The only doctor in Nome and the surrounding communities was Curtis Welch,[2] who was supported by four nurses at the 25-bed Maynard Columbus Hospital.[2] In the summer of 1924, his supply of 80,000 units of diphtheria antitoxin (from 1918) expired, but the order he placed with the health commissioner in Juneau did not arrive before the port closed.
On December 15, 1924, shortly after the departure of the Alameda, the last ship of the year, a two-year-old Alaska Native became the first to display symptoms of diphtheria. Welch diagnosed it as tonsillitis, dismissing diphtheria because no one else in the family or village showed signs of diphtheria, which is extremely contagious and can survive for weeks outside the body. The child died the next morning, and an abnormally large number of cases of tonsillitis were diagnosed through December, including another fatality on December 28, which is rare. The child's mother refused to allow an autopsy. Two more Alaska Native children died, and on January 20 the first case of diphtheria was diagnosed in three-year-old Bill Barnett, who had the characteristic grayish lesions on his throat and in his nasal membranes. Welch did not administer the antitoxin, because he was worried the expired batch might weaken the boy, who died the next day.
On January 21, seven-year-old Bessie Stanley was diagnosed in the late stages of the disease, and was injected with 6,000 units of antitoxin. She died later that day. The same evening, Welch called Mayor George Maynard, and arranged an emergency town council meeting. Welch announced he needed at least one million units to stave off an epidemic. The council immediately implemented a quarantine, and Emily Morgan was appointed Quarantine Nurse.
