Yellow Fever

Yellow fever, so named because it caused liver failure and jaundice, turning the skin yellow, was a dreaded disease in Texas from its earliest days to 1905 and brought not only sickness and death but also exacerbated rivalries between cities and created financial hardships. Yellow fever created mass panic as it took lives, caused a concentration of deaths in only a few weeks, and brought commercial transactions to a standstill. Although other diseases, especially tuberculosis and smallpox, killed more people, yellow fever was dreaded as it brought horrible effects, and no one knew what caused the disease, although there was much speculation. Texans were aware that yellow fever flourished in the summer and ended with the first frost.

In fact, yellow fever is caused by an arbovirus spread from victim to victim by the blood-sucking Aedes aegypti female mosquitos. Frost kills mosquitos, therefore the disease is most common in tropical locales. The mosquito breeds in fresh water, and port cities on the Gulf Coast, such as Galveston, which were teeming with people, containers of fresh water, and ships full of produce such as fruit and coffee from tropical lands, were ideal for the spread of yellow fever.

Yellow fever is a brutal disease. When someone contracts a mild form, it is a flu-like disease that lasts approximately a week. Symptoms include fever, chills, muscle aches, and nausea. For many others, yellow fever symptoms quickly progress to a dangerously high fever, jaundice signifying liver failure, and a systemic breakdown of the clotting system, causing the body to hemorrhage from the gums, nose, and stomach lining. The dark, digested blood regurgitated by yellow fever victims is commonly called “black vomit.” Kidney failure is followed by death within one or two days. Death from yellow fever takes about a week and occurs in an estimated 10 to 60 percent of yellow fever cases.

Yellow fever was well-known in Texas since before the days of the Republic. One of the best-known was the Galveston epidemic of 1839. Ashbel Smith, a physician who had a medical degree from Yale and had been trained in the latest scientific methods in Paris, wrote the first significant medical report in Texas based on his work in Galveston. He published An Account of the Yellow Fever Which Appeared in the City of Galveston, Republic of Texas, in the Autumn of 1839, with Cases and Dissections in 1839. Smith served as Texas’s surgeon general and was on hand to treat patients. Utilizing bleeding and prescribing opium, he maintained careful records and performed postmortem examinations.

While no one had made the connection to mosquitos, many people, including Ashbel Smith, did realize that the cause of yellow fever was unsanitary conditions and unfilled marshes. The South which had both a semi-tropical climate and unsanitary conditions was a perfect breeding ground for disease—factors that contributed to the region’s reputation, regarded by some in other parts of the nation, for being backward and disease-ridden.

A few short years later, in 1844, yellow fever struck Texas with a vengeance and took one-third of the population at Galveston. From 1836 to 1867 there were almost yearly epidemics in Texas, including 1853, 1854, 1858, 1859, 1862, and 1867. One of the problems in combating yellow fever involved the availability of public information. Many cities failed to disclose epidemics because outbreaks drove everyone away, and cities wanted to develop commerce and encourage immigration.

During the Civil War Union officers feared yellow fever more than Rebel bullets. Two years after the war in 1867, while Texas remained under Union control, the state endured the deadliest yellow fever season in its history. In Galveston, 1,000 died out of a population of 22,000. Of the population of approximately 6,000 in Houston, 492 perished from yellow fever. The victims included Richard William “Dick” Dowling, who had orchestrated a Confederate victory in 1863 at the battle of Sabine Pass. The deadly outbreak in 1867 struck citizens from all walks of life. According to an account by Galveston resident fourteen-year-old Lillie Barr, Union soldiers “were dying like flies on fly paper.”

In the 1870s improved transportation systems, such as the Gulf, Colorado and Santa Fe railroad which brought freight and passengers to and from Galveston, also brought new exposure to yellow fever to people in the interior of Texas. Marshall in East Texas suffered a serious outbreak in 1873, for example. Health reports, cases of fever, and quarantine policies appeared in various newspapers across Texas—in towns such as Victoria, Corpus Christi, Beaumont, and San Antonio.

The outbreaks as well as the fear of outbreaks wreaked havoc on local economies and threatened the stability of Southern markets due to leery investors. Concerned citizens intensified efforts to quarantine their cities and even instituted shotgun quarantines to prevent entry of anyone carrying yellow fever. Rival cities, such as Galveston and New Orleans, treated each other with harshness and suspicion. Trains were stopped, travelers were forced into detention camps, and ships were treated with chemicals.

Finally in 1900 Maj. Walter Reed, who was with the U. S, Army’s Yellow Fever Commission, conducted research to fully investigate the theory set forth by Cuban epidemiologist Carlos Finlay, in 1879, that mosquitoes caused yellow fever. Reed confirmed that the Aedes aegypti mosquito was the cause of the disease. Subsequent to Reed’s death, Maj. William C. Gorgas, a physician and friend of Reed’s, spearheaded a widespread sanitation campaign to eradicate the Aedes aegypti mosquito in Havana, Cuba. His extensive efforts to destroy their breeding grounds, inspect all dwellings in the city, protect quarantined patients with mosquito nettings, and other measures were very successful and served as a blueprint for other cities. Though there was one more yellow fever epidemic in Texas in 1905, cities soon took action to clean up standing water, which provided a breeding ground for the mosquitoes which spread the deadly virus, and implement sanitation practices introduced and promoted by Gorgas, who was appointed United States Army surgeon general in 1914. Such cleanup procedures were still in practice in the early twenty-first century. Although there have been a few cases of deaths from yellow fever since the 1990s, they are of individuals who contracted the disease overseas. See also EPIDEMIC DISEASES, HOWARD ASSOCIATIONS.