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History of yellow fever

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History

Photograph taken during the 1965 Aedes aegypti eradication program in Miami, Florida

West Africa has long been regarded as the home of yellow fever.[1] Yellow fever has had an important role in the history of Africa, the Americas, Europe, and the Caribbean.

Cuba: 1762–1763

British and American colonial troops died by the thousands in the British expedition against Cuba between 1762 and 1763. Epidemics struck coastal and island communities throughout the area during the next 140 years, with 10% of the population dying as a result.

Philadelphia, Pennsylvania: 1793

The Yellow Fever Epidemic of 1793 killed as many as 10,000 people in Philadelphia, Pennsylvania.[2] Thousands, including President George Washington, fled the city, including most members of the Federal (Philadelphia was the capital of the United States at this time) and city governments. As a result, civil services collapsed and almost vanished. However, the mayor remained and eventually, with the help of a "Committee of Twenty" composed of volunteer residents drawn from all walks of life, order and civil services were restored.[3] Members of the Free African Society, a charitable organization of African-Americans originally founded as a self-help group, were instrumental in this regard. They served as nurses and home-care attendants, often for no pay, and Mayor William Clarkson later praised their work when racist claims of price-gouging and theft were raised.[3]

Although many other well-to-do citizens chose to leave the city, Stephen Girard stayed to care for the sick and dying. He supervised the conversion of a mansion outside the city limits into a hospital and recruited volunteers to nurse victims, and personally cared for patients. For his efforts, Girard was feted as a hero by the City Hall after the outbreak subsided.[4]

The first family of Dolley Madison, née Dolley Payne, who would later become First Lady of the United States during James Madison's administration, was stricken in this epidemic. John Todd, Dolley's husband, was a Quaker and a lawyer. He felt it was his duty to remain in Philadelphia and provide legal services (wills, probate, etc.) to those who were dying or the families of those who died. However, he moved his family across the river. One day on a visit to his family, he collapsed into his wife's arms on the doorstep of their house and died soon after. Dolley and her eldest son, John Payne Todd, contracted yellow fever but survived. Dolley's youngest son William Temple Todd and John's parents also perished in the 1793 epidemic.[3] Alexander Hamilton and his wife, Elizabeth Schuyler, contracted yellow fever but survived.

Dr. Benjamin Rush also contracted yellow fever, but survived. His fame, as a signer of the Declaration of Independence and as head medical doctor for the American army in the middle Atlantic states region during the American Revolution, brought him hundreds, perhaps thousands, of patients during this epidemic. His methods were severe and split the medical community at that time, resulting in an ongoing letter-writing war in the press both during and after the epidemic. Some contemporaries, notably William Cobbett, objected to Rush's extreme use of bloodletting. Cobbett accused Rush of killing more patients than he had saved. Rush sued Cobbett for libel, winning a judgment of $500.[5] However, unlike a number of other doctors, he remained in Philadelphia and did his best to help the residents who were struck down by the disease.[6]

At the time of the Philadelphia epidemic, the most widespread belief was that the disease spread via contaminated water. A "Watering Committee" was appointed and recommended a municipal water supply, which came into use in 1801. The initial installation, by Benjamin Latrobe, was inefficient and unreliable, and was replaced in 1812-1815. Of course the water system did nothing directly to alleviate yellow fever, but it allowed city residents to remove their makeshift arrangements of wells and cisterns, which had provided breeding places for mosquitoes. Thus, the desired effect was actually achieved.

Haiti: 1802

In 1802, an army of forty thousand sent by First Consul Napoleon Bonaparte of France to Haiti to suppress the Haitian Revolution was decimated by an epidemic of yellow fever (including the expedition's commander and Bonaparte's brother-in-law, Charles Leclerc). Some historians believe Haiti was to be a staging point for an invasion of the United States through Louisiana (then still under French control).[7]

New Orleans, Louisiana: 1853

This outbreak claimed 7,849 residents of New Orleans. The press and the medical profession did not alert citizens of the outbreak until the middle of July, after over a thousand had already died. The reason for this silence was that the New Orleans business community feared that word of an epidemic would cause a quarantine to be placed on the city, and commerce would thus be hurt.

Norfolk, Virginia: 1855

A ship carrying persons infected with the virus arrived in Hampton Roads in southeastern Virginia in June 1855.[8] The disease spread quickly through the community, eventually killing over 3,000 people, mostly residents of Norfolk and Portsmouth. The Howard Association, a benevolent organization, was formed to help coordinate assistance in the form of funds, supplies, and medical professionals and volunteers which poured in from many other areas, particularly the Atlantic and Gulf Coast areas of the United States.

