American Experience (1988) s19e05 Episode Script

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MAN:
It would come without warning.
It would jump
from house to house.
It could come
into a house and make
one person sick,
two people sick,
but not make
the other people sick.
It attacked the rich,
it attacked the poor.
It attacked the clean,
it attacked the dirty.
NARRATOR:
For two centuries
it terrorized the nation.
Bankrupted cities.
Took tens of thousands of lives.
It was called the visitor.
The invader.
(gasping)
WOMAN 2:
Yellow fever was horrible.
The patient is spraying
black vomit across the room.
They're in agony,
they're screaming.
It happened so fast,
it killed so quickly.
MAN:
The only thing
that comes close to the fear
that yellow fever engendered
back in the 19th century
is a biological attack.
Where an unknown agent
moves around the community
in some ways that's sort
of random, that makes no sense.
NARRATOR:
Unraveling the mystery
of yellow fever
would take a leap of logic
by an obscure scientist
the conversion
of a skeptical army doctor
and a young surgeon's
ultimate sacrifice.
In the summer of 1693,
Admiral Joseph Wheeler's fleet
arrived in Boston
from the West Indies
with a cargo of rum and sugar.
Within weeks, men and women
scattered across the city
began to show symptoms
of a strange illness:
jaundice, high fever,
black vomit.
Yellow fever
had come to America.
For the next 200 years,
the disease would strike
city after city,
with frightening regularity
and no apparent cause.
JIM WRITER:
There are some severe
epidemics that take place.
Late 1700s, Philadelphia
loses 10% of its population.
As we move into the 1800s,
the disease moves south, away
from the northeastern seaboards
to the southern states.
There are
some devastating epidemics
that strike
along the Gulf Coast,
especially in New Orleans.
NARRATOR:
Hot and humid,
bustling with trade
from the Caribbean,
where the fever
was present year-round,
New Orleans was especially
vulnerable to yellow fever.
Summer epidemics
would claim hundreds,
even thousands of lives.
DR. JOHN PIERCE:
There was no way
to protect yourself from it.
Even though they knew that it
would come in the summer,
sometimes it didn't come.
There were some summers
where there was
very little yellow fever.
And then,
another summer, it would come
and it would be a scourge
of biblical proportions.
NARRATOR:
On July 24, 1878,
the New Orleans Picayune
confirmed 14 cases
and seven deaths in the crowded
tenements of the First District.
Soon, cases of yellow fever
were reported
in the better sections of town.
Panic gripped the city.
MAN:
There was no way to predict
who was going to be next
or how it was going to spread.
The way it moved
through a community,
from house to house, skipping
houses, skipping neighborhoods,
coming back and getting
neighborhoods later on;
attacking rich and poor,
in some way that makes no sense,
that's sort of random.
The way it attacked
and what it did to its victims
just horrified people.
DR. PAUL JURGENSEN:
People develop a headache,
they develop fever.
They develop back pain.
They hurt all over
and ache all over.
And these symptoms usually last
for about 48-72 hours.
And it's just like
having the flu.
And then the virus
attacks the liver.
And when the liver is destroyed,
proteins,
which are very necessary
for proper blood coagulation,
are also destroyed.
JOHN TONE:
You would bleed from your eyes,
from your nose, from your mouth.
One of the worst aspects
of the disease
in its final stages
was that you're bleeding
internally into your stomach,
and then that blood is digested
and you end up vomiting it out,
and it's sort of like
wet coffee grounds.
It's not a quiet death.
You are struggling,
you're frantic.
Doctors would have to strap
their patients down
while they watched them die.
NARRATOR:
New Orleans physicians struggled
to treat and understand
an illness that seemed
to defy all explanation.
They prescribed bloodlettings,
carbolic acid,
massive doses of quinine.
To ward off the illness,
citizens covered themselves
in mustard plaster.
Shut windows
to keep the fever out.
Burned tar
in the belief that the smoke
would disturb the "miasma"
The noxious emissions
that, for centuries, had been
thought to carry disease.
