The 1901 St Louis Incident: The First Modern Medical Disaster

• antitoxin
• diphtheria
• tetanus

On October 19, 1901, Dr R.C. Harris, a St Louis physician, attended to a young girl named Bessie Baker who was suffering from advanced diphtheria. As was his routine, he injected diphtheria antitoxin into the child and, as a preventive, her 2 younger siblings and concluded that “she would soon be entirely well.” But 4 days later he was called back to the Bakers’ home to a terrifying discovery:“There I found that the little girl was suffering from tetanus (lockjaw). I could do nothing for her. The poison was injected so thoroughly into her system that she was beyond medical aid.”¹

Bessie died of tetanus the following day, as did her 2 siblings within the week. So began one of the worst safety disasters in the history of American public health, in which, by the time it was over, some 13 children had died of tetanus from contaminated antisera.

Diphtheria was a scourge throughout the 19th century. It primarily affected children, and it killed through the release of an exotoxin that creates a pseudomembrane inside the throat of affected patients. When death occurred, which it did in 10% to 40% of patients, it did so primarily through asphyxiation.

In 1884, Friedrich Loeffler, a scientist in Berlin, discovered how to culture diphtheria in the laboratory and he grew it in guinea pigs. Loeffler’s colleagues in Germany and Paris developed experiments proving that a diphtheria toxin when injected into guinea pigs, and later dogs and horses, produced a substance in their blood that could be used to treat diphtheria in another species.^{2 …}

Address correspondence to Ross E. DeHovitz, MD, Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA 94301. E-mail: dehovir{at}pamf.org