Typhus epidemic in the Warsaw Ghetto

The Jewish doctor Jakub Penson, describing the phenomenon of the typhus epidemic in the Warsaw ghetto, described it as “[…] an experiment on the ghetto population of several thousand […]”, which had to lead to an epidemic of a huge scale and the death of thousands of people trapped in the ghetto.

Area at risk of typhus. Warsaw ghetto.

Typhus was the occupier’s “child”. Born to be tested on humans. Jakub Penson, a Jewish doctor, one of the founding fathers of the science of nephrology, concisely told the story of typhus in Warsaw. In mid-1946, in Łódź, he appeared before District Commission for Investigation of German Crimes in Poland. He testified in “The case file on the indictment of Ludwik Fischer and others”: “There are laboratory tests conducted in America in the field of epidemiology in which spreads of epidemics among mice were observed in isolated places constructed specially for that purpose. a new healthy or infected animal was thrown into such a group of laboratory animals. The Germans repeated this experiment with a population of many thousands of people in the Ghetto. From time to time, where the small foci of a typhus epidemic were smouldering, thousands, and later tens of thousands, of newcomers, initially from Poland and then from all Europe, were thrown by the Germans into the population that had been concentrated to an unbelievable degree, doomed to cold, starvation, filth, louse infestation and mental lethargy as a result of constant ill-treatment and beating. It was certain to cause the outbreak of a typhus epidemic on a large scale It was certain to cause the outbreak of a typhus epidemic on a large scale”. [7 Also: 8] A few months later – in January 1947 – he repeated these words in the courtroom while standing before the Supreme National Tribunal in Warsaw. [7 Also: 9] The trial of Germans governing the occupied Warsaw was underway. One of the defendants was Ludwik Fischer, Warsaw District Governor. He was regarded as the embodiment of crime, incarnated proof of the methodical destruction of the Jewish population in the Warsaw Ghetto. His words resonate with this exact context. They cannot be explained or interpreted in any other way, only as spoken by the witnesses. Jewish and Polish doctors. They recreated recent events, still fresh in their memories, accurately. Especially, the former, as they took part in these events. Day after day, with their own eyes, they witnessed the tragedy unfolding. To the best of their, extremely limited, abilities, they tried to help their people. They were among the few who managed to escape the ghetto on the eve of the first liquidation. They survived. Excerpts from the accounts told by many are the best evidence in the case.

German aggression in 1939 marked the beginning of the end of Jewish history in Poland. Restrictive regulations introduced in the General Government, including Warsaw, ruled out the presence of Jews in public space, excluded them from the social security system, denied them the right to receive treatment in hospitals, reduced food rations, and restricted their relocation. As misfits, they had no right to feel human. They were stigmatised – they had to wear a band with a star of David on their right arm.    Jewish businesses were liquidated. Those that remained opened were placed under compulsory administration. This caused a decline in employment. Everyone lost their jobs: cooks, waiters, musicians, war-disabled, labourers, city workers, doctors and lawyers. Jews were dispossessed of their property and assets, their bank accounts and deposits were blocked, and the amount of cash they possessed was restricted. The looting of the property was done by German officers and private individuals. Every person between the age of 14 and 60 was subjected to forced labour – officially for two days a week. In reality, there were no limitations. Beaten and humiliated, they were used like slaves carrying out the most burdensome work.

Since late 1939 the Germans took measures to concentrate the Jewish population in a zone isolated from the rest of the urban area. Formally, they justified it by the need to protect the remaining inhabitants from a typhus epidemic. In March 1940 antisemitic incidents took place (most probably initiated by the occupant). This was another argument for closing the district: to protect Jews from Polish aggression. The ghetto was established in the so-called Northern District, the area with the largest Jewish population. The wall around it was 3 m high and topped with barbed wire. The “Jewish Residential District” was closed to the outside world on 16 November 1940. It was later described by Zygmunt Warman, a lawyer: ” One third of the Warsaw residents had to find space in the area which made up one twentieth of the urban area. There were no green plots in the district as its borders were delineated in such a way that it only had bare walls. With the area packed so tightly with so many Jews, who were deprived of their livelihood, […] conditions were in place which, coupled with a difficult food situation, inevitably led to emaciation, hunger, and epidemic” [14].