The city became
a smoke-filled hell,
pierced by the anguished
sounds of the dying,
and the acrid smell
of putrefying blood.
Those who could,
fled in the tens of thousands.
WRITER:
People are running in fear.
Those who remain
are struggling to survive.
There may be no food coming in,
there is no goods going out.
All commerce grinds to a halt.
DR. MARGARET HUMPHREYS:
With everything
shut up and closed,
New Orleans quickly
became a ghost town.
The whole fabric
of life is disrupted
in ways that, um,
other diseases didn't do.
NARRATOR:
For decades, yellow fever
had been a Southern scourge,
its ravages confined
below the Mason-Dixon line.
But now, steamboats and
railroads united the country
north to south, east to west.
Yellow Jack,
as the disease was known,
could travel far,
and travel fast.
WRITER:
1878 was the turning point
in the history of yellow fever.
People are more mobile
than they were
in the pre-Civil War period.
Yellow fever has
new opportunities
for moving away from the port
where it's introduced
and it does.
It takes those opportunities.
It rides the rails
out to Mobile,
up to Memphis,
over to Chattanooga.
NARRATOR:
To Kentucky, Indiana, Illinois,
even into Ohio it went,
aboard trains crowded
with refugees heading north.
HUMPHREYS:
Towns where those people
might go to
didn't want them to come,
so people burned bridges,
they tore up train tracks
Anything
to keep the epidemic out.
NARRATOR:
Some states set up
official quarantines,
but in many towns, citizens took
matters into their own hands.
(gunshot)
HUMPHREYS:
Armed men would meet the trains
and either force them
to go on or turn back,
and they called that
"shotgun quarantines."
One man with a shotgun is going
to keep a train either moving
or at least keep people
from getting off of it.
NARRATOR:
But there was no stopping
Yellow Jack.
The epidemic spread to 11 states
and 200 communities.
120,000 people became infected.
"The King of Terrors continues
to snatch victims
with fearful rapidity,"
wrote a Memphis resident.
"One by one,
those who remain in the city
and are liable to the
monster malady are taken down."
By the time it ended, with
the arrival of the first frost,
the Great Mississippi Valley
Epidemic had taken 20,000 lives.
Economic losses were estimated
in the hundreds of millions.
The City of Memphis was forced
to declare bankruptcy.
As news spread, the magnitude
of the tragedy registered
in every corner of the nation,
from San Francisco to New York.
HUMPHREYS:
Suddenly, what had been
a Southern problem
was now a national problem
in terms of finance, in terms
of just spread of disease;
and the feeling is
that the South cannot take care
of this problem themselves.
Either they won't because
they're stupid or they're inept
or they're too poor,
and the Federal government
really needs to step in here
because now the South's problems
are everybody's problems.
NARRATOR:
The Federal government
took decisive action.
Congress established
the National Board of Health,
with authority to intervene
in a public health emergency.
The Board would also help
Southern states put in place
sanitary improvements and
administer a quarantine system,
designed to keep yellow fever
from entering the United States.
But neither sanitation
nor quarantine
would prove to be enough.
What was needed were answers
to some crucial questions
about yellow fever
and how it spread.
(thunder rumbles)
At his laboratory in his home
in Old Havana,
Dr. Carlos Finlay had been
studying yellow fever
for quite some time.
The son of a Scottish father
and a French mother,
Finlay had left Cuba
as a young man
to study in Europe,
then at Jefferson
Medical College in Philadelphia.
He returned to Cuba in 1864,
where he settled down.
In 1872, he began to investigate
yellow fever, a disease
that year after year swept
through his native country.
He looked at changes
in temperature, altitude,
even the alkalinity
of the atmosphere.
Then, young Dr. Finlay made
a scientific breakthrough.
TONE:
He had read that some diseases
could be spread
through an intermediate host.
There's a particular disease of
wheat that has to first incubate
in another plant
before it can be spread.
So he deduced
that what was necessary
to spread it was an agent
that would take it
from the sick person
to a healthy person.
NARRATOR:
In 1879, an American scientist
handed Finlay his next clue:
microscopic slides of tissue
from yellow fever victims.
