Thousands of children infected during the great ringworm epidemic of 1950

From the archives of the Sault Ste. Marie Public Library:

When you consider major epidemics in Sault Ste. Marie’s history, there are a number of outbreaks that may come to mind: typhoid, smallpox, or the 1918 Spanish Influenza pandemic, just to name a few.

But there was another epidemic in 1950 that affected an enormous number of the Sault’s children. It led the Sault Daily Star to declare it the worst outbreak of its kind, and it garnered international attention. Its severity mystified doctors, with the Sault’s Medical Officer of Health Dr. J. E. Gimby telling Life Magazine, “We’ve got these things with us all the time. But every once in a while a disease like this seems to develop a warlike generation.”

The outbreak in question? Ringworm, a fungal infection of the skin that causes a characteristic itchy, red ring. In mid-September 1950, Dr. Gimby ran a notice in the Sault Daily Star, informing readers that around 300 students had been found to have ringworm. He noted that these children were not to return to school until they began treatment for the condition, and that any child infected with ringworm was to wear a cap that would cover their hair. He also provided information about diagnosing cases, particularly for preschool children who would not have access to a school nurse. He noted that the West End Library would soon have a Wood’s Lamp available to use, a black light under which ringworm would glow.

But that was just the beginning.

While early reports seemed confident that the ringworm outbreak would be contained, that optimism waned as the months wore on. At one point, there were hundreds of new cases being diagnosed per day, from preschool children all the way up to high school.

By November, the Sault Daily Star, Time Magazine, and Life Magazine declared the outbreak to be “the severest ringworm epidemic ever recorded in Canada or the United States.”

There was some speculation over how this all might have gotten so out of control. Time Magazine had an explanation: “Last March five youngsters with ringworm were allowed back to school too soon after routine treatment by their family doctors. All summer the disease spread (encouraged by a long damp spell and barbers’ unsterilized clippers). Not until school opened did authorities realize how far it had got out of hand.”

The fungal infection quickly spread, from five youngsters to approximately 150 preschoolers, 1,300 elementary school children, and 64 teens and adults. And it was still spreading.

Nevertheless, authorities were confident that with the proper containment measures, the ringworm outbreak was being brought under control. The Globe and Mail reported that while the city was unprepared for the outbreak and initially provided “sketchy” treatment, they quickly borrowed equipment from Sudbury. Doctors were even prescribing a new, experimental treatment and various ointments — at least, until it became too cost-prohibitive.

And then there were the hats.

All children, infected or not, wore white skullcaps to try to prevent the transfer of ringworm from one child to another. These were to be boiled every night, in an effort to sterilize them. Life Magazine declared that in the Sault, “no conscientious parent would send his child out in public without a white bonnet.”

By Nov. 20, the Sault Daily Star reported that the epidemic was “definitely subsiding,” with only a handful of new cases appearing per week. But just over a week later, things had clearly taken a downturn: the headline “Ringworm Quarantine Recommended” splashed across the front page, part of an article about the failure to contain the epidemic.

At that point, 900 children were currently undergoing treatment for ringworm, with many more having recovered.

City Council recommended much stricter measures in the form of a quarantine: they advocated for “[banning] all infected children from school and other public places by confining them to their homes.”

Councillors described the situation as “most disgraceful” and argued in favour of closing schools to prevent the spread. They highlighted the importance of mitigation efforts, saying that “ringworm would be with us for the next few years at least,” and stronger efforts were necessary to keep it in check.

Nevertheless, officials were concerned that even strict quarantine measures would not successfully contain the epidemic. At a citizens’ meeting, the chair of the school board was quoted as saying, “You can’t keep those infected children out of shows and places of amusement.”

He continued, saying that it would be impossible to keep track of all infected students if they weren’t in school, and that “instead of decreasing, ringworm would probably increase” as a result of a quarantine.

Public opinion, however, seemed to be in favour of quarantining infected children and not allowing them to attend school. There were people who viewed schools as being vectors that would allow ringworm to spread. One woman claimed to have kept her children uninfected “by keeping them home and educating them [herself].”

In early December, with the outbreak still raging, Toronto skin specialist Dr. Raymond Smith spoke to the Sault Ste. Marie Medical Society on the topic. He felt that the ringworm epidemic was not of much concern — many of the cases would have gone undetected before, so more precise methods of diagnosis were making it appear worse than it was.

He pointed out that there were few treatment options. Ointments were hit and miss; there was no drug to cure ringworm. The only proven way of ridding someone of a ringworm infection at that point was to remove the hair roots in the infected area — either with forceps or with x-rays.

Children in the city were being treated with both methods: x-rays for the most severe cases, and hair removal followed by a salt compress in milder ones. According to Time magazine, “in spite of loud screams echoing down the halls, this Spartan procedure was necessary because the fungus penetrates the follicle clear down to the hair root.”

Given that ringworm infections resolved spontaneously and typically only affected the young, and given that there were limited treatment options, Dr. Smith felt that the epidemic did not need to be controlled at all. It could merely be allowed to run its course, as it already did in many other locations; it would “gradually [lessen] as the patients’ resistance to the infection [increased] over a period of months.”

By this point, the epidemic had become so severe, at least some students had resorted to prayer in the hopes of resolving things. The Globe and Mail ran a photo of a group of at least 20 schoolchildren, all in white skullcaps, praying together in their classroom for the end of the epidemic.

By September of 1951, hundreds of students were still showing up at local schools in their white caps. Eventually, the epidemic did resolve — but not before many of Sault Ste. Marie’s children were affected. While various sources reported wildly different and conflicting numbers, some estimated that as many as half of the city’s 5,700 elementary students were infected.

Regardless of the exact numbers, it was a major health event in the city, and one which affected students for well over a year.

Each week, the Sault Ste. Marie Public Library and its Archives provides SooToday readers with a glimpse of the city’s past.

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