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This module provides an introduction to yellow fever, including its symptoms, treatment and quarantine, and major outbreaks in the Americas.

Introduction to yellow fever

Yellow fever is an infectious disease transmitted to humans from monkeys through the bite of infected Aedes aegypti mosquitoes. This disease cannot be transmitted from person to person.  Once a person contracts this virus, they have 5-25% chance of becoming ill, depending on the strength of each individual’s immune system.  Yellow fever was known as yellow jack, saffron scourge, sylvatic yellow fever, urban yellow fever, vómito negro (black vomit- vómito prieto ), totaling more than 150 names.

Yellow fever patient’s clinical chart

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This clinical chart tracks Charles Raymond, yellow fever patient’s health progress, his pulse and temperature were recorded over a period of several days until he was discharged. He was treated by Dr. Paul Osterhaut in Bocas del Toro, Panama

Symptoms

Yellow fever presents itself through a variety of symptoms including chills, fever, weakness, nausea, decreased urination, delirium, muscle and lower back aches, irritability, and restlessness, seizures, vomiting, and can lead to a coma. Symptoms usually occur 3-6 days after infection; the fever lasts between 3-4 days and is followed by remission and a second febrile phase, which is the most dangerous, affecting internal organs such as liver and kidneys, causing jaundice and hemorrhages in the digestive tract.  This in turn causes the yellow coloration of the skin and white of the eyes and of vomiting a black substance.

The symptoms of a yellow fever patient

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This chart tracks Vaughan Philpott’s health progress from the first to the sixth day of his treatment for yellow fever starting on February 15, 1906 in Bocas del Toro, Panama. The patient was pronounced dead on the sixth day by Dr. Paul Osterhaut.

Treatment and quarantine

During the 19th century, it was a common belief that the firing of a cannon disrupted air particles, creating large amounts of air turbulence that could destroy the unknown agent that caused yellow fever. Along with this procedure, a common treatment for yellow fever was fumigation and burning sulfur in the patients’ room. This treatment actually caused patients to cough consistently and even choke because of the sulfuric fumes. Following the smoking of sulfur, the physician continued treatment by using a lancet to bleed the patient so rapidly they usually fainted. This treatment was known as “syncopal bleeding”. Afterward, the patient was encouraged to take large doses of calomel, which is toxic and causes people to salivate continuously and suffer from uncontrollable diarrhea. Alongside the toxic calomel, the patients were given cinchona bark, an anti-malarial agent, which actually caused intense stomach irritation and bouts of vomiting. To reduce this harsh effect, doctors applied poultices to the skin on the abdominal area which oftentimes caused blistering of the skin (VanItallie 329). Following this harsh treatment, patients’ temperature oftentimes returned to normal for a few days during remission and later rose again during the third phase. The patients soon began suffering from jaundice and vomited a black substance resembling ground coffee. They also bled from the mouth, nose, and eyes, due to the inflammation of the liver. After this level of illness, the patient usually fell into a coma, often resulting in death. The harsh treatments were replaced with more soothing procedures towards the end of the 19th century. New remedies consisted of hot mustard foot baths, bed rest, crushed ice and lemonade, cool sponging, and gentle nursing care (VanItallie 332).

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Source:  OpenStax, Yellow fever: medicine in the western hemisphere. OpenStax CNX. Oct 11, 2011 Download for free at http://cnx.org/content/col11312/1.4
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