IntroductionThis is a story about Camp Alger. It is also a story about space. It is a story about how, in 1898, typhoid fever, endemic to the Unit-ed States, was spread by the mobilization of troops to state and national assembly camps. It is a story about how concentrating and crowding soldiers into these camps produced the environmental-spatial relationships that allowed the dissemination of the typhoid bacillus. It is a story about the spatial rela-tionship of the typhoid bacillus to the human intestinal tract and the devastating effects that follow when that relationship is allowed to occur. Finally, it is a story about the ephemeral, temporal-spatial relationship we have to places that are no longer visible and often long forgotten.

War and MobilizationWhen the United States declared war on Spain in April of 1898, it did so with an Army that was entirely unprepared for the effort. At the onset of the war with Spain, the US Army was limited to 25,000 men.1 The Spanish were estimated to have 400,000 men in uniform.2 The need for rapid expansion and mobilization of US Army forces was self-evident. In a matter of a few months in 1898, Army end strength would swell to over 200,000 men. The need to equip, transport, house, feed, and pro-vide medical care for the volunteers quickly overwhelmed the War Department’s capabil-ities. The chaos that ensued provided a rich environment in which the typhoid bacillus would thrive. By the conflict’s end, com-bat-related injuries would claim 345 lives.1 Typhoid fever, on the other hand, would claim over five times that number leaving 2000 dead.3

Watercolor (top) courtesy of the Fairfax County Public Library Archive

Secretary of War Russell A. Alger, Camp Alger’s namesakePhotograph courtesy of the Library of Congress

Headline Middleburgh (PA) Post, April 28, 18981

Anatomy of an Epidemic: Camp Alger, The Spanish-American War, and Typhoid Fever, 1898

Dale G. Dunn

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The Epidemic in Military CampsTyphoid fever was one of the major scourg-es of the nineteenth century and a notori-ous military camp disease. During the Civil War, over 75,000 cases occurred and more than 25,000 died.1 At the onset of the war with Spain, typhoid fever was endemic in the United States. In 1898, the US Army’s method of mobilizing from numerous small state camps to five large national assembly camps facilitated the spread of the disease. These densely populated encampments provided the perfect setting for transmis-sion of typhoid fever. Some 24,000 soldiers contracted the disease in these camps. At the height of the epidemic, up to 350 were struck down each day.2 Seven miles west of Washington, DC, the situation was no less dire at Camp Alger.

View of Camp Alger (right) in the summer of 1898Photograph courtesy of the Fairfax County Public Library Photographic Archive

US Army sketch map of Camp Alger, June 10, 1898, overlaid on a current map of the same geographic location

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Camp AlgerIn the spring of 1898, the fields and for-ests of Woodburn Manor -a largely untend-ed and overgrown farm on the west side of Falls Church in the Dunn-Loring region of northern Virginia- would be inundated with soldiers preparing for war with Spain.4 From May to August, over 23,000 soldiers would call this 1400-acre parcel of land home. During its tenure as one of the five national assembly points, Camp Alger would host 24 infantry regiments from 14 states.5 Overcrowding quickly became an issue. A dry spring and summer that year resulted in a short supply of potable water. An in-sufficient latrine system further complicat-ed efforts to achieve and maintain sanitary measures.

Mapping the arrival of typhoid fever at Camp Alger in 1898

Visual evidence of overcrowding at Camp AlgerPhotograph courtesy of the Fairfax County Public Library Photographic Archive

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Enter the Typhoid BacillusA report on the origin of the spread of ty-phoid fever, issued after the war, identified eight states with infantrymen who were in-cubating the disease upon arrival at Camp Alger.3 Volunteers were drawn from various backgrounds throughout the country. They would have possessed inherently different patterns of immunity and were likely im-mune-compromised by the physical and psychological stress associated with deploy-ment.2 Given these individual characteristics and the unsanitary conditions, the disease quickly exploded at Camp Alger and else-where.

Exposure to the bacterium, Salmonella ty-phi, typically results in signs of gastroenteri-tis producing diarrhea, fatigue, and fever. However, infection can manifest in a variety of ways from asymptomatic carriage to the systemic disease known as typhoid fever.6 Transmission primarily results from fecal contamination. The disease may last for weeks. Death is a common outcome, which was the case for many of the soldiers who contracted the disease at Camp Alger in the summer of 1898.

