Monthly Archives: January 2014

Walter Reed and the Deadly Yellow Jack

During the Spanish-American War, Robert Cooke and two other soldiers of the US army volunteered for an especially hazardous and unusual job. They agreed to come face to face with an enemy that had, over the course of the previous century and before, taken down thousands of US soldiers, an enemy far deadlier than any human brandishing a weapon. As part of a noble experiment, these brave men agreed to spend twenty days in a simple frame structure full of filthy, smelly carpet, bedding, and other textiles. They would exchange their uniforms for the filthy stinking ones they found in the building. The conventional wisdom was that these men would never walk out of this building. They would have to be carried out. And if they survived, it would be by the grace of the Almighty God. Quite simply most regarded it as a suicide mission.

Their commanding officer thought otherwise. He was in charge at Camp Lazear, a unique experimental facility in Cuba in late 1900. He was sure that these healthy men would get sick to their stomach and lose a meal or two in that filthy place, but otherwise they would be fine. The dreaded enemy wouldn’t bother them. Though he was sure they would come to no real harm, Dr. Walter Reed admired their courage nevertheless. He hated it that human volunteers, human guinea pigs, were so necessary for this project. But there was no other way.

The dreaded enemy was Yellow Fever, often called “Yellow Jack.” And it was serious. This malady, a scourge of American civilization, seemed to have originated in Africa in the early years of the slave trade. Traveling over the Atlantic in ships loaded with their sad human cargos, it was a deadly import to the Americas, afflicting slave trading Europeans as a sort of divine revenge growing in proportion to the slave trade itself. Major epidemics afflicted English, Spanish, French, and Portuguese colonies and plantations, especially in the Caribbean and in Southern ports along the Gulf Coast. Native Americans, at least those who had survived the various smallpox epidemics now had another worry. Only the Africans seemed, for the most part, immune. Unfortunately this didn’t help them. Since they weren’t particularly vulnerable to the malady, this made them all the more desirable as slaves. And the terrible slave trade continued until finally outlawed in the Americas in the mid-nineteenth century. By then Yellow Fever was firmly established.

Yellow Fever was the most dreaded disease in North America for over two hundred years. There was no cure. All that could be done was to try to keep it from breaking out in the first place or to keep it from spreading when it did break out. Upon arrival in a port ships were often quarantined and the crews forced to remain on board until local authorities, after making the necessary examinations, were sure that no sick persons were aboard. When epidemics broke out in towns and cities healthy persons fled to the countryside and sick persons were kept in hospitals apart from the general population. Their clothing and bedding was burned. Floors were scrubbed with chemicals and every effort was made to keep the “infection” from spreading. But all too often it seemed that the epidemics, despite the best efforts of doctors and health officials, simply had to run their course. And, curiously enough, those epidemics always broke out in warm or hot weather. In more temperate areas, with the first frost and the coming of cooler weather, new cases diminished and finally ceased.

US history is replete with Yellow Fever epidemics. The worst occurred in the city of Memphis, Tennessee in the summer of 1878, when it seemed that the wrath of God visited that place. At the beginning of the terrible episode half the population departed and stayed away until the thing had run its course. Many businesses closed, some never to reopen. Thousands died, especially among those who stayed in the city. No class or ethnic group was spared. Entire families perished. “Death wagons” with coffins piled high, rolled down the streets collecting the latest victims day after day, week after week. Memphis nearly became a ghost town. Even now one can visit Memphis cemeteries filled with Yellow Jack victims. Many graves are unknown because when buried, no persons remained alive who could identify the deceased. Curiously enough, the African-American population was the least affected. Their death rate was much lower.

The symptoms of Yellow Fever are easy enough to spot. First, the victim feels a severe headache and loss of energy. Then comes a painful sensitivity to light. Then comes a terrible high fever, the body’s attempt to kill the invader. The victim feels as if his/her bones are cracking. If the condition worsens, the kidneys shut down and the body is poisoned. Blood seeps from the eyes and nose. The tongue swells and turns purple. A black vomit pours out and the whites of the eyes turn yellow shortly before death-thus the disease is named. When fatal, the whole process usually lasts about seven to ten agonizing days. It’s not a pleasant way to go.

