Initially, no official announcement was made concerning Harrison's illness, which fueled public speculation and concern the longer he remained out of public view. By the end of the month, large crowds were gathering outside the White House, holding vigil while awaiting any news about the president's condition. Harrison died on April 4, 1841, nine days after becoming ill and exactly one month after taking the oath of office; he was the first president to die in office. Jane McHugh and Philip A. Mackowiak did an analysis in Clinical Infectious Diseases (2014), examining Dr. Miller's notes and records of the White House water supply being downstream of public sewage, and they concluded that he likely died of septic shock due to 'enteric fever' (typhoid or paratyphoid fever). His last words were to his attending doctor, though assumed to be directed at Vice President John Tyler:
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