The walls were also a symbol of a transition. An end was coming to what the Jewish population had become “accustomed” to: the current policy of the occupier. To this moment they were believing that this policy is hard but predictable. The process of crystallising German goals was progressing. The symbol of which were the words of L. Fischer spoken shortly before closing “Jewish Residential District”: Jews have to adapt to all situations, and we will try to create such conditions as to make it the most difficult as possible. They will die of starvation and misery, and the Jewish problem will turn into a cemetery” [16, 218]. Although the phrase “epidemic” was not expressed, in the author’s mind it was certainly the reason for using terms such as: “conditions”, “starvation” and “misery”.  Those living in ghetto understood it perfectly. Jerzy Landau, a Jewish physician and the director of the Anti-Epidemic section in the Ghetto stated: ” the establishment of the Ghetto was not a measure to combat the epidemic, but an intentional way to exterminate Jews” [23,160-161].

The conditions were very favourable for typhus to spread: people in the ghetto were starving. These phenomena were attributed to each other and fell into the category of the most serious ghetto diseases. As Ludwik Hirszfeld, scientist, bacteriologist, epidemiologist, immunologist and head of the Healthcare Council of the Jewish district in the ghetto described: “When I compiled the statistics concerning the mortality of the population, it turned out that the difference between the mortality from spotted typhus and general mortality was such that it can only be explained in one way: people were dying of hunger” [10]. The first victims were the resettled. Upon their arrival to the district, they lived in misery, on the brink of life and death: “In transit camps, people were dying of starvation and the only food available was the soup that was distributed in public kitchens. These places were like Dante’s Inferno. The Germans did not give any food rations for the newcomers” [13]. Also: 1, 2, 23]. The next victims were Jews from Warsaw that were deprived of work and property. Young and old, men and women, bourgeoisie and the proletariat, traders and the intelligentsia, deprived of their social class and downtrodden. Pauperised. Gradually, they sank into abject poverty.  Starvation intensified more and more and became the all-powerful master in the crowded streets of the Ghetto” [7].

The starvation had as many faces as there were victims. L. Hirszfeld distinguished and characterised two of its types: “Some look like balloons – pale, swollen face, eyes cannot be seen, legs like an elephant. Or skeletons covered with pale yellow skin” [17,209-210 Also: 26,131-142]. Most dramatic was the image of the children. Stanisław Różycki, a person involved in the independence movement, reported: “They howl, they beg, they sing, they wail, they tremble from the cold with no underwear, no clothes, no shoes, in tatters, sacks, rags tied with string around a miserable skeleton, swollen from hunger, deformed, half-conscious, at the age of five already completely mature, gloomy, discouraged… The majority are wraiths of old people, they are miserable rags, lamentable remnants of “former” humanity” [16,229-230]. Another example was presented by L. Hirszfeld: “The mother feeds an infant with a dried-up breast and next to her a dead body of the older child.  And dying or pretending to be dying, stretched through the whole width of the sidewalk. A face twisted with pain, swollen from hunger, sometimes frostbitten limbs” [17, 209]. And ended up with a question: “. Are they the big artists? Or is the life so bad?”. It was the art of dying…

