The Story of CC 112

Turquoisia McNabb, Department of Agricultural and Life Science, University of Florida‘17

Whitley Hatton, Department of Biology, Howard University '17


Editor’s Note     

This series of biographical sketches were authored by the 2015 class of the Howard University branch of AAMC’s Summer Medical Dental Enrichment Program at the W. Montague Cobb Research Laboratory. The students were assigned a Cobb Collection Individual and conducted research about that individual. The papers were reviewed by The Backbone Editorial Team and the name of the CC individual was redacted.

CC112, Negro, age 60, died from meningitis on November 18, 1934 at Gallinger Municipal Hospital. According to Sara E. Branham and Sadie A. Carlin from the National institute of Health, the first recorded outbreak of meningitis in the United States was in 1806. Meningitis since then has a periodic return to epidemic2 proportions at intervals of approximately ten years.   At the National Institute of Health, meningitis showed peaks of cases in 1918, 1929, and 1936. Since there was an outbreak of meningitis from 1928 to 1934, we know now that CC112 contracted this virus during the outbreak. Looking through ancestry.com and many other websites, we found endless records going by the name of [Redacted]. Searching through, it was very difficult to narrow down to just one name because there were so many factors we had to consider. For instance, on ancestry.com, there came up 11 different people that had similar backgrounds to our person. One selection was a man that died the same year, but lived in Virginia and not D.C. Another man we looked up lived in D.C., but died earlier than our date of death. But not one of the sources on ancestry matched completely and none of these sources had died from meningitis. After finding a never ending list of [Redacted]’s, we then turned our search to the hospital and treatment of meningitis during the 1930’s. CC112 was treated at Gallinger Municipal Hospital. This hospital resided in southeast D.C. and was first built in 1846. This hospital was first an Asylum that housed the city’s indigent patients and a work house for the people convicted of minor crimes. In 1922, after placing a new building, the Asylum became more of a hospital with a smallpox hospital, quarantine station, and disinfectant plant. 


According to Jacob Fenston, who wrote “From Public Hospital to Homeless Shelter: The long History of D.C General”, he explains that hospitals during the time it was functional were for the poor, homeless, and criminals. By the 1940’s, the hospital was a filthy place swarming with flies, according to a U.S. Senator. To know who this hospital was used for, the time period our person was living in, and what he died from, we can make an educated assumption on CC112 and his life. There are two types of meningitis, viral and bacterial. Viral meningitis most often caused by enteroviruses that live in the intestines and can be spread through food, water, or contaminated objects. This kind of virus occurs mostly in kids and babies. Bacterial meningitis is a very serious illness. This is passed from one person to another through infected saliva or mucus. Streptococcus pneumoniae and Neisseria meningitides. This kind of bacteria can be located in your throat without getting sick, but can be transferred to others. Also, this kind of meningitis occurs mostly in adults. so we can assume that CC112 was diagnosed with bacterial meningitis since he was older and because bacterial meningitis is more severe than the viral infection. 


Although anyone can be infected with meningitis, there are many factors that can increase risk. Genetics, being male, being in crowded living conditions, exposure to insects and rodents, not having your immunizations, and not receiving vaccinations are all factors that can increase the chance of contracting meningitis. In all of these factors, we can assume that since CC112 was a Negro during the early 1900’s that he was of a lower class and didn’t have great access to health care. We can also take a guess that CC112 also lived in crowded living conditions, had a greater exposure to rodents and insects, and was an older adult that didn’t receive their vaccinations. We can make an educated assumption that during this time, blacks were living in a crowded neighborhood of their own, which in the D.C. area could be infested with insects and rodents. Since CC112 was an older man who was diagnosed with meningitis, we can also assume that he didn’t receive his immunizations as well. Anacostia was a city designed in the 1900’s for the working class. The only surprising thing I found, was that most of Anacostia was for working class of whites and not blacks. This finding made me think that maybe CC112 was a more well off Negro that had a better paying job, till he couldn’t work anymore. So I can come to a safe conclusion that CC112 as he got older, moved into a more crowded area of the city, didn’t receive his immunizations due to lack of money probably from retiring. Since he was placed in Gallinger Municipal Hospital, makes an even better guess that he had become poorer as he aged. 

