The 1793 Yellow Fever Outbreak in Philadelphia, Pennsylvania
Fleeing from the slave revolution in the Caribbean, French immigrants arrived at the port of Philadelphia in the spring of 1793. They were unaware that their arrival would unleash Yellow Fever upon the city. The disease was so devastating that it killed nearly 10% of Philadelphia’s population. All throughout the summer, Yellow Fever wreaked havoc in the city. People suffered from fever and bloody vomiting. Plus, they exhibited the hallmark sign of yellow skin, for which the disease likely received its name.
Yellow Fever spread primarily through mosquitoes, which is why it was rampant in warm countries in Central America, South America, and Africa. At its peak, Yellow Fever killed over 5,000 people in just four months. Amid the deaths, plenty of people also sought to escape Philadelphia. However, the exodus was overwhelming enough that some neighboring cities refused refugees while some enforced quarantines. It wasn’t until the weather cooled that the outbreak abated, with the frost likely eliminating the mosquito population and the diseases it carried.
Have you ever played the old-school computer game called The Oregon Trail? Okay, they have newer versions of the game, and one way to die is cholera. It was common back in the day and is an ongoing joke on the silly (raunchy) movie A Million Ways to Die in the West. The situation was dire and the future was bleak.
This was the mood in the city of New York in July of 1832 when a mysterious, yet highly infectious disease started to ravage the city. It caused thousands to flee and many more to succumb to gastrointestinal infections. The epidemic was cholera, a waterborne outbreak that spread swiftly from India throughout the rest of the world. When it reached the shores of New York, it killed roughly 3,515 of the city’s 250,000 population.
Cholera is a bacterial infection that spreads through contaminated food and water. In the 1800s, when modern sewage and water treatment were yet to be a feature of most cities, lack of sanitation likely drove the disease to proliferate. It would be years before cholera outbreaks started to abate and eventually peter out in the early 1900s. Nevertheless, the condition still exists today, with about 95,000 reported deaths a year worldwide.
With cholera, immediate treatments are crucial to mitigating its more lethal effects. Widespread use of antibiotics, zinc supplementation, and rehydration can keep patients from worsening, while modern sewage, vaccines, and good hygiene have been key to keeping the disease at bay.
Living in a big city can be a glamorous experience, sure. Yet sometimes it isn’t all its cut out to be. With a large, often crowded population, cities like New York are prone to disease outbreaks. Case in point: not only has New York dealt with a cholera epidemic in the 1800s, but just a century later, it also had to contend with a serious outbreak of polio. A largely asymptomatic illness, polio spreads through contaminated food and water and can lead to paralysis and even death. When the disease overtook New York in 1916, it infected several thousand people and killed two thousand, primarily in the borough of Brooklyn.
Back then, doctors knew little about the disease, and the city’s primary way to fight it was through a combination of quarantines, public space closures, sanitation, and the emergence of special clinics to fight it. Polio eventually receded to oblivion with the success of vaccines. However, recently, doctors detected it once again in New York City, of all places.
New York just can’t catch a break on the disease front. As if dealing with cholera and polio wasn’t enough, the city also had to contend with a severe typhoid outbreak fever that was spread famously by Mary Mallon. Often referred to as “Typhoid Mary,” Mary Mallon was a cook on an estate and a unit hospital. During her time there she became largely responsible for spreading the bacterial infection to about 122 New Yorkers of which, 5 died.
The total casualty count during that 1906-1907 outbreak was 25,830, with Mary as the primary driver of the disease. Typhoid typically causes sickness and red spots to form on the chest and abdomen, and thought prevalent at the time, it is now rare thanks in large part to a vaccine developed in 1911 and antibiotic treatments in 1948.
Most of the pandemics the world has ever lived through have been catastrophic events, killing millions and drastically reducing the human population. But if there was a single pandemic responsible for the most death and devastation in human history, that title belongs to the Black Death. This bubonic plague ravaged Europe, Africa, and Asia in the mid-14th century. The plague was so widespread and devastating that it killed between 75 and 200 million people. It reduced the population of Europe by 30-60 percent. Likewise, the Middle East had a third fewer people by the time the plague receded out of circulation.
Yes, the plague’s origins are still uncertain. Nevertheless, researchers first found it in Crimea before spreading through trade routes to parts of Europe and Africa. Infected fleas living on rats were the primary vector for the spread of the disease. However, researchers believe that they eventually spread via aerosols making the transmission of the disease more efficient and, as a result, more deadly.
My kid, my choice? With so many recent advances in the health sciences, it’s hard to imagine widespread outbreaks of a particular disease in modern times, and yet that is precisely what happened in Los Angeles in 2010 when the city experienced one of the highest reported numbers of cases of Pertussis in more than 60 years. Over 9,000 cases of Pertussis or whooping cough at the time led to 809 hospitalizations and ten deaths. Measles and whooping cough came back with a vengeance.
Most of the patients affected were Hispanic babies younger than six months. Likewise, all deaths and hospitalizations occurred primarily among infants three months or younger. The government responded with tetanus, diphtheria, and pertussis vaccination drives in response to the unprecedented spread of the disease and to protect the youngest individuals. They also had public and provider education, as well as free vaccines for postpartum women and infant contacts. The world is yet to see the last of Pertussis. Fortunately, though, with vaccinations and early mitigation, we just might be able to drive it back into irrelevance.
The only thing surprising about being named “The Heaviest Drinking Metro Area” in a state known for having beer as its best product is that the title doesn’t belong to Milwaukee. Although they’re technically the “Brewers,” it’s that the crown sits on neighboring Green Bay’s head. About 26.5% of the adult population in Green Bay drink excessively, a number higher than the state average of 26.2%. In comparison, the standard for the country is only about 18%.
It’s not exactly clear if the excessive drinking rates in the metro Green Bay area create a particular public health problem. There haven’t been any studies linking the higher-than-average alcoholism to incidences of cancer, other illnesses, gun violence, or domestic abuse. However, there seems to be a link to cases of alcohol-related driving deaths. Studies show that about 50% of driving deaths in Green Bay involved alcohol consumption to some extent.
It’s already been five decades since Lionel Richie and Michael Jackson launched a united effort to end hunger in Africa. Who remembers their song “We Are the World?” Yet, the world is no close to helping African countries with food security. In Somalia alone, the most recent report by UNICEF paints a dire picture: worsening drought and famine could lead to malnutrition in children, with 1.8 million (54.5%) children projected to suffer from acute malnutrition and another 513,550 children likely to become severely malnourished in the coming months.
Add to that the rising number of cholera cases that compound the drought and hunger that the country is currently facing, and it is a recipe for disaster. The Somali government and other humanitarian organizations have been working with UNICEF to address this problem. However, the global aid agency warns that the situation could get much worse if operations don’t scale up than even their most dire projections.
One of the poorest cities in the world is Monrovia, the capital of Liberia. The city has been plagued with civil war since the 1990s, giving rise to child soldiers, land mines, and conflicts with neighboring Sierra Leone. Even after the civil war abated, the city still struggled to regain its footing. As a result, it fell far behind other capital cities in terms of the quality of life for its residents. With 54% of the population living below the poverty line, the World Bank highlights the difficult living conditions in the city. Most of its inhabitants practically surviving on only $2 a day.
Even the city’s infrastructure is a testament to the inescapable poverty of its residents. Narrow, poorly paved streets litter the downtown area, and they are unable to keep up with the demand for personal vehicles. Public transportation is virtually non-existent in a city prone to flooding and diseases. Lack of running water, an erratic power supply, and substandard healthcare all contribute to keeping Monrovia one of the poorest cities in the world.