Pellagra South

About Pellagra South

Pellagra, caused by niacin vitamin B3 deficiency, reached epidemic proportions in the American South in the early 20th century. From 1906 to 1940, approximately 3 million Americans contracted pellagra and approximately 100,000 died. Symptoms included the four Ds: dermatitis, diarrhea, dementia, and death. The disease was linked to poverty and a corn based diet. Joseph Goldberger, a Public Health Service physician, investigated pellagra starting in 1914. He observed that staff at institutions with pellagra outbreaks never developed the disease, suggesting it was not infectious. Goldberger conducted controversial experiments including injecting himself with blood from pellagra patients. He proved pellagra was a nutritional deficiency by modifying diets in orphanages and prisons. Nicotinic acid, or niacin, was identified as the missing dietary factor in 1937. Improved diets and the enrichment of flour and bread largely eliminated pellagra in the US by the 1950s. Goldberger died in 1929 before his work was fully validated.