Mount Sinai and the History of Infectious Disease Treatment

Cholera. Typhoid.

To 21st century ears, the names of these once universally fatal diseases sound oddly quaint. Nevertheless, these diseases were serious threats to the health of New Yorkers in the early-to-mid 19th century, nearly all of whom were immigrants from eastern and southern Europe living in cramped tenements with poor ventilation and worse sanitation. These diseases, along with tuberculosis, formed the "Evil Trio" of infectious disease in New York City at that time.

Initially, the trustees of Mount Sinai – then known as "Jews’ Hospital" – routinely admitted tuberculosis patients and those with cholera to the facility. However, they initially drew the line at patients with typhus until they became convinced by the medical staff in 1855 that patients with typhus were not contagious when they were hospitalized and cared for under sanitary conditions.

Nothing much happened in the diagnosis or treatment of infectious disease until 1897. That’s when Mount Sinai’s assistant pathologist, Dr. Charles Elsberg, published his work on cell agglutination in the diagnosis of typhoid disease using something called the Widal test. His discovery helped identify a typhoid carrier who had inadvertently infected the nursing staff.

Building on Dr. Ellsberg’s work with agglutination, Dr. Nathan Brill identified a new strain of typhus that didn’t react to the Widal test. This finding helped identify a new form of typhus, labeled Brill’s disease in recognition of Dr. Brill’s contribution.

In 1910, Dr. Emanuel Libman – the discoverer of the disease-causing streptococcus enteritis bacterium – continued his work on this bacterium and published his findings on the causes of infection in patients with endocarditis.

Mount Sinai and its physicians and nurses rose to a great challenge in 1918 – the year of the influenza epidemic that killed an estimated 50 million people worldwide. Base Hospital #3 – established in France – treated hundreds of patients with influenza. One Mount Sinai surgeon stationed with the unit, Dr. Alexis Moschowitz, headed a commission whose recommendations were responsible for reducing influenza mortality rates from 50 percent to just five percent.

Patients with influenza often succumbed to infected lung abscesses. It was thanks to an unnamed team of thoracic surgeons at Mount Sinai who developed a swift, one-stage method for draining lung abscesses that improved the post-influenza survival rate considerably.

Mount Sinai also treated a large number of venereal disease cases since its founding in 1853. For the longest time, there was nothing but palliative care available for this group of diseases that included syphilis and gonorrhea. However, in 1940 – several years before the introduction of penicillin -- Dr. Louis Chargin, the chief of dermatology, along with medical service chief George Baehr and colleagues developed a treatment for syphilis. Using arsphenamine – an arsenic compound – on affected patients over a five-day course of treatment had remarkable results. Only penicillin, developed after World War II, was as effective. It soon eclipsed arsphenamine as a viable treatment for syphilis.

Today, the Division of Infectious Diseases has focused on the molecular aspects of chronic viral infections including HIV, spearheading an initiative to find new and effective therapeutic and prevention strategies for a variety of viral diseases while at the same time coming to understand infectious disease prevention and eradication at the molecular level.

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