Seeing large numbers of people in China and elsewhere being quarantined due to the new coronavirus brings to mind that in 1878-79, citizens of Little Rock and many other Arkansas towns implemented strict quarantines during the yellow fever epidemic then plaguing the lower Mississippi Valley.
While Arkansas escaped the kind of death count that saw Memphis undertakers unable to bury all the dead, the epidemic vividly demonstrated how unprepared the state was to deal with epidemics.
In 1878, Arkansas did not have a public health program to react to the outbreak of feared diseases. The cause of yellow fever was unknown in the 1870s, so developing methods for dealing with the mosquito-borne disease were generally wasted.
Historian Timothy Wingard, in his engaging new book Mosquito, describes yellow fever as one of at least 15 debilitating and deadly diseases carried by female mosquitoes: "Mosquito-borne pathogens can be separated into three groupings: viruses, worms, and protozoans (parasites)."
Yellow fever and its not-as-toxic twin malaria are both caused by viruses. The female Anopheles mosquito is to blame for generations of Arkansans suffering from malaria, with its alternating fevers and chills and sometimes death.
A particular species of female mosquitoes, Aedes aegypti, carries the yellow fever virus and is now better known for causing Zika fever. This African species came to the new world aboard slave ships. A certain karma might be at work here, since many enslaved Africans benefited from an evolved resistance to some mosquito-borne diseases, while their new owners usually had none.
Although people speculated over the centuries on a possible connection between insects and yellow fever, it was not until 1901 that researchers under the leadership of U.S. Army physician Walter Reed confirmed the cause.
While 19th-century Arkansans did not know the cause of yellow fever, the disease was all too well-known. Originating in Africa about 3,000 years ago, yellow fever has initial symptoms similar to malaria, but a majority of sufferers recover quickly. An unfortunate 25 percent or so suffer delirium, jaundice (hence the name yellow fever), severe abdominal pain, diarrhea, and bleeding from the mouth, nose, and ears. A coma usually precedes death.
Called vomito negro by the Spanish and Yellow Jack by the British, yellow fever came to the Americas at least by 1647. In the United States, outbreaks usually occurred along the Gulf Coast or major inland waterways. The epidemic of 1853 killed 13,000 people, with 9,000 deaths in New Orleans alone. One New Orleans doctor said the ravages of the epidemic went "far beyond decimation." Newspapers told of outbreaks in Florida, Alabama, and Texas.
When a yellow fever epidemic struck Memphis in the summer of 1878, Arkansans were terrified. Five years earlier, in the summer of 1873, yellow fever had made a deadly appearance in Memphis, resulting in a spillover into Arkansas. Thirteen cases had been diagnosed in Arkansas, most of them among refugees from Memphis, all quarantined to the north side of the Arkansas River.
Little Rock's response to the 1873 threat had been hampered by what late historian Ira Don Richard described as a board of health given to "dilatory ways." He attributed this to a fear among some members of the board that quarantines would cause "economic disruption."
Local authorities faced some of the same concerns in 1878, but were forced to act decisively by the scale of the Memphis epidemic as well as a frightened public.
On Aug. 3, 1878, when word arrived in Little Rock that yellow fever had been detected in New Orleans, city authorities acted swiftly, activating the city's health board and establishing a quarantine. The city board of health consisted of five prominent physicians, at least two of whom were later founders of the local medical school.
Later, when resistance arose to board edicts, a group of lay advisers--including future governor Simon P. Hughes--were added to the board to provide political cover. The advisers were also expected to raise funds to support the work of the board since neither the city nor the state provided funding.
With no state health board, it fell upon the Little Rock board of health to extend its reach beyond the five-mile limit authorized by state legislation. The board decided to follow both of the prevailing schools of thought on dealing with yellow fever: quarantines and sanitation. Enough money was raised to buy barrels of carbolic acid to clean sidewalks and public places. Neither of these approaches fully dealt with the fact that mosquitoes were the culprits.
Little Rock residents began to panic when they learned on Aug. 13 that yellow fever had arrived in Memphis, only 125 miles away. A public meeting the following day--described by one historian as large and chaotic--led the health board to extend the quarantine all the way to Hopefield, the railhead opposite Memphis. Both rail and water travel were prohibited.
Stopping the trains left passengers stranded. The state had to send a special train to Forrest City to retrieve Gov. William R. Miller. Historian Sarah C. Hudson has written that the most inconvenienced was a group of more than 100 passengers, including women and children, forced to disembark at the Galloway depot about 10 miles east of Little Rock. Many were believed to be from Memphis.
Galloway was merely a stop, and no facilities existed to house the unfortunates. Following a "piteous appeal" from the stranded travelers, the medical board authorized an evacuation by rail, but that did not materialize because of fear among the train crews.
Local residents shared that same fear, as Sarah Hudson has written: "Except for a few kindnesses done by some black residents, the people of Galloway refused to help the refugees in any way." Finally, Phil Pfeifer, a lay member of the board of health, managed to provide food and water as well as a transfer to Little Rock.
Towns located along the closed rail lines and the Arkansas River soon were pleading for special "relief trains" to deliver medicines and food. The board of health determined on Aug. 21 that "there is no sanitary reason why transportation should not run locally between Little Rock and Forrest City." These efforts to lift the total quarantine resulted in threats to destroy the tracks on the Memphis line. A hostile public meeting in Little Rock made things worse.
However, by the end of August, the board allowed limited train service to Forrest City and boat service to Pine Bluff.
Other cities also imposed quarantines, including Helena, where armed pickets patrolled the perimeter of the city. Smaller towns sometimes had informal and arbitrary quarantines, derisively called "shotgun quarantines" by the more civilized folk. Many of the local boards of health also coordinated their work with the Little Rock board.
In essence, as Sarah Hudson has contended, the Little Rock board of health demonstrated in 1878 the need for a state board of health. That would not happen until 1881 when the Legislature created a board but failed to provide meaningful funding.
It appears that no one died in Little Rock during the 1878 crisis. However, about 30 residents volunteered to go to Memphis to treat the sick. At least one of the volunteers was a physician, but most were men and women described as "nurses." On Sept. 10, word reached Little Rock that "eight Little Rock nurses are down, one dead." Eventually nine of the Arkansas volunteers would die in Memphis, including Dr. E.T. Easley.
Tom Dillard is a historian and retired archivist living near Malvern. Email him at Arktopia.email@example.com.
Editorial on 02/16/2020
Print Headline: Battling the spread of yellow fever