Typhus had its origin in the conditions created by the occupier. The conditions were described by Peretz Opoczyński in his reports on the Warsaw Ghetto: “Uncovered latrines, dead horses in the streets, living like pigs in the shelters made in the musty, mouldy cellars, did their work. The angel of death – typhus – started its walk through the city. Typhoid fever, typhus fever and – the most dangerous – epidemic typhus” [21,259-260]. In the densely built ghetto, (approx. 3 km²), per 1 km² there were between 128,000 to 146,000 people. At its peak, in April 1942, the “Jewish Residential District” was inhabited by more than 400,000 people. The streets were full of people and the dwellings were overcrowded.  There was a lack of sanitary facilities. The overcrowding meant that dwellings quickly deteriorated. The living conditions were deteriorating day by day. There was filth. Particularly palpable, literally, in the shelters for the resettled (the so-called “transit camps”): people deprived of almost everything – clothes, underwear, blankets – were still arriving there. They were placed in synagogues, schools and sometimes in larger apartments. People had nothing to sleep on. Some slept on straw, others on the bare floor” [11. Also: 6,20]. Housing and sanitation in most shelters were terrible. Almost all of them were ruins. They needed renovation. The cramped conditions and cold soon led to terrible contamination of the “transit camps”. Filth was regarded as something inseparable for “the resettled.” An unknown author of a ghetto diary, perhaps working in an institution supporting “transit camps”, wrote of their impression after visiting a refugee town: “We saw a picture that the most vivid imagination of an artist could not create, that cannot even appear in dreams. Faeces flooding the corridors and stairs, piles of waste, garbage, excrement in the courtyard reached the level of the first floor, in the rooms the living – if they could still be called alive – sleeping next to each other, next to corpses, typhus patients together with the healthy, men, women, children – unreal wraiths. Its entirety was like Dante’s Inferno” [7,123]. Stanisław Gombiński, an employee of the Jewish Ghetto Police believed that they were detached from – even this worst, ghetto one – reality: ” They do not strive for anything, they do not fight for anything. It’s – the bottom” [22, 246].

The filth – result of the garbage produced, accumulated, and not removed – was an inseparable element of the ghetto. Stanisław Adler, a lawyer, said: “Month by month, in each courtyard, more and more piles of decomposing waste grew.  The burning of rubbish or its transport into burnt-out buildings was a palliative which did not solve the problem at all” [9]. The Jewish ghetto authorities repeatedly attempted to solve the “garbage” problems, but their effectiveness was rather relative. The cleaning company was more interested in smuggling than in cleaning the ghetto [28]. In the first quarter of 1942, Judenrat tried to “regulate” the issue of cleanliness by publishing sanitary and order regulations for the Jewish Residential District in Warsaw. While it does include a ban on “polluting streets, gates, yards, staircases”, among others, it is likely that the document’s signatories were aware of how “unreal” the contents of the document were.

The Germans were afraid of typhus. They treated it as an all-purpose measure. In effect, used to justify the implementation of their plans. Therefore, for the international public opinion, the image of a German occupant who not only does not harm the Jews but, on the contrary, guided by the highest values, helps the enemy in the face of the epidemic, was created. That was the German humanitarianism created for public opinion. How different the “practical” acts were. The first step was isolation. Next, large-scale disinfection and disinfestation of the ghetto and its inhabitants. The plans and works were to be for the benefit of all residents of Warsaw. However, this method of operation proved to be problematic from the beginning: there was a lack of proper equipment, trained personnel and money. The “war” against the epidemic was intertwined with the malice of the occupier and the powerlessness of the Jewish population. Their common denominator was bribery on a large- scale.

The only thing that was meticulously carried out was the systematised harassment of Jews: “The German system of controlling the epidemic was inefficient: this system (the so-called policing system) involved compulsory disinfection and disinfestation of the entire domicile and all the residents of the building where a case of the disease had occurred, including locking the house for a day” [8]. All were subjected to forced bathing in a public bathhouse. There were a lot of cases where, while on their way to the “parówa” (bathhouse), people were beaten and humiliated and their dwellings robbed. In the bathhouse: “Women were bald-headed and they reacted desperately and desired to escape” [11]. Their clothes, in which they came in, were “washed”. After many, usually several, hours, “fainting, cold, hungry”, they returned “not as from a bathhouse, but as from a dark dungeon” [21]. Worse still, such bathing created a domino effect: “bathing all residents was an absolutely pointless order […]; it could cause the spreading of infected lice as a result of the contact of clean people with lice-infested ones” [11].