The malady is not always fatal. As often as not, the victim recovers. When this occurs, he/she develops immunity, and is likely to survive the next epidemic. Often such survivors later rushed to assist in areas where epidemics had broken out. A number of those working in US army hospitals in 1900 in Cuba were survivors of the 1878 Memphis plague.

Yellow Fever and Malaria were the big killers in the Spanish-American War. Of the 5000 or so Americans who died, only 180 died as a result of warfare. The Spanish military was the least of our problems in that popular, “splendid little war.”

Major Walter Reed, a native of Virginia in his late forties, a career soldier and longtime member of the medical corps, was determined to do something about it. Though highly regarded by his peers, most of these respectfully disagreed with him on his theories regarding Yellow Fever, including the surgeon general himself. Nevertheless, because of the magnitude of the problem, he was able to secure permission and funding for a bold experiment in Cuba. His laboratory would be Camp Lazear, named in honor of a comrade and dear friend who had perished the previous year in Yellow Fever research.

Reed believed that the infection was spread, not by any sort of human contact or through contact with the possessions of yellow fever victims but by the bite of the lowly mosquito. That was, in his view, the ONLY way contract the disease. No one could ever get it by contact with a diseased person or his things. Quite simply, it couldn’t spread in this way. In 1900, this was a highly controversial view, a view scoffed at by most of Reed’s peers.

Walter Reed was not the first to suggest this. Other doctors and researchers had published papers and made reports along similar lines. But none of these had been able to offer real scientific proof. In 1900, it was still widely believed that Yellow Fever was contagious and spread from person to person through close contact or somehow upon or within the possessions of sick persons in a manner similar to smallpox or cholera. Gases emanating from swamps could spread the sickness as well it was thought. Malaria, interestingly enough, had been linked to the mosquito, but the medical community, for various reasons, refused to do the same with Yellow Fever.

When Cooke and his two friends happily emerged from the Infected Clothing Building after an unpleasant, but uneventful twenty day stay, Reed felt vindicated. As he had predicted, they were fine. No one had been stricken with the disease even though they had been deliberately exposed to clothing, bedding and other textiles that had been used by or come in close contact with yellow fever patients.

This was huge. For years people had been burning clothing, furniture, and cleansing buildings in an attempt to halt “contagion.” For many years people had been quarantined and separated from loved ones when stricken with the deadly pestilence. Extraordinary and expensive measures, born of fear and desperation, had been the accepted mode of dealing with Yellow Fever epidemics such as the departure of nearly half the population of Memphis from the city in 1878 when it was announced that the disease had appeared in their city. By getting away from the diseased and their infected homes and possessions, one would probably avoid the disease.

In one bold stroke, Walter Reed and his associates proved that nearly all of these oft employed extreme measures were utterly useless and needlessly cruel. Yellow Fever was not contagious like smallpox. If anything could give a person Yellow Fever, wearing the stinking, filthy, vomit stained uniform of a Yellow Fever patient should do it. Sleeping on the bedding or using the blankets and sheets from a Yellow Fever patient should do it. But it didn’t. The test had been unpleasant and sickening for Cooke and his comrades. Their stay in the Infected Clothing Building made them sick at their stomachs but hadn’t made them sick with Yellow Fever.

Reed wasn’t finished. It had long been a universally accepted fact that one could “catch” Yellow Fever from a sick person, that it was contagious and therefore spread by human contact. Reed thought not. A human being couldn’t give you the disease. This was an even more radical notion than his belief that “infected “ things were harmless. He had observed that many of the non-immune volunteers at hospitals full of Yellow Fever patients NEVER came down with it. In those areas stricken with epidemics, plenty of people who had come in close contact with the diseased never developed the malady. For a non-immune person, working at a hospital or being around the sick at home or elsewhere was risky, but it was not a surety that he/she would develop the malady. Furthermore, many of those who had fled Memphis in 1878, people who had had no contact with the sick, nevertheless came down with it. It almost seemed to be in the air they breathed but that really didn’t make any sense. Something else was spreading it. And Reed had a good idea as just what was responsible.

