The Battle Against Contagious Diseases

If you lived in Iowa during the 1800s, getting sick could be a frightening experience. People had no idea why they became sick. Even doctors didn’t know causes for many diseases. They treated people for the symptoms and not the causes of diseases. Little was known by scientists about the causes of various diseases. No one knew about bacteria, germs or viruses and how they could spread disease. Treating an illness often combined guesswork, superstitious practices, the use of herbs and home remedies. Early doctors did not have many ways or choices for treating patients.

What Caused Disease

Disease was thought to be caused by bad vapors or smells called "miasmas." People thought disease traveled through the air, in the winds, the water and underground. They thought disease was caused by miasmas coming from filth, rotting vegetation, garbage, unclean water, sewage and damp soil.

People didn’t realize that cleanliness played an important part in good health. Keeping clean was hard work. Early homes often had dirt floors or wooden floors that allowed dirt to settle between the boards. Homes didn’t have running water or indoor bathrooms. People did not wash themselves or their clothes very often. Taking a bath was even considered to be unhealthy. If you wanted soap, you had to make it. People did not brush their teeth every day. Some families had large numbers of people living in very crowded spaces. The standards of cleanliness were much different than today.

Contagious Diseases and Immigration

It was the rich soil and the inexpensive land prices ($1.25 an acre) that brought new settlers to the Iowa territory. About 38,000 people had settled here by 1840. Communities of settlers established permanent homes, businesses and farms. After Iowa became a state in 1846 European immigrants came to the state in large numbers. Immigration from Europe was strongest from 1870–1900. The 1880 census showed over 260,000 immigrants lived in Iowa. The total population of the state was about 1.6 million.

The immigrants who came to Iowa brought their languages, customs and cultures. They also brought something else to their new homeland. They brought diseases including malaria (ague), cholera, diphtheria, typhoid fever and smallpox. These diseases quickly spread among many people. Iowa newspapers were cautious in reporting local outbreaks. They feared a negative impact on the local economy. News of epidemics might discourage new businesses or settlement by new families.

Epidemics Take Lives

Epidemics threatened the lives of early Iowa settlers. Highly contagious diseases—cholera, smallpox, diphtheria and typhoid fever—spread quickly from person to person. Both the poor and the wealthy were affected by the dreaded diseases. An epidemic could affect whole families at one time as described in Iowa History Illustrated:

When one of a family became sick [with cholera], another and another would be attacked, till often whole families in a few hours would be taken away. Neighborhoods would be alarmed and many left their homes, and frequently it was difficult to get any one to take care of the sick, or bury the dead.

Cholera was one of the most dreaded diseases. In many cases the spread of cholera may have been related to the arrival of immigrants. The ships they traveled on were unclean and very crowded. Animals on the ships, including rats, were carriers of the disease too. The symptoms were severe. Victims suffered from nausea, vomiting, chills, thirst and spasms. Some had to be put in isolation or quarantined. Quarantines often did not prevent the spread of this disease. Many immigrants died from cholera.

Another common disease Iowa settlers suffered from was called ague. The symptoms for ague were similar to what we would consider the “flu” in today’s society. Victims would experience fever, followed by chills and sweating. Sometimes whole families came down with the disease at once. It could last for hours, days or months. What the settlers called ague was probably malaria.

An early resident of eastern Iowa in the 1840s is remembered in Iowa Heritage Illustrated:

We just shook and shook and shook, with the ague. We could only eat when the chill was on us, being too sick when the fever was on. I will remember how the cup would rattle again my teeth when I tried to drink.

Public Health Reform

Important changes related to public health and the spread of diseases happened in the late 1800s. Iowa established a State Board of Health in 1880. It worked hard to dispel the idea that vapors or miasmas from decay and filth caused disease. The Board emphasized that things like overcrowding of population, faulty ventilation and the presence of filth were conditions not causes of diseases. Ridding towns and cities of filth and decay was the goal of the great sanitation movement.

In the battle against disease health workers turned their focus to controlling contagious diseases. They worked to prevent illnesses from spreading. Quarantines, vaccines, antitoxins and other preventive measures were the weapons they used to fight the battle.

American homemakers also played an important role in disease control and health reform. Women were given information about nutrition, childrearing, housekeeping and cleanliness. Mothers reminded children to keep the flies out, wash their hands and cover their mouths when they sneezed or coughed. Advertisements were aimed at women and their concerns for healthy families. New words such as “sanitary,” “pure,” “disinfects” and “germ-fighting” appeared in ads. The scent of pine was added to cleansers. Packaged food and cellophane-wrapped bakery goods replaced uncovered, open-air displays of groceries. Anyplace where dirt and germs could lurk was considered the culprit of disease. Special soaps, deodorants and mouthwashes attracted the American consumer.

Modern expectations and standards for cleanliness are very different from the past. Looking back allows us to see how far public health has come. Advances in medicine have eliminated the contagious diseases that at one time brought death to many.

Today there is an emphasis on health and preventing illness. People have a curiosity about the nature of disease. Modern technology makes it easier for the general public to access medical and health related information. Maintaining good health and living a healthy lifestyle are now easier than in the days of the early settlers.


  • Houlette, Dr. William. Iowa The Pioneer Heritage. Des Moines, Iowa: Wallace- Homestead Book Co., 1970.
  • Kalman, Bobbie. Early Health and Medicine. New York: New York: Crabtree Publishing, 1983.
  • “Medicine in America.” Cobblestone 4, No. 3 (March 1983). 
  • Swaim, Ginalie. “Salubrious or Unsanitary Iowa? The Struggle for the Public’s Health.” Iowa Heritage Illustrated 86, No. 2 (Summer 2005).
  • Posten, Margaret. This Is the Place–Iowa. 3rd Edition. Ames, Iowa: The Iowa State University Press.


Written for Iowa Pathways by Marcia Meller