The Pandemic Century

by The Pandemic Century- One Hundred Years of Panic, Hysteria

  TODAY FEW PEOPLE recall the hysteria surrounding the great parrot fever pandemic of 1929–1930, but in an era when parrots were all the rage and itinerant peddlers went door-to-door with “lovebirds” for widows and bored housewives, the idea that one’s pet parrot or parakeet might be harboring a deadly pathogen from the Amazon was the stuff of domestic nightmares and a story few newspaper editors could resist. Indeed, were it not for the yellow press, and the Hearst newspaper group in particular, it is unlikely that the connection between parrots and psittacosis would have come to light so fast, or that the PHS would have reacted so quickly. The story about the Argentine theatrical troupe had appeared in the January 5 edition of the American Weekly, a lavish supplement distributed with the Sunday editions of the New York American and other papers in the Hearst group, under the headline “Killed by a Pet Parrot.” Mrs. Martin probably read the story in the Baltimore American sandwiched between an article about a tony twice-divorced couple and the “astonishing confessions” of a slave trader. Morrill Goddard, the editor of the American Weekly, had spotted the tale about the troupe in an obscure Argentine scientific journal the previous November and had wired the paper’s Buenos Aires correspondent, asking for further details. The correspondent found the theater where the troupe had been performing shuttered, but managed to trace the surviving cast members. The most prominent victim had been Carmen Mas, the show’s star and a well-known Argentinian comedian. Her leading man, Florencia Paravincini, had also been felled by the disease, but, according to the Hearst correspondent, after “17 days of agony” had recovered. Nevertheless the “bacillus passed from the parrot” had exacted a considerable toll. Prior to the attack Paravincini had been a “big, heavy-set man with hair as black as leather.” Now, he weighed less than one hundred pounds and his hair was “as white as snow.” It was a doctor at the hospital who had put two and two together. After speaking to the company’s prop man, he learned that the actors had been required to pet the parrot on stage and that said bird had since died. As a result, an alert was issued by the Asistencia Publica, the Argentine National Health Board, and soon reports of similar outbreaks connected to sickly parrots but wrongly diagnosed as typhoid or influenza were coming to light. In Cordoba, fifty cases were traced to a parrot dealer who had set up shop in a local boarding house. His birds were promptly slaughtered but too late to prevent the distribution of other suspect psittacines. According to the correspondent, the outbreaks in Argentina were entirely avoidable and would not have occurred had dealers observed some simple precautions familiar to indigenous forest peoples accustomed to living alongside wild birds in their natural habitat.

  In semitropical parts of Argentina where the parrots are caught, the parrot disease is well known among the natives, who never have the creatures for pets, and keep away from them unless they make a business of catching and shipping them to the cities. The professional parrot catcher takes care not to get hold of a sick bird. If by mistake he does catch a “quiet one” he knows it is deadly and lets it go as well as any healthy captives with which it may have come in contact.

  The outbreak in Cordoba was subsequently traced to a consignment of 5,000 parrots imported from Brazil that had been kept in unsanitary conditions in overcrowded crates. By the time Goddard came to learn of the outbreaks, the connection between psittacosis and Brazilian parrots was well known in Argentina and the authorities had outlawed the trade. However, passengers on cruise ships calling at Buenos Aires were largely ignorant of the ban, creating an opening for unscrupulous dealers to offload their sickly birds on unsuspecting tourists. It was this practice that most likely led to the introduction of psittacosis to the United States.

  As the term pandemic implies, the United States was not the only country affected. In the summer of 1929, four cases of suspected psittacosis were reported in Birmingham, England, and by March of the following year one hundred cases had been recorded across England and Wales. One notable early victim was a ship’s carpenter who had purchased two parrots in Buenos Aires, only to see them perish on the voyage to London (when he presented at the London Hospital in December 1929, the carpenter’s symptoms were mistaken for typhoid, just as with the Kalmeys in Annapolis). Although most cases seemed to involve sustained exposure to live birds, British researchers observed that this was not always the case, one example being a man who had merely stopped for a beer in a public house in which a sick parrot had been present. By January 1930, similar outbreaks were also being reported in Germany, Italy, Switzerland, France, Denmark, Algeria, Holland, and Egypt. There were even reports of an outbreak in Honolulu.