The State of Military Medical CareThe epidemic was enhanced by many fac-tors. Members of the Army Medical Depart-ment, while competent professionals, were too few in number to adequately support the deployment. Medical officers had varying levels of experience. Those from larger state militias typically were familiar with mili-tary organization and medicine. Those from smaller state organizations did not have the experience needed to deal with the scale of the deployment. Purely advisors, medical officers lacked the authority to enforce san-itary measures.1 A deficiency in leadership was evident at some camps. At Camp Alger, regimental surgeons, preferring to maintain state allegiance, resisted efforts to consoli-date resources into larger division hospitals, which may have improved care and treat-ment.4 Nursing skills were in critically short supply and basic sanitary measures were of-ten ignored by undisciplined soldiers. Camp hospital staffs were often unskilled in the de-tection of typhoid fever. This deficit resulted in a delay in recognizing the outbreak when early cases were misdiagnosed as malaria.

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Sources1. Pierce, Gerald J. “Public and Private Voices: The Typhoid Fever Ex-perience at Camp Thomas: 1898.” Ph.D. diss., Georgia State University, 2007.2. Matthew Smallman-Raynor and Andrew D. Cliff, “Epidemic Diffu-sion Processes in a System of U.S. Military Camps: Transfer Diffusion and the Spread of Typhoid Fever in the Spanish-American War, 1898,” Annals of the Association of American Geographers 91 (2001): 71-91.3. Reed, Walter, Edward O. Shakespeare and Victor C. Vaughan. Report on the Origin and Spread of Typhoid Fever in U.S. Military Camps During the Spanish War of 1898. 2 vols. (Washington, D.C. GPO, 1904.)4. Harrison, Noel Garraux. City of Canvas: Camp Russell A. Alger and The Spanish American War. Falls Church: Falls Church Historical Commission, 1988.5. Anderson, Eric, “Camp Russell A. Alger, Falls Church, Virginia,” On Point, Spring (2014): 44-48.6. Hurley, Daniel, Matthew P. McCusker, Seamus Fanning and Marta Martins, “Salmonella-host interactions-modulation of the host im-mune system,” Frontiers in Immunology 5(2014): 1, accessed Novem-ber 16, 2015, doi:10.3389/fmmu.2014.00481.7. War Department, Office of the Adjutant General. Manual for Non-commissioned Officers and Privates of Infantry of The Army of the United States. Document No. 574. Washington, D.C., 1917.

About the AuthorDale G. Dunn is a retired US Army Veterinary Corps officer and veterinary pathologist. He is currently studying history in the graduate school at George Mason University. Dr. Dunn's family lived in the vi-cinity of Camp Alger in 1898 and a great grand uncle of his served with the 3rd Va Infantry. A copy of the sketch map (page 2) given to him by his father many years ago prompted his interest in Camp Alger.

The OutcomeTallying morbidity and mortality data for all regiments passing through Camp Alg-er, there were 322 deaths attributed to ty-phoid fever from among the 2726 confirmed or probable cases.3 In the largest national camp, Camp Thomas in Georgia, 761 deaths were attributed to typhoid fever. It was as or more deadly to have passed through these two camps as it was to have faced enemy fire. Ultimately, during the Span-ish-American War, every regiment would experience typhoid fever, nearly 1/5th of all soldiers would contract the disease, and over 86% of all deaths would be attributed to it.1 Some regiments would eventually car-ry the disease with them to Puerto Rico and Cuba.2

The Manual for Noncommissioned Officers and Privates of Infantry of The Army of the United States, 1917, sums up the entire history of the camp disease experience so:

The AftermathThe McKinley administration faced consid-erable criticism on the handling of the war with Spain. Consequently, Secretary Alger resigned. President McKinley appointed Major General Grenville Dodge to lead a commission to investigate the War Department's conduct. The Army Surgeon General, George Sternberg, organized his own sanitary commission. The latter’s Report on the Origin and Spread of Typhoid Fever in U.S. Military Camps During the Spanish War of 1898 is still regarded as a landmark in epidemiological studies.1 The recommendations issued by these two com-missions would catalyze major reforms in the Army’s (and by extension the nation’s) medi-cal system. By the onset of World War I, with improved understanding of disease transmis-sion, better hygienic practices, and the advent of a vaccine, typhoid fever would largely be under control.

Notice in the Alexandria (VA) Gazette, July 19, 1898

Men of the 8th Ohio ready to leave Camp AlgerPhotograph courtesy of the Library of Congress

“History has shown that in almost every war many more men die of disease than from wounds received in battle... It is a terrible truth than one man who violates any of the great rules of health may be the means of killing many more of his comrades than are killed by the bul-lets of the enemy.”7