Leprosy in Minnesota

When Minnesotans think about leprosy, they may recall Biblical references to the “unclean,” the National Leprosarium in Louisiana, or a Hawaiian leper colony. In our state, however, leprosy was a medical concern during the late 1800s and early 1900s, when many of the affected were Norwegian immigrants.

Since the 1960s, leprosy discovered in its early stages has been successfully treated and cured with a combination of antibiotics. However, leprosy was once and still is a highly feared disease around the world that results in discrimination, maltreatment, and isolation of affected people and their families. Untreated individuals experience disfiguring changes in skin color and texture, swelling under the skin, nerve damage resulting in paralysis of the hands and feet, shortening or loss of fingers and toes, and pain. An 1888 newspaper article described the facial blotches as resembling “the black matter that often accumulates on ears of corn while on the stalk.”

In the 1860s, there were more leprosy cases in Norway, which had three leprosy hospitals, than any other European country. Found primarily on the coast and in peasants more generally, the disease was often attributed to a diet high in fish. In 1873, Gerhard Armauer Hansen, a Norwegian physician, discovered bacteria in the lesions of a leprosy patient and was the first to suggest that bacteria caused leprosy. Others believed that the disease was hereditary since bacteria had not yet been proven by scientists to cause disease. Leprosy is also known as Hansen’s disease and is caused by slow-growing Mycobacterium leprae bacteria.

In 1888, Dr. Hansen arrived in St. Paul to study leprosy because of the high number of Norwegian immigrants in the state. His goal was to prove that leprosy was not hereditary but contagious only through close contact. He stated that if diseased people wanted to live in their own homes, they should have their own eating utensils and clothing, washed separately from others’, and their own beds. He wrote that from 1857 to 1895, there were about 5,053 new cases of leprosy in Norway and about 170 people with the disease immigrated to North America. Since disease symptoms can take up to twenty years to exhibit, he said, only twenty of the 170 were known to be infected prior to immigration. His statements refuted accusations that Norway was sending infected immigrants to the United States to rid Norway of leprosy. Other Norwegian physicians believed that leprosy was hereditary and became symptomatic due to the stresses associated with ocean fishing and farming in the rugged Norwegian landscape.

Also in 1888, Dr. Hansen traveled to Red Wing to spend several weeks with Dr. Christian Grönvold, a member of the State Board of Health and chairman of its leprosy committee. Dr. Grönvold was an immigrant from Norway who lived in Goodhue County, home to a large population of Norwegian immigrants.

Henry Bracken, M.D., served as chief executive officer of the Minnesota State Department of Health and secretary of the State Board of Health. In 1906, a Mr. J. D. wrote to Dr. Bracken that his wife had died of leprosy and that he had fumigated the house with sulfur. He asked for information on what else he should do. Dr. Bracken responded that J. D. should thoroughly clean and scrub the house with formaldehyde and liberally use paint and whitewash throughout. He instructed him to destroy his wife’s clothing and bedding and to contact the health officer in the neighboring town for additional help.

In 1912, a letter appeared in a Minnesota newspaper asking readers to send items such as books and magazines to an eighteen-year-old boy, E. B., who was suffering from leprosy. The writer said E. B. was “deserving of a Carnegie medal” since he had cared for his mother until she died from leprosy in 1905. Now E. B. was isolated in a log cabin and waiting to die himself. County commissioners helped to build the family a new house, and E. B. remained in the old home. Parents in the nearby township refused to allow their children to attend school with the boy’s siblings. (E. B died in 1913.)

Also in 1912, Dr. Bracken resolved a dispute between a creamery and E. B.’s family. The creamery refused to buy the milk from the family since the belief was that the milk could transmit leprosy. Dr. Bracken wrote to the creamery management and said that the people who handled the milk were not in contact with E. B. Leprosy, moreover, was not as contagious as tuberculosis. He said at the time there were seventeen or eighteen cases of leprosy in the state, but there were over 10,000 cases of tuberculosis. Because of his letter, the creamery reversed its decision. In 1921, after E. B.’s sister, who no longer lived with the family, was diagnosed with leprosy, physicians visited the remaining family members and evaluated their conditions. E. B.’s father and other sister and brothers showed no evidence of the disease.

Doctors and officials from other states routinely wrote to Dr. Bracken asking about how the state of Minnesota managed leprosy. He responded that the affected were usually cared for by their families or at county poor farms. They would occupy a room by themselves with their own bedding, towels, and dishes. Soiled bandages were burned and washable bedding and clothing were disinfected. He wrote that there was no quarantine or persecution of the individual and no panic regarding the person.

Dr. Bracken stated that no one with a family member with leprosy should be allowed to enter the country so the disease would die out. He was an advocate for a national home to care for the patients so they could be moved from filthy homes where adequate hygiene was not practiced. He said this action would be more economical, provide more satisfactory care, and segregate but not isolate them. He wrote of a woman from Sweden who wished to die to free her family from the persecution caused by her disease. Her husband, who was a carpenter, could not find work, and her children could not go to school due to public sentiment. Bracken said her family would be free of this stigma if she could be cared for in a leprosarium.

In 1898, Dr. Bracken reported that he knew of fifty-one people affected with leprosy in Minnesota prior to 1890. Of the fifty-one, he said twenty-one were married and had a collective total of seventy-eight children. None of the children or spouses had developed leprosy at the time. As of 1948, there had been ninety-eight leprosy cases reported in the Minnesota population—fifty-three Norwegians, thirteen Swedish, 8 with Swedish or Norwegian parents or grandparents, 8 to 10 that were probably Norwegian, and 14 from other countries.

In the twenty-first century, the Minnesota State Department of Health requires that a newly identified case of Hansen’s disease must be reported to them within one working day of discovery. The disease is uncommon in the twenty-first century, with zero to three cases per year reported. The risk of developing Hansen’s disease in the United States is very low, since 95 percent of the worldwide population has natural immunity. Close and prolonged exposure over several months to an infected individual is required to catch the disease; it is likely spread by droplets released during coughing and sneezing.