Yellow Fever! What the hell is it?

YELLOW FEVER!  WHAT THE HELL IS IT?

It ain’t chicken if you define things against Captain Courageous! And it don’t care ’bout you, just about your tissues.  So stop saying such foolish things.  You know better, and it’s bigger than you, anyhoo!  It was also called, “Bronze John,” “Yellow Jack,” “Malignant Fever,” and “Black Vomit!”

But it is a virus, and a serious one if you define it against the death it causes.  One of the enveloped, single-stranded RNA (Ribonucleic acid) type viruses of the Genus Flavivirus.  And we don’t like that.  It is transmitted by two types of mosquitoes, and we don’t like them either.  The one found in urban areas is called Aedes aegypti.  The name indicates where it was first described, so what is it doing around here?

In fact, both mosquitoes developed on the African continent, but are now found just about everywhere else.  Nice white markings on the legs of adults.  Helpful to identify, since that is the one that is sucking your blood!  And capable of spreading both the Dengue Fever [another virus, found mainly in the southern areas of Asia and South America], and Zika Fever [remember that one?  Again, a virus, first found in Africa, then Brazil in 2015, but, thankfully, last seen in the United States in 2017], as well as the Yellow Fever virus. And all three are members of the Flavivirus genus.

And mosquito larvae ain’t pretty either.  They are pale, wriggly, and scary little things.  No wonder they used to spread oil on lakes to suffocate the hated beings.  They have a “siphon” to breathe air from the surface, much like a submarine.  Right down there, near all their anal stuff.

DDT was thought to be an improvement, but not for Eagle eggshells or human health.  Remember those fumigating fogs of DDT, spread around to kill the insects?  I do.  At Camp Lejeune, we would open the windows to get complete exposure, and ride our bikes through them like young warriors.  Aedes aegypti is found all over the southern half of our nation.

Yellow Fever was imported into the Americas along with the Sub-Saharan people enslaved by the Europeans.  An additional horror to that inflicted on humans.  Get bitten by a mosquito that is infected with Yellow Fever, and you face liver and kidney damage, and the condition now known too well in the Age of Covid as a “cytokine storm” [where your immune system overreacts and attacks your own systems].  This occurs in about 15% of the cases [and I suppose that makes you feel safe because you think you are an 85%er!]. With jaundice.  That’s where the “yellow” comes in.  The color of your skin!  There is a 50% mortality rate in the most severe cases.

We take for granted that our nation is so great in geographic extent.  It was our “Manifest Destiny.”  As though God made it a mandate that we expand so far west.  But the instrument of our expansion was more deadly than we admit. For it was in Haiti [then, “Saint-Domingue”], and with the slaves that fought for their freedom there, that our opportunity arose.  It seems that the American Revolution set lofty aspirations for more than just the people in Paris!

In 1787, there were about 8,000 plantations on Haiti growing sugar, cotton, tobacco, coffee, cacao and indigo. Hundreds of ships sailed there yearly and, in 1787, carried 40,000 black people from Africa imported as slaves. In those terrible conditions of bondage, most only lasted for about five years.  It was cheaper to just import more slaves, than to care for them humanely.

But the plantation owners imported more than just black slaves.  They brought over the mosquito, Aedes aegypti, and in that bloodsucking creature, the Yellow Fever virus.

The Africans had already been exposed, and their population was much more immune to that terrible disease [and Dengue Fever also provided additional “crossover” immunity to infection by the Yellow Fever virus].  Not so much for the Europeans concentrated on the island.  And the French troops stationed there had no immunity! On the island, there were one-half a million slaves and forty thousand Europeans.  The conditions were ripe for rebellion.

Cornwallis surrendered to Washington at Yorktown in 1781.  The Bastille fell in Paris in 1789, propelling the French Revolution forward.  In 1791, the slave population of Haiti rose up under the leadership of the black “Spartacus” [also known as the “Father of Haiti”], Toussaint Louverture.  The French Revolutionaries in Paris then freed and armed the slaves in defense of the New French Republic.

In 1801, the new French First Consul, Napoleon, decided to take back the island by force.  A 65-ship armada and 30,000 French troops encountered a wily, disciplined Haitian Army able to harass, and yet avoid a decisive battle.  The French landed in December of 1802.  Napoleon soon thereafter reinstated slavery, abolishing the abolition of slavery previously decreed by the Republic.