If the ghetto itself was something unimaginable, it is difficult to define examples of actions carried out by German doctors. Concerning the “fight” against the epidemic. As in the case of the medical officer of Warsaw, Wilhelm Hagen: “He mustered some energy, took his military policemen, closed Krochmalna Street and searched all the dwellings. He discovered many unreported people, hidden in closets, in bathrooms, in attics. In these proletarian houses there were more than fourteen thousand people, generally the poor. He had them all bathed and disinfected. The only thing he forgot was, there were not enough showers. And when he disinfected the dwellings, he did not think about where to house the people. And the poor were lying on the ground; those who wanted to escape were shot at, and when the doctor came the next day to see the results of his actions, he found a dozen or so corpses of old, sick people in the yards, who simply could not survive such a cold night outside, on cold stones” [17, 236].

Mass disinfection and disinfestation involved the temporary confiscation of all the clothing of the building’s residents. For many, it was the ultimate misfortune: “The odds to survive the disease were eighty percent, and disinfection could cause the loss of all possessions” [17, 235]. The clothes were packed into large sacks and transported to adapted for this purpose laundry. There, all the items “waited”, sometimes several days, to undergo the delousing. L. Hirszfelt wrote about the “quality” of such a procedure: “I became interested in this disinsection. […] We put the tubes with lice in the bundles placed in the chambers. The only louse that died, it died from laughter. We deduced that all the louse in bundles of clothes had survived” [17, 233].

The Jews tried, by all means, to avoid the “help” given to them. Various measures were taken. Even before the “Jewish Residential District” was closed, they used typhus for “personal use”: “On the gates of individual houses […] in the area with the highest percentage of the Jewish population, plates with the inscription “Seuchengefahr” began to appear. As these plates protected against the intrusion of German soldiers, they were often placed even if the residents were not ill” [18, 59]. However, the best “remedy” to combat the German “help” was money: “First thing in the morning, the Ghetto Police arrives and closes the house. The house committee, informally notified in advance, had already prepared breakfast. There’s vodka and sausage. Polish and Jewish doctors, Jewish disinfectors, and German supervisors, whose presence makes the procedure even more delicate matter, arrive. But on the other hand, Germans, as they beat people, are more feared, so the house committee bargains less. Things we do for business. Chairperson of the committee discreetly hands over the appropriate sum, the breakfast advances peacefully, racial conflicts are forgotten” [17, 233]. There was also a “market” for certain services in the ghetto: “What to do when someone dies of the typhus at home? After all, it is a threat to all the residents. There are two possible courses of action: either to put the dead person on the street at night, or to sell them, that is, for a suitable fee, to place them in the house of the poor, who, for a few hundred or a few thousand zlotys, agree to stand in a queue, or go into quarantine” [17, 234].

The others, those who do not have adequate resources, were sentenced to enforced quarantine. Closing of houses, sometimes sections of streets, lasted from several to a dozen days. It had far-reaching consequences: “[Closing of houses] without food supplies meant starvation to many people, and it was completely impossible to help them with other diseases such as pneumonia or kidney stones” [11]. Terrible conditions prevailed among the resettled and the poor: “I was in that quarantine”, recalled L. Hirszfeld, “It could have been a dream. People on sacks or on the floor, starving. Lavatories in such terrible conditions that cannot be used, so people excrete on the floor. Awfully lice-ridden. For who can delouse these masses? And such a quarantine – it is the economic ruin of the family, the final blow” [17, 234]. It was proof that the “German system” of combating the epidemic was not working.