Without antibiotics and immunizations there is an eighty percent chance mortality rate. Penicillin is used for patients with meningitis. Since penicillin was discovered in 1928, it was probably only available for people who could afford it. With this knowledge, we can assume that CC112 didn’t have healthcare that could afford him to take penicillin, or penicillin wasn’t known to help treat meningitis at this time. With all these findings and factors, we can see how and why CC112 died. During his time, he wouldn’t survive, unfortunately should he have been alive today, he would have probably survived.

CC112 was one of the many people in year 1934, to catch meningitis. During this era this epidemic had over 500 different strains present in multiple communities around the nation. On November 18, 1934 in the Gallinger Municipal Hospital this epidemic ended CC112’s life. 

The outbreak of what is now known as meningitis was very popular in the early 19th century. CC112 most likely went to Gallinger Municipal Hospital prior to his death with symptoms of a stiff neck, headache, and severe sensitivity to light. This was diagnosed with a spinal tap. Physicians would take a long needle and stick it in the back and draw fluid from around the spine. With this fluid they could tell if there was inflammation in the meninges.  Symptoms for this disease varies according to age (Healthline.com). Once diagnosed with meningitis he was admitted into the hospital for treatment. At this particular time there were no ground breaking vaccines available so patients were treated with penicillin (Chapter 28: a history of bacterial meningitis). The cause of meningitis in this time period were identified later in the 19th century as Streptococcus pneumoniae, Neisseria meningitis and Haemophilus influenza (Chapter 28: a history of bacterial meningitis), but these causes were only for bacterial meningitis which wasn’t discovered until the 20th century.  

CC112 could have had one of five meningitis diseases or another disease associated with meningitis known as meningococcal disease. Meningitis is inflammation on the meninges around the spinal cord and brain (Healthline.com). It causes fever, intense headaches, stiff neck, nausea, vomiting, drowsiness, confusion, and sensitivity to light (Healthline.com). Unlike meningococcal bacteria which specifically affects adolescents aged eleven to seventeen. Meningococcal causes an infection in the blood stream. Symptoms include: joint pain, red or purple rash that does not turn white when pressure is applied, and coming into close contact with a person with the disease (Meningitis vs Meningococcal: Difference in deadly diseases).  

If CC112 would have caught this disease in the 20th century his chances of living would have increased greatly. Vaccinations for meningitis debuted in the early 20th century. Vaccinations against Neisseria meningitis and Haemophilus influenzae were also created (Chapter 28: a history of bacterial meningitis).  Those two diseases were the two causes of meningitis. With new research found on the disease doctors were able to narrow the strands on meningitis down to: bacterial, viral, fungal, parasitic, and noninfectious meningitis.
 

Bacterial meningitis is very similar to Neisseria meningitis and Streptococcus pneumoniae (CDC). These medical conditions require immediate medical attention. Bacterial meningitis is usually taken care of with antibiotics because the medication kills the bacteria. These antibiotics include: ampicillin, claforan, rocephin, gentamicin, penicillin G, and vancocin (Web MD). This medications can be taken for a specific amount of time and the disease would have been cured. If CC112was around during this era his life would have lasted a little longer. 
Viral meningitis is caused only by viruses like non-polio enteroviruses, arboviruses, and herpes simplex viruses (CDC). Compared to bacterial meningitis this is not that severe. People with a healthy immune system can fight this virus on their own within 7 to 10 days (CDC). People at risk of catching this disease are five and under (CDC). The likeliness of CC112 having this strand is very low. 