Now, Reed knew, was the time and place to prove it. He made ready for the next experiment. They were a long ways from a cure, but finding out just how the disease spread, or rather did NOT spread, would be a major step. Now they would seek to answer this question: If not through human contact, just how was a healthy person infected with Yellow Fever? It had to be the mosquito. Nothing else made sense.

The theory that the lowly, tiny mosquito spread the pestilence from one person to another(as mentioned before) was not a new one. Walter Reed was not the first research doctor to hold this idea. At Camp Lazear he resolved once and for all to answer the question: was this little bug the culprit? Could it be that the simple mosquito bite was the thing to be avoided, not contact with an infected person, either direct or indirect? Reed had to prove it. The many skeptics out there, particularly in the medical community, demanded hard proof. Until this was produced, the old ways of dealing with the disease would continue.

In another one room building called the Infected Mosquito Building at Camp Lazear, Reed conducted the next important experiment. Into this building he placed three healthy, non-immune volunteers. A large screen or tight-woven net was placed down the middle with two men on one side and John Moran on the other. All three men breathed the same air, used the same linens, ate the same food, wore the same clothing etc. except for one important difference: Carefully selected mosquitoes raised and cultivated in a nearby laboratory were released on Moran’s side of the net. He allowed himself to be bit multiple times. On the “safe side” the other two were protected. They received no bug bites.

It didn’t take long to get results. On Christmas Day John Moran, after only four days in the building, awoke with a headache and chill. Later that day his temperature was 104 degrees. He remained in the room and was treated there. Without a doubt he had contracted Yellow Fever. Over the course of his illness he lost twenty pounds. But, fortunately, he survived and lived to tell the tale. The two men on the other side of the building watched it all and stayed for the entire allotted time staying in close proximity to Moran. They never contracted the illness.
Walter Reed was elated. Finally, the long-awaited scientific breakthrough had been accomplished. It was the mosquito all along and only the mosquito. There was no longer any doubt.
No one had yet identified just what the nasty little bug was doing to its human victims, but he was doing more than simply taking blood OUT of humans and moving their blood around from person to person: he was putting something deadly INTO a human at the same time. We know now of the Yellow Fever virus. But it would be several more years and many more hours in laboratories before this tiny, tiny sneaky and highly adaptable killer would be isolated and identified. Other forms of Yellow Fever, different from the American variety, would be discovered in Africa. More researchers would die. Although it has largely been banished from the Americas, (for the time being)Yellow Fever, in various forms, remains a terrible scourge worldwide.

Walter Reed and his brave volunteers simply pointed us in the right direction. Not only did they not discover the virus, the real enemy, they didn’t discover a cure for Yellow Fever. But finally at long last, the means by which that tiny enemy was injected into humans had been identified. For all practical purposes the mosquito WAS the enemy. And in most wars, enemy identification is half the battle. Reed and his associates discovered that the more a person was protected from mosquito bites, the better were his chances of avoiding a bout with Yellow Fever. It was that simple. Fight the mosquito and you fight Yellow Fever.

Reed’s findings gained quick acceptance and a war against the mosquito ensued. When possible, swamps were drained and stagnant pools emptied. Extensive use of insect repellants and netting helped as well. The results were remarkable. When, a few years later, enormous crews arrived in Panama to resume the construction of the long-awaited canal, they did the smart thing and attacked the mosquito first. Yellow Fever casualties were kept to a minimum. This time there was no epidemic and one of the greatest engineering feats in human history, the Panama Canal, was finally completed in 1914. Reed and his courageous volunteers at Camp Lazear had made this possible.

Walter Reed returned to the United States a hero, the recipient of promotions, awards and honorary degrees. He is best remembered in our time for the Washington DC military hospital that bears his name. Unfortunately he didn’t enjoy his new found success for long. He died in 1902 of a ruptured appendix at the age of 51.
Today Walter Reed is regarded as the brilliant research doctor who gave humankind a long-awaited breakthrough, the first great victory in the long war with a deadly killer: Yellow Fever. We owe him a great debt.

SOURCE: THE AMERICAN PLAGUE by Molly Caldwell Crosby, Berkley Books, New York, 2006.




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