Immigration and Disease

Immigration and Disease

Immigrants line up for examination at Ellis Island. Photo courtesy of the Library of Congress.

SCIENCE – Steamship companies had to inspect their passengers for diseases. Before leaving the port, the companies had to vaccinate, disinfect, and determine the health of the ships occupants. But often these examinations were superficial.

A physician for the U.S. Marine Hospital Service inspected first and second-class passengers who arrived in New York in the privacy of their cabins. The government felt that these more affluent passengers would not end up in institutions, hospitals, or become a burden to the state. On occasion, first and second class passengers had to go to Ellis Island for further inspection because of illness or legal problems.

This experience of arriving in America was far different for steerage or third-class passengers. On board, a superficial inspection to check for outbreaks of cholera, smallpox, typhus, or yellow fever occurred. Immigrants in steerage traveled across the ocean near the bottom of ships. It was crowded and often unsanitary conditions were present. Rough Atlantic Ocean crossings, which could last up to two weeks, often left third-class passengers sea-sick. Arriving in New York City, ships would dock at the Hudson or East River piers.

First and second-class passengers would disembark, pass through Customs at the piers and then entered the U.S. But for steerage passengers, everyone would undergo a medical and legal inspection on Ellis Island.

Ships carrying passengers with contagious diseases were quarantined and flew a yellow flag at their masthead. Authorities then took those passengers to hospitals on Hoffman and Swinburne islands.

The Inspection

Immigration and Disease

Immigrants undergo the dreaded eye examination at Ellis Island. Photo courtesy of the Library of Congress.

As a group, immigrants entered the main building where authorities inspected their bags. Then they walked up a stairway to the first in a series of medical inspections that took place. Public Health doctors watched as new arrivals climbed the stairs, looking for signs of health problems like wheezing, coughing, or limping.

In the Registry Hall, and inspector stamped the immigrant’s health inspection card and then watched. As the immigrant looked to see what was on the card, doctors looked to see if they revealed any eye problems.

“Beware of the eye man.” The second station, many immigrants knew about before leaving home. This painful exam checked for trachoma, a highly contagious disease that caused blindness. Officials immediately deported anyone found with trachoma.

Men and women were segregated for inspection, and female doctors and nurses examined the women. By 1924, the Public Health Service had four female physicians on duty. After completing the exams, immigrants waited until their names were called so that they might leave or be taken to another facility.

Ellis Island had its own hospital, contagious disease ward, mental ward, autopsy theatre, morgue, and crematory. In 1911, physicians examined nearly 750,000 immigrants. Of these, almost 17,000 had physical or mental defects, which included 1,363 with loathsome or dangerous contagious diseases and 1,167 who had trachoma. Loathsome contagious diseases included favus (scalp and nail fungus), syphilis, gonorrhea, and leprosy. Dangerous contagious diseases included trachoma and pulmonary tuberculosis. During Ellis Island’s history, more than 3,500 immigrants died on the Island, including 1,400 children and more than 350 babies were born.

Questions for Further Thought

  1. What was the examination procedure like for different classes of immigrants when they arrived at Ellis Island?
  2. Explain the thought behind the rigorous exams for steerage passengers. How does this compare to first-class and why would these passengers have less inspections?


Additional Resources



Immigration and Disease

Photo courtesy of the Library of Congress.

Detail view of hydro-mechanical control panel in sanitary room on second floor – Ellis Island, Contagious Disease Hospital Measles Ward G, New York Harbor, New York County, NY.


Immigration and Disease

Image courtesy of the Library of Congress.

Measles Ward G, constructed in 1907, is one of 11 individual treatment wards in the contagious disease hospital complex on Island 3. One of eight wards designated as measles treatment buildings, these buildings also housed patients with scarlet fever, diphtheria, pneumonia and whooping cough. Like the other seven measles wards in the contagious disease complex, Ward G was built from a single, standardized design and arranged in a pavilion plan – a wing and corridor form popular for hospitals since the nineteenth century. The plan isolated contagious patients from those in the main hospital. It also helped prevent the spread of disease among patients with other infectious illnesses.

Ward G’s architectural styling, along with its materials and finishes, integrates it with the other buildings within the hospital complex to form a cohesive design unit. Ward G and its sister wards are the largest and most significant group of buildings within the contagious disease hospital complex.

Immigration and Disease

Child with measles in tent home of his migrant parents in Edinburg, Texas, 1939. Photo courtesy of the Library of Congress.

Ellis Island Oral History Program – approximately 1900 interviews. The interviews include people from dozens of countries, former Immigration and Public Health Service employees, military personnel stationed at Ellis Island and the Statue of Liberty as well as people detained at Ellis Island during World War II until it closed in 1954.


Immigration: Ellis Island 1892 – 1955,” Genealogy Today.

Sharon DeBartolo Carmack, Guide to Finding Your Ellis Island Ancestors (Cincinnati: Family Tree Books, 2005).

Dr. Howard Markel, “Before Ebola, Ellis Island’s terrifying medical inspections,” PBS Newshour, October 15, 2014.

See also: Alan M. Kraut, Silent Travelers: Germs, Genes, and the ‘Immigrant Menace’ (New York: Basic Books, 1994).

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