The purpose of the following paper is to examine the history of yellow fever within the United States. With the use of articles and a book on the subject, this paper will look at the response of the United States government to the spread of yellow fever, as well as the methods employed to study and combat the disease. The reemergence of yellow fever both in the United States and abroad will also be considered.
Yellow fever or “yellow jack” is a name many will recognize, especially in the United States. But awareness of the infectious disease is probably more literary than it is medical. Yellow fever often appears in works of nineteenth-century literature, but the historical reality and impact of the disease should not be neglected or underestimated. The following sections will examine the history of yellow fever in the United States, the efforts expended to study and remedy the disease, and the current status of yellow fever both within the country and at large.
The exact origin of yellow fever is a mystery, though its place of birth can be traced to the forests of Africa (Crosby, 2007). The disease is carried and spread by the female Aedes Aegypti mosquito, though that fact was not discovered until the late nineteenth-century (Bryant, Holmes, & Barrett, 2007; Frierson, 2010). Yellow fever first manifests itself as a fever and headache, and in fatal cases, moves on to induce kidney failure and internal hemorrhaging (Crosby, 2007). Earning its name from the yellowing it induces on the skin and eyes, the deadly virus eventually became associated with the European slave trade and shipping industry (Crosby, 2007).
The spread of yellow fever to North America was inevitable. In her book on the history of the disease, Crosby (2007) discusses the arrival of yellow fever on the shores of the future United States, and links it to the prolific African slave trade of the eighteenth-century. “As each slave ship arrived into the ports of the New World, bringing over ten million slaves to this hemisphere, yellow fever made a giant, evolutionary leap. It adapted. It spread” (p. 12). With its unveiling in North America, yellow fever would go on to establish a reign of terror there for two-hundred years (Crosby, 2007). The most devastating epidemic would occur throughout the Mississippi River Valley in 1878. An unseasonably warm winter brought with it swarms of infected mosquitoes and coupled with the many European immigrants not immune to the virus, resulted in the deaths of 20,000 people (Crosby, 2007). It is clear that yellow fever, in many ways, dominated early American history, and its horrific spread would have continued were it not for the determined efforts of individuals anxious to terminate its grip.
The devastating effects of yellow fever in America throughout the nineteenth century demanded a response from the government. Unsuccessful attempts had been made to create a bacterial vaccine for the disease, and it was not until Dr. George Sternberg was appointed U.S. surgeon general in 1900 that progress began to be made (Frierson, 2010). Sternberg created the Yellow Fever Commission. Led by Walter Reed, the commission finally established that mosquitoes were responsible for communicating the disease. But the efforts of the commission to produce a viable vaccine met with failure (Frierson, 2010).
While the U.S. government confined its strategy for combating yellow fever to mosquito control (Frierson, 2010), others were forging ahead to find a successful immunization. The International Health Division of the Rockefeller Institute began the arduous journey of discovering a vaccination for yellow fever. Their early efforts were marked by trial and error, including the production of a vaccine that was later withdrawn due to its ineffectiveness. (Frierson, 2010). In his article, Frierson (2010) discusses the difficult process of producing a vaccine to combat yellow fever. “The problems of attenuation of the virus in tissue culture, its large-scale manufacture in eggs, and elimination of contaminants all pushed the limits of scientific knowledge of the time” (p. 10). It was Max Theiler who discovered that by hosting and passing the virus through the brains of mice, he could create an attenuated strain of it. A combination of the altered strain with serum from immune humans produced a workable, though flawed, vaccine. Max Theiler and Hugh Smith later perfected the vaccine during the 1930s and it came to be known as 17D (Frierson, 2010). With the application of 17D, countless lives have been saved around the world, and the terror once inspired by yellow fever has diminished significantly. But what is the current status of the infamous disease both in the United States and abroad?
Could yellow fever reign again? The possibility might not be as unthinkable as it initially seems. Yellow fever still manages to claim 30,000 lives every year and is expanding in West Africa due to poor vaccination programs (Bryant et al., 2007). In a New York Times article, Grady (2002) considers the probability of global warming assisting in the spread of infectious diseases like the West Nile virus, which shares the same genus as yellow fever (Bryant et al., 2007). In their study of the molecular structure of yellow fever, Bryant et al. (2007) raise concerns about an all too familiar method of spreading disease. “Global trade and transportation in the modern era continues to facilitate the movement of pathogens and vectors farther and faster than ever before, thus altering the potential geographic distribution of infectious diseases” (Results/Discussion section, para. 7). It is sobering to consider the possibility of yellow fever spreading the same way it did three-hundred years ago, only now with the aid of modern technology. Nevertheless, the danger is a very real one and requires vigilance on the part of humanity. The ongoing study of infectious diseases and the discovery of methods to alleviate their effects must continue and be given precedence.
The significance of yellow fever to the history of the United States cannot be denied. Through the bite of mosquitoes, the disease wreaked havoc for two centuries, and it was not until the early twentieth-century that a successful vaccine was discovered. Today, the threat of infectious disease remains, particularly in less developed countries, and can be distributed through climate or modern modes of transportation. The history of yellow fever both in America and around the world should teach us that the battle against disease never ends. Though methods of combating it may prove successful, complacency should never become our habit. As sure as there will always be mosquitoes, infectious disease will remain a nefarious tenant of the natural world, and therefore the responsibility of mankind.
Bryant, J.E., Holmes, E.C., Barrett, A.D.T. (2007). Out of Africa: A molecular perspective on the introduction of yellow fever virus into the Americas. PLoS Pathog 3(5): e75. doi:10.1371/journal.ppat.0030075
Crosby, M.C. (2007). The American plague: The untold story of yellow fever, the epidemic that shaped our history. New York, NY: Berkley Books.
Frierson, J.G. (2010). The yellow fever vaccine: A history. Yale Journal of Biology and Medicine, 83. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892770/#__ffn_sectitle
Grady, D. (2002, August 20). Managing planet Earth: On an altered planet, new diseases emerge as old ones re-emerge. The New York Times. Retrieved from http://www.nytimes.com/2002/08/20/science/managing-planet-earth-altered-planet-new-diseases-emerge-old-ones-re-emerge.html?pagewanted=1