon for the inhabitants of the Tsimshean villages to distrust medical treatment not indigenous to their culture.

Although circumstances surrounding the Ebola outbreak and modern healthcare are far removed from the colonial context discussed here in relation to the smallpox epidemic that swept through the British Columbia coast, it’s important to remember that medicine is in a constant state of evolution. Fear has the ability to create and perpetuate distrust, but collaboration at all levels seems imperative to combat the spread of this already deadly disease. Canada has a unique history in regard to medical treatment, and perhaps more study into smallpox and epidemic control is needed. At the very least, reflection has the ability to create another important level of awareness.