Measles at the 64th parallel ============================ * Gus A. Mertens FIGURE 1 The CN wire received by Indian and Northern Health Services in Ottawa on Dec. 15, 1955 put the situation in a nutshell: ![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/12/1551/F1.medium.gif) [Figure1](http://www.cmaj.ca/content/161/12/1551/F1) Figure. "The sun out there does not arrive any earlier than 10 o'clock." Measles epidemic serious - stop - 15 out in rash, 6 with complications and 21 more in bed - stop - Am in contact with Dr. Patry, Churchill, daily - stop - Have 89 Eskimos at post 42, at Snafu 71 at camp 16 miles away and 40 at Duke of York Bay all have contacted measles - stop -request assistance as think a nurse to see the patients out at camps suggest plane to take her out as I have my hands full here and that camp is 5 days travel by dog team from here - stop - request supplies of penicillin and aureomycin stop - at present have on hand 170 doses penicillin 300.000 units and 1200 capsules aureomycin 250 mgms and 2000 triple sulfa. M.E. Swaffield RN Coral Harbour NWT This request came from Mary Swaffield, registered nurse and wife of Bert Swaffield, the Hudson's Bay Company manager in this small Inuit community on South-hampton Island in present-day Nunavut. For Dr. Gus Mertens, stationed at the Fort Alexander Indian Hospital in Pine Falls, Man., it represented "the chance of a lifetime to travel into the Arctic for a bit of an adventure and do something useful, all at Government expense." Two days after Swaffield's wire arrived he was on his way in an RCAF Dakota - with June Elder, a public health nurse in Fort Alexander, and Joe Ross, a registered nurse from The Pas - via Fort Churchill to Coral Harbour. They were met on the frozen DEW Line airstrip and taken by bombardier snowmobile to the HBC trading post that was to become their headquarters. Before they parted, the pilot said: "goodbye and good luck ... for your information it is now 40 degrees below." Out of the total Inuit population of 198 in the area, 183 became ill with measles. There was one fatality - a baby girl who died early in the outbreak. The number of cases peaked on their first day there; a second peak followed around Christmastime. Ross made his base at the far camps while Mertens and Elder tended to the majority population on the island. House calls were made by dogsled from sunrise at 10 am to sundown at 3 pm. The disease had reached the community through an Inuit woman who had recently returned from a tuberculosis sanatorium to the south. During the incubation period a small group of Inuit had left the camps for Duke of York Bay, on the island's north shore, 5 days away by dog team. They were presumed to be infected. Mertens and Elder managed, after one attempt foiled by weather, to reach the bay by plane. They found the entire community post-measles and well, aside from one woman who was in need of treatment for tuberculosis. The following excerpts are taken from a lively account written by Mertens for his family. FIGURE 2 ![Figure2](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/12/1551/F2.medium.gif) [Figure2](http://www.cmaj.ca/content/161/12/1551/F2) Figure. "The fresh water supply for the Hudson's Bay Company post was stacked up at the residence." Bill, the driver of the bombardier snowmobile, was a big, gentle chap with a frozen red beard. He was determined to get us to the Swaffields, come hell or high water. And so he did. The machine was very loud, and I don't recall that the engine blew any heat to its inside. It was also dark, with the headlights reflecting on and off the frozen snow surface outside. Bill drove like fury. We got into a large pack of icefloes, some of which looked the size of a house. Bill, who hadn't uttered a word to this point, started to mumble unintelligibly, obviously determined to get through this mess. We bounced and crashed and our heads hit the ceiling of the snowmobile. We hung on grimly. Eventually Bill stopped the snowmobile; the lights of the HBC post were shining somewhere behind us. And there we stood, with Bill mumbling something like "I am lost." Then 2 people arrived, straight out of the dark, one carrying a rifle. It was Bill Swaffield, the HBC manager, with his clerk Jimmy. They had expected us and when they saw our headlights passing in the distance they figured it was time to have a look. We got out of the snowmobile very happily and had a bit of a cold, midnight talk in the middle of nowhere. We walked to the HBC post, where we met