Yellow fever historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
Yellow fever has had an important role in the history of Africa, the Americas, Europe, and the Caribbean. Scientists believe that yellow fever evolved in Africa around 3,000 years ago. [1] In 1937 Max Theiler working at the Rockefeller Foundation developed a vaccine for yellow fever that gives a ten-year or more immunity from the disease and effectively protects people traveling to affected areas, while at the same time being a means to control the disease.
Historical Perspective
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Europe 541-549
Fragile after the fall of Rome, Europe was further weakened by "Yellow Plague" (Yellow Fever). The Byzantine Empire suffered as well.[2]
1600s
- Yellow fever was imported into the Western Hemisphere on slave ships from West Africa.
- In 1648, the first definitive evidence of yellow fever in the Americas was in Mayan manuscripts describing an outbreak of the disease in the Yucatan and Guadeloupe.
- Outbreaks were reported on the eastern coast of the United States, including in New York (1668), Boston (1691), and Charleston (1699).
1700s
- In the 1700s the yellow fever spread to Europe.
- In 1730, one of the first epidemics described, 2,200 deaths were reported in Cadiz, Spain. This epidemic was followed by outbreaks in French and British seaports. Over the next century, widespread epidemics were recorded in tropical and subtropical areas of the Americas, including the West Indies, Central America, and the United States.
Havana, Cuba: 1762-1763
- British and American colonial troops died by the thousands in Havana between 1762-1763.
- Epidemics struck coastal and island communities throughout the area during the next 140 years.
Philadelphia: 1793
- In 1793, the largest yellow fever epidemic in American history killed as many as 5,000 people in Philadelphia, Pennsylvania—roughly 10% of the population.[3]
- At the time, the port city was the largest in the United States, as well as the seat of U.S. government (prior to establishment of the District of Columbia). Philadelphia had recently seen the arrival of political refugees from the Caribbean. The summer that year was especially hot and dry, leaving many stagnant water areas as ideal breeding grounds for mosquitoes. The yellow fever outbreak began in July and continued through November, when cold weather finally eliminated the breeding ground for mosquitoes, although the connection had not yet then been established.
- Thousands of Philadelphians, including prominent government officials like George Washington and Alexander Hamilton fled the national capital.
- Benjamin Rush, the city's leading physician and a signer of the United States Declaration of Independence, advocated the bloodletting of patients to combat the disease, but the treatment was controversial. Stephen Girard also helped supervise a hospital established at Bush Hill, a mansion just outside Philadelphia. Though many high-ranking people of Philadelphia fled, a few officials stayed. Mayor Matthew Clarkson as well as the mayor's committee tried to hold the city together as the death toll increased.[4]
- Matthew Carey published a fast-selling chronicle of the yellow fever crisis, A short account of the Malignant Fever, Lately Prevalent in Philadelphia that went through four editions.
- Although other ethnic groups were included, Carey's account failed to include the involvement of the city's African Americans in the community's response and relief efforts, despite the fact that African American leaders Richard Allen and Absalom Jones had rallied their church community to assist victims.
- Allen and Jones subsequently wrote a pamphlet, Narrative of the Proceedings of the Black People, During the Late Awful Calamity in Philadelphia, which detailed the contributions of the African Americans during the epidemic.[5]
1800s
- Until the mid-1800s, scientists believed yellow fever was spread by direct contact with infected individuals or contaminated objects.
- The first suggestions that the vector might be a mosquito were made by the American physician Josiah Clark Nott in 1848 and by Cuban physician Carlos Finlay in 1881.
- Between 1839 and 1860, annual outbreaks in New Orleans led to more than 26,000 cases of yellow fever.
- Yellow fever caused difficulties for the US Army in Cuba during the Spanish-American War; reportedly more soldiers died of the disease than in battle. The ongoing outbreaks prompted military efforts for further research and the formation of the Reed Yellow Fever Commission led by Walter Reed, an American army surgeon.
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 dwindled out 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).
Norfolk, Virginia: 1855
- A ship carrying persons infected with the virus arrived in Hampton Roads in southeastern Virginia in June of 1855.
- 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.
1900s
- The Reed Yellow Fever Commission proved that yellow fever infection is transmitted to humans by the Aedes aegypti mosquito, later determined to be the vector of the urban transmission cycle of yellow fever virus.
- Following the demonstration that Ae. aegypti mosquitoes are responsible for transmission of the yellow fever virus to humans, intense sanitation programs began in Panama and Havana, Cuba. These efforts led to the eradication of the disease in these areas.
- Eradication of yellow fever in Panama enabled completion of the Panama Canal in 1906. The previous construction had been hampered severely by yellow fever infection among the workers.
- In 1930s, two yellow fever vaccines were developed, the 17D vaccine and the French neurotropic vaccine.
2000s
- Yellow fever vaccine was incorporated into the routine childhood vaccinations of several South American and African countries.
- Although this strategy decreases the number of persons susceptible to the disease over time, a large portion of the at-risk population is not covered in the short term.
- Hundreds of cases of yellow fever from endemic countries in South America and Africa are still reported annually to the World Health Organization (WHO).
Carlos Finlay and Walter Reed
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- Carlos Finlay, a Cuban doctor and scientist, first proposed proofs in 1881 that yellow fever is transmitted by mosquitoes rather than direct human contact.[7]
- Dr.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.[8]
- The acceptance of Finlay's work was one of the most important and far-reaching effects of the Walter Reed Commission of 1900.[9]
- 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's efforts were recognized while most of the scientific community ignored Finlay's methods of mosquito control.
- 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; according to the PBS American Experience documentary The Great Fever, houses were fumigated, cisterns for drinking water were inspected, and pools of standing water were treated 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.
References
- ↑ "Centers for Disease Control and Prevention (CDC). Yellow Fever: History, Epidemiology and Vaccination Information. (Internet). Atlanta, GA: US Department of Health and Human Services, CDC; 2010".
- ↑ "The Yellow Plague". Oxford Journals. Retrieved 2006-11-08.
- ↑ "Yellow Fever Attacks Philadelphia, 1793". EyeWitness to History. Retrieved 2007-06-22.
- ↑ "The Death of "Yellow Jack" (Angelo, M)". JEFFline Forum. Retrieved 2006-04-18.
- ↑ Laurie Halse Anderson (2002). Fever 1793. Aladdin. ISBN 0-689-84891-9.
- ↑ http://wellcomeimages.org/
- ↑ Chaves-Carballo E (2005). "Carlos Finlay and yellow fever: triumph over adversity". Mil Med. 170 (10): 881–5. PMID 16435764.
- ↑ "General info on Major Walter Reed". Major Walter Reed, Medical Corps, U.S. Army. Retrieved 2006-05-02.
- ↑ "Phillip S. Hench Walter Reed Yellow Fever Collection". UVA Health Sciences: Historical Collections. Retrieved 2006-05-06.