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Responses to time

One hundred and thirty years ago the Smallpox Sufferers Isolation Hospital, now the Emílio Ribas Infectious Diseases Institute, was set up


A deserted place, at one of the highest points in the state capital, was chosen by the City Council to isolate smallpox patients in the second half of the 19th century. According to the view prevalent at the time, the place offered many advantages,: it was near the cemetery and far from the center, there were few residences in the vicinity and the wind rarely blew towards the city, which at the time had just over 40,000 inhabitants. In 1880 the Smallpox Sufferers Isolation Hospital was inaugurated alongside the Pinheiros Highway (now Rebouças Avenue), which became simply the Isolation Hospital eight years later, the Emilio Ribas Hospital in 1932 and the Emilio Ribas Institute of Infectious Diseases in 1991. “It’s one of the precursory institutions of a modern metropolis like São Paulo, and one of the pillars of a city under development,” says researcher, Monica Musatti Crytrynowicz.

She is the co-author with Roney Crytrynowicz and Ananda Stücker of the recently published, Do Lazareto dos Variolosos ao Instituto de Infectologia Emílio Ribas – 130 anos de história da saúde pública no Brasil [From the Smallpox Isolation Hospital to the Emilio Ribas Institute of Infectious Diseases – 130 years of public health history in Brazil] (Narrativa Um publishing house / Government of the State of São Paulo, 192 pages).


Although the land belonged to the City Council, the construction ended up being paid for by the people of the city through donations. The hospital building was constructed on a single floor in accordance with the theories of the time about transmission of disease. There was great concern about air circulation. The floor of the isolation hospital was high off the ground, with openings for ventilation. The ceiling was high and the windows were large.
On the roof, a fan kept the air circulating. These precautions derived from the belief in contamination by miasmas, fumes that would propagate diseases. The discoveries of Louis Pasteur, Robert Koch and Joseph Lister that resulted in microbiology were still going on in Europe, but little was known of them here.

With the Republican Constitution of 1891, the states began to manage public health. The new powers allowed the São Paulo state government to set up the Health Service the following year and new organs, like the Chemical Analysis, Bacteriological, and Pharmaceutical laboratories of the Vaccinogenic Institute were established. In 1898, Emilio Ribas was appointed Director of the Health Service, which was responsible for the Isolation Hospital, the new name for the former Smallpox Hospital. A well-informed doctor and a careful reader of scientific news, Ribas carried out a remarkable experiment in the hospital where he confirmed, along with Adolfo Lutz and other volunteers, that yellow fever was transmitted by mosquitoes (see Pesquisa FAPESP nº 157).

EMÍLIO RIBAS PUBLIC HEALTH MUSEUM (MUSPER)Observation Wing (right), in 1894, where patient screening was carried outEMÍLIO RIBAS PUBLIC HEALTH MUSEUM (MUSPER)

In the 20th century the clinical staff increased to meet increased demand. “The hospital was always at the forefront of the fight against epidemics,” says Arary da Cruz Tiriba, a doctor and professor of medicine who began working at the Emilio Ribas in the early 1950’s. At 85, he recalls that the research done there was always field research, when they investigated outbreaks of disease all over the state, and nursing research. “Some of us, however, insisted on publishing our discoveries and conclusions, like José Toledo Piza, who first described Brazilian spotted fever in 1932.”

Over the past 40 years the hospital has established itself as a reference center in conduct formation, knowledge generation and the training of specialists in infectious diseases. Between 1971 and 1975 it played a central role in coping with meningococcal meningitis – in 1974 the hospital admitted 1200 patients. At the beginning of the 1980’s the arrival of AIDS changed the hospital and the very specialization of infectious diseases, according to David Uip, the Institute’s current director. “We went from being specialists in endemic diseases and in fieldwork, to being specialists in hospital care,” he said in a statement he made for the commemorative book.