By 1900, Nags Head had become a thriving tourist destination. Photo: N.C. Division of Archives and History
By 1900, Nags Head had become a thriving tourist destination. Photo: N.C. Division of Archives and History


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Millions of people will flock to the state’s beaches this summer. But the first tourists of the 19th century sought the ocean shore for a different reason — to escape death.

By Jared Lloyd

Coastal Review Online

In the summer of 1830, it took a full day for Francis Nixon and his family to sail across Albemarle Sound.

It was a gamble. Pocked with shoals, oyster beds and remnants of a drowned forest, the inland body of water also had notoriously unpredictable weather. But Nixon and his family pressed on.

Francis Nixon built his house in 1815 in the Old Neck community of Perquimans County, where it stands today. Photo: N.C. State Historic Preservation Office
Francis Nixon built his house in 1815 in the Old Neck community of Perquimans County, where it stands today. Photo: N.C. State Historic Preservation Office

Stepping out onto the sand of the barrier islands at a little village called Nags Head, Nixon drank in the salt-infused ocean air. This was the reason for the journey, the first of its kind for a well-to-do Carolina planter in search of refuge for himself and family.

Nixon was desperate for a cure, an escape from the “fever and agues” that plagued the mainland at that time of year. His discovery didn’t immediately cure disease, but it built a foundation for Nags Head as a healthful place of respite.

Summer could bring death

Summer was the season of sickness, an annual event that swept across the South.

People spoke of “seasoning,” that first summer in the Carolinas that would determine whether you lived or died. Those who survived the first round of fevers would push on, most likely suffering again in the future, but not on their death beds.

In his journal, German traveler Johann Schoepf wrote in 1784: “Carolina in the spring is a paradise, in the summer a hell, and in the autumn a hospital.”

On the mainland, the heat of summer mixed with hellish humidity and searing sun as slaves, servants and those of lower castes toiled in fields of rice, cotton and tobacco.

But as the sun began to set, and temperatures subsided, the dark brought with it another type of hell – mosquitoes.

No air conditioning or screens protected people’s health. No one understood that mosquitoes were vectors of disease.

The age of disease

The age of exploration and imperialism ushered in what historian Alfred Crosby christened the Columbian Exchange. As ships sailed from ports on both sides of the Atlantic, animals, crops, insects and diseases crossed oceans and continents. Within a few hundred years species mixed across the globe in ways that had not been possible for roughly 175 million years.

Slavery brought with it countless horrors. Unknown at the time was the presence of a pathogen in the veins of many slaves who survived the voyage to the New World; one that had grown up along with people in Africa and the Mediterranean.

The introduction of slavery in the American South brought with it a particularly deadly strain of malaria. Illustration: Library of Congress
The introduction of slavery in the American South brought with it a particularly deadly strain of malaria. Illustration: Library of Congress

Those who survived their dark passage had already survived seasoning as a child in Africa. Many also carried one of several genetic mutations which had evolved in that region to impart immunity to the effects of malaria. The best known of them was sickle-cell anemia.

But people of European and Native American ancestry were unequipped for Plasmodium falciparum – the most deadly and virulent strain of malaria.

It’s a disease that continues to kill one million people worldwide annually.

This strain of malaria needs both female Anopheles mosquitoes and humans to survive. Upon arriving in the colonial South in the blood of slaves, the Plasmodium parasite found both uninfected humans, and species of mosquito that fit the criteria. In short order, the disease would spread like a wildfire from Virginia to Florida and points west to encompass the Gulf States.

Carolina planters such as Nixon couldn’t fathom the connection between mosquitoes and the sickness and death they watched sweep over their communities each summer. They could only make generalizations, associating the sickness with a season and the understanding that it was worse near swamp lands.

The leading theory at the time was that the sickness was caused by “miasma,” a stench or smell considered negative and potentially unhealthy. This notion that these seasonal fevers were caused by bad smells coming from lowlands has a long history dating back to the early days of Rome, which suffered the burden of a unique strain of malaria – Plasmodium vivax.

From Rome we inherited the name malaria: mal aria, or “bad air.” It was this “bad air” in the lowlands that, according to legend, prompted Romulus to build Rome atop seven hills to escape the pestilence.

The scourge of malaria

Nixon and his family are believed to be the first of the Carolina planters to head to the Outer Banks to escape the malarial fevers that plagued the mainland. With knowledge that the area known as Nags Head was generally free of sickness, he procured a 200-acre plot for his family’s summer retreat near the base of Jockey’s Ridge. Word spread quickly to the other Perquimans plantations of the healthy climate and disease-free respite Nixon had discovered.

By 1900, Nags Head had become a thriving tourist destination. Photo: N.C. Division of Archives and History
By 1900, Nags Head had become a thriving tourist destination. Photo: N.C. Division of Archives and History

By 1838 the first official hotel was opened in Nags Head to accommodate those well-to-do families who could afford to step away for a few months each year to escape the sickness that had come to define the South and its people.

It is difficult for modern Southerners to understand the effect malaria had here, as it was officially eradicated from United States soil in the 1950s. Generations have been born into a world where such a disease only inflicts the tropical Third World. But before the discovery of the connection with mosquitoes in the 1890s, death tolls in the South were identical to those in contemporary sub-Saharan Africa.

Actual statistics are hard come by. Many deaths are directly attributed to malaria, others simply to the disease’s symptoms. Some deaths went unreported altogether. In all, probably one out of ten deaths annually were attributable to this disease annually.

During the Civil War, some 10,000 Union soldiers died each year from  malarial fevers they contracted while fighting in the South.

In 1913, Henry R. Carter, senior surgeon for the United States Public Health Services wrote in Malaria in North Carolina that people in the state’s tidewater regions could not survive to age 30 unless they were able to acquire significant immunity to the disease. The plague of malaria was so pervasive that the Centers for Disease Control and Prevention was established for the sole purpose of controlling and eradicating this disease from the South. That’s the reason it is based in Atlanta instead of Washington, D.C..

A resort is born

From an unknown hamlet tucked behind towering sand dunes, Nags Head grew into the premier summertime resort community of North Carolina – rivaled only by Asheville. That mountain city also traces its rise in prominence to wealthy people’s desire to escape malaria in the regions below.

Boardwalks were built; grand hotels were erected. Business people organized horse races and imported all manner of entertainment to keep North Carolina’s landed gentry occupied and happy while on the island. The activity laid the groundwork for the kind of resort destination that Nags Head would become into the 21st century.

Drainage activities, Virginia, 1920's. Photo courtesy: CDC.
Drainage activities, Virginia, 1920’s. Photo courtesy: CDC.

Today, the Outer Banks is one of the United States most sought-after vacation destinations. Each year millions of visitors flock to the coast of North Carolina, making tourism here a multi-billion dollar industry.

People come for the rejuvenating effects of days spent with toes in sand and lungs filled with salty air, even though the sickness of malaria may no longer drive the need for escape.

Drive along N.C. 12, south past Jockey’s Ridge and Kitty Hawk Kites, you can see remnants of a time long passed, seen in the architecture of homes that front the Atlantic. They will see a line of houses quite unlike the mansions that have come to typify ocean-front property on the Outer Banks. Weathered, bleached from the sun and seasoned by salt, many of these houses date back more than 100 years.

The “unpainted aristocracy,” they are called. With their porches open to health-bestowing ocean breezes, they stand as windows into a history mostly long forgotten.

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