The earliest accounts of illness recognized as yellow fever were found in a Mayan manuscript describing illness that occurred in Guadeloupe and the Yukatan peninsula in 1648.
“Yellow Jack”, as yellow fever was known at the time, was a dreaded disease that plagued crews on vessels engaged in slave trade between West Africa and Spanish-Portugese America during the 1600s. The legend of the “Flying Dutchman” was inspired by yellow fever: the crew perished when fellow fever broke out and the vessel was doomed to haunt the seas around the Cape of Good Hope. Although a clinical description of the fever that occurred off the coast of Senegal in 1768 was not provided in the vessel’s records, the illness was later attributed to yellow fever because it first occurred in men who had been ashore and then spread to others on the vessel. Although it was not recognized at the time, overcrowding on ships and water storage tanks provided infected mosquitos with near-perfect transmission conditions.
A report of fever on the Synochus Atrabiliosa in Senegal in 1778 by Schotte is believed to be the first clinical report of yellow fever. Schotte describes vomiting that became green, brown and finally black coagulated in small lumps, continual diarrhea with gripings that resulted in large volumes of black and putrid stool, and petechiae on the skin.
During the next two centuries, “Yellow Jack” caused outbreaks throughout the Atlantic shipping trade route. Waves of epidemics occurred in the southern U.S. and as far north as Philadelphia (20 epidemics), New York (15 epidemics), Boston (8 epidemics) and Baltimore (7 epidemics). Benjamin Rush mistakenly attributed the Philadelphia yellow fever epidemic in 1793 to rotting coffee left on the Arch Street wharf. With a population of 50,000, 11,000 people in Philadelphia became infected and 5,000 died.
Serious outbreaks also occurred in Spain, France, England and Italy, and the West Indies, Central America and southern U.S. were repeatedly swept by epidemics. In 1803, following an epidemic that almost wiped out his troops, Napoleon sold Louisiana and a number of western territories to the U.S. government. The American army suffered considerable morbidity and mortality in Cuba during the Spanish-American war.
Although fever is now recognized as a symptom that is easily treated with over-the-counter medications, historically it was believed to be a disease in itself. Mortality due to fever was much higher before medications became available to control and prevent damage resulting from the effects of fever. Diseases associated with fever were feared and dreaded, perhaps even more so because their cause, and therefore prevention, were unknown.
In 1848, Josiah Clark Nott suggested that yellow fever was spread by mosquitos, but it was not until 1881 that the first serious theory of yellow fever mosquito transmission was published by Cuban physician C. J. Finlay. Finlay recognized the role of the mosquito bite in viral transmission.
Sources:
Pre-vaccination epidemiology 1700-1930
A short history of yellow fever in the U.S.
