Immigration and Disease

Immigration and Disease

SCIENCE – Learn about disease during the age of immigration to the United States.

Learning Target:

Use evidence constructed from information from various formats to answer questions, formulate an opinion, and discuss. Scroll to the bottom to find Education Standards.

Time needed for implementation: 2 class periods

Beginning- Expert Input: (15 Minutes)

The teacher will introduce the topic of immigration and disease by conducting a discussion and analysis of this primary source from the Library of Congress where an immigration inspector is examining an immigrant.

Photo courtesy of the Library of Congress.

Middle- Task: (50 Minutes)

Students will read the article and interact with the other resources located below these instructions. Students will then complete this Sutori activity.

Next, students will locate (either on the SSHSA website, the Library of Congress, or National Archives) a pertinent primary source that they will upload to Thinglink and create an interactive information source related to the topic using the primary source.

End- Evaluation & Reflection: (15 Minutes)

The teacher will end the activity with a discussion using the discussion questions listed below.

  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?

Article & Resources for Students

By 1870, more than 90 percent of immigrants to America arrived by steamship. Steamship companies relied on the immigrant trade as their main source of income into the 1920s. These 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.

View of steerage passengers from the First Class deck on the Kaiser Wilhelm Der Grosse, c. 1902.

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

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.

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).

Education Standards

National School Library Standards – AASL

I.B. Learners engage with new knowledge by following a process that includes:
1. Using evidence to investigate questions

II.C. Learners exhibit empathy with and tolerance for diverse ideas by:
1. Engaging in informed conversation and active debate.
2. Contributing to discussions in which multiple viewpoints on a topic are expressed.

IV.C. Learners exchange information resources within and beyond their learning community
1. Accessing and evaluating collaboratively constructed information sites
3. Joining with others to compare and contrast information derived from collaboratively constructed information sites

V1.A. Learners follow ethical and legal guidelines for gathering and using information by:
1. Responsibly applying information, technology, and media to learning..
3. Evaluating information for accuracy, validity, social and cultural context, and appropriateness for need.

National Council for Social Studies

National Science Education Standards

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