public health

The Epidemic That Wasn't

By Caitlin Hollander

A 47-year-old leather importer and his wife arrived in New York City on a business trip. Most likely exhausted from the long journey from Mexico, they checked into a midtown hotel where the businessman noticed that he had a headache. He took some medication and went to sleep, probably thinking it little more than a side effect of the stress of the trip. But he started to feel worse and after developing worrying symptoms, went to the hospital. They transferred him to another hospital, one more able to handle a potentially contagious condition. There, he was determined to be having an adverse reaction to the headache medication he had taken - nothing serious. The appropriate medication was administered; yet, his symptoms worsened. After 8 days in New York City, he was dead. The cause of death was ruled “erythema multiforme with laryngotracheobronchitis and bronchopneumonia” - essentially, the allergic reaction plus bronchitis and pneumonia.

Then, two patients who had also been in the hospital at the same time as the businessman became ill with the same symptoms:, a young man in his 20s and an infant. Both had already been discharged and returned home to their families. More tests were performed - after all, allergic reactions are not contagious - and it was discovered that they had something far worse than anyone had imagined.

Smallpox

The year was 1947. Eugene LaBar was the first smallpox fatality in New York City in 35 years. The two additional patients had gone home to crowded apartments; it would be discovered later that the young man, Ismael Acosta, had infected his wife, Carmen, who would be the second fatality in this outbreak. Carmen Acosta was 27 years old, eight months pregnant, and the last person to die of smallpox in New York City.

Ever

Page 2 of Eugene LaBar’s death certificate, dated March 10, 1947, indicating that he had died of “erythema multiforme with laryngotracheobronchitis and bronchopneumonia”

Page 2 of Carmen Acosta’s death certificate, dated April 12, 1947. Her cause of death is one word- Variola, the medical name of smallpox. She was 27 years old, and had died within 6 days of showing symptoms

But how was this possible? How was such a communicable disease halted in its tracks in a city where, ten years prior, 165,000 families living in tenements still did not have access to private toilets? How did the outbreak only last two months and only infect 12 people?

From the The Brooklyn Daily Eagle, Mon, Apr 14, 1947

The answer is what became the most ambitious and aggressive public health campaign to date at the time, perhaps in all of history. Quarantines were issued, travel histories were tracked, and most importantly, the mass vaccination of the residents of New York City began. In under a month, 6,350,000 people were vaccinated. 5,000,000 of them were vaccinated in the first two weeks. 179 locations across the city, from police stations to doctors’ offices to public schools, were opened up as free vaccination clinics. WWII air marshals were remobilized to go door-to-door, letting people know where they could be vaccinated.

In short, the entire city was mobilized to stop the progression of the disease.

But who led the charge? Who saw the danger, acted, and saved the lives of hundreds, potentially thousands, of New Yorkers?

This is the story of Dr. Israel Weinstein, a man nearly forgotten to history, who saved the lives of countless men, women, and children in the smallpox outbreak of 1947.

New York Times, April 9, 1947

To the left, an image from the New York Times of Dr. Weinstein vaccinating his staff. Above, a recording of one of his many public health messages. Audio courtesy of the NYC Municipal Archives WNYC Collection


The ship’s manifest of the ship bringing Rosa (later called Freida), Dina, and Josef Weinstein into the US- they are entries 34-36

On October 30, 1890, the SS Augusta Victoria departed from Hamburg bound for New York City. In steerage was a young mother named Rosa Weinstein and her two children, Josef and Dina. They were travelling to New York from Brest (now Belarus) to meet their husband and father, David, who was living in a tenement on the Lower East Side. They reunited, and in 1891 another son, Alexander, was born. Another son would follow on May 26, 1893: Israel. All of the Weinstein children were born at home; Alexander, Israel, and Marie in tenements on the Lower East Side, and the youngest two, Milton and Gilbert, in Bronx tenements. And although he was only two when his younger sister Marie died, when his brother Gilbert died, Israel was nine – old enough to remember. Both children died of pneumonia.

Israel went on to graduate with his Bachelor of Arts from City College in 1913, followed by a Masters in 1915 at Columbia, and a 1917 D.Sc at NYU. During this time, he was working as a biology teacher at Morris High School. His life would be interrupted by something far greater than his education, however: the First World War.

Israel Weinstein’s WWI service card, detailing his officer’s service; his enlisted card is far shorter and only covers the months before his commission.

At 24 years of age, Israel Weinstein delayed medical school and instead enlisted into the US Army in December of 1917. He was commissioned as a first lieutenant the following February and served in the Army Expedition Force, seeing action during the Battle of Saint-Mihiel. He finally came home and returned to his job teaching biology, where he would stay until 1922. It was during WWI, however, that he designed his first public health campaign, directed at soldiers to reduce venereal diseases.

