6. Yellow Fever in the Americas

Question 1

What is yellow fever? 5

Answer 1

1. viral with mosquito vector
2. originated in west africa
3. slaves carried it to americas, when they went to work on sugar, cotton and tobacco plantations in the caribbean, south and southern americas
4. has remained a problem
5. deforestation led to stagnant water and sugar can provided a food source, creating the perfect conditions for it

Question 2

Describe yellow fever in the 18thC. 3

Answer 2

1. 1791 - french revolution outbreak on saint-dominique
2. yellow fever very prevalent in north american/caribbean trade ports eg. new orleans and phili, then capital
3. quarantine began

Question 3

Describe the factors that led to the yellow fever outbreak in saint-dominque (now haiti). 6

Answer 3

1. 1791-1804 slave leaders in haiti led revolution against french rulers and slave system
2. french attempted to repress outbreak therefore many soldiers travelling to area and around it
3. not immune so suffered greatly
4. rebellion spread to other caribbean islands eg. jamaica (british)
5. new influx of soldiers to control leading to spread of disease
6. haiti declared independence

Question 4

How did yellow fever spread in the USA and what was done? 6

Answer 4

1. epidemic spread to southern plantations and port cities of usa
2. 1790s- post-american revolution (slump) expansion of plantations began
3. slaves imported, so more goods, traffic etc, leading to crowded ports, increasing the spread of yellow fever
4. benjamin rush, philidelphia physician, believed 1793 epidemic originated in rotting coffee beans on dock and began to clean up phili
5. 1792-3 epidemic encouraged use of quarantine efforts in port cities
6. by 1815, no loner a major threat in USA due to precautions, but persisted in new orleans and caribbean and south america

Question 5

Who was oswaldo cruz? 3

Answer 5

1. doctor trained in pasteur institute
2. began clean up in rio de janeiro
3. ordered spraying of rooves to prevent yellow fever

Question 6

Describe the american preoccupation with cuba. 3

Answer 6

1. justified interest by claiming yellow fever in havana was a threat to the usa
2. invaded in 1898
3. yellow fever had not been studied, so americans arrived to study in havana in late 19thC

Question 7

How was the cause of yellow fever discovered? 9

Answer 7

1. carlos finlay, a cuban and pasteurian doctor, had suggested that mosquitoes were a vector for the yellow fever parasite - ignored
2. major walter reed, a bacteriologist, experiemented in camp lazear, cuba
3. hut 1 - people put in with a screen and blankets etc. covered in yellow fever vomit and waste - people did not fall ill
4. hut 2- people put in with mosquitoes, screen in middle as control
5. mosquito hut people got malaria
6. reed invited finlay to view his experiment
7. army brought in to every home - fumigation and removal of mosquitoes and water
8. the following year, only one death from yellow fever instead of 300
9. yellow fever continued to affect rural towns as they were not cleared

Question 8

What relationship did the panama canal have to yellow fever? 5

Answer 8

1. opened in 1914
2. fever of yellow fever from immigrants in america and also fears from asia
3. willian gorgas, a sanitary official in havana, began mosquito clearance
4. appointed to panama canal region during building
5. cleaned as in havana
6. no major yellow fever outbreaks after his work

Question 9

What is heroic medicine, and who are classed as the heroes? 6

Answer 9

1. scientists like manson, ross, pasteur, finlay, reed, gorgas and cruz became known as those who performed heroic medicine
2. doctrine of health forcefully pressed on people
3. relocated people, chemical spraying
4. central roles in international disease eradication
5. defined local and international health policies and diplomacy
6. this was a very masculine, confident and somewhat aggressive form of science

Question 10

Describe the events that led up to the formation of the pan-american health organisation (PAHO). 5

Answer 10

1. 5th international sanitary conference in washington DC in 1880
2. USA pushed for resolution to protect usa ports from yellow fever
3. 1901 - details about yellow fever, cholera and plague became clear by now, and in usa, international sanitary bureau formed in 1902 to deal with these threats
4. 1901 - second international sanitary conference of american states in mexico city, PAHO recommended with DC headquarters, showing increasing power of usa
5. first international sanitary convention of american republics in 1902, following series of meetings led to american sanitary organisaiton in 1947, and PAHO in 1958

Question 11

summarise the 2006 paper by m. espinosa about the us intervention in cuba and how this was related to yellow fever.