TONE:
He left Finlay
with some photographs
that clearly indicated to Finlay
that yellow fever must be spread
somehow through lesions
in the blood vessels
That it must be a biting insect
that accesses
those blood vessels.
That's how he first came upon
the idea that it was a mosquito.
NARRATOR:
With nearly a thousand species
of mosquitoes,
Finlay searched painstakingly
for the one
that transmitted the disease.
TONE:
What he did was
he figured out where
that mosquito was present
and he mapped that against where
cases of yellow fever occurred;
and since they mapped perfectly
to each other, he deduced
that yellow fever was spread
by this particular mosquito
The Aedes egypti mosquito.
NARRATOR:
It was a remarkable idea,
perhaps too remarkable
for its time.
HUMPHREYS:
In the 1880s, the germs that
cause the most familiar diseases
were just being identified,
and these germs got into the
body in fairly obvious ways.
Cholera you swallow it,
tuberculosis or diphtheria
is inhaled.
But the idea that another way
that germs could get
into the body
was through an insect
was not out there.
NARRATOR:
In August 1881,
at an international scientific
conference in Havana,
Carlos Finlay unveiled
his mosquito theory,
outlining three conditions
necessary
for the transmission
of yellow fever.
TONE:
Number one, the presence
of a person with yellow fever.
Number two, a person apt
to contract yellow fever.
And number three, an agent
that can transmit yellow fever
from a sick person
to a healthy person.
And he tells them that
in light of all this,
all the focus on quarantines
and all the other measures
that they were proposing to take
to control yellow fever
would be useless
and that what they really needed
to focus on
was the intermediate agent.
NARRATOR:
At the end
of Finlay's presentation,
there were no questions,
no rebuttals.
"No one spoke against my
theory," Finlay later recalled,
"but I would have preferred it
to the silence.
That conspiracy of silence
and silence"
WRITER:
Finlay is so far out on the
edge, so far ahead of his time,
there's no way
the medical community
is going to take him seriously.
He becomes the mosquito man,
the crazy Cuban doctor
who's got this wild theory
about insects carrying disease.
NARRATOR:
For the next 20 years,
Finlay worked tirelessly
to win scientific acceptance
for his theory.
Conducting experiments
with mosquitoes
on 100 volunteers,
he focused on transmission
while others searched
for a cause.
TONE:
Scientists all over the world
are drawing blood
from yellow fever patients,
they're culturing the blood,
they're trying to identify
the bacterium
that causes yellow fever.
Finlay wasn't doing that.
He was concentrating
on the mosquitoes.
WRITER:
What Finlay needs to do is
to show that he can
consistently move yellow fever
person to person
using the mosquito as a vector.
That there is
no other explanation
for that person's case
of yellow fever.
And in general,
he can't do that.
He can get a case
here and there
Sporadic cases but he still
is missing conclusive proof.
TONE:
Because he is working in Havana,
which is an endemic center of
yellow fever, people would say,
"Well, maybe your patients
caught yellow fever
"not from the mosquito bite,
but from something else
in the atmosphere."
He could never really adequately
answer those objections.
NARRATOR:
Finlay's theory languished.
(boat chugging)
(bells clanging)
NARRATOR:
In 1898, the United States
declared war on Spain.
(bells clanging,
engine chugging)
40,000 American troops landed
on the island of Cuba,
a Spanish colony.
WRITER:
Cuba has been suspected
for decades as being
a source of the yellow fever
that comes
into the United States.
It's an endemic disease in Cuba.
It's always there, and that
raises all sorts of fears.
There's fears about soldiers,
and becoming infected in Cuba.
There's fears about soldiers
returning from Cuba
and bringing yellow fever
with them.
Really opens up
a whole new pathway
for yellow fever
to infect the United States.
(man shouting commands)
(rhythmic marching)
NARRATOR:
In only three months,
the American army defeated Spain
and occupied Cuba.
Fewer than 400 American soldiers
were lost to Spanish bullets,
but more than 2,000 came down
with Yellow Jack.