  During the first week of illness, most patients appeared comparatively well in spite of running high temperatures. After five or six days, however, headache, insomnia, and an irritable cough would set in, and they would complain of profound exhaustion, their symptoms often being accompanied by lung consolidation. Soon after, many patients slipped into delirium and became semicomatose. This was the critical period, with death often following soon after. However, in other cases, just as it looked as if the illness was about to take a fatal turn, the patient’s temperature would fall and his condition would suddenly improve. Full recovery might take a further week or two, and sometimes as long as eight. During this protracted convalescence period, physicians had to constantly monitor their patients’ temperatures, as relapses were frequent.

  It was not until much later, of course, that doctors would become familiar with the typical course of the illness and recognize it as psittacosis. Instead, it was the story in the American Weekly and Dr. Martin’s telegram that appears to have alerted Cumming to the outbreak and prompted him to put McCoy and Armstrong onto the case. By then, psittacosis was widely seeded in cities on the eastern seaboard of the United States and had already been communicated via dealers to other caged birds popular with American consumers, such as shell parakeets (Australian budgerigars). The result was that as parrot fever spread from Annapolis, to Baltimore, New York, and Los Angeles, the outbreak became a headline writer’s dream. “Parrot Fever Hits Trio at Annapolis,” declared the Washington Post on its front page on January 8, 1930. “Parrot Disease Fatal to Seven,” reported the Los Angeles Times three days later. ‘‘Women’s Case Brings Parrot Victims to 19,” announced the Baltimore Sun on January 16.

  For widows and bored housewives, caged birds were the FM radios of their day. The chirping of canaries provided a soothing background music, punctuating the drudgery of household tasks, and, in the case of parakeets—parrots’ smaller, sprightlier cousin—their facility for words and humorous phrases provided a facsimile of human conversation. Estimating that New York City alone was home to some 30,000 parrots, National Geographic dubbed Amazons and African grays “the ballyhoo barkers of birdom, noisy clever, side-show performers of the tropical forest rainforest.” Their pint-sized cousin, the lovebird (genus Agapornis), had a reputation for similarly buffoonish behavior, and with their talent for hanging upside down or dancing on their owners’ shoulders were a source of endless amusement for children and an entertainment for house guests. Little wonder then that in 1929 nearly 50,000 parrots, parakeets, and lovebirds, and some 500,000 canaries were imported to the United States. These birds arrived not only from Brazil and Argentina, but from Colombia, Cuba, Trinidad, Salvador, Mexico, and Japan. The majority entered the United States via New York, the center of the East Coast bird trade. However, in the case of Australian budgerigars, the main ports of entry were San Francisco and Los Angeles. Indeed, following the Wall Street crash in 1929, a huge bird breeding industry had grown up in Southern California, with hundreds of independent breeders raising lovebirds in their backyards to supplement their incomes. To the naked eye these birds appeared perfectly healthy. However, when they were packed into crowded aviaries or containers and shipped across state lines, many began to shed the virus and transmit the infection. It would prove an invisible and combustible combination.

