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yellow fever

historical background

The sinking of the Maine has historically been labeled as the reason behind the U.S. going to war with Spain. More recent studies however have looked beyond the Maine in the main cause of America's involvement. The U.S. Minister had spoken to European leaders about the intention of the U.S to go to war with Spain months before the sinking of the Maine. Yellow Fever is one of the alternate reasons that America went to war. Cuba was a staging ground for many diseases entering the Southern United States causing higher mortality rates and quarantines. Fear over the disease has been known to shut down whole cities showing the effects Yellow Fever can have on an urban setting. In the summer on 1793 Philadelphia experienced on of these epidemics. It was noted that an increase of mosquitoes on the streets was an indication of this however it was not yet known that the mosquitoes were what carried the fever. Benjamin Rush noted the return of Yellow Fever however within months ten percent of the forty thousand citizens of Philadelphia had died from it. In 1798 an outbreak happened in Philadelphia, New York, Boston and other cities. In 1878 twenty thousand people died from the disease in lower Mississippi. In this case the estimated economic loss was over one hundred million dollars. “^^Espinosa pg.548” Ten years later another outbreak started between Tampa and Orlando and eventually reached Jacksonville. Once in Jacksonville the disease spread to Decatur, Alabama, and Jackson Mississippi. This was the first widespread outbreak in ten years causing public fear leading to calls to strengthen the countries defense against the disease. One such action taken against outbreaks was the use of Revenue Cutters, with sanitary inspectors from the USMHS, from the United States Revenue Cutter Service which were used to find smugglers from Cuba and bring them to quarantine zones. These Smugglers were a threat because they were avoiding quarantine zones to make money of smuggled goods which meant they could start an epidemic in the U.S. despite initial precautions. The economy was at risk every time there was a yellow fever outbreak because Quarantines and panics shut down trade in many cases whole cities came to a complete stop. Fear over yellow fever was one of the reasons that America went to war with Spain once the Cuban insurrection started an epidemic. In fact due to constant quarantines around this time due to yellow fever scares public health officials all over the U.S. expected the government to clean up Havana. It was originally believed that cases of Yellow Fever would increase through trade with Cuba however when Spain invaded Cuba in February 34, 1895, an epidemic of the disease started creating an increased threat from the disease to the Southern States. During the second month of the Cuban insurrection the epidemic phase of yellow fever began which was characterized by three waves of infections corresponding with Yellow Fever Seasons of 1895, 96, and 97. Maximo Gomez said that his greatest commanders were “General June, July, and August,” which were months when Yellow Fever was most active. Because of a large amount of Spanish soldiers coming down with Yellow Fever the sugar storage houses in Regla were used for makeshift hospitals. This led to concern that that sugar would be contaminated with the disease. Despite efforts such as quarantine zones and Revenue Cutter patrols smugglers from Cuba still managed to get into the U.S. and in 1897 an outbreak happened in Mississippi and quickly spread to other states. During this time the opinion that the United States needed to seize Cuba in order to end the epidemics became more common among federal government officials, state sanitarians, and newspaper editors. During this time journalists in the Southern States advocated the annexation of Cuba in order to stop the spread of Yellow Fever Public outcry and fear of the effects outbreaks had on the community was one of the reasons that America went to war with Spain.

U.S. intervention

When war began the ““New York Times”” held an article reminding readers that Spain deserved what was coming to them. The opinion in this piece was that Spain made no attempt to improve living conditions in Cuba which created the threat of outbreaks through trade. It wasn't till the end of the Spanish insurrection that the epidemic ended however many American soldiers were still infected during the Spanish American War. After Spain’s surrender Yellow Fever started ravaging the ranks by July 24th, 3 days before the start of peace talks, close to one third of American forces were sick with Yellow Fever. Fear of this disease led to the decision to leave all those with Yellow Fever in Cuba to prevent an outbreak in the United States. Only Black soldiers of the Twenty Fourth Infantry volunteered to stay behind to tend to the sick. Out of the 471 volunteers only 27 were fit for duty once there service was no longer needed. It was believed that Cuban’s and black people were immune to Yellow fever because during the Spanish American War white soldiers contracted the disease more frequently. This is because a mild case of Yellow Fever during childhood creates immunity in the individual. The mistaken believe that the immunity was based on the person’s race led to this outcome. Yellow Fever took 5645 American lives less than combat which took 345 lives. One reason for the initial lack of success in combating the disease is that the theory of how it was spread was incorrect. The medical thinking of the time was that the disease was spread through filth when in reality it is spread by infected mosquitoes. Efforts by William C. Gorgas to sanitize Puerto Rico and Havana and burn Siboney were ineffective. Walter Reed and his colleagues were able to discover that Aedes aegypti after an incubation period were able to spread yellow fever to humans that they bite. Reed was able to discover that mosquitos carried the disease so soon because Cuban physician Carlos Finlay convinced Reed that they carried the disease. Finlay in 1881 theorized that mosquitoes carried Yellow Fever between humans however he wasn’t able to prove it. When Reed tested Finlay’s theory he proved it to be correct thus paving the way for sanitarians to make areas around human settlements up habitable to the Mosquitoes. Reed allowed for an incubation period of the disease in a mosquito before testing if it could transmit the disease which is what Finlay over looked which kept him from proving his theory himself. Gorgas who learned that the disease was spread from human to human by mosquitoes made changes to Cuban lifestyle in order to prevent the spread of the disease. These changes were to cover all cisterns under a ten dollar fine, and the elimination of all other standing bodies of fresh water. Further more extreme changes began with included burning down jungles to increase the speed of evaporation and to uncover more still water. Oil was placed on top of still water in order to deprive the Aedes aegypti of oxygen. This oil treatment was also used in homes, oil was poured into receptacles that held standing water. Many of the houses in Havana had cesspools which were ideal breeding places for Mosquitoes. One problem with this method is that often citizens would remove oil from cisterns and other places which they obtained fresh water. The Mayor of Havana as a result ordered that all fresh water receptacles be kept oiled and covered and pumps would be used to obtain water from the bottom. Barrels of water which were used by the people in cities were also destroyed, depriving people of a mobile water source but also mosquitoes from breeding. A report to Gorgas stated that houses found with mosquito had fallen from 100% to 0.6% showing the success oil Gorgas also used Insecticide and Fumigation Techniques in the control of the mosquito population. Larvae eating fish were also used in the attempt to completely eliminate the mosquito population. When Occupation of Cuba by the United States ended over ten million dollars had been spent on the sanitation efforts which was the most spent on the budget.

withdrawal from Cuba

The Platt Amendment of the Cuban Constitution was required in order for U.S. withdrawal from the country after the war. In this amendment Cuba was required to keep up sanitation in order to prevent another outbreak of the disease in Cuba and by extension the southern United States. It also stopped Cuba from preventing the U.S. from starting sanitation programs on the island. The previsions relating to sanitation in the Platt Amendment were needed because Cuba itself did not as much as the United States from changes in sanitation. In Cuba it was only in the cities that yellow fever was endemic and even there epidemics did not happen. The previsions were needed to insure that Cubans followed through with changes put forth by the United States. The Spanish American war led to changes in Cuban life style and policy which stopped outbreaks of Yellow Fever from happening in both Cuba and the Southern United States.