An African-American regiment,
the 24th Infantry,
lost a third of its men
to the disease.
Two years into the occupation,
a yellow fever epidemic
raged across the island.
The lives of 15,000
American troops were at risk.
TONE:
Because they didn't understand
the role of the mosquito,
what they would do is, someone
would catch yellow fever,
they'd be put in a
in a hospital
next to someone who had malaria,
next to someone else
who had typhus.
Meanwhile, there are mosquitoes
buzzing around them,
biting one, biting the other,
spreading disease
back and forth.
PIERCE:
We thought that it was
transmitted by fomites.
A fomite was
any inanimate object
that could transmit an illness.
And so, it was felt
to be something on the clothes,
on the furniture, the sheets
that the sick people slept on.
There was felt to be something
in those materials
that could transmit the disease.
NARRATOR:
In July 1900, an outbreak
of yellow fever was reported
at a U.S. camp
just west of Havana.
American troops now faced
the same danger as other armies
who had ventured
into the region.
TONE:
Yellow fever had been the enemy
of colonial powers
in the Caribbean
for a long time.
It had destroyed an army that
Napoleon sent to Haiti in 1802,
and in the 1890s,
it had devastated Spanish armies
in Cuba.
Americans were well aware
of all of this,
so they were very fearful
that their armies in Cuba
not suffer the same way.
NARRATOR:
The officer in charge
of protecting the health
of U.S. troops was Surgeon
General George Sternberg,
a leading bacteriologist.
Like many scientists,
Sternberg had spent years
searching
for the yellow fever germ.
Now, he appointed
an ambitious Army doctor
to lead a commission to Havana
to try to find it.
Major Walter Reed was
the youngest man
ever to be granted
a medical degree
by the University of Virginia.
After two decades of service
in the American West,
he was not one to shy away
from a challenge.
WRITER:
Reed is a frontier doctor,
basically.
Most of his career has been
spent out on the frontier
Indian country in Arizona,
in Kansas, in Nebraska.
He takes a class
in bacteriology
at Johns Hopkins,
and it begins to transform him,
brings him into contact with
the new science of medicine.
He moves
from this frontier doctor,
working with small Army posts,
and now becomes a scientist.
PIERCE:
He was highly motivated.
He worked most of his life
with the idea
that there was going
to be an opportunity for him
to make a big difference.
NARRATOR:
Reed chose a trusted friend,
James Carroll, as his assistant.
To head the laboratory
at Havana's Columbia Barracks,
he named a young
American bacteriologist,
Jesse Lazear.
The Yellow Fever Board's
first task was to disprove
an Italian scientist's claim
that he had found
the elusive yellow fever germ.
HUMPHREYS:
There had been
a lot of research,
a lot of people
trumpeting their discovery,
and then someone else
has to come along and prove
that that one's wrong,
and this had happened a lot.
The problem was that
And they didn't realize it
Yellow fever is caused
by a virus.
It's a particle
that cannot be seen
through the kinds of microscopes
they had in 1900.
NARRATOR:
Jesse Lazear chafed
at what he saw
as his colleagues focus
on petty scientific disputes.
"Reed and Carroll have notions
that I don't agree with,"
he wrote.
"And are not inclined
to do as much
as I would like to see done."
Left on his own, Lazear believed
he could discover the real cause
of yellow fever.
WRITER:
I have this picture of Lazear
as being a real go-getter.
He knows he's smart,
he knows he's got the training,
he's got the education.
And he's got an opportunity now
to make a name for himself
in the world
of medical research.
(birds singing)
NARRATOR:
Lazear had arrived in Cuba
with his son, Houston,
and his wife Mabel,
who carried their second child.
Camera in hand,
the young couple enjoyed
the historic sites of Havana.
A contract surgeon,
Dr. Lazear had left behind
a position
as head of the laboratories
at Johns Hopkins University,
where he had been working
on malaria,
only recently proved
to be carried
by an intermediate host.
HUMPHREYS:
Malaria and yellow fever
are both diseases
that occurred
in certain patterns
that matched
when the mosquito was active.