Typhus was everywhere. It’s last “stop” was the hospital. Hungry, exhausted, sick, they tried with all their might to get there: “Many of the unfortunate going to the hospital, were going into their final journey –recounted Emil Apfelbaum, general practitioner, cardiologist; editor and co-author of the book “The Warsaw Ghetto Hunger Study” – In the vicinity of the hospital, most of these people were lying in the sidewalks” [5,5 Also: 27]. When some of them – “running a fever, half-conscious” [5, 4] – made it to the hospital, they brought typhus there. The Jewish health care in the ghetto was in appalling condition. E. Apfelbaum assessed the situation clearly: “The conditions in which they died, on the street and in the hospital, hardly differed” [5, 5]. Everything was improvised. When, at the turn of 1940/1941, the Jewish Hospital in Czyste was moved to the ghetto, the Bersohn and Bauman Children’s Hospital remained as the only one (at the end of 1941, its affiliate was opened in the ghetto): “Hospital equipment was mostly not allowed to be taken away. The carts full of the hospital belongings were usually stolen, requisitioned, or given to local residents” [5, 7].

Everything was in short supply: medicines, bandages, medical tools. Over time, treatment has been limited to basic care performed in less and less equipped medical facilities. Chronic hunger prevailed: “we were completely helpless as far as the treatment of […] diseases was concerned, since fat and protein […] and vitamins which were indispensable for such cases, […] [were] unavailable for us. at our disposal were only [dr]y bread, groats and potatoes” [7] The conditions were bad: “Beds without bedclothes. The patients laid like filthy rags, one bed usually accommodated two, or even three, patients. There were cases that a typhus patient and a patient with fever caused by an unspecified disease were placed next to each other – one infected the other” [5, 4. Also: 4, 13]. Marek Edelman, who worked there at the time, wrote about everyday life in the hospital: “Simultaneously spotted fever raged in the Ghetto. All hospitals, by now handling contagious diseases exclusively, were overcrowded. The dying were viewed impatiently-let them vacate quicker for the next one” [15, 13]. The personnel became infected. “Cleanliness and hygiene are just an interpretation of a higher standard of living. It is of no use to tell a man to wash if they are not given soap, and to change their underwear if their last shirt is taken from them” [17, 230]. The growing number of patients made it impossible to maintain basic sanitary conditions. After all, one this was certainly not lacking: dedication, devotion and fidelity to the Hippocratic oath by all those who served in the hospital.

Typhus was one of the symbols of the ghetto. The symbol that was remembered and imagined by all those alive at the time: perpetrators, victims and witnesses. It thrived simultaneously with the existence in the ghetto. Its “life” was like waves. It rose with the arrival of the new people relocated from occupied Poland, and later from other European countries. It fell when the number of its fatalities increased proportionally. The epidemic began to die out beginning in mid-1942. Not because the Jews became immune, the conditions in the ghetto changed, or due to the actions taken by the German occupier. One theory suggests that this was due to the “Grossaktion” when nearly 300,000 Warsaw’s Jews were deported to die in Treblinka extermination camp: “Actually, at the moment when they started taking out Jews from the ghetto, there was no typhus epidemic” [8].

Did ghetto residents have a chance to survive the epidemic? L. Hirszfeld was sceptical of that: “The district would have likely become extinct in eight years”, he believed, “Of course, a handful would have remained who were able to survive” [10]. Another doctor, Jakub Penson, argued that the epidemic would eventually die out and the population would become immune: “The German administration intentionally unleashed the typhus epidemic in the Ghetto; The grotesque method of combating the epidemic, in reality, favoured its spread. Although the living conditions constantly deteriorated, the epidemic died out on its own. After a large proportion of the population had been ill with typhus, the […]virulence of the germ decreased – this is a known biological phenomenon” [7].

