Smallpox in South Bend: The Epidemic of 1926

In January 1926, smallpox returned to South Bend. The city's response was swift, coordinated, and devastatingly effective. A century later, that's what seems impossible.

BY AARON HELMAN // POSTED DECEMBER 18, 2025

South Bend was a pretty great place to live in 1926. Industry was thriving, wages were soaring, and everyday citizens had more leisure time and entertainment options than ever before. With a few exceptions, the city was in the midst of a prosperous run. It was a good time to be in the city.

So long as you could survive it.

There was plenty to be afraid of in 1926. Car accidents killed people. Train derailments killed people. Fires killed people. People were still dying in horseback accidents. All of that was just in January.

But scariest of all was the vengeful return of a disease that most South Benders thought had been left somewhere in the past. 1926 brought with it the return of smallpox. The city wasn't expecting it, but by the middle of January, the health commissioner was ready to call it an epidemic.

The first smallpox vaccine was developed in 1796, and it reached the shores of North America in 1800. The vaccine was a modern miracle and earned immediate endorsements from historic titans like Napoleon Bonaparte and Thomas Jefferson. It was 1813 when President James Madison signed 'An Act to Encourage Vaccination.' The vaccine became mandatory in parts of the United States by the 1840s.

Vaccination against smallpox wasn't a new thing. It was old, institutionalized, and legally mandated. By 1926, when the outbreak hit South Bend, vaccination had been a part of American public health for over a century. Smallpox, as a threat, was supposed to be over.

For Dr. John B. Berteling, South Bend's Health Officer, it must have felt like he'd been thrown directly into the fire. He'd been sworn in 24 hours earlier, and now there was an epidemic threatening the city. Berteling dd what he had to do. He acted quickly and decisively.

On January 2, as his first act in office, Berteling issued a public warning. Smallpox was spreading rapidly. It was not confined to any one part of the city. It was everywhere. A young woman was dead of the disease, fewer than 30 hours after she began experiencing symptoms.

The stakes were dire, but the solution was simple:

“The only safe way of preventing smallpox is by vaccination. Those already vaccinated who have not had a successful vaccination within seven years should be revaccinated.”

The Board of Health did not mince words when it came to the threat that the brewing smallpox epidemic presented to the city:

“Officials of the health board declared today that unless the public submits to vaccination, South Bend may look forward to an epidemic of the disease, causing illness and death and loss of time and money.”

I'm not sure if people were more frightened about losing their lives or their money, but the proclamation was heard across the city, and action was swift. Families rushed to be vaccinated, infected people were quarantined, and schools even cancelled their spelling bees, expecting that so many people in an enclosed space would further the spread of the disease.

The Board of Health released daily dispatches to be printed in newspapers hoping to persuade latecomers, to keep the public informed, and most of all, to help keep them safe. They even responded directly to the naysayers:

“Anti-vaccination agitation, in the light of our present knowledge is only an exhibition of a certain type of mind which refuses to accept facts and deductions.”

A hundred years later, all of this is unconscionable. It's impossible to imagine that a disease long considered eradicated could return as a threat in our modern era.

Or at least it should be.

Back in 1926, the response to the smallpox epidemic was overwhelming. Officials cancelled events. Sick people were quarantined. Vaccines were mobilized and deployed on a massive scale — in three weeks, the Health Department inoculated more than 8,000 people.

The result? By the end of January, the epidemic was over. It lasted just three weeks.