It's worse
in more tropical areas.
So it made sense
that this disease, yellow fever,
could be, like malaria,
spread by a mosquito.
NARRATOR:
On May 23, Lazear struck out
on his own.
He went to Quemados,
a Havana suburb,
and the starting point
of the 1900 epidemic,
and brought back four mosquitoes
captured
in an infected person's room.
He dissected the insects,
and looked in vain
for the yellow fever germ.
Then, in July, Lazear, Reed,
and the rest of the Board
paid a visit to Old Havana
To the home of Dr. Finlay.
TONE:
In a sense,
Finlay was the last option.
They had tried everything.
They had tried sanitation,
they had cleaned Havana,
they had disproved
various candidates
for yellow fever,
but they hadn't actually
found the agent.
With so many troops
falling sick,
and yellow fever being a threat
to the American occupation,
they finally prove willing
to listen to Finlay.
NARRATOR:
As he handed
his Aedes egypti eggs
to the Yellow Fever Board,
Carlos Finlay had every reason
to be pleased.
WRITER:
Finally, somebody's
taking him seriously.
Finally, somebody is going
to test out his theory,
take his mosquitoes,
and give it a shot.
NARRATOR:
On August 2, Walter Reed left
for Washington.
Although deeply skeptical
of Finlay's theory,
Reed had instructed his staff
to begin conducting
mosquito experiments.
PIERCE:
They agreed at that point
in time
that, as they began
their mosquito experiments,
they would experiment
on themselves.
That they would be
the first guinea pigs
to take the mosquito bites
to see if they could
transmit yellow fever.
NARRATOR:
Convinced that mosquitoes
were harmless,
Reed expected little to happen
in his absence.
He could not have been
more mistaken.
Jesse Lazear took over
Finlay's mosquitoes.
Meticulously following
Finlay's techniques,
each day, Lazear would take
his "birds," as he called them,
to Las Animas, the U.S. Army
yellow fever ward.
There, he would have them load,
feed on the blood
of infected patients.
Then he would have
the loaded mosquitoes
bite healthy volunteers.
After nine inoculations,
two on himself,
Lazear had failed to produce
a single case of yellow fever.
Discouraged,
he was ready to give up.
(birds singing)
Then, on August 27,
Lazear noted that one
of his birds had failed to load.
Concerned that the mosquito
might die without a blood meal,
he asked his colleague
James Carroll
if he would allow it to feed.
Two days later,
Carroll fell ill.
He appeared jaundiced.
His temperature rose
to 103 degrees.
He was diagnosed
with yellow fever.
PIERCE:
Lazear takes it upon himself
to go find another volunteer.
The young soldier,
named William Dean,
is bitten by the same mosquito
that has made Carroll ill.
Dean, a few days later,
gets sick,
and so he progresses
to what is an obvious case
of yellow fever.
"Dear Mabel,"
Lazear wrote his wife,
who had returned
to the United States
to give birth.
"I rather think I'm on the track
of the real germ.
"But nothing
must be said as yet.
I have not mentioned it
to a soul."
WRITER:
He's the physician
who inoculates Carroll,
which is the first case
that the team
probably transmits
from a mosquito to a person.
He's the person
who inoculates William Dean,
who is definitely the first case
that the Army team
transmits yellow fever to
with a mosquito.
If he can prove
that the mosquito
transmits yellow fever,
the potential for a Nobel Prize
may not be out of line.
NARRATOR:
The morning of September 18,
Jesse Lazear did not
report to work.
The next day he was taken
by ambulance
to the Columbia Barracks
Hospital.
Lazear explained
that he had been bitten
by a stray mosquito
while loading at Las Animas.
But a page
from his laboratory book
later revealed
that he had knowingly
subjected himself to the bite
of an infected mosquito.
WRITER:
When Lazear exposes himself
to yellow fever,
he probably doesn't think
that his risk of dying
is all that great.
He's infected two other people:
Carroll James Carroll
and William Dean.
And they've become ill,
but they're both recovering.