  DESPITE ITS NAME, parrot fever or psittacosis is not confin
ed only to parrotlike birds but has been isolated from some 450 other bird species, including canaries, finches, pigeons, doves, and kestrels.† Moreover, although human infections are typically acquired by exposure to parakeets, bird-to-human transmission has also been documented from poultry and free-ranging birds. The culprit is a tiny intracellular parasite, Chlamydophila psittaci, a member of the same family of bacteria that transmits chlamydia, a common infection of the eye and genital tract. In the wild, psittacosis lives in equilibrium with its host. Hatchlings are usually infected in the nest through contact with mature birds who harbor the bacillus in their guts. Under natural conditions this contact results in a mild infection that confers lifelong immunity. However, under conditions of stress, such as when food becomes scarce or birds are packed into small crates or confined to cages for long periods, immunity can wane and the infection can be reignited. Typically, a bird’s feathers become rough and dirty, and instead of squawking and clawing at the bars of the cage it becomes listless and inert. Sometimes, bloody fluid may leak from its beak and nose, but the most common symptom is diarrhea. It is the feces that pose the principal threat to humans, especially when they become dry and powdery, as occurs in cool conditions. Then, all it takes is a flap of the birds’ wings or a sudden breeze from an open window for the particles to be wafted into the atmosphere. The final stage comes when a person enters the same space and inhales the aerosolized particles, allowing the psittacosis bacillus to lodge in the respiratory tract from where it is free to colonize the lungs. Sickness usually occurs six to ten days later, the first sign being a fever accompanied by headache, an irritable dry cough and, on occasion, discharges of bloody mucus from the nose.

  It is likely that aboriginal peoples from South America suffered psittacosis from time to time, particularly given the fondness of the Awa and other Brazilian tribes for headdresses featuring brightly colored feathers from macaws, parrots, and toucans. However, it is unlikely that they would have noticed sudden die-offs due to epizootics, since birds falling from the trees in the jungle would have been camouflaged by vegetable debris on the forest floor or rapidly consumed by insects and other scavengers. By contrast, sudden die-offs of birds in captivity are highly visible and difficult to ignore.

  No doubt European aristocrats who started the vogue for importing exotic birds from Africa and elsewhere noted such occurrences as early as the eighteenth century, but it was not until 1872 that Jakob Ritter, a Swiss physician living in Ulster, near Zurich, gave the first detailed description of the disease when an outbreak occurred at his brother’s house, infecting seven people and killing three. Ritter named the disease “pneumotyphus” and blamed it on a consignment of parrots and finches caged in his brother’s study that had recently been imported from Hamburg. This was followed, in 1882, by a second outbreak in Switzerland, this time in Bern, in which two people died. On that occasion, suspicion fell on some sick parrots imported from London. However, the outbreak that attracted widest comment occurred in Paris in 1892 and centered on the homes of two bird fanciers who had recently shipped some five hundred parrots to the French capital from Buenos Aires. During the sea crossing, three hundred birds had died, and people coming into contact with the survivors had rapidly developed symptoms of influenza. On this occasion the outbreak had a mortality rate of 33 percent, prompting the interest of Edmond Nocard, a young assistant of Pasteur. Nocard was unable to get hold of any live birds implicated in the outbreak. Instead, he examined a packet of dried wings taken from parrots that had died during the voyage. From their bone marrow, he was able to cultivate a small Gram-negative bacterium. He then injected or fed the organism to a wide variety of test animals—parrots, pigeons, mice, rabbits and guinea pigs—and demonstrated that in all cases it caused a fatal illness similar to the human disease. Nocard named the microbe Bacillus psittacosis, psittacosis being the Greek word for parrot. However, other researchers found it difficult to cultivate Nocard’s bacillus from the blood, lungs, urine, or feces of presumed human cases, and as agglutination tests proved similarly negative or inconsistent, doubts gradually grew as to the bacillus’s etiological role.

  Scientists were right to question Nocard’s claim: in fact, the organism he had isolated was a type of salmonella and had nothing to do with psittacosis. Unfortunately, this would not become known until after the 1929–1930 outbreak. In the meantime, just as with Pfeiffer’s erroneous claim about the bacterial etiology of influenza, Nocard’s error spread confusion, making medics and public health officials reluctant to accept that parrots had anything to do with the human cases of typhoid-like illness.‡ This only compounded the uncertainty and fears about the source of the epidemic.

