Discovering the causes of infectious diseases had been a lifelong quest for Brazilian physician Henrique da Rocha Lima and his friend, Czech pathologist Stanislaus von Prowazek, with both men taking a particular interest in typhus. At great risk to themselves, they followed outbreaks and epidemics right across Europe, travelling to Serbia in 1913 to study one outbreak, and observing another in Constantinople the following year. In the winter of 1915, as war raged across Europe, they worked to contain a sudden and devastating outbreak among Russian prisoners of war in a camp near Berlin. Here, both men became infected, and von Prowazek quickly died. Da Rocha Lima recovered, however, and became more determined than ever to track down the cause.
In 1916, after a period of intense research, he announced the discovery of an entirely new group of bacteria that, once introduced into a person’s bloodstream, induced the familiar symptoms of high temperature, aches, rashes, delirium, sensitivity to light, often coma and, above all, the terrible stench—all the indications of typhus. In honour of his late colleague and another prominent victim of the disease, an American researcher named Ricketts, da Rocha Lima named his new strain of bacteria Rickettsia Prowazekii, and further announced to the world that the means by which it had, for thousands of years, been introduced into the human system was via one of mankind’s oldest companions, Pediculus humanus humanus, the common body louse. The discovery revolutionised the treatment of typhus. Lice were hunted down and destroyed with purpose and vigour like never before and by World War II, when DDT and later a vaccine had been developed, the incidence had been so reduced that the vaccine’s production was actually halted.
For the passengers and crew of the Ticonderoga, however, such developments were far in the distant future and in 1852, doctors Sanger and Veitch lacked the benefit of any such knowledge. Nor could they have had any idea as to the pathology of the disease: how it will eventually kill the louse itself; how the bacteria contained within its faecal matter will keep living on the surface of human skin for several days; how the unbearable itching of the louse’s bite will cause the patient to scratch, forcing the bacteria directly into the bloodstream; how the incubation period can last up to two weeks; how one single louse can lay up to 200 eggs; and that the ideal environment for the creatures to propagate was in humidity above 40 per cent and in temperatures between 29 and 32ºC—precisely the conditions the Ticonderoga had been experiencing as she sailed slowly south over the warm waters of the equator.
A lack of real knowledge of the disease notwithstanding, when Jane Gardiner died on board the ship in the early days of September, Sanger and Veitch had a terrible suspicion that there would soon be more to follow.
17
Typhus takes hold
The word ‘typhus’ derives from the Greek word typhos, meaning smoke or fog, and was originally used in the context of the disease by the great Hippocrates himself to describe the stupor and ‘confused state of the intellect’ he observed in its victims.[1] What would not be observed—neither by Hippocrates nor anyone else—for another 2000 years was the relationship between the disease and the common body louse, Pediculus humanus humanus.
As research into the twentieth century revealed, typhus is spread when the louse feeds on the blood of a person already infected with the disease. After several days, the Rickettsiae bacteria thus introduced into the louse’s system will in fact kill it, but not before the louse crawls off to find a fresh victim whose body is neither too hot with infection nor cold from death. Prior to killing the louse, the bacteria multiplies exponentially inside it, to be excreted onto a person’s skin in the creature’s faecal matter, where it can remain viable and infectious for many days. The itching of the bite compels a sufferer to scratch, thus infecting themselves by forcing the bacteria into their own bloodstream via tiny cuts and abrasions. After an incubation period of about ten days, the first signs of the disease will start to appear, thus perpetuating the gruesome cycle.
A victim’s clothes would also become great spreaders of the disease, with garments not carefully removed from the victim releasing clouds of lice dust, eggs and faecal matter, which would reattach and infect again, partially vindicating the prevailing theory that the disease was wholly spread by stale and ‘infected’ air. The Ticonderoga’s innovative wind sails, which in fair weather distributed at least some air throughout the fetid lower decks, ironically helped to spread the disease.
How the typhus came on board the ship in the first place will never be known. Despite the best efforts of the staff at the Birkenhead depot, and the spick and span condition of the ship that Captain Boyle had gone to such lengths to present to Captain Patey and the inspectors of the Colonial Land and Emigration Commission; despite the washing and re-washing of the passengers’ clothes before embarkation, someone—most likely in the seams of a jacket or shirt or bonnet or perhaps even in the smuggled blanket of young Janet Blair, had unknowingly brought on board the seeds of disaster in the form of a tiny colony of lice or their eggs. In her exhaustive research, Mary Kruithof believes that it was unlikely to have been Jane Gardiner, one of the first of Dr Sanger’s ‘fever victims’, who was incubating the disease when she came aboard, and that it was more probable that she caught it from another person in the married quarters—possibly someone she knew from her own part of Northumberland, quartered with her on the ship.[2] Without knowing anything beyond an awful itch and a terrible headache, Jane Gardiner would first have become aware of the bites on her body a fortnight or so earlier. She may even have noticed them, in shock and grief at the recent loss of her daughter, Eliza, just ten days after setting sail from Birkenhead. The incubation period being at an end, the symptoms took hold of her quickly. Then, as her temperature rose, the lice themselves either died or vacated her overheated body for newer, cooler premises—and in the cloying proximity of the Ticonderoga’s passenger decks, such newer premises abounded.
The following day, another tragedy unfolded for the Appleby family from the Somerset village of Baltonsborough. Silas Appleby, 28, was listed as a literate, Church of England agricultural labourer, and was undoubtedly anticipating a better life for his family with significantly improved wages and conditions for his work in Australia. He had boarded the Ticonderoga with his wife, 23-year-old Sarah, their daughter, Emma, and son John, three. Little Emma had already passed away on 24 August, mere hours after contracting the raging fever that could not be contained. By 9 September, Sarah herself had contracted the disease and died. Mercifully, perhaps, she did not live to see the death of her remaining child, John, who would be buried at sea three weeks later on 2 November. Silas Appleby, having walked onto the Ticonderoga the head of a family of four, would depart it a grieving widower, entirely alone.
The next day, 10 September, 28-year-old Mary Ritchie from Inverness died after what seemed like a pathetically short battle with the disease. Her little Samuel had been the first infant to perish on board, and the very next day after her own death, the second of her children, two-year-old Alexander, also passed away. This left, once again, only the father, James Ritchie; having set out with his family of four, he was now also all on his own. He would soon be joined by others facing a similarly wretched situation.
The day Alexander Ritchie died, so did twenty-year-old Jane Dempster, a Scots girl housed in the single women’s quarters. By the middle of September, Sanger and Veitch realised that a full-blown epidemic was breaking out around them. Dreadful enough in itself, it was to be greatly exacerbated as the ship continued on to the Great Circle, ploughing into colder waters and freezing winds. The Ticonderoga’s passengers, already weakened by seasickness, a foreign diet and the claustrophobic ordeal of ship life, having been exhausted by weeks of sweltering heat and humidity utterly beyond their experience, would now be forced to endure the freezing latitudes of the sub-Antarctic. To keep warm in the icy gales and endless storms that would soon follow, families would huddle even closer together in the berths, sharing what warmth they could in their inadequate clothing. This scenario of prone bodies lying side by side would, over the next few weeks, present the most ideal conditions imaginable for the spread of typhus, and the Ticonderoga’s doctors would be tested beyond their limits. A particular burden, however, would fall on the shoulders of the young assistant surgeon on his first voyage, Dr James William Henry Veitch.
1
Online Etymology Dictionary,