Lazear probably believes
that he, too,
can produce a case
of yellow fever in himself
and that he, too, can recover
and carry on his work.
(labored breaths)
NARRATOR:
News of Lazear's illness
reached Walter Reed
in Pennsylvania.
A career military man,
Reed now realized
that he had left his men
in harm's way.
"I have been so ashamed
of myself for being here,
in a safe country," he wrote,
"while my associates have been
coming down with Yellow Jack.
Still I feel that Lazear
will pull through."
Lazear progressed to an advanced
case of yellow fever.
In the delirium
of his final hours,
a friend reported
he was tormented by thoughts
of his wife and son,
and the daughter
he would never meet.
PIERCE:
When she got the telegram
"Dr. Lazear died this evening,"
she was in horrible shock
because she didn't
even know he was sick.
Didn't know that he had
yellow fever.
She just got a telegram
that he had died.
NARRATOR:
"He was a splendid, brave fellow
and I lament his loss
more than words can tell,"
wrote a devastated Reed.
"But his death was not in vain.
"His name will live
in the history
of those who have
benefited humanity."
When he had left for Washington
six weeks before Lazear's death,
Reed had doubted
Finlay's mosquito theory.
Now, as he returned
to Cuba on October 4,
he was firmly converted
to the belief that the mosquito
was indeed the transmitter
of yellow fever.
WRITER:
Reed has got to be comfortable,
before he tells the world
that, in fact, he has
an indisputable case
of experimentally transmitted
yellow fever
where the mosquito
was the agent of the disease.
NARRATOR:
Known to be cautious
and meticulous,
Reed now worked furiously.
He poured over Lazear's
lab books,
and noted a 12-day interval
between the time of loading
and the day the mosquito
transmitted yellow fever
to Carroll.
16 days in the case of Dean.
This observation fit
with a theory
developed by a doctor
in Mississippi
that there was a lapse
of two weeks
between the first appearance
of yellow fever
and the appearance
of a second case.
PIERCE:
The light bulb probably
just went off and said,
"Hey, this is it.
"You've got to have
this period in the mosquito.
"Not sure what takes place
in the mosquito,
"but it must take place
in the mosquito
and it must take at least
12 days for it to happen."
So I think that was, uh
kind of an epiphany-type thing.
NARRATOR:
During that 12-day interval,
the virus ingested
with a blood meal
matures in the mosquito's
digestive track,
making its way
to the salivary glands
to be transmitted
when the mosquito bites again.
This was the missing piece
The one that had eluded
Carlos Finlay.
Less than three weeks
after returning to Cuba,
on October 23rd,
Reed made his case
for the mosquito theory
at a gathering
of the American Public
Health Association.
PIERCE
It basically had two cases:
it had Carroll's case,
it had Dean's case.
Lazear had died,
but they had no evidence
that he had experimented
upon himself
at that point in time.
He and Sternberg wanted to get
this published
as soon as they could
because they knew
there were other people
working in the field
and they wanted
to get credit for the Army Board
and for the men involved.
NARRATOR:
While some observers
were impressed,
The Washington Post
called the mosquito theory
"silly and nonsensical."
Faced with skepticism,
Reed realized that he needed
incontrovertible proof.
He obtained permission
to pay $100 in gold
to American soldiers
and Spanish immigrants
to serve as volunteers.
$100 more if they became ill.
Though all were required
to sign consent forms,
the human experiments
triggered a wave of criticism.
The Spanish Council in Cuba
issued a formal complaint
to the American authorities.
Reed was undeterred.
On November 20th, 1900,
at an isolated spot in Havana,
Walter Reed opened a specially
designed experimental station.
He called it Camp Lazear.
WRITER:
He designs a camp that accounts
for just about everything
that he can think of
that might interfere
or put any doubt
into his results.
It has to be precise
scientific method.
There can be no sloppiness
at all in what he does.
NARRATOR:
He placed his volunteers
in two separate cabins,
which he called Building One
and Building Two.
HUMPHREYS:
They put one set of volunteers
in a cabin that was screened.
