Colonial Public Health Events
•1699  First yellow fever epidemic in Charleston kills about 160 of estimated 3,000 residents. “A most infectious pestilential and mortal distemper...which from Barbados or Providence was brought in among us in Charles Town about the 28th or 29th of Aug. last past....This Distemper from the time of its beginning aforesaid to the first day of November killed in Charles Town at least 160 persons.” Among the victims were the “chief justice, receiver-general, provost marshal, and almost half of the assembly.”
•From Duffy, Epidemics in Colonial America,1953, p. 143
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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.
John Duffy. 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.