Answer 11

1. after 1897 epidemic, the american government was fixed on stopping another from cuba
2. the usa intervened in cuba/spain war for several reasons, incl trade, pity and yellow fever
3. 1897 - yellow fever in new orleans caused mass panic and shut down transport links
4. several southern cities eg. jackson and housten were worried, quarantine imposed and businesses closed. many fled
5. impacted economy - shares in south, then new york, dropped in value
6. yellow fever brought via ocean springs and smugglers from havana
7. 1878 - huge epidemic originating in havana, 120 000 ill, 20 000 died
8. 1879 - us national board of health sent the havana yellow fever comission to cuba to investigate
9. it was thought that the poor cuban sanitation led to yellow fever, and usa ordered improvement, but spain couldn’t afford this so it fell to residents
10. meanwhile, a strict spanish-style quarantine was imposed in the states and integrated by late 1880s
11. constant flow between cuba and florida was a threat to public health
12. during the cuban war for independence, revenue cutters patrolled the seas to ensure no cuban ships avoided quarantine
13. surgeon general walter wyman, in 1895, shared growing concern about the poor conditions in cuba, especially the dirty, yellow fever ridden ports
14. ill sailors were often brought back to avoid hospital costs
15. usa continued to encourage better sanitation which spain ignoredand yellow fever worsened as war continued
16. there were fears that goods eg. sugar could carry the disease
17. when a boat evaded quarantine infecting ocean springs in 1897, the usa sent more experts to cuba to research the cause of the disease
18. stronger calls for the usa to take cuba, but spanish did not agree
19. fumigation was to be carried out across the south, but many argued this would be pointless without taking measures in havana as yellow fever would return, so cuba was going to be taken
20. the us government met with international ambassadors to explain that peace in cuba was vital to protect american citizens
21. 1898 - usa declared war on spain
22. usa won within months, but cuba still suffered yellow fever despite cleanups
23. 1900- yellow fever caused by mosquito bites - new mosquito measures eradicated yellow fever from cuba by end of 1901
24. cuban government agreed to prevent further outbreaks

Question 12

A. Stern. 2005. What work was done to increase public health surrounding the building of the panama canal? 6

Answer 12

1. US around the isthmus canal zone of panama
2. gorgas, experienced from havana,had sanitary methods and sanitation was an important part of the isthmus
3. locks were needed for canal, but dangerous for mosquitoes if proper measures not taken
4. isthmian canal commission (ICC) had control over 2 large cities (colon and panama) and used this to gather data and enforce sanitary shipping measures
5. no quarantine, cleaning equip or proper water systems
6. perry wanted to educate unhygienic people as well as improve systems, unhygienic seen as poor/non white

Question 13

A. Stern, 2005. How were the lessons learnt about public health from the building of the panama canal revealed to the public? 2

Answer 13

1. panama-pacific internation exposition (PPIE) was put on to celebrate panama canal opening
2. exhibitions by the PHS (public health service) educated public in bacteriology, new disease discoveries and preventative measures

Question 14

M. cueto. 1992.

Describe the yellow fever vaccine. 4

Answer 14

1. noguchi isolated the microorganism supposed to have caused yellow fever
2. produced a vaccine
3. not primary means of prevention but was still widely used
4. got it wrong, vaccine was useless

Question 15

M. cueto. 1992.

Describe the yellow fever outbreak in peru. 6

Answer 15

1. fumigation was pointless, only killed adult mosquitoes
2. sick isolated, and cleaning water tanks heavily encouraged
3. fear of hospitals as place to die
4. open sewers
5. land quarantines enforced and evaded
6. put in place by a man called hanson

Question 16

Can we see yellow fever as the cholera of the atlantic world? 9

Answer 16

1. fear and panic in usa
2. quarantine measures eg. new orleans
3. sanitary measures viewed as invasive
4. yellow fever commission tried to address yellow fever in havana in terms of cleaning and removal of marshes - similar to port sanitary authorities
5. quarantine could also fail, and was ended in 1897
6. however, here there was power at stake also
7. american economy at stake - like britain
8. drs and scientists placed at forefront of politics
9. political events became linked with disease

Question 17

What was the importance of heroic medicine? 4

Answer 17

1. this concept was built up in the media
2. heroism had limits - only heroes when in own self-interest in some cases
3. heroes of medicine improved profile of science via the media - had important roles inside and outside the lab
4. important for scientists to share their work outside the lab