YELLOW FEVER

YELLOW FEVER. The first reference to yellow fever in America is found in that indispensable sourcebook The History of New England (1647) by John Winthrop, governor of Massachusetts. The effort of the colonial court to exclude from Massachusetts the crew and the cargo of the ship that had brought the fever ("Barbados distemper") from the West Indies to America was the colonies' initial enforcement of quarantine. Later, in 1694, British ships that had sailed from Boston in an unsuccessful effort to capture Martinique brought back an epidemic of yellow fever, and subsequently, despite its endemic focus on the African coast, yellow fever emerged as a peculiarly American disease ("the American plague"). It spread through America as the African slave trade increased. With the single exception of smallpox, the most dreaded verdict on the lips of a colonial physician was "yellow fever."

The worst American epidemic of yellow fever occurred in 1793 and doomed the supremacy of Philadelphia among U.S. cities. Approximately 10 percent of the city's population died from the disease. Forty years later, the combined effects of yellow fever and cholera killed about 20 percent of the population of New Orleans. The last epidemic of yellow fever in the United States occurred in New Orleans in 1905.

Recurring epidemics of yellow fever and cholera led to the formation of municipal health boards in most major U.S. cities by mid-nineteenth century. But for much of that century, these agencies had few powers. Their lack

of authority was, in part, due to distrust of the medical profession—a distrust fed by the inability of physicians to satisfactorily explain epidemic diseases. One camp of physicians argued that yellow fever was transmitted by touch and called for strict quarantines. Other physicians supported the "miasm" theory and argued that yellow fever was carried through the air by poisonous gases (miasm) emitted by rotting vegetation or dead animals. They called for swamp drainage and thorough cleaning of streets and abandoned buildings.

In 1900 the U.S. Army Yellow Fever Commission, with Walter Reed, James Carroll, Jesse W. Lazear, and Aristides Agramonte, was sent to track the pestilence in Cuba. The group, working with the aid of Carlos J. Finlay, demonstrated Finlay's theory that the infection is not a contagion but is transmitted by the bite of the female Aëdes aegypti mosquito. William Crawford Gorgas, chief sanitary officer of the Panama Canal Commission from 1904 until 1913, eliminated the mosquito in the region of the canal and made possible the building of the Panama Canal. Vaccines against the disease were developed in the early 1940s and today are required of anyone traveling to a hazardous area.

BIBLIOGRAPHY

Carrigan, Jo Ann. The Saffron Scourge: A History of Yellow Fever in Louisiana, 1796–1905. Lafayette: University of Southwestern Louisiana, Center for Louisiana Studies, 1994.

Ellis, John H. Yellow Fever and Public Health in the New South. Lexington: University Press of Kentucky, 1992.

Foster, Kenneth R., Mary F. Jenkins, and Anna Coxe Toogood. "The Philadelphia Yellow Fever Epidemic of 1792." Scientific American 279, no. 2 (August 1998): 88.

Humphreys, Margaret. Yellow Fever and the South. New Brunswick, N.J.: Rutgers University Press, 1992.