Could Yellow Fever Return To The United States?

Peter Hotez and Kristy Murray from Baylor College of Medicine highlight the potential for yellow fever to return to the southern cities of the United States

In the summer-fall of 1878 an epidemic of yellow fever destroyed the city of Memphis, Tennessee.  Likely introduced into the Caribbean by trade from the West Coast of Africa and later brought up the Mississippi River by a steamer ship (the Emily B. Souder) with sick and dying sailors, yellow fever killed an estimated 5,000 Memphis residents, almost one-third of its population who did not flee the city that August [1].   According to Molly Caldwell Crosby in her detailed account, the summer-fall 1878 yellow fever epidemic in the Mississippi Valley was possibly “the worst urban disaster in American history” [1].

Among the factors responsible for the 1878 tragedy were an unusually warm winter and spring that year, which helped Aedes aegypti mosquitoes  to flourish in the Mississippi Valley, together with a lack of adequate urban drainage and a functioning sewer system, and a susceptible (non-immunized) population – the yellow fever vaccine would not be developed for another 50 years.