Yellow fever
The disease that exterminated five million people
In 1894, renowned French developer Ferdinand de Lesseps, after some rest on the laurels of the Suez Canal construction, started the second great project of his life: the construction of another canal, this time in Panama, that would join the Atlantic and Pacific Oceans. But the Sinai desert had nothing on the jungles of Central America. An epidemic broke out on the huge construction site, killing two-thirds of the workmen and, shortly afterwards, Lesseps himself. That was the infamous yellow fever. The project was abandoned, and was finished much later by the Americans, only after a way to fight the disease had been found.
Yellow fever was first mentioned in 1648, and is up there with the greatest and most lethal infections that humankind has known, like the plague of the Peloponnesian War, the disease that Mark Antony’s legions brought to Rome from Mesopotamia, the Black Death of the Middle Ages, the Great Plague of London. Yellow fever was considered a disease of the New World, because that is where it was first noted, but, as it was proven much later, it had existed long before in Africa.
The particular disease was awful and its symptoms horrible. It started with pain in the stomach, the joints and bones, followed by convulsions and black viscous vomit, and continued with rashes all over the body, fever, coma and death. That development unfolded within five days and its mortality rate was almost 100%. It first appeared in Guadelupe in 1648, before moving to Cuba, New York, South Carolina, Boston. Wherever it arrived, people died in droves. All the traditional defence methods – quarantines, isolations, disinfections – proved useless. For two centuries, yellow fever appeared out of the blue and killed people without anyone knowing how it was transmitted. In the tropics it was endemic. In temperate places it appeared in spring and summer. Neither the cremation of the dead nor the disinfection of houses and ships could stop it.
In 1741, yellow fever exterminated three-quarters of the English troops at the siege of Cartagena. In 1799, it killed 31,000 people around the Caribbean. In 1878, another 25,000 victims followed suit. The disease was terrifyingly contagious. In 1781, a frigate sailed from the Honduras towards Port Royal, in Jamaica; it never arrived, and, when found drifting aimlessly, some time later, it was revealed that the entire crew had died of yellow fever.
Years went by, the fever claimed more and more victims, but medicine could not find a cure. The English and French sugarcane plantation owners, to save themselves, abandoned Jamaica and Martinique and returned to their cooler countries, leaving their properties and slaves in the hands of their halfbreed overseers. Medicine, wrapped in a cocoon of conservatism, refused for decades to adopt new ideas in order to find the cause of the disease. Yellow fever had been classified as a contagious miasma, an incurable disease of the New World, and was persistently ignored, despite its lethality. Two of its worst outbreaks occurred in New Orleans in 1853 and in the American Southwest in 1878, with 25,000 victims.
On 14 August 1881, a pioneer doctor named Carlos Finlay overcame traditional beliefs and, in a speech before the Royal Academy of Havana, expressed for the first time the view that yellow fever was transmitted by mosquitoes of the genus Aedes Aegypti. The Academy doctors laughed and rejected Finley’s theories, branding them ridiculous. Twenty more years passed, and the disease kept killing. An eminent bacteriologist, Giuseppe Sanarelli, based on the old views, claimed that the fever was caused by a bacillus that he called “icteroid”. His theory was immediately accepted and acclaimed, while the unknown doctor’s view had been ridiculed.
Three decades later, the Americans who occupied Cuba, seeing that the disease would not abate, remembered Carlos Finlay, who was old by that time. Finlay helped, despite his bitterness, and the appointed committee concluded that the fever was spread by the mosquitoes. So, in order to fight it, they had to disinfect the standing waters in the marshes and cisterns and destroy the mosquitoes’ eggs. The American military accomplished that by putting fish in the cisterns, that ate the floating eggs. Yellow fever receded from Cuba.
In the rest of America, however, civilian doctors refused to accept the conclusions of their military colleagues; the usual medical rivalries. So, while the problem was solved in Cuba, there was a new outbreak in the mainland, which was not treated, as yellow fever was still considered an incurable disease. Only when the epidemic crossed over to Cuba again and was repelled once more did they deign to check the new method and adopt it. After 1910, yellow fever was practically eradicated, after exterminating an estimated five million people in two centuries.
I am left with the impression that, in the end, history allows medicine to cure a grave disease only when the conditions are ripe for the surfacing of another, much more lethal, one which will also be considered incurable for a long time.
© Dimitris Kambourakis 2003, All Rights Reserved
Translation from the Greek © M.A.K. 2008, All Rights Reserved
Posted by Mary Contrary 