From Israel Weinstein’s Jewish Serviceman’s Questionnaire, from the records of the American Jewish Committee. This portion details his service, including his work in charge of the educational campaign to reduce VD

In 1920 Israel’s father David died of heart disease. Perhaps this event changed the direction of Israel’s life because he entered Columbia College of Physicians and Surgeons not long after, graduating in 1926. During this time period, he began working for the New York City Department of Health giving public health lectures.

In 1930 Israel received his PhD from Columbia, his last in a series of advanced degrees. He was unmarried and living with his oldest brother Joseph and his family. Tragedy would strike the Weinstein family yet again, however, when Joseph died in 1938. Israel was forced to move and live with his older brother Alexander and their widowed mother. But their mother Freida (once called Rose) would die in an accident while visiting Israel’s sister Dina in Michigan in 1942.

From The Daily Register. Red Bank, New Jersey, Thu, Oct 29, 1942

As for Israel? He had once again signed up for the army with the outbreak of WWII, now as a major. Once again, he was giving public health lectures.

With the end of the war, Israel found himself in a new position. He was released from the army on May 18, 1946, and by May 27, was officially New York City’s new health commissioner.

Less than a year later, Eugene LaBar would come to New York City with an undiagnosed case of smallpox and spark the health campaign that marked Dr. Weinstein’s career.


Above: An article about Dr. Weinstein’s appointment (The Brooklyn Daily Eagle, May 26, 1946).

Above: The Brooklyn Daily Eagle (April 15, 1947)
Below: The Daily Messenger, Canandaigua, New York (April 18, 1947)

According to Dr. Weinstein’s writeup after the fact (which I have included at the end of this article), smallpox was officially confirmed in Ismael Acosta on April 4th; nearly a month after LaBar’s death on March 10th. Immediately, the Health Department sprang into action. The laboratories producing the vaccination began working 24 hours a day. 179 city buildings were used for vaccination stations:schools, hospitals, police and fire stations. Hundreds of thousands of doses were sent by the army and navy. Mayor O’Dwyer was among the first to be vaccinated, and even President Truman was vaccinated in order to give a speech in New York City. To quote Dr. Weinstein:

“In a period of less than a month, 6,350,000 people were vaccinated in New York City, over 5,000,000 of them within the two week period following the appeal for universal vaccination by the Mayor. Never before had so many people been vaccinated in such a city and on such short notice.”

The task was monumental. But somehow, when the city was declared smallpox-free in mid-April, only 12 people had been made ill and only two had died. To contrast, in a 1945 outbreak in Puget Sound, Washington, 65 people caught smallpox and 20 died. Again, to quote Dr. Weinstein:

“During the period 1900 to 1929, epidemics of virulent smallpox were reported throughout the United States. Notable among these were the outbreaks in 1921 in Denver and Kansas City, when the former city reported 924 cases and 37 deaths, and the latter 943 cases and 160 deaths. In 1924, Detroit reported 1,610 cases and 163 deaths. In 1901, an epidemic of smallpox in New York City resulted in 1,959 cases and 410 deaths. Had the same rate prevailed in the 1947 outbreak, there would have been 4,310 cases and 902 deaths.”

To give an idea of the magnitude of this achievement, in 1972 there was a smallpox outbreak in what was then Yugoslavia. 175 people would be infected, and 35 would die. This was a fraction of what happened in New York City a quarter of a century before. One would think that Israel Weinstein’s name would be shouted from the rooftops, that there would be schools, hospitals, and streets named after him. But there are not. 

Fort Worth Star-Telegram, February 10, 1948

Seven months after the outbreak ended, so did Dr. Weinstein’s time as health commissioner. He resigned Nov 3rd. He briefly served as the director of the Bureau of Health Education until 1949, when he retired.

From here, he would fade into something resembling obscurity. Except for the rare newspaper mention of public lectures he was giving (as close as Brooklyn and as far as Tel Aviv), very little is said of Dr. Weinstein or the 1947 outbreak until his death in 1975. He never married and had no children; he outlived his parents and five of his six siblings. All that he merited was a brief obituary, summing up his life into one short column in the New York Times.

So what can be said of this man?

He was the middle child of Jewish immigrants. The son of a man in the garment industry in New York City, as so many were. He devoted his life to education and to public health. He served in two world wars, and while he did not serve in combat positions his contributions were no less vital.

And he most likely saved hundreds, if not thousands of lives. Despite many saying after the fact that he overreacted, or acted too soon, he did what was needed at a time when the lives of many hung in the balance.

For this, at the very least, he should be remembered. 

Israel Weinstein’s single column obituary in the New York Times

Israel Weinstein’s single column obituary in the New York Times