  Scientists were not the only ones to fail the public. Reflecting on the parrot fever pandemic in 1933 in his best-selling book, Men Against Death, Paul de Kruif would describe the outbreak and the panic that accompanied it as “one of our American hysterias.” If so it was a hysteria that he and other journalists helped engender. This was a pity, as de Kruif ought to have known better. Before turning to science writing de Kruif had worked as a bacteriologist at the University of Michigan and during the First World War had served as a captain in the US Sanitary Corps, where he helped develop an antitoxin for gas gangrene. Afterwards, he joined the Rockefeller Institute, but just as it looked as if he were set for an illustrious career as a medical researcher, de Kruif wrote an ill-advised book, Our Medicine Men (1922), containing thinly disguised portraits of his Rockefeller colleagues. The book cost him his position at the Rockefeller Institute but launched his career as a science journalist. In 1925, he teamed up with Sinclair Lewis to write Arrowsmith, a runaway best seller about a country doctor turned research scientist that fired the imaginations of a generation of American medical researchers. This was followed in 1926 by Microbe Hunters, a nonfiction book profiling the pioneers of microbiology, such as Koch, Pasteur, and the Nobel Prize–winning physiologist Paul Ehrlich, who had reversed centuries of medical superstition by applying laboratory techniques to the study of infectious disease. But successful as these books were, de Kruif’s bread and butter was “scare” stories about obscure microorganisms that posed a theoretical threat to American housewives. “In American milk today there lurks a terrible, wasting fever, that may keep you in bed for a couple of weeks, that may fasten itself on you for one, or for two, or even for seven years—that might culminate by killing you,” he informed the readers of Ladies Home Journal in 1929. De Kruif was referring to undulant fever, or brucellosis, a disease of cattle that, while it might cause cows to abort prematurely, in truth posed little threat to people. However, in an era before pasteurization when many housewives still drank “raw” milk drawn from local dairy herds, undulant fever was a perfect candidate for a germ panic, fitting the template of what medical historian Nancy Tomes calls the “killer germ genre of journalism.” Drawing on the latest microbiological discoveries and Progressive Era messages about the importance of sanitation and personal hygiene, this genre played on the dangers that lurked in everyday objects, such as coins, library books, or drinking cups. Dust and insects were targets of similar scaremongering, hence the advertisements urging housewives to mop regularly with disinfectants and spray their homes with insecticides. By the 1920s, as Americans adopted new germ-conscious regimes, even handshaking and kissing babies came to be frowned upon.

  These fears were not only used to sell bleaches, detergents, and bug sprays, they were also a way of selling newspapers; hence Goddard’s decision to hype the story about the Argentine theatrical troupe. In a germophobic era, even the normally level-headed New York Times was not immune to the parrot panic. “Many have long had the feeling that there is something diabolical about the parrot tribe,” opined a columnist at the height of the scare. “More than one family pet, known by its owners to possess the amiable and gentle disposition of a kitten, is regarded with fear and trembling by visitors. Until more has been learned about the nature of the malady the safest course seems absolute ostrac
ism for recent immigrants of the parrot family.”

  Within days of that editorial, however, the New York Times was quoting the opinion of a Viennese expert who thought the scare “baseless” and that Americans were victims of “mass suggestion.” Two days later, psittacosis—or parrots, at least—had become a laughing matter as the paper regaled its readers with the story of Secretary of State Henry Stimson’s pet parrot, “The Old Soak.” Stimson’s bird had been caught misbehaving while his master was overseas, cursing at tourists and their guides as they entered the Pan-American Building. The bird, apparently, was “quite a linguist,” and was said to have learned the profanities “during his days in the Philippines.” As a punishment, The Old Soak was confined to the basement of the Pan-American building where he could curse without giving offense. However, no joking could hide the fact that America’s Microbe Hunters had missed something that had been known to their medical colleagues in Argentina since the previous summer, and that had most likely been incubating under their noses since the fall of 1929. How had this been possible, and who would be the person to restore the reputation of the US Public Health Service?