treatment of measles due to its lack of stigma. Therefore, the measles epidemic can only be understood with a clear understand of societal view of childhood and innocence in the 1900s.
Child labor before the 1900s was normalized. Young boys were traded between farms and started their apprenticeships even before adolescence. With the shift to factory work, children were ideal workers because they fit in small spaces, were easy to control, and could be paid less. It was not until the Great Depression when the employment of children began to be questioned. The need for adult labor increased, and consequently, more children were pushed out of the workplace. Additionally, efforts from the National Child Labor Committee pushed for mandatory school attendance for children of a certain age . With new economic pressures, more families decided to have less children. This decrease in the birth rate, removal of children from unsafe workplaces, new value of education resulted in a new conceptualization of childhood that marked children as pure beings that should remain protected and invested in. “Childhood increasingly was seen as a developmentally distinct stage of life, and children were viewed with greater tenderness—reflecting a new, middle class belief in childhood’s importance and concern with children’s vulnerability” . Many organizations fought to combat poor child health, poverty, child labor, and “unfit” families. This put children on an unintentional pedestal in which society valued children more, and when affected by diseases, they were never condemned.
Unlike many other diseases, measles lacked stigma because it disproportionately affected children more than adults.
In “When to be Afraid: A Common-Sense Talk About Children’s Disease,” Emma E. Walker, MD warns mothers to make sure their children get adequate sleep, get to play in fresh air, and bathe to remove germs that live on tissues and fluids to prevent bodily entry . Contrasting these recommendations with those during the times of conditions such as the plague, Black Death, and syphilis, children with measles are not being blamed for being the carrier of the diseases and were instead “innocent victims” with the culprit suspected to be microbes. There was no sin associated with the disease, and children had done no wrong. With less emphasis on blame, the people in the time if the measles epidemic were able to focus on efforts of decreasing contamination and identifying the
disease. With the emergence of measles in the early 20th century, there was heavy emphasis as a means of prevention in homes and schools through sanitation and even school closings. In “How to Keep Well,” Doctor William A. Evans expresses that shutting down schools is a bad decision and instead schools should have hired a school nurse and doctor. The school doctor would be for examining cases at the school and distinguish the common cold from the measles. When children were diagnosed with measles, they would be sent home with instructions on how to take care of themselves .Walker further explained how it would then be the job of the school nurse to go home with the child to teach parents what to do. Allowing a school doctor and nurse to handle the problem of disease would have allowed children access to an education and dismissed measles to an individual problem opposed to a societal concern. Furthermore, children with measles were encouraged to find time to play after isolation because society maintained the value of giving children a right to an education and a happy childhood regardless of the fear of mass contamination.
With its high level and rapid appearance of spreading, measles was considered one of the most contagious diseases in history, and children with the disease were often isolated to prevent further contamination. Emma E. Walker MD expresses how most times, this isolation is a little too late, but it helps save the portion of the population that society felt needed to be most protected —babies. She stated that reducing the probability of allowing infants to be protected from this exposure was “the most important fact” of the benefits of isolation regardless of its time limitations . Similarly, Evans suggested that after a relatively short period of isolation, ten days, children should have been tagged and allowed a chance to play in fresh air. He states that babies should stay away from tagged children when they go out to play . Being that they are doctors, authoritative figure throughout history, writing to families through a newspaper, their emphasis on protecting the quality of life for babies can further reflect the societal value of childhood and innocence of that time. The isolation of children with measles is unlike that of previous diseases where the carriers of the disease were seen as useless and presumably dead by society. These children were temporarily removed, allowed play time, and the separation was more from the germs and contaminants instead of from the child themselves. Through the recommendations of the medical professionals it can be seen that childhood came first, and the inherent innocence of children protected them from societal condemnation. Instead, medical professionals and organizations worked to save children from this health burden and innovate ways to balance treatment with the joys of childhood.
The 1900s was also a time of other childhood epidemics such as mumps, scarlet fever, rubella (German measles), and whooping cough. The combination of all these diseases that disproportionately affected children caused for medical professionals to further distinguish child life from adults. While analyzing the distribution of the disease, Emma Walker notices that birthday parties, a tradition mainly for children to celebrate with their peers a new turn of age, are vessels for mass contamination not only through nasal drip but through clothing and consumption of infected food. Additionally, scarlet fever was showed to spread through the medium of milk, a substance commonly given out at schools. Similarly, the description of the distribution of the whooping cough from baby to baby explains the immobility of the infant. She explains a case of two infants in their strollers, each being pushed by their different, respective mothers, and through the brief passing of the strollers, the diseases were carried through the air . Extrapolating a new thought that disease no longer had to be passed on through direct exposure, a new threat that is especially worrisome for children and babies.
With the turn of medical advancements and vaccines came a light at the end of the tunnel for many parents and prospective parents. With the encouragement of play and a healthy childhood, child inevitably interacted with each other and isolation was not proving to help with the measles epidemic, so new hope was found in the measles-mumps-rubella (MMR) vaccine that was distributed to children at early stages of their lives and to some adults that were not immune. Alan Hinman, the director of the immunization division of the Center for Disease Control in Atlanta advocated for all families to accept the vaccination as a means of disease prevention. He argued that it reduced the chance of developing a rash and encephalitis, and the side effects experienced were very minute .
However, to some, these vaccines seemed more dangerous and experimental than helpful. Even before the appearance of the controversial article that connected the measles-mumps-rubella (MMR) vaccine with autism spectrum disorders, some mothers did not trust medical professionals enough to try the vaccine. One mother in particular, Barbara Syska, withstood the withdrawal of her child from school due to his lack of immunization proof because she passionately opposed the new medical intervention that had not yet been proven to help in the long run. She tried to sue the Montgomery Count Board of Education for keeping her child out of school because of her personal medical concerns. This presented a largely controversial debate about vaccines where some people saw those who did not allow their children to be dangerous to society, because those children allowed for a greater chance of measles contamination . Even with this debate, children without the vaccine are not those who are being condemned by society but their parents. Childhood innocence and inherent adult responsibility over children changed the way disease control and measles treatment was viewed and enforced by society. Parents were the ones to blame if they did not protect their children or those within the community. Children in this context were not though of as individuals with their own choices and sources of blame, but vessels of disease transmission.
This medical distrust extends today where the appearance of “past” childhood diseases like measles and mumps are reemerging. Vaccine resistance sparked by the anti-vaccine movement due to the findings of the controversial MMR vaccine and autism link has continued into present day life and medical perceptions. When people do not get vaccines, it is believed that they leave other susceptible because it decreases the effectiveness of certain vaccines and increases the adaptation of disease-causing pathogens. Dr. Porteous argues that recent outbreaks at Disneyland in Southern California highlight the risk of contamination for vaccine and non-vaccine users when those refuse vaccine use . It can be argued that the transition to protecting children and valuing their children in the 1900s has transformed into a form of dangerous overprotection in the 21st century.
Childhood diseases seem to provide an interesting window to the societal viewpoint of innocence and childhood of that time. With the appearance of measles in the 1900s shortly after a shift in child labor and other reforms, the distinction between adult and child life was made. Children were encouraged to go to school and stay in school even in the presence of the disease. They were also granted the simplicities of childhood, such as playing, even while being sick. When compared to the personhood and quality of life of carriers of diseases of different times, there is a clear difference in stigma and blame. Children seem to be protected by societal condemnation, and illness is conceptualized differently. Measles was not seen as a moral issue and was instead combatted from an individualized, public health framework. This shows how the importance and valuation of childhood and innocence in the 1900s affected the discussion of distribution, research, and treatment of measles.