Armstrong – Table of Contents

changes following vaccination against smallpox. Fortunately, in the early 1930s, on the
basis of experimental observations as described in an earlier chapter, Charles Armstrong
was able to suggest a strategy to help eliminate the tragic consequences of postvaccinal
encephalitis. It is with the above background that the appearance of encephalitis in the St.
Louis area presented such urgency.
During five weeks from August 7 to September 10, 1933, an “encephalitis”
epidemic of explosive proportions struck the vicinity of St. Louis, Missouri and the
adjacent St. Louis County (5). In this time period physicians reported 656 cases to the
local health departments. The severity of this outbreak invited the attention of the
national, local and Washington, DC, news media (5). One month later (6), at a special
session of the American Public Health Association on Epidemic Encephalitis (under the
auspices of the Health Officers Section) the reported case number had increased to 522 in
the County and 533 in the city. The suddenness of the epidemic course and the magnitude
of the number of patients involved presented to the municipal health personnel a problem
of emergent priorities. During the early part of the epidemic the local health officers of
the St. Louis area formed a Metropolitan Health Council, and the Council appointed
committees on administrative control, including epidemilogical records and on research.
The groups involved in the Council included the Health Department of the City of St.
Louis, the Missouri State Health Department, St. Louis University, Washington
University as well as the practicing medical professionals and the communities
concerned. Among the first actions of this organization was an appeal to the newly
constituted National Institute of Health (from the old Hygienic Laboratory) for
epidemiological and investigative expertise.