Mary. I spread my down sleeping bag out on a folding cot in the unheated part of the house and slept like a log. FIGURE 3 ![Figure3](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/12/1551/F3.medium.gif) [Figure3](http://www.cmaj.ca/content/161/12/1551/F3) Figure. "Even now it is not easy for me to forget the travel by dogteam on that cold silent sea ice where there is no horizon." The runners of a komatiq, a dogsled, are coated with mud, which is pasted on like cement mortar. This is the time-honoured way of making the sled go. Mud is collected in the summer and, during the winter months, kept inside. Then it is mixed with water into a paste and applied to the runner, where it hardens in a jiffy with a final coat of water, from a mouthful delivered through pouted lips. The komatiq at rest is turned upside down, like a parking brake. The dogs are keen for a good romp and if not restrained they are, before you know it, on the way with an empty sled to the North Pole. When he's ready to go the driver looks at you with a question in his eye ... you nod ... he turns the rig right side up, and you jump on. FIGURE 4 ![Figure4](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/12/1551/F4.medium.gif) [Figure4](http://www.cmaj.ca/content/161/12/1551/F4) Figure. "The homes at Coral Harbour were really not much more than shacks, built from leftover lumber from the DEW Line construction site. Impossible to heat and not wind tight." It's not a life-or-death situation, but it seems that way. Dogs are barking and there is action. The snow is frozen hard. None of this Walt Disney stuff with snow flying around and the driver yelling "mush ... mush!" The animals run together in one direction; rocks and other obstacles are just part of one great playground. This is where the driver's skill enters in. He sits up front, ready to push or pull the komatiq to the left or right, avoiding most rocks. We were warned by our drivers never to hang on with our hands to the outside of the sleigh. Any rock travelling by will take your fingers off at the knuckles. Instead of engine noise and the odour of gas we soon got our snootful of dog farts. To be in the slipstream of 8 exuberant dogs is a unique experience. At times Johnny, my driver, got picky with one or the other animal, who in his judgement had not been doing his share. Then the long whip, which so far had been trailing behind on the ice, came out to snap the slacker into shape. He was quite accurate. The poor thing howled, and our vehicle accelerated into high gear on all 8 cylinders. We had daily contact with every man, woman and child in all the camps in the area. We examined them for the typical rash, sore throats with white spots, red eyes and fever. Those who were sick were very sick, but they were gracious patients. We gave penicillin only to those who had abnormal chest sounds or complained of ear trouble. Penicillin was given by needle in disposable long-acting units. Tablets of this drug had not been invented yet. The trouble with the injectables was that they always arrived solidly frozen and had to be thawed when you got inside. The epidemic had reached its second peak when we heard that a charter aircraft was on its way from Churchill to get us to Duke of York Bay. Our pilot flew us out by the seat of his pants: visual contact only and no higher than 1500 feet. No radar. How he found his way is still a mystery. It is a large island with scattered low mountains and everything is white. The native settlement was invisible from the air but our pilot had been there before; he knew. He "buzzed" over low and suddenly the place was like Broadway in a snowstorm. Folk jumped out from holes in the snow and outlined a suitable landing strip on the sea ice. FIGURE 5 ![Figure5](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/12/1551/F5.medium.gif) [Figure5](http://www.cmaj.ca/content/161/12/1551/F5) Figure. "At Duke of York Bay we soon found out that the measles had arrived and that all were well and recovering." The homes there were very different from the shacks around Coral Harbour. They were large permanent bee-hives of wood and whalebone with a narrow entrance and all of it covered by a thick icing of frozen snow, real cozy. There were raised areas for all to sleep and a wick burning seal oil in a soapstone dish. FIGURE 6 ![Figure6](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/12/1551/F6.medium.gif) [Figure6](http://www.cmaj.ca/content/161/12/1551/F6) Figure. "The infinity of ice and that incredible arctic silence."