Typhus caused the death of tens of thousands of Jews residing in the Warsaw ghetto between 1940 and 1942. This is just statistical data. In the 21st century, along with the popularisation, and probably trivialisation, of the tragic history of the Warsaw ghetto, there are judgements and opinions that the ghetto society managed to overcome the epidemic [e.g., 29]. Was it possible? To answer such stated question, it is wise to approach this matter with caution. After all, the team of doctors unequivocally stressed that improved hygiene conditions, new clothes, and food that met the daily energy requirements were prerequisites for the dying out of typhus. And there never were never plenty. Could there have been rational, mass, and effective prevention measure – secondary socialisation – educating residents to “live healthy” in a sick city? The value of all the activities – concerning medical treatment and support – was priceless. And their effectiveness? Ludwik Hirszfeld was critical about it, stating: “All our Healthcare Councils, vaccinations and deliberations –it was only a mental hygiene… for ourselves” [17, 145].   

Paweł Wieczorek – Doctor of humanities. Specialty: contemporary history. Cooperation: United States Holocaust Memorial Museum in Washington, the Jewish Historical Institute, and the Social and Cultural Association of Jews in Poland. Winner of Jewish Historical Institute’s Majer Bałaban contest for the best doctoral dissertation (2014). Participant of international research programme “Pogroms of Jews in the Polish lands in the 19th and 20th centuries” (2013-2016). Author of books and articles. Research interests: Polish-Jewish relations after 1945, Jewish social and political movements, national and ethnic minorities in Poland, cold war, and totalitarianism.

Photo from the collection of the State Archives in Warsaw

Archival materials: 

  1. AŻIH, sygn. 301/162, Relacje Chai Markiewicz. 1946, k. 2.
  2. AŻIH, sygn. 301/479, Relacje Filipa Wajdenfelda. 1945, k.15
  3. AŻIH, sygn. 301/468, Relacje Estery Bieżuner. 1945, k. 2
  4. AŻIH, sygn. 301/497, Relacje Idela Singiera. 1946, k. 8, 13
  5. AŻIH, sygn. 301/4510, Relacje Emila Apfelbauma. 1945, k. 3 – 8
  6. AIPN GK, Protokół Rozprawy Głównej w sprawie Fischera i innych , 196/76, Zeznania Józefa Gitlera Barskiego, www.zapisyterroru.pl
  7. AIPN GK, Akta w sprawie oskarżenia Ludwika Fischera i innych, 196/64, Zeznania Jakuba Pensona, [w:] www.zapisyterroru.pl
  8. AIPN GK, Protokół Rozprawy Głównej w sprawie Fischera i innych, 196/76, Zeznania Jakuba Pensona, [w:] www.zapisyterroru.pl
  9. AIPN GK, Akta w sprawie oskarżenia Ludwika Fischera i innych,,196/64, Zeznania Tadeusza Radwańskiego, [w:] www.zapisyterroru.pl
  10. AIPN GK, Akta w sprawie oskarżenia Ludwika Fischera i innych, 196/64, Zeznania Stanislawa Adlera, [w:] www.zapisyterroru.pl
  11. AIPN GK, Protokół Rozprawy Głównej w sprawie Fischera i innych, 196/76, Zeznania Ludwika Hirszfelda, [w:] www.zapisyterroru.pl
  12. AIPN GK, Akta w sprawie oskarżenia Ludwika Fischera i innych, 196/64, Zeznania Mikołaja Łąckiego, [w:] www.zapisyterroru.pl
  13. AIPN GK, Protokół Rozprawy Głównej w sprawie Fischera i innych ,196/76, Zeznania Józefa Maciejuka (Moszka Gelbkrona), [w:] www.zapisyterroru.pl
  14. AIPN GK, Protokół Rozprawy Głównej w sprawie Fischera i innych, 196/64, Zeznania Bolesława Mirowskiego (Jerzego Landaua), [w:] www.zapisyterroru.pl
  15. AIPN GK, Protokół Rozprawy Głównej w sprawie Fischera i innych, 196/76, Zeznania Zygmunta Warmana, [w:] www.zapisyterroru.pl 



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