Oregon Experience: White Plague

TB Among Native Americans

Excerpt taken from Medical Clinics of North America 1993. The History of Tuberculosis as a Global Epidemic by Joseph H. Bates, MD and William W. Stead, MD.

The first major outbreaks of TB among the native people of North America began in the 1880s after they were settled on reservations or forced to live in barracks in prison camps.

When Native Americans were required to live in small fixed huts, an epidemic began. Contact with the surrounding white settlers was frequent, and the children were crowded into boarding schools. Under these conditions TB spread rapidly. When several hundred Apache prisoners were kept in the Mount Vernon barracks by the US government in 1887, the death rate rose from 54.6 per 1000 people in the first year of imprisonment to 142.8 per 1000 people in the fourth year. Nearly half of these deaths were caused by TB.

When TB is first introduced into a population, it produces a subacute illness that resembles typhoid fever more closely than the chronic pulmonary disease most commonly seen today. Death comes so quickly that little spread of infection to others occurs. Those who survive this phase are subject to the chronic pulmonary diseases, the form that is the most infectious.

As Native Americans were confined to reservations, death rates from TB increased rapidly. By 1886 the TB death rate reached 9000 per 100,000 people. These rates are 10 times higher than ever observed in Europe at the peak epidemic there and, indeed, are the highest rates ever recorded anywhere.

Photo Courtesy Library of Congress