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The Smallpox Outbreak That Almost Stole Christmas: Sussex County, 1919

By 

René F. Najera, DrPH

December 24, 2024

In December 1919, , an illness that had long haunted humanity as one of the deadliest diseases in history. The trouble began near Millsboro, in the Indian River Hundred, where early reports suggested it might be a milder illness, like chickenpox or the "." But health officials soon confirmed the worst: smallpox had returned, with 20 cases initially identified. Although no deaths occurred, the threat was serious enough to prompt swift and strict public health measures.

Households with cases of smallpox were quarantined, roads were patrolled to prevent travel from affected areas, and the state banned the shipment of Christmas wreaths, a major seasonal livelihood for many in Sussex County. As the days passed, the number of cases climbed, and so did the sense of urgency. On December 11, state health commissioner Chester H. Wells announced that everyone in the Indian River Hundred must be vaccinated or face arrest. Vaccination certificates became mandatory for anyone in public places, and compliance was demanded across a wide area known as the “safety belt,” which encompassed five neighboring hundreds.

The measures were not universally welcomed. By late December, about 75% of the population had complied, but resistance brewed. When Commissioner Wells personally came to Georgetown to enforce vaccination orders in January, tensions boiled over. Hundreds of angry residents gathered at the Brick Hotel, confronting Wells and demanding he leave town. The commissioner, fearing violence, departed under escort. Local officials resigned en masse amid accusations of siding with the protestors, and eventually, a new health board decided arrests for noncompliance would no longer be pursued.

By the end of February, the outbreak was under control, with only two cases remaining, both well-quarantined. Sussex County was able to breathe a sigh of relief, but the 1919 outbreak left a mark. It highlighted the challenges of enforcing public health measures during a crisis, especially when trust in officials and vaccination was strained. Despite the turmoil, the county managed to contain the outbreak, setting the stage for broader vaccination efforts that would eventually contribute to the global eradication of smallpox decades later.

Click here for a video with a poem about this outbreak: 

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