Memphis, Tennessee: 1878

There were several outbreaks of yellow fever in Memphis during the 1870s, culminating in the devastating 1878 epidemic, with over 5,000 fatalities in the city itself and 20,000 along the whole of the Mississippi River Valley. It has been claimed that the large death toll was due to commercial interests taking precedence over reporting the outbreak of yellow fever.[9]

The French Panama Canal Effort: 1882–1889

The French effort to build a Panama Canal was fatally damaged by the prevalence of endemic tropical diseases in the Isthmus. Although malaria was also a serious problem for the French canal builders, the numerous yellow fever fatalities and the fear they engendered made it difficult for the French company to retain sufficient technical staff to sustain the effort. Since the mode of transmission of the disease was unknown, the French response to the disease was limited to care of the sick. Unfortunately, the French hospitals contained many pools of stagnant water, such as basins underneath potted plants, in which mosquitoes could breed. The eventual failure, as a result of the deaths, of the French company licensed to build the canal resulted in a massive financial crisis in France.[10]

Carlos Finlay and Walter Reed

An entomologist demonstrates the attraction of female yellow fever mosquitoes to his hand in an olfactometer.

Carlos Finlay, a Cuban doctor and scientist, first proposed proofs in 1881 that yellow fever is transmitted by mosquitoes rather than direct human contact.[11] Walter Reed, M.D., (1851–1902) was an American Army surgeon who led a team that confirmed Finlay's theory. This risky but fruitful research work was done with human volunteers, including some of the medical personnel, such as Clara Maass and Walter Reed Medal winner surgeon Jesse William Lazear, who allowed themselves to be deliberately infected and died of the virus.[12] Although Dr. Reed received much of the credit in history books for "beating" yellow fever, Reed himself credited Dr. Finlay with the discovery of the yellow fever vector, and thus how it might be controlled. Dr. Reed often cited Finlay's papers in his own articles and gave him credit for the discovery, even in his personal correspondence.[13] The acceptance of Finlay's work was one of the most important and far-reaching effects of the Walter Reed Commission of 1900.[14] Applying methods first suggested by Finlay, the elimination of yellow fever from Cuba was completed, as well as the completion of the Panama Canal. Lamentably, almost 20 years had passed before Reed and his Board began their efforts, twenty years during which most of the scientific community ignored Finlay's theory of mosquito transmission.

Finlay and Reed's work was put to the test for the first time in the United States when a yellow fever epidemic struck New Orleans in 1905, although efforts had been successful in Havana since 1901. A conference organized in New Orleans in 1905 by Dr. A. L. Metz resulted in President Roosevelt directing the United States' Government to take control of the matter.[15] The United States Public Health Service put into effect a mosquito control campaign,[16] this included, fumigating houses, inspecting cisterns for drinking water, and treating pools of standing water with kerosene. The result was that the death toll from the epidemic was much lower than that from previous yellow fever epidemics, and that there has not been a major outbreak of the disease in the United States since. Although no cure has yet been discovered, an effective vaccine has been developed, which can prevent and help people recover from the disease.

  1. ^ Cite error: The named reference History was invoked but never defined (see the help page).
  2. ^ "Yellow Fever Attacks Philadelphia, 1793". EyeWitness to History. Retrieved 2007-06-22.
  3. ^ a b c Murphy, J. 2003. An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793. Clarion Books. ISBN 0-395-77608-2.
  4. ^ Wilson, George (1995). Stephen Girard. Conshohocken: Combined Books. pp. 121–133. ISBN 093828956X.
  5. ^ Fruchtman, Jack (2005). Atlantic Cousins: Benjamin Franklin and His Visionary Friends. New York: Thunder's Mouth Press.
  6. ^ Powell, J.H. 1949. Bring Out Your Dead: The Great Plague Of Yellow Fever In Philadelphia In 1793. University of Pennsylvania Press. ISBN 1432576623.
  7. ^ Bruns, Roger (2000). Almost History: Close Calls, Plan B's, and Twists of Fate in American History. Hyperion. ISBN 0786885793.
  8. ^ Mauer HB. "Mosquito control ends fatal plague of yellow fever". etext.lib.virginia.edu. Retrieved 2007-06-11. {{cite web}}: Unknown parameter |accessyear= ignored (|access-date= suggested) (help) (undated newspaper clipping).
  9. ^ Crosby, MC. 2006. The American Plague: The Untold Story of Yellow Fever, the Epidemic That Shaped Our History. Berkley Books. ISBN 0-425-21202-5.
  10. ^ The Path Between the Seas: The Creation of the Panama Canal, 1870–1914, David McCullough, Simon & Schuster, 1978 (a comprehensive history of the building of the canal).
  11. ^ Chaves-Carballo E (2005). "Carlos Finlay and yellow fever: triumph over adversity". Mil Med. 170 (10): 881–5. PMID 16435764.
  12. ^ "General info on Major Walter Reed". Major Walter Reed, Medical Corps, U.S. Army. Retrieved 2006-05-02.
  13. ^ Pierce J.R., J, Writer. 2005. Yellow Jack: How Yellow Fever Ravaged America and Walter Reed Discovered its Deadly Secrets. John Wiley and Sons. ISBN 0-471-47261-1.
  14. ^ "Phillip S. Hench Walter Reed Yellow Fever Collection". UVA Health Sciences: Historical Collections. Retrieved 2006-05-06.
  15. ^ "Biography of METZ, Abraham L." Retrieved 2008-08-16.
  16. ^ "Medical Timeline". Retrieved 2008-08-06.
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