And the cabin was loaded up
with all sorts of nasty things
from yellow fever patients.
Blankets they'd vomited on
and just all sorts of, you know,
diarrhea on the things.
And they had to sleep
in these beds and these pillows
that were soaked
from yellow fever victims,
many of whom had died.
WRITER:
The other building
that Reed sets up
is Building Two it's called
the infected mosquito building.
Same size as the infected
clothing building,
but it's divided
into two chambers
with a screen
between the two chambers.
In one side of the building
is a volunteer.
Infected mosquitoes are let
loose into the building
and they bite the volunteer.
TONE:
The people who were
exposed to mosquitoes,
they caught yellow fever.
The people in the fomite cabin,
of course,
never did catch yellow fever.
It was an elegant
and clever experiment.
And it convinced
the scientific world
that it wasn't some particle
of yellow fever contagion
in the blood or in skin tissue
or something like that.
That it had to be transmitted
via mosquitoes.
He convinces
the scientific world
where Finlay couldn't.
NARRATOR:
Reed invited Carlos Finlay
to Camp Lazear
to witness the success
of his experiment.
"I suppose old Dr. Finlay
will be delighted
beyond bounds," Reed wrote,
"as he will see his theory,
at last, fully vindicated."
It had been 20 years
since Finlay had postulated
that getting rid of yellow fever
meant controlling the mosquito.
Now, Major William Gorgas,
Chief Sanitary Officer,
ordered U.S. Army troops
onto every street,
and into every home
in Cuba's capital, putting
Finlay's theory to the test.
HUMPHREYS:
As soon as he heard
about a case
of yellow fever, the patient was
put in a screened room,
so that the mosquitoes
couldn't get in or out.
And they did things
to eradicate any mosquitoes
that were in that room.
WRITER:
Teams move out across the city
fumigating homes and buildings,
tracking down places
where mosquitoes breed,
eliminating standing water.
NARRATOR:
The campaign was
a resounding success.
In 1900, there had been 300
yellow fever deaths in Havana.
The next year, following the
mosquito eradication campaign,
there was only one.
PIERCE:
Despite what had
had happened in Cuba,
despite the fact that yellow
fever had gone away from Havana
effectively, within months,
not years, but months,
people still didn't
accept the theory
that insects
could carry disease.
NARRATOR:
Back in Washington, Walter Reed
spent much of his time trying
to convince health officials
that controlling mosquitoes
was the key
to controlling yellow fever.
HUMPHREYS:
Reed was particularly frustrated
with some of the leaders
of Southern Public Health
and the State Board
of Health of Louisiana.
He wrote a letter
to one of his friends
and said maybe we should
arrange for a few of them
to be bitten
by some loaded, uh, stegomyia
the name they had for the
Aedes egypti mosquito that
to get them out of the way.
But Reed's influence
in the yellow fever debate
would come to an unexpected end.
In 1902, Walter Reed died from
complications of appendicitis.
The nation's champion of
the mosquito theory was gone.
New Orleans, 1905.
The city once known
as the Necropolis of the South
had been relatively free
of yellow fever
for more than two decades.
Proud officials
attributed the success
to a wall
of quarantine stations,
specially designed
to keep the disease at bay.
TONE:
When a ship came in,
they would make sure
that no one aboard the ship
had yellow fever.
Then they would
go aboard the ship,
they would fumigate it,
they would wash it.
They would use everything
from vinegar to smoke
to try to cleanse the ship,
to sanitize it.
HUMPHREYS:
They filled the holds of ships
with sulfuric acid gas.
They took all the bedding
and clothing
and hung it up
in giant autoclaves
I mean, they were
these giant ovens
And toasted the clothing
up to 250 degrees Fahrenheit.
It was a very impressive
looking apparatus,
and very active service.
The whole system had seemed
to work for 20 years,
so now they're supposed
to just shut these things down?
It did not seem prudent.
NARRATOR:
The head of the New Orleans
Health Board,
Dr. Quitman Kohnke, disagreed.