In all, Napoleon sent 65,000 troops to the island.  About 40,000 died of Yellow Fever.  So, by 1803, Napoleon discarded the ambition of a French Empire expanding on the continent of America.  Needing to fight his European enemies, he contracted with President Thomas Jefferson and sold the Louisiana Territory for whatever the United States would pay him.

So it is not unfair to say that the lowly mosquito and its deadly disease, “Yellow Fever,” made our “Manifest Destiny” a reality.

How can you protect yourself?  Don’t travel to infected locations without first getting a vaccination.  The disease is rarely found in the United States, but is endemic in Central and South America and Sub Saharan Africa.

Whew!  That’s great.  Not here, just over there.  Convenient thinking that’s not always helpful.  We live in the age of commerce and people moving around quickly[remember the spread of Covid-19 internationally?].  History is a good indicator.

It was too late, in 1699, to stop the epidemic in Philadelphia.  “… died six, seven, and sometimes eight a day, there being few houses, if any, free of the sickness.  Great was the fear that fell on all flesh!”

In 1732, Charleston stopped ringing church bells, their dead were so frequent. In 1793, thousands died again in Philadelphia.  President Washington considered moving out Congress, which was then still meeting in that city.  Ten percent of the city’s population died.  And that is when Alexander Hamilton contracted the disease.

About one hundred years later, in 1878, 13,000 people died along the lower Mississippi river. Did the French abandon the construction of the Panama Canal because of Yellow Fever and Malaria?  They didn’t know then that it was the mosquito they were fighting.

And now my favorite part of these written exercises.  The History of Science.  In this case, when epidemiology was just starting, and those who thought they knew, thought that Yellow Fever was caused by a “miasma” [a medieval theory that disease was caused by foul air or bad particles breathed in].

Enter the Cuban doctor, Carlos Juan Finlay.  He correctly figured out the transmission agent for Yellow Fever, but no one believed him.  He had studied in Philadelphia, and had learned the new “germ theory” of disease.  Not “miasmas,” but tiny little infectious creatures.

Hard to believe now, but then, that was radical thinking.  His 1882 paper was entitled “The Mosquito Hypothetically Considered as an Agent in the Transmission of Yellow Fever”.  He next correctly identified Aedes aegypti as the specific culprit!

The World Health Organization (WHO) says the virus can cause headaches, chills, fever, nausea, vomiting, delirium, yellow skin and eye, heart, liver, and kidney damage (and sensitivity to light).  In the worst cases, bleeding from your nose, eyes, and mouth, then seizures and a deathly coma.  Serious business, where up to one-half of the serious cases will die.

And now for the quote describing grotesque symptoms, as though such a statement could adequately convey the pain so associated.  Yellow Fever has been called “The Hurricane of the human frame.”

Here is the description by Dr. George Pinckard of his own symptoms, after having arrived in the West Indies from Britain in 1806.

“… the pulsations of the head and eyes were most excruciating … conveying a sensation as if three or four hooks were fastened into the globe of each eye and some person, standing behind me, was dragging them forcibly from their orbits back into the head … the calves of my legs … as if dogs were gnawing down to the bones…”

 

There is no cure for Yellow Fever, just vaccination and mosquito control in its prevention.  It is not a contagious disease, but must be passed from human to human through an intermediary.  Hence the discovery of the mosquito as the deadly transmission agent.

As we have seen in this series on pandemic diseases, scientific testing and discovery have propelled our understanding of epidemiology.  And science, through the scientific method, is self-correcting when presented with new data.  In this case, 20 years later.

That is when Walter Reed [the same as the name of the hospital attending our Presidents] sent Jesse Lazear to Cuba to study the disease that was killing so many U.S. Army soldiers in the Spanish American War.  Using controlled experiments where volunteers were deliberately bitten by infected mosquitoes, Lazear demonstrated that the mosquito was the only mode of disease transmission.

His discovery was a triumph of the “germ theory,” and an advance of our understanding of the movement of disease vectors.  Yet tragedy lurks in the exploration of hidden places.  At age 34, Jesse Lazear died of Yellow Fever as a result of his experiments.

So it is with the progress of humankind.  We should pay more attention to the lessons we’ve learned.  Gather more data and learn more of what’s out there.

Such information will help us fight against those things that continue to try and kill us!

 

 

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