Like the Western Pennsylvania Institute for the Blind, the Trudeau Sanatorium—which treated tuberculosis patients—was a naturally isolated facility. Unlike WPIB, however, Trudeau was also geographically isolated, located as it was in the tiny village of Saranac Lake, NY. We identified the Trudeau as a provisional escape community, but the amount of information on the sanatorium during the 1918–1920 influenza epidemic is rather scant.

At a Glance

• Type of Site: Logging town in upstate New York.
• Population: 356 patients admitted in 1918;259 discharged; average daily patient census of 150.
• Pop. Density: N/A
• Geographical Considerations: The Trudeau Sanatorium was located deep in the Adirondack Mountains; access was difficult even during the warm-weather months.
• Influenza Cases: 0
• Influenza Deaths: 0
• First Reported Case: Unknown.
• NPI Implemented: A de facto protective sequestration existed; isolation as practiced at the time for ill TB patients.

Case Study

Dr. Edward Trudeau’s tuberculosis sanatorium was located on the shores of Saranac Lake in the Adirondack Mountain Range of upstate New York. A sufferer of tuberculosis himself, Dr. Trudeau ventured to the area in an attempt to regain strength and health. The cold air treatment appeared to have worked and inspired the physician to establish a sanatorium in the hope that other tuberculosis sufferers might benefit. After his death in 1915, the sanatorium that bore his name continued with great clinical distinction. Indeed, it was one of the most famous tuberculosis hospitals in the world at the time of the 1918 influenza pandemic. That year, 356 patients were treated at Saranac Lake. Approximately 150 patients were resident at any given time during the year. Many of the physicians and staff members at the Trudeau Tuberculosis Sanatorium were at one time active tuberculosis patients themselves, but by the time they were appointed to the staff (as at other tuberculosis sanatoria of the era), their cases were considered quiescent or healed before they were allowed to have contact with patients.

This small, remote community of tuberculosis patients escaped influenza in the fall of 1918. With the threat of influenza looming, the physicians vaccinated most of the patients. The efficacy of vaccination, with what turned out to be the wrong microbial agent (Pfeiffer’s bacillus), was considered doubtful even by the physicians in charge at the time. Nevertheless, as of October 29, 1918, there were no cases of influenza at the sanatorium. One explanation for this striking statistic may have been the de facto protective sequestration that already existed at the sanatorium because of the pre-existing and consistent isolation of the tuberculosis patients and staff from the community at large. Tuberculosis sanatoria of this era were deliberately removed from society, and traffic into and out of them was strictly regulated. Such isolation likely assisted in the defense against influenza.

In addition, tuberculosis sanatoria benefited because they already paid scrupulous attention to contemporary sanitary measures and methods, procedures that likely placed the patients of Trudeau Tuberculosis Sanatorium at an advantage. It is reasonable to surmise that the caretakers of the sanatorium took every precaution in attempting to prevent the introduction and spread of influenza—as well as any other contagious disease—among the patients.

The town of Saranac Lake itself experienced a few cases of influenza in the late fall and early winter of 1918, although the actual number of cases is not known. By December 13, 1918, there were seven cases in town, as documented by a public health survey taken by a New York City physician. Even though it seems Saranac Lake was only lightly affected by influenza in the fall, it is hard to tell with specificity, as records of the town are scarce and as the only influenza statistics available for the town come from a tattered news clipping.

During what would be considered the third wave of the influenza pandemic (January to April 1919), 27 cases were recorded at the Trudeau Tuberculosis Sanatorium. They included a number of nurses as well as one orderly (who subsequently died). According to Dr. Walter James, President of the Sanatorium, the arrival of influenza was not unexpected. In a letter to Vice-President Dr. Edward Baldwin, Dr. James wrote, “I am sorry that the influenza has descended upon you, but, after all, it is only what you had a right to expect, and I am glad that you are not getting it very severely.” If additional NPI were taken at the sanatorium in February, we have been unable to find documentary evidence of them.

With the patient population isolated from the small community of Saranac Lake, the sanatorium regularly had to deal with social issues related to extended periods of isolation. To help entertain the residents, many activities were held at the facility. For example, motion pictures were shown regularly, and an “Evening Club,” run by the patients themselves, was held weekly. The club hosted live entertainers and lecturers on a variety of topics throughout each year. Additional live entertainment events, featuring high profile, out-of-town guests, were scheduled from time to time as well. It seems highly unlikely, however, that outside entertainers were invited to the facility during the course of the influenza pandemic, and most likely, instead that entertainment was self-generated by the patients and staff during this period.

Research Materials

As mentioned above, the amount of primary source material relating to the Trudeau Sanatorium and the 1918–1920 influenza epidemic is minimal. Digitized sources include:

Newspapers:

• Adirondack Enterprise

Archival Material:

• Letters from Walter B. James, President of the Sanatorium
• Trudeau Sanatorium Annual Reports

Adirondack Enterprise

Date	Title	PDF
12/13/1918	Getting Statistics on the Epidemic	ae01
12/13/1918	Influenza Precautions	ae02

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Letters from Walter B. James, President of the Sanatorium

Box/Folder	From/To	Date	Description or Title	PDF
James to Baldwin Letters	W. James to E. Baldwin	10/29/1918	Writes, “I am glad to hear that the Sanatorium has escaped influenza.”	james01
“	“	11/20/1918	Writes, “I hope everything is going well and that you have no more illness in the village.”	james02
“	“	2/5/1919	Indicates that the roads to and from Saranac Lake were not passable in the winter, effectively isolating the community.	james03
“	“	2/25/1919	Writes, “I am sorry that the influenza has descended upon you, but, after all, it is only what you had a right to expect, and I am glad that you are not getting it very severely.”	james04

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Trudeau Sanatorium Annual Reports

Box/Folder	Date	Description or Title	PDF
	Nov. 1918	Thirty-Fourth Annual Report of the Trudeau Sanatorium	tsreport1918
	Nov. 1919	Thirty-Fifth Annual Report of the Trudeau Sanatorium	tsreport1919
	1919	Thirty-Fifth Annual Medical Report of the Trudeau Sanatorium	tsreport1919_01

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