We are NOT authorized by Govt of India for Yellow Fever Vaccination

Thursday, September 25, 2014

More than 1 million Ebola cases may hit West Africa by January - CDC Estimate

 The Ebola epidemic in West Africa could reach up to 1.4 million cases by late January 2015 under a worst-case scenario, says a report by the U.S. Centers for Disease Control that comes as experts from the World Health Organization call for drastic improvements in measures to prevent the virus from becoming endemic.
In a worst-case scenario, Liberia and Sierra Leone could have 21,000 cases of Ebola by Sept. 30 and 1.4 million cases by Jan. 20, the CDC model suggests, assuming that effective control measures aren’t put into place.
"A surge now can break the back of the epidemic," Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, told reporters on Tuesday.
The model also shows the severe cost of delay, which not only increases the risk of deaths and further infections but makes the job of stamping out Ebola more difficult, Frieden said.
The CDC analysis focuses on data available in August from Liberia and Sierra Leone, two of the three worst affected countries. Guinea, where the epidemic started, was not included.
The analysis is based on a mathematical model that allows researchers to test how different actions affect the course of the epidemic.

Value of immediate action

The World Health Organization published another analysis of data from the first nine months of the epidemic in all three countries late Monday in the New England Journal of Medicine.
"If we don't do anything immediately then the exponential growth that has been forecast will continue, so far as we can see, and we'll have not a few thousand cases but probably tens of thousands of cases," said Christopher Dye of the World Health Organization in Geneva.
Dye said they’re beginning to see signs in the response that offer hope the increase in cases won’t happen. For example, when Ebola entered Lagos in Nigeria, a city of 20 million people, health officials were able to stop transmission, he said.
Speed is of the essence, both CDC and WHO stressed. Had there been more interventions in Guinea between March and July, for example, control could have been achieved, the WHO researchers said.
Dye’s team also calculated the death rate to be about 70 per cent among hospitalized patients. Part of the difficulty in estimating the fatality rate is that many Ebola cases were only identified after death.
The researchers used data from informal case reports, diagnostic labs and burial records for the study.
The case fatality rate among hospitalized patients could differ from patients who are never seen by a doctor, the researchers said.
The WHO researchers said they infer that the epidemic is "exceptionally large" not because of the biological characteristics of the virus itself but rather features of the affected population  such as the highly interconnected populations in the three worst-affected  countries and insufficient control efforts so far.
Ebola virus temperature checks
Tundunwada Secondary School principal Enenwan Essien checks a student's temperature for Ebola during an assembly in Abuja, Nigeria, on Monday. Health officials were able to stop transmission in Lagos, Nigeria, Doctors Without Borders says, a hopeful sign. (AFP/Getty)
Dr. Armand Sprecher, an infectious diseases specialist at Doctors Without Borders, questioned WHO’s projections.
"It's a big assumption that nothing will change in the current outbreak response," Sprecher said. He noted that Ebola outbreaks usually end when people stop touching the sick and practise safe burial, which local health officials in West Africa now emphasize in education campaigns.
Gayle Smith, special assistant to U.S. President Barack Obama and senior director of the National Security Council, also stressed that there’s been a tremendous surge in resources and response to the Ebola outbreak in the last few weeks.
The surge includes a pledge from the U.S. to build more than a dozen medical treatment centres in Liberia and to deploy 3,000 troops to help. Britain and France have also pledged to build treatment centres in Sierra Leone and Guinea. The World Bank and UNICEF have sent more than $1 million worth of supplies to the region.
The African Union is deploying health-care workers, and Asian countries, South Africa and Cuba have also responded, Smith said.
To stop transmission in the community, the WHO team said, the period from when symptoms appear to hospitalization needs to be reduced from the average of five days reported in the study. Surprisingly, the researchers said, the average time was not shorter among health-care workers, who are both at higher risk of infection themselves as well as transmitting it to others.
So far, about 2,800 deaths have been attributed to the Ebola virus in the current outbreak.
In Sierra Leone, officials said they found 130 confirmed cases of Ebola infection during a weekend lockdown designed to slow the spread of the outbreak.
About 70 more suspected cases are still being tested, said Deputy Minister for Political and Public Affairs Karamoh Kabba.
With files from The Associated Press and Reuters

Tuesday, September 9, 2014

Polio cases reported from Cameroon, Ethiopia, Equatorial Guinea & Somalia - CDC Alerts

Cameroon
Updated: August 11, 2014

Nearby Polio Outbreaks:

What is the current situation?

