Presidents and Pathogens

With news today that President Trump has tested positive for the novel coronavirus that causes COVID-19, I’ve received a number of messages and phone calls asking for a historical perspective on what is going on. President Trump is not the first Chief Executive who has had to deal with a disease. British Prime Minister Boris Johnson contracted the disease in March and was hospitalized in intensive care because his symptoms were serious. President Jair Bolsonaro of Brazil also contracted COVID-19, but his condition was not reported as serious at any time, and — like Mr. Johnson — continued in power throughout the course of his illness.

In April 2009, just as the H1N1 influenza pandemic was beginning, President Barack Obama visited Mexico City. During his trip, President Obama visited a museum whose chief archaeologist later died of H1N1 influenza complications. The President was then tested several times and found to not have contracted the disease, but his “close call” was covered in the news and by pundits as a threat to national security. The worries were that an infectious agent that can’t be seen with the naked eye could disable the Chief Executive and Commander in Chief of one of the most powerful nations and armies in the world. (There is a plan for that, the Line of Succession, that has worked well in the past, even if it has had some hiccups.)

Although he did not contract polio while in office, President Franklin Delano Roosevelt had to deal with the physical consequences of polio during his three full terms in office, passing away from a brain bleed in 1944. While confined to a wheelchair most of the time, President Roosevelt did steer his administration’s response to the Great Depression and most of World War II. He was also instrumental in the fundraising efforts for research into a polio vaccine that would arrive ten years after his death.

In 1841, President William Henry Harrison passed away after a bout of pneumonia. He was in office for thirty-one days. After contracting what is described as a “cold” from being out in the elements, he was then diagnosed with lobar pneumonia. The complications of that — along with the inexistence of antibiotics and other modern medical interventions available today — led to one of the shortest presidencies in history. When Vice President John Tyler was sworn-in as President, it set a precedent for a peaceful transfer of power in a time of crisis and for what has since been the first step in the Line of Succession.

In 1850, President Zachary Taylor died from an intestinal infection after being in office for 16 months. Like with President Harrison before him, the Vice President was sworn-in, and the country continued normal operations. According to History.com:

Outbreaks of cholera, a deadly disease caused by bacteria, occurred frequently during the summer months in hot, humid Washington during the 1800s, when sewage systems were primitive at best. The bacteria were mostly likely present in the water or iced milk Taylor drank, though other sources have claimed that Taylor died of gastroenteritis caused by the highly acidic cherries combined with fresh milk. Others suspected food poisoning or typhoid fever. It appears no one suggested foul play even though Taylor, a Mexican War hero, opposed secession and vowed to personally lead a military attack against any state that threatened to secede from the Union.

Taylor died on the evening of July 9, after four days of suffering from symptoms that included severe cramping, diarrhea, nausea and dehydration. His personal physicians concluded that he had succumbed to cholera morbus, a bacterial infection of the small intestine. His vice president, Millard Fillmore, was sworn in as the new president the next day.

Not all encounters with pathogens have ended in tragedy for US Presidents. In 1992, while on a state visit to Japan, President George HW Bush fell ill to gastroenteritis and vomited on the Japanese Prime Minister during a state dinner. As he vomited, the President also fainted for a moment. When he came to, he allegedly asked the Secret Service agents with him to just “roll him under the table” and leave him there until the end of the dinner. video of the incident has since become a source of jokes about “bad sushi.”

In his time fighting the United States War of Independence, Andrew Jackson contracted smallpox while a prisoner of the British. He was not yet president, but his encounter with smallpox as a soldier did inform his views on the disease and the vaccine that would become available in the 1800s. According to Professor J. Diane Pearson, the Jackson Administration selectively used smallpox vaccination as a political tool against Native American tribes in the 1830s.The professor asserts that the Indian Vaccination Act of 1832 allowed President Jackson to selectively vaccinate some tribes that acquiesced to his demands for land and their relocation while leaving vulnerable to smallpox those tribes who did not agree with him.

The Office of the President of the United States is a very powerful position for many different reasons beyond the economic and military ones that the person who occupies that office directs. Since George Washington first peacefully transferred power to his successor, the tradition of stability and assured continuance of that office has allowed the United States to stand out from other nations where civil strife and even violence accompanies a transfer of power from one person to another, or from one political party to another. We certainly wish President Trump, his family, his Cabinet and anyone else in the world battling COVID-19 — or any other disease or condition — the best and wish for them also a speedy recovery.

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Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen

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