Eventually, however, the severity of the outbreak became impossible to deny. Pennsylvania Governor Thomas Mifflin declared the presence of a contagious fever in Philadelphia. Benjamin Rush, along with other physicians, published lists of recommended prevention methods. People and goods arriving by ship in the Port of Philadelphia were subject to quarantine measures, and members of the public began to avoid contact with one another. Once political leadership acknowledged the epidemic, the city’s economy and social scene froze. Philadelphia came to a standstill, and everything from intimate familial relations to mourning rites were affected. Rush notes the effects in a letter to his wife: “parents desert their children as soon as they are infected, and in every room you enter you see no person but a solitary black man or woman near the sick” (Pruitt). Infected people with no relatives taken to Bush Hill, a mansion that was turned into a quarantine hospital where patients were made comfortable during their last days. Proper burials became scarce as, by October, up to 100 people died a day (“Yellow Fever”). The deaths from the fever constituted nearly 10% of the city’s total population within a three-month interval (Shryock 10). The logistical problem of removing numerous and possibly contagious corpses was solved by the essential labor of mostly Black volunteers. They pulled carts around the city and called on Philadelphians to “Bring out your dead!” According to historian J.H. Powell, the bodies of the dead seemed not to belong to anyone as they were carted away for burial as part of the “sad routine” (181). Soon, mass burial sites were filled to capacity and closed. For all the pride Philadelphia took in its medical establishment, they had very little idea how to address the outbreak. What we now know is that Yellow Fever is a Flavivirus transmitted through Aedes aegypti mosquito bites. In moderate cases, the virus accumulates in the lymph nodes and, in mild cases it presents as aches, fever, nausea, and dizziness, before resolving. In severe cases, the symptoms resolve only briefly before returning in a new, more dangerous form. In such instances, the virus progresses to the liver, inducing jaundice and internal hemorrhaging (Finger). The patient experiences delirium as they bleed out of their ears and nose and retch bloody gastric contents or “black vomit.” In the terminal phase of the disease, they become comatose as their organs fail. Epidemiological evidence suggests that the disease originated in Africa and was brought to the United States through the Atlantic slave trade, but this would not be understood until nearly 100 years after the epidemic in Philadelphia. The outbreak was most likely brought to the city with sick passengers and Aedes aegypti mosquitoes in ships from Saint-Domingue, where Yellow Fever was a regular occurrence. Immunity is acquired when patients survive the infection, so Philadelphia’s population, which had little to no exposure to the disease (the last outbreak had occurred more than 30 years ago), provided 56
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