According to the Global Polio Eradication InitiativeExternal Web Site Icon, as of August 11, 2014, 5 cases of polio have been reported in Cameroon for 2014. There were also 4 cases reported in 2013. This outbreak of polio is the first reported in Cameroon since 2009.
CDC recommends that all travelers to Cameroon be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. As of May 5, 2014, people of all ages staying in Cameroon for longer than 4 weeks may be required to show proof of polio vaccination when departing Cameroon. Polio vaccine must be received between 4 weeks and 12 months before the date of departure from Cameroon and should be officially documented on a yellow vaccination card (International Certificate of Vaccination or Prophylaxis). Travelers should talk to their doctor about making sure they are properly prepared for any requirements they may face exiting Cameroon.
Because of the risk of cross-border transmission, CDC recommends a single lifetime booster dose of polio vaccine for fully vaccinated adults who are traveling to Central African Republic (CAR), Chad, Republic of Congo, and Gabon to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.
For travelers to the bordering country of Nigeria, where polio remains endemic, CDC also recommends that all adults receive a single lifetime booster dose of polio vaccine.
Equatorial Guinea
Updated: July 25, 2014

Nearby Polio Outbreaks:

What is the current situation?

According to the Global Polio Eradication Initiative,External Web Site Icon as of July 15, 2014, 5 cases of polio have been reported from Equatorial Guinea. Before 2014, no cases had been reported in Equatorial Guinea since 1999.
CDC recommends that all travelers to Equatorial Guineabe fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. As of May 5, 2014, people of all ages staying in Equatorial Guinea for longer than 4 weeks may be required to show proof of polio vaccination when departing Equatorial Guinea. Polio vaccine must be received between 4 weeks and 12 months before the date of departure from Equatorial Guinea and should be officially documented on a yellow vaccination card (International Certificate of Vaccination or Prophylaxis). Travelers should talk to their doctor about making sure they are properly prepared for any requirements they may face exiting Equatorial Guinea.
Because of the risk of cross-border transmission, CDC recommends a single lifetime booster dose of polio vaccine for fully vaccinated adults who are traveling to Gabon to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.
Ethiopia

What is the current situation?

According to the Global Polio Eradication InitiativeExternal Web Site Icon, in 2013, 10 cases (1 case in 2014) were reported from the Somali Region of Ethiopia. These are the first wild poliovirus cases reported in Ethiopia since 2008.
CDC recommends that all travelers to Ethiopia be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. As of May 5, 2014, people of all ages staying in Ethiopia for longer than 4 weeks may be required to show proof of polio vaccination when departing Ethiopia. Polio vaccine must be received between 4 weeks and 12 months before the date of departure from Ethiopia and should be officially documented on a yellow vaccination card (International Certificate of Vaccination or Prophylaxis). Travelers should talk to their doctor about making sure they are properly prepared for any requirements they may face exiting Ethiopia.
Because of the risk of cross-border transmission, CDC recommends a single lifetime booster dose of polio vaccine for fully vaccinated adults who are traveling to Djibouti, Eritrea, Kenya, Sudan, South Sudan,* and Yemen to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.
Somalia

What is the current situation?

According to the Global Polio Eradication InitiativeExternal Web Site Icon, as of July 21, 2014, 4 cases have been reported in Somalia for 2014. In 2013, 194 cases of polio were reported from Somalia. These are the first wild poliovirus cases reported in Somalia since 2007.
CDC recommends that all travelers to Somalia be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. As of May 5, 2014, people of all ages staying in Somalia for longer than 4 weeks may be required to show proof of polio vaccination when departing Somalia. Polio vaccine must be received between 4 weeks and 12 months before the date of departure from Somalia and should be officially documented on a yellow vaccination card (International Certificate of Vaccination or Prophylaxis). Travelers should talk to their doctor about making sure they are properly prepared for any requirements they may face exiting Somalia.
Because of the risk of cross-border transmission, CDC recommends a single lifetime booster dose of polio vaccine for fully vaccinated adults who are traveling to Djibouti, Kenya, and Yemen to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.

What is polio?

Polio is a disease caused by a virus that affects the nervous system and is mainly spread by person-to-person contact. Polio can also be spread by drinking water or other drinks or eating raw or undercooked food that are contaminated with the feces of an infected person.
Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. Most people recover completely. In rare cases, polio infection causes permanent loss of muscle function in the arms or legs (usually the legs) or if there is loss of function of the muscles used for breathing or infection of the brain, death can occur.
New: Documenting Polio Vaccine
When you get the polio vaccine, you should be given a yellow card called the International Certificate of Vaccination or Prophylaxis (ICVP) that states when you were vaccinated.  

