In the winter of 1862, a serious epidemic of smallpox broke-out among Confederate prisoners in a Union prisoner-of-war camp in Alton, IL. Rather than run the risk of infecting residents of Alton, prison officials moved the sick prisoners to Sunflower Island, out in the middle of the Mississippi River. Not surprisingly, it became a place where men went to die. Smallpox Island is a good indicator of the understanding Civil War-era medical personnel had regarding sanitation, infection, and contamination.