Encephalitis Lethargica A Mysterious “Sleepy Sickness" that Killed Millions

Recently I’ve been discussing encephalitis lethargica with a family member who contacted me. Her ancestor, Krehl Samuel Hocker, died of the illness back in the 1930s. But, like most people, she had never heard of it.

What is Encephalitis Lethargica?

In the wake of the influenza epidemic of the early twentieth century, another mysterious illness swept ‘round the world. Between 1915 and 1926, more than five million people took ill with the disease.¹ Nearly a third of those stricken died. Those who survived were never the same. Despite all this, most people have never heard of it.

It started with a high fever, sore throat and headache. As it progressed, patients also experienced lethargy, double vision, tremors and strange body movements, and sometimes violent behavior or psychosis. Symptoms rapidly worsened and doctors were at a loss on what to do.

Some patients improved only to devolve into convulsions and paralysis. These patients were left in a motionless and speechless state, aware and reactive to outside stimulus, but unable to act on their own, living but not really alive. Survivors often ended up in comas, sometimes indefinitely.

What Causes It?

For 70 years, the medical establishment has considered the illness a “medical mystery.” Because it hit so soon after the Spanish Flu, many believed that it may have been related. However, doctors found no evidence of the flu in the brain tissue of it’s victims.

In recent years, however, there have been new patients identified who have been diagnosed with the disease. In studying it’s progression in those patients, doctors found that all the cases started with a sore throat. Further testing showed evidence of a rare form of streptococcus bacteria in all the patients. Additionally, in studying the case records from the earlier epidemic doctors found that not only did the patients present with a sore throat, but there was evidence of diplococcus, a form of streptococcus, involvement.

The thinking now is that encephalitis lethargica is the result of an autoimmune reaction to a bacterial infection—most likely a form of streptococcus. The immune system goes into overdrive and attacks normal cells in the brain, causing brain inflammation, which ultimately results in the wide-range of symptoms experienced by patients.

Our Connection

Two of our Hockers died of this disease.

Krehl Hocker, son of Albert C. and Lillian A. (Leedy) Hocker, was a relatively young man in 1930, just 45 years-old. The only member of his family to go to college, he was living and working in Philadelphia as a chemist.² He’d been married only twelve years and had two young children: Robert, aged ten, and Elizabeth, aged eight. At some point that year, he contracted encephalitis lethargica. Partially paralyzed, he was sick and bedridden for what remained of his life. He died of the disease at home on 7 July 1935.³

Incredibly, he was perhaps the more fortunate of the two.

Laurence Stokes, son of Joseph B. and Emma Matilda (Hocker) Stokes, was also a young man. Born 29 January 1890, he was only 38 years-old when he contracted the disease in 1928.⁴ He was living and working in Philadelphia as a shoemaker at a factory.⁵ Unlike Krehl, he was institutionalized after he became ill.⁶

Without his medical records, it’s impossible to know what exact symptoms he experienced that led to him being confined. Some of the reports from the time are truly terrible. But we can hypothesize that whatever his symptoms, he either couldn’t be cared for in a home environment or had no one to take care of him. He died at the Philadelphia Hospital for Mental Illnesses on 31 March 1932.⁷

Disease affected our ancestors in large ways and in small. In this case, a largely unknown disease affected the lives of two of our Hockers and their families in a profound and painful way.

• Category: Research
• Tag: Disease