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Typhoid Epidemic 1903-1904

As the month of November 1903 began, Butler was booming. The city had grown to a population of 18,000, thanks to the expansion of manufacturing industries in the area. The growing city of Butler, filled with life, was unprepared for the public health disaster waiting just around the corner. By the end of that November, Butler would be in the midst of an outbreak of typhoid that would cause the deaths of more than 100 people.

Typhoid is a strictly human-borne disease carried in the bloodstream and intestinal tract. Symptoms of infection include sustained high fever, stomach pains, and possible rashes. Secondary infection can be spread by coming into contact with carriers, and many cases are a result of eating contaminated food, or drinking polluted water, as were the cases for Butler.

Throughout the summer of 1903, most of Butler’s citizens were relatively confident in their water supply. In July the Butler Eagle published an article that simultaneously acknowledged the deadliness of typhoid and the protection from the disease that the town possessed through the filtration of the water supplied by the Butler Water Company, a private company contracted to run the city’s water system. However, a series of unfortunate events that fall would prove such confidence unfounded.

On August 28, a summer of heavy rains led to Butler experiencing a minor natural disaster. The Boydstown Dam north of the city broke, causing flooding south all the way into town. In some areas, floodwaters were as high as six feet. After the dam burst, the Butler Water Company found it challenging to supply the town with sufficient water, despite assurances made to the citizens of Butler that there would be no shortage. Earlier in the year, the company had begun construction on a new dam in Oakland Township. The new dam, known as the Thorn Run dam, was to be twice as big as the one at Boydstown, but at the time of the burst the new dam was not finished.

With both dams under construction, the water company decided to draw its water directly from an emergency intake point on the Connoquenessing Creek. The citizens of Butler were not notified of this change, nor were they notified when the company stopped filtering the water from October 20 until November 2. Later investigations by the local and state health boards revealed that, not only had there been multiple typhoid fever cases throughout the Connoquennessing Creek Valley, but that the drainage of those victims' houses ran into the Connoquenessing Creek. Thus the water company was directly supplying contaminated water to the majority of the citizens of Butler.

By the end of the first week of November, the number of typhoid cases in Butler began to cause alarm. The Butler Board of Health advised that all drinking water first be boiled, although the source of the outbreak had not yet been determined. An angry letter to the editor of the Butler Citizen insisted that the cause of the outbreak was due directly to the pollution of the water supply. The author claimed to have seen a number of pollutants in the creek including: dead turkeys, chickens, rats, cats, dogs, hogs, fish, boxes of decayed vegetables and fruits and cast off garments, among other debris.

As November progressed, the increasing number of typhoid cases hampered daily life in the city. The epidemic and fear of infection caused an economic slump in town, and Butlerites were often given conflicting information - even as health officials investigated the cause of the cases and cautioned citizens to boil their water and wash their vegetables, the Butler Daily Eagle assured readers there was not "any cause for alarm at the present time."  A November 13 article in the same paper declared tests had found no germs in Butler's water and that citizens could disregard the boiling instructions, much to the outrage of the Board of Health. Three days after the article, more than 100 new cases were reported in a single day.

An emergency epidemic fund was appropriated by State Senator Andrew Williams, and local business leaders formed a Relief Committee to raise money to provide for the needs of the ill and their families. On November 23, 1903, the Butler School Board announced its decision to close the schools due to the high number students and teachers with the disease. The school board also called upon the Pennsylvania State Health Board to assist with the epidemic.

Declaring unanimously its opinion that the epidemic definitely stemmed from the water supply, the State Board of Health opened a field office on Main Street, urged residents to boil their water to avoid infection, and distributed disinfectants to the public. Still, the disease continued to spread. Several town buildings were converted into temporary relief hospitals. In the December 10th issue of the Butler Citizen, the epidemic was given the title “Butler’s Scourge.” The Citizen claimed the epidemic would “go down into the medical history of the state and nation as one of the most remarkable that has, as yet, occurred in the country.” Seven weeks in, over 1,200 cases were recorded, and fifty-one deaths had occurred. Two members of a traveling theater troupe caught the bug during a performance and died some time later. By December 17th reported cases surpassed 1,300 with over sixty recorded deaths.

The epidemic received national attention. Clara Barton, founder of the American Red Cross, visited Butler personally and advocated for relief donations; Andrew Carnegie and President Theodore Roosevelt were among those who donated towards relief efforts. After reluctantly acknowledging that the water was indeed the source of the epidemic, the Butler Water Company worked to correct the problem during the month of December, draining and cleaning their reservoir, and flushing out all water pipes and mains before bringing the new Thorn Run dam online. As a result of these efforts, infection rates began to slow.

January 1904 brought, at last, some welcome news. During the week of January 21st, only two more deaths occurred. The Relief Committee issued a statement that the crisis had passed, and the temporary relief hospitals, such as the Car Works Hospital and the Brotherly Love Hospital, closed down and sent their remaining patients to Butler’s General Hospital. By February, the deadly epidemic had ceased to be news, and had already become history. At the height of the epidemic, 1 in 13 people in the town were infected; the final death toll was 111.

The "Butler scourge" illustrated the dangers of an unregulated water supply, and the disastrous ramifications unclean water could have on a population. In 1905, largely as a result of the Butler epidemic, the Commonwealth of Pennsylvania enacted important legislation to better protect the health of its citizens. A more capable body, the state Department of Health replaced the largely ineffective state Board of Health. A standing emergency fund was established specifically for the suppression of epidemics. And the Pennsylvania Water Supply Commission was established in order to regulate water companies and to annually report on the water supplies across the state. By 1906, The New York Herald acknowledged that the reforms stemming from the Butler  epidemic caused Pennsylvania to go from a state notorious for its lack of concern toward public health to “a model well worth copying.”


Source of typhoid Image taken from the State Board of Health Report, depicting a privy, used by fever victims, that drained into the Connoquennessing Creek.
Headline and map from Chicago Sunday Tribune, January 3, 1904. The article criticized the Butler Water Company and the city's public officials for not taking the initial outbreak seriously enough. Source: Chicago Sunday Tribune Date: January 3, 1904
Butler newspaper ad, 1903 As typhoid spread in Butler, savvy entrepreneurs were quick to offer a solution. The daily newspaper ran advertisements for everything from bottled water to typhoid "cures" to "physician recommended" soft drinks. Date: 1903
Butler newspaper ad, 1903 As typhoid spread in Butler, savvy entrepreneurs were quick to offer a solution. The daily newspaper ran advertisements for everything from bottled water to typhoid "cures" to "physician recommended" soft drinks. Date: 1903
Citizens Relief Committee Certificate A certificate honoring Louise Geary, a student at the University of Pennsylvania School of Nursing who traveled to Butler to treat patients during the typhoid epidemic. In the age before antibiotics, nursing measures - such as replacing fluid loss, making sure the patient ate, keeping the patient clean and preventing secondary infection - were crucial to a patient's survival chances. Source: Barbara Bates Center for the Study of the History of Nursing. “Echoes and Evidence: An Introduction.” Bates Center Blog. Accessed September 17, 2015. Date: April 1, 1904



Kevin Lukacs and Alysha Federkeil, “Typhoid Epidemic 1903-1904,” Butler County Historical, accessed March 3, 2024,