The Geography of Immunology

A Chronological Overview of Hawai‘i and Public Health

by Charles Richter and John S. Emrich
July 2020, pages 34–35

This article originally appeared as an inset article in “How Honolulu’s Chinatown "Went Up in Smoke:" The First Plague Outbreak in Hawai’i, 1899–1900.”

A Canoe of the Sandwich IslandsA Canoe of the Sandwich Islands Epidemic diseases have devastated the native population of Hawai‘i since 1778, when Captain James Cook first landed in the islands. Centuries of isolation meant that Hawaiians were particularly vulnerable to diseases from all over the world. Estimates of the native population in 1778 range from 300,000 to nearly 700,000. Just 40 years later, the figure had dropped to about 150,000, and by 1900, to only 28,800. Aggressive public health measures prevented an even worse decline, and today the Native Hawaiian population has returned to nearly 300,000.

Since first contact with Europeans, the islands became a strategic trading and military location in the middle of the Pacific Ocean. By the late 19th century, as U.S. naval power increased, Hawai‘i became more attractive to the expansionist nation. American business and government interests incrementally seized control of Hawai‘i, which impacted every level of governmental control, including public health.


300–500 AD

Polynesians first inhabit Hawaiian Islands



British explorer Captain James Cook lands in Hawai‘i; he publishes an account of the “Sandwich Islands,” providing the earliest documentation of European contact with the islands


The first trading ship lands in Hawai‘i on its way to China; sandalwood trade and whaling soon become major industries



“Okuu” (probably cholera) epidemic kills nearly 15,000



Kamehameha formally establishes Kingdom of Hawai‘i and proclaims himself king after a 15-year struggle with the ali‘i (chiefs)


King Kamehameha II abolishes the kapu—the traditional religious and legal system that governed all aspects of Hawaiian life



The first Protestant missionaries arrive from the United States



The Aedes mosquito is first identified in Hawai‘i


The first commercially successful sugar plantation is opened by Ladd and Company



Leprosy is first diagnosed in Hawai‘i



Influenza, dysentery, measles, and whooping cough kill approximately 10,000



King Kamehameha III enacts the Mahele, a land division act that introduces legal provisions for private ownership of land, opening the way for rapid growth of sugar plantations



A smallpox epidemic kills approximately 10,000; smallpox vaccination is made mandatory


Queen’s Hospital, named for Queen Emma, is founded to provide medical care to the Hawaiian people


Leprosy patients are first sent to Kalawao, Moloka‘i


Scarlet fever kills “great numbers” of Hawaiians



King Kamehameha V dies without an heir, ending the House of Kamehameha



Riots during the subsequent succession crisis are suppressed by U.S. and British troops; Kalākaua becomes King of Hawai‘i



The Reciprocity Treaty signed between the United States and Kingdom of Hawai‘i provides for duty-free import of Hawaiian agricultural products into the United States and of U.S. agricultural products and manufactured goods into Hawai‘i; the growth and consolidation of sugarcane plantations and processing plants soon follows


The Reciprocity Convention extends the Reciprocity Treaty (1875) and provides the United States exclusive rights to Pearl Harbor



King Kalākaua is forced to sign a new constitution (the “Bayonet Constitution”) that strips the monarchy of power and severely restricts voting rights. The constitution was written by the Hawaiian League, a group of mostly Hawaiian-born American and British businessmen and lawyers who favor annexation by the United States


Whooping cough kills 104



Diphtheria kills 104



King Kalākaua dies and is succeeded by his sister, Queen Lili‘uokalani, who refuses to recognize the Bayonet Constitution and calls for a replacement



The U.S. Marines arrive in Hawai‘i at the request of the Hawaiian League, effectively blocking Queen Lili‘uokalani from continuing her rule; the Provisional Government of Hawai‘i is formed; although the U.S. Congress, in 1894, found no party guilty of a coup against the kingdom, a joint Apology Resolution of Congress nearly a century later (1993) accepted U.S. responsibility for overthrowing the sovereign kingdom


The Republic of Hawai‘i is established



Government-led food inspection begins; Chinese Hospital opens



The Spanish-American War begins (April 25); the U.S. Territory of Hawai‘i is created when the United States annexes the islands (July 7); Pearl Harbor emerges as a key naval base for the war


Bubonic plague kills 61; first sewers are laid



Influenza pandemic kills 2,338



Measles outbreak kills 205



The United States enters the Second World War after the attack on Pearl Harbor (December 7)


Democrats take control of the Territorial Legislature and push for statehood



Hawai‘i becomes the 50th state of the United States

This article originally appeared as an inset article in "How Honolulu’s Chinatown "Went Up in Smoke:" The First Plague Outbreak in Hawai’i, 1899–1900."

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