Skeeters stung Philly in the 1790s

Dr. Benjamin RushSkeeters stung Philly in the 1790s

By William C. Kashatus
Philadelphia Daily News
February 25, 2016

The outbreak of the Zika virus in Central and South America has triggered an international public health emergency because of a possible link to microcephaly, a neurological disorder that results in babies being born with abnormally small heads, as well as to Guillain-Barre, a rare syndrome in which the immune system attacks the nerves.

Although the virus was discovered nearly 70 years ago in the Zika forest in Uganda, most people had not heard of it until the past few months. But Philadelphians became very familiar with a similar mosquito-transmitted infection in 1793 when it claimed the lives of 4,400 residents, nearly 10 percent of the city’s population.

Known as “Yellow Fever,” the 1793 epidemic was traced to the Aedes aegypti mosquito, the same carrier of Zika. Like the Zika virus, yellow fever belongs to same family of viruses that exist in a human-mosquito cycle. While the virus is generally confined to tropical and subtropical regions, it is able to adapt to high density urban regions. That’s what happened in Philadelphia during the summer of 1793.

During the early summer, yellow fever had been raging in the West Indies. But the cause was not attributed to the Aedes aegypti mosquito. Instead, Dr. Benjamin Rush, a signer of the Declaration of Independence and the city’s most prominent physician, attributed the virus to “a damaged cargo of coffee dumped by sailors on the Arch Street Wharf.”

Within a month, yellow fever, which had an incubation period of eight to 12 days, reached epidemic proportions. To prevent transmission, he urged Philadelphians to hold handkerchiefs soaked with camphor oil or vinegar to their nostrils as they moved about the streets. Rush also insisted that victims be bled extensively so that “four-fifths of the total volume of blood or twenty pounds be drawn away.” At the same time, the patient should be purged with “high dosages of calomel and jalap.” Although the practice of bleeding and purging was not uncommon for severe viruses, the practice actually weakened the victims, almost insuring a swift death.

The height of the epidemic occurred on Oct. 11, 1793, when the fever claimed the lives of 119 victims. By that time, nearly 20,000 of Philadelphia’s 44,000 residents had fled the city, along with the federal, state and municipal governments.

Rush placed himself in the greatest danger. Working day and night, he made his rounds in the city’s lower class wards, imperiling his own life by treating as many as 150 patients in a single day. Pennsylvania Hospital refused to admit plague victims in an effort to protect the other patients. As a result, the stricken were herded to Rickett’s circus grounds and makeshift hospitals on the outskirts of the city.

The first frost in late October slowed the death rates and many Philadelphians began to file back into the city. On November 10, President George Washington, who retreated to Germantown during the epidemic, also returned, signaling that the city was safe again.

No one suspected the Aedes aegypti mosquito as the cause of the epidemic. Predictably, yellow fever returned to Philadelphia in 1796 and 1797, though neither plague was as devastating as the 1793 outbreak. For those who survived, daily affairs continued. But not without a new appreciation of good health, and a reverence for life itself.