Fungal Meningitis is caused by fungi like Cryptococcus and Histoplasma and acquired by inhaling fungal spores in the environment (CDC). This strand of meningitis is rare and only caused by other fungus. People with other diseases like diabetes, cancer, and HIV are at higher risk of catching fungal meningitis (CDC). It also takes longer to cure people with these diseases because they are known for having low immune systems. The benefit of having this strand versus any other is this strand is not contagious and cannot be given to another person. Fungal meningitis can be treated with high doses of antifungal medications, usually given though IV (CDC).  

Primary amebic meningoencephalitis (PAM), also known as parasitic meningitis is the fourth strand it is caused by parasites and less common in developed countries (CDC). These parasites usually contaminate food, water and soil. This disease is popular in places with large bodies of warm and fresh water, the diseases could also be contracted from pools that are not properly maintained. Catching parasitic meningitis is very dangerous, although there is treatment most people that get treated still die (CDC). This disease presents symptoms very similar to bacterial and viral meningitis according to centers for diseases control and prevention.  

Finally, there is Non-Infectious Meningitis. This form of meningitis is caused by cancers, systemic lupus erythematosus, certain drugs, head injury, and brain surgery (CDC). Its symptoms are just like the others, sensitivity to light, confusion, vomiting, and nausea (CDC). This form or meningitis is not contagious because you can only get it if you have one of the causes listed above. Since Mr. Jackson cause of death was only meningitis I think it is safe to say he did not have noninfectious meningitis either. 

Since 1806, meningitis has been a fatal disease and has killed thousands of people since then. Mr. Jackson was one of the many taken by such a fatal disease. Mr. Jackson was at an extremely high risk of getting the disease because he was African American, poor and elderly living in an era when medicine was not readily available. His chances of living a longer life would have increased greatly if he was present in the millennium. New medication has been invented since 1806, which have increased the life expectancy of people with meningitis. Discrimination in health care has also decreased greatly so he would receive great care. Mr. Jackson would have been one of many a survivors of such a fatal disease. ***

References


Lights, Verneda, and Elizabeth Boskey. "Meningitis." Healthline. August 16, 2012. Accessed July 3, 2015
Ken, Tyler. "Chapter 28: A History of Bacterial Meningitis." Pubmed.gov. 2010. Accessed July 3, 2015.
Adams, Andie. "Meningitis vs Meningococcal: Difference in Deadly Diseases." Nbcsandiego.com. February 20, 2014. Accessed July 2, 2015.
Bacterial Meningitis." Centers for Disease Control and Prevention. April 1, 2014. Accessed July 3, 2015.
Thompson, Gregory. "Antibiotics for Bacterial Meningitis." WebMD. November 14, 2014. Accessed July 3, 2015.
"Viral Meningitis." Centers for Disease Control and Prevention. November 26, 2014. Accessed July 3, 2015.
"Fungal Meningitis." Centers for Disease Control and Prevention. April 1, 2014. Accessed July 4, 2015.
"Parasitic Meningitis." Centers for Disease Control and Prevention. April 1, 2014. Accessed July 4, 2015.
"Non-Infectious Meningitis." Centers for Disease Control and Prevention. March 15, 2012. Accessed July 3, 2015.

Ms. Turquoisia McNabb (tmcnabb@ufl.edu) is a junior at the University of Florida, who received her high school diploma from Jones High School in Orlando, Florida. She is pursuing a Bachelor’s degree in Family Youth and Community Science with a minor in Disabilities in Society. She plans on obtaining her Master’s Degree in Heath Education and Behavior before matriculating into medical school to become a Pediatrician.  The Cobb research project was the first project she has ever completed. She is on the Executive Board as the Community Service Chair of the Multicultural Association for Pre Health Students at the University of Florida. This summer, she had the opportunity to partner with us through Howard's Summer Medical and Dental Education Program. Outside of academia she enjoys spoken word music and assisting youth in her community. She had served as a cheerleading coach, peer mentor to college freshman, and she assists patients at Shands Hospital.


Cobb Lab