|1699 brought the
first yellow fever epidemic to South Carolina. Yellow fever is a truly
dreadful disease. It is an acute
infectious, viral disease that is carried by the Aedes aegypti mosquito. The disease process is
characterized by sudden onset, fever, chills, headache, backache, generalized
muscle pain, prostration, nausea and vomiting. Jaundice is moderate early in the disease
and intensifies, giving patients a yellow skin coloration. After the fifth
day, severe cases progress to hemorrhagic symptoms, including bleeding from
the nose and mouth, and vomiting blood, which usually partly digested and
dark brown or black in color. Death results from kidney and liver failure;
the case fatality rate ranges from 20% to 50%. Yellow fever is not
communicable by contact.
|Yellow fever is
important for the history of public health in the South, because the disease
was so terrifying and had such a severe impact that it led many communities
to take public health measures seriously.
It will be a main theme for the first 200 years of public health in
South Carolina, and I will return to it from time to time. Before 1900, the mode of transmission was a
mystery. People observed that yellow fever occurred from July to November,
and that it was sometimes imported on ships. They wrongly believed that it
was contagious because it was so widespread, even though some people who had
close contact with the victims did not contract the disease. Strict quarantine
measures were often implemented. The
disease is endemic to Africa, and is believed to have been imported from
there to the West Indies in the early 1600’s.
|George C. Kohn
(Ed.). 1995. Encyclopedia of Plague and Pestilence. New York, NY:
Facts on File, pp. 57-59.
1953. Epidemics in Colonial America.
Baton Rouge, LA: Louisiana State University Press, pp. 138-163.
|Abram S. Benenson
(Ed.). 1995. Control of Communicable Diseases Manual, Sixteenth Edition.
Washington, DC: American Public Health Association, pp. 519-524.