Yellow Fever: In the News on September 12, 1820

One of the major topics of conversation in 2020 is how to prevent the spread of COVID-19. Two hundred years ago, people were holding similar discussions except the dreaded scourge-of-the-day that they were trying to prevent was yellow fever.

A series of 19th-century illustrations showing the progression of yellow fever and how the various symptoms appeared. Images courtesy of Wellcome Images via Wikimedia Commons

Yellow fever is a mosquito-born disease that most experts now believe originated in Africa and spread to the West (particularly in the West Indies) because of the slave trade. It eventually made its way to the United States through the port cities. Most people who contracted the illness initially experienced fever, chills, muscle aches, and headaches, but they would then recover and have immunity to the disease. However, for about 15 percent of those afflicted, after the initial symptoms subsided, they would experience a second onslaught of the disease, which would attack their liver, thereby leading to jaundice or yellowing of the skin (hence the name “yellow fever”), internal hemorrhaging, and vomiting up “black blood.” Many of those so afflicted, ultimately died.

In an article published by the Woodstock Observer on September 12, 1820, the article’s unidentified author noted the health crisis in Philadelphia caused by yellow fever and advocated for quarantining and preventing people from entering the city in order to control its spread. He or she notes that previously the disease was believed to be contained in one section of the city, but it had since spread to other quarters.

The people of Philadelphia had good reason to be concerned with a yellow fever epidemic. Many of them still remembered 1793, the infamous year when yellow fever struck Philadelphia with a vengeance. At the time, there was disagreement about whether the disease had been brought by refugees fleeing the disease in the tropics, or whether it was caused by such things as vapors given off by the area’s tan yards, ditches with stagnant water that had been created when clay was extracted from the ground, or the local air being contaminated by a cargo of rotting coffee that had been dumped near the wharf.

Article published in the Woodstock Observer on September 12, 1820

Although doctors in the early 19th century did not fully understand the nature of the disease, its causes or its spread, many knew that it would be safer to leave Philadelphia. About 20,000 people – roughly two-fifths of the city’s population – fled, looking for a healthier environment in which to weather the storm. Most of those who were able to seek safety in other geographic areas were from the upper social strata.

For those who were left behind, there was little to do except employ what were being promoted as “preventative” measures. These measures included covering their faces with handkerchiefs that had been soaked in vinegar, chewing garlic, avoiding hand shaking, and burning bonfires or smoking cigars to cleanse the air around them. For those unfortunate ones who contracted the disease, they not only had the symptoms of the disease with which to contend, but also the supposed cures. Some of the most lauded doctors of the times promoted such “cures” as forced vomiting, bloodletting, and sweating powders.

Ultimately, in 1793, about 5,000 people, or 10 percent of the people in Philadelphia died as a result of that epidemic. However, according to J. Erin Staples, who serves on the CDC’s “Surveillance and Epidemiology” team, for every death, there were “about 23 other infections.” As with COVID-19, many of the people who contracted yellow fever in 1793 were either asymptomatic or only had a light case and then recovered.

In Philadelphia, yellow fever erupted several more times in the 1790s; however, the impact was not as great as the 1793 epidemic. In other areas, yellow fever appeared more regularly. New Orleans was particularly hard hit. On years when it struck that city, it would often decimate up to 10 percent of the city’s population.

One professor who has studied the yellow fever epidemics of the Antebellum South is Kathryn Olivarius, a professor at Stanford University. She concluded that the impact of the disease went beyond just the loss of life. For instance, she notes that in New Orleans, because there was such a high mortality rate from yellow fever, many employers were unwilling to invest the time and money in training new employees because up to 50 percent of the people living in the area would likely die from the disease before ever gaining immunity. This made it difficult for new immigrants who had not been “acclimated” to the illness to find work, and it left these new immigrants in a “social and professional purgatory” that hindered their social mobility. It also appears that yellow fever was used as a justification for the slavery of African Americans in parts of the deep South as some argued that whites were more susceptible to yellow fever and, therefore, those who were supposedly less susceptible should be the ones doing the types of hard physical labor where the risk of exposure might be greater. While some enslaved people of African descent may have been less susceptible to the disease because of exposure either in the West Indies or in Africa prior to coming to the United States, they were not automatically immune, and in some areas they, too, suffered high mortality rates.

While there are many differences between the historic yellow fever epidemics that took place 200 years ago and our present-day crisis, there are also many similarities, including people fleeing the epicenters of the outbreaks and trying to prevent transmission through face coverings. Fortunately, none of our present-day doctors are advocating for “cures” such as forced vomiting, bloodletting, and sweating powders to cure COVID-19. But, as with many things, sometimes the most important lessons we learn are from our mistakes. Being informed about past epidemics can hopefully help us to understand and cope with the crisis at hand, and realize that we are not the first (nor sadly the last) generations who have had to deal with such hardships.