The evolutionary origins of yellow fever most likely lie in Africa.[1] It is assumed that the virus originated from East or Central Africa and spread from there to West Africa. The virus as well as the vector Ae. aegypti, a mosquito species, were probably brought to South America by ship after 1492. The first probable outbreak of the disease was in 1648 in Yucatan, where the illness was termed xekik (black vomit). At least 25 major outbreaks followed, such as in Philadelphia 1793, where several thousand people died and the American administration as well as George Washington had to flee the city.[2] Major outbreaks also occurred in Europe, e.g. in 1821 in Barcelona with several thousand victims. 1878, about 20,000 people died in an epidemic in the Mississippi River Valley and the last major outbreak in the US occurred in 1905 in New Orleans.[3]
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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 (among the casualties was 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).[4]
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. The outbreak was dramatized, in part, and played a crucial role in the plot of the 1938 film Jezebel starring Bette Davis.
A ship carrying persons infected with the virus arrived in Hampton Roads in southeastern Virginia in June 1855.[5] 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.
The entire Mississippi River Valley from St. Louis south was impacted, as tens of thousands fled the stricken cities of New Orleans, Vicksburg, and Memphis. An estimated 120,000 cases of yellow fever resulted in some 20,000 deaths.[6]
There were several outbreaks of yellow fever in Memphis during the 1870s, culminating in the devastating 1878 epidemic (called the Saffron Scourge of 1878 ), 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.[7]
In 1878 the worst yellow fever epidemic Mississippi had seen ravaged the state. The disease, sometimes known as 'Yellow Jack,' and 'Bronze John,' devastated Mississippi socially and economically. Entire families were wiped out while others fled their homes in panic for the presumed safety of other parts of the state. Quarantine regulations, passed to prevent the spread of the disease, brought trade to a stop. Some local economies never recovered. Beechland, near Vicksburg, became a ghost town because of the epidemic. By the end of the year, 3,227 people had died from the disease. [8]
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.[9]