What can travelers do to prevent polio?

  • Get the polio vaccine:
    • Ask your doctor or nurse to find out if you are up-to-date with your polio vaccination and whether you need a booster dose before traveling. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster dose to make sure that you are protected. See individualdestination pages for vaccine recommendation information.
    • Make sure children are vaccinated.
    • See Vaccine Information Statements (VIS) for more information.
  • Eat safe foods and drink safe beverages: Follow the Food and Water Safety tips to avoid exposure to any food and drinks that could be contaminated with the feces of a person infected with polio.
  • Practice hygiene and cleanliness:
    • Wash your hands often.
    • If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
    • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
    • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
    • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.

Traveler Information

Clinician Information

All travelers to any country should be up-to-date on routine vaccinations, including polio vaccine. CDC recommends a single lifetime inactivated poliovirus vaccine (IPV) booster dose for travelers to certain countries. See the Vaccine section in Chapter 3, PoliomyelitisCDC Health Information for International Travel, for specific vaccination details.
See our Clinical Updates for more guidance on polio vaccination to polio-infected countries:

Additional Information


Monday, September 8, 2014

Hajj & Umrah in Saudi Arabia - Travel Health Alert from CDC

Updated: August 06, 2014

What is the current situation?

The annual Hajj pilgrimage to Mecca, Saudi Arabia, is among the largest mass gatherings in the world. Hajj draws about 3 million Muslims from around the world, and more than 11,000 Americans make the pilgrimage each year. This year, Hajj will take place from approximately October 2–7, 2014. Umrah is a similar pilgrimage that can be undertaken at any time of the year.
Because of the crowds, mass gatherings such as Hajj and Umrah are associated with unique health risks. If you plan to travel to Saudi Arabia for Hajj or Umrah, follow the recommendations below to help you stay safe and healthy.  

What can travelers do to protect themselves?

Before your trip:

Protect yourself from MERS
For travel health recommendations related to the MERS outbreak, seeMERS in the Arabian Peninsula.

During your trip:

  • Follow security and safety guidelines. Hajj is the largest mass gathering in the world.
    • Avoid the most densely congested areas, perform rituals during nonpeak hours, and be aware of emergency exits. Stampedes at previous Hajj events have injured or killed hundreds, most recently in 2006. However, the Saudi government has spent more than $25 billion to help thin crowds and minimize this risk. Saudi religious authorities have also expanded the times when certain rituals can be performed.
    • Carry a photocopy of your passport and entry stamp.
    • Carry the contact information for the nearest US embassy or consulate in Saudi ArabiaExternal Web Site Icon and local emergency service numbers.
    • Follow all local laws and social customsExternal Web Site Icon.
  • Follow food and water safety guidelines: Eating contaminated food and drinking contaminated water can cause illnesses such as hepatitis Atyphoid fever, and travelers’ diarrhea. Read about how to prevent these diseases by visiting the Safe Food and Waterpage. Beware of food from street vendors, ice in drinks, and other foods and drinks that may be contaminated and cause travelers’ diarrhea.
  • Prevent mosquito bites and use insect repellent: Diseases spread by mosquitoes are a risk in Saudi Arabia. Read more about ways to prevent bug bites by visiting the Avoid Bug Bitespage.
  • Follow guidelines for hot climates: Dehydration and heat-related illnesses are common during Umrah and Hajj. Temperatures in Mecca can easily exceed 100°F in the summer and early fall. Drink plenty of (bottled!) water, keep cool, and wear sunscreen. Read more about how to prevent these conditions by visiting the Travel to Hot Climates and Sun Exposurepages.
  • Use disposable, single use blades for head shaving: Men are required to shave their heads after Hajj (many men shave their heads after Umrah as well), and unclean blades can transmit disease. Male pilgrims should go to officially designated centers to be shaved, where barbers are licensed and use disposable, single-use blades.
  • Avoid swimming in fresh water—lakes and rivers.  Schistosomiasis is a parasitic infection that can be spread in fresh water that may cause serious health problems. It is a low risk in Saudi Arabia but still known to be present.
  • Choose safe transportation: Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries. Read about ways to prevent transportation injuries by visiting the Road Safety page.
  • Reduce your exposure to germs:
    • Wash your hands often.
    • If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
    • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
    • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
    • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.
  • If you feel sick during your trip—

After your trip:

  • If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic. Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.
  • For more information, see Getting Sick after Travel.

Additional Information

Clinician Information

Wednesday, September 3, 