A firm believer
in the mosquito theory,
he urged his colleagues
to put in place
a program of mosquito control.
HUMPHREYS:
Kohnke said this is
what we need to be doing.
We need laws about screening
cisterns and all the rest of it.
He didn't get very far and
people somewhat laughed at him.
They drew cartoons of this guy
Saint George and the Dragon
fighting off a huge mosquito.
NARRATOR:
In the spring of 1905,
a smuggler's ship
with a cargo of bananas
bridged New Orleans quarantine
wall and quietly made its way
through the backwaters
of the Mississippi.
On June 12,
two suspicious deaths were
reported near the waterfront.
Yellow fever once again
threatened New Orleans.
And once again,
the city was unprepared.
Without effective
mosquito controls in place,
millions of Aedes egypti
bred undisturbed.
Most dangerously
in the 70,000 backyard cisterns
where families
stored their water.
On June 22,
New Orleans authorities
declared an emergency.
By then, 100 people had
come down with the disease.
20 had died.
Kohnke decided there was
no more time to waste.
"Even if you are not positive
"that the mosquito is the only
source of the transmission
of yellow fever,"
he told New Orleans' physicians,
"give your city
the benefit of the doubt
in this important
and vital matter."
Under Kohnke's direction, New
Orleans organized as if for war.
"Science has discovered
the cause and has learned
to exterminate it," heralded
the New Orleans Picayune.
The mosquito control techniques
that the US Army
had used so effectively
in Havana
were now applied
to the Crescent City.
House by house, block by block,
workmen screened cisterns
to prevent mosquitoes
from laying eggs.
To suffocate the larvae,
all standing water was treated
with kerosene.
Saturdays and Sundays
were declared fumigation days.
On a single day,
residents burned
an estimated 300 tons of sulfur.
Giving the mosquito,
as the Picayune put it,
"a dose of real brimstone."
Citizens were urged
to sleep under nets
and help with the oiling
and screening of cisterns.
Fines of up to $25
or 30 days in prison were issued
to those who failed to comply.
It was a race
against the mosquito,
but years of inaction had given
the Aedes egypti a head start.
Barely a month after
the beginning of the epidemic,
600 yellow fever cases
were reported.
The epidemic is spreading
and the city
doesn't have enough money
to fight the epidemic.
So what they do is call
in the federal government.
There's a lot of resentment
to federal power
but also recognition
that that's the only way
we're going to get
this disease under control.
NARRATOR:
"We regard this as the first
crucial test in America
of the mosquito theory,"
proclaimed federal authorities,
and it must be perfect
to be efficient."
WRITER:
They have a mission.
Destroy the mosquito.
There's no if, ands or buts.
If you don't cooperate,
they'll do it for you.
NARRATOR:
Whenever a new case
of fever was reported,
a squad went immediately
to screen the patient's room
and fumigate the house.
They were instructed
to behave unemotionally,
and get their work done.
"It was like watching
a huge machine,
well-oiled and efficacious,"
one reporter wrote.
Still, the epidemic seemed
to be getting out of control.
On August 12,
100 people became ill.
Years before,
the numbers of sick
would have risen exponentially:
thousands would have died
by the first frost.
But this time,
the mosquito control measures
that so many had doubted
made all the difference.
In September, the number
of victims began to decline.
A month later,
the epidemic was all but over.
The final tally for the city
of New Orleans was 452 deaths
A fraction of the toll exacted
by epidemics in the past.
HUMPHREYS:
It really was a triumph
for science
in an era when the expert
is increasingly
being called upon
to guide government action.
NARRATOR:
It would go down in history
as America's most successful
public health campaign
and the last ever waged
against yellow fever
in the United States.
The brilliance of Carlos Finlay,
the dedication of Walter Reed,
and the sacrifice
of Jesse Lazear
spared the United States
the suffering and fear
that once made Yellow Jack the
nation's most dreaded epidemic.
Though a cure for yellow fever
has not been found,
nor the virus eradicated,
in the United States, there has
not been a yellow fever epidemic
for more than 100 years.
There is more at
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