Tracking the source of a killer epidemic

Nurse Marjorie Cunningham, posed in front of the Scarlet Fever Isolation Ward at the Royal Columbian Hospital. The scarlet fever isolation ward was converted to a T.B. isolation ward c.1927.

Today we know that scarlet fever is caused by a bacterium known as Group A Streptococcus. Treatment is very straightforward – fluids, rest and antibiotics – the same ones used to treat strep throat, and people who have scarlet fever are considered contagious only until they have had at least 24 hours of antibiotic treatment.

But in the 1800s, scarlet fever was among the most common of a long list of diseases that caused rash and fever in children. Unfortunately, it was often severe and in the 19th century, it was a leading cause of death among children in America. Streptococcal bacteria were identified in the 1870s, but it was not until the early 20th century that they were effectively identified in routine cultures.

In 1913, a 7-year girl named Gladys-May lived with her family on Sherbrooke Street in New Westminster, just a block from the Royal Columbian Hospital. On Monday, January 6th, in her usual good health, she went to school at nearby Richard McBride Elementary, but the next day she developed a fever and within 24 hours, she was dead.

Two days later, the local paper reported 25 cases of scarlet fever centered around Sherbrooke Street, and there were concerns that they might have to close the schools. A week later on January 14, with the epidemic continuing to grow, a second death occurred. This time it was a 24-year old man who died at RCH of the disease. Most victims of scarlet fever were children, but this young man had had previous bouts of quinsy, a condition affecting the tonsils, making him susceptible to scarlet fever.

In spite of the children with the disease being quarantined in their homes, the epidemic continued to grow – still centered on a small two or three block area of Sapperton. With over 50 cases now, orders were given to close Sunday Schools and churches and to cancel all public meetings.

Dr. A.L. McQuarrie, while treating the victims of the disease as best he could, also took on the challenge of tracking down the source – clearly there was something more than person-to-person contact at work. Within a few days he had the mystery solved – one particular supplier of milk. In Dr. McQuarrie’s words, “the milk supply was at the root of the present epidemic and literally cans of scarlet fever were delivered to New Westminster customers”. Once he knew that, and had the infected supply stopped, it was just a matter of time for the disease to run its course. The paper said, “the epidemic which for a time proved so threatening in Sapperton is now dying a natural death”.

Milk-borne scarlet fever was known in the late 1800s, but it was not quickly obvious in this case because the disease followed the route of one milk delivery wagon, and that took some detective work to identify.

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3 Comments on “Tracking the source of a killer epidemic”


  1. Thank you for the wonderful history!


  2. […] Another familiar name to blog readers is Dr. A.L. McQuarrie. He was the “detective” who solved the mystery of the source of the killer scarlet fever epidemic in 1913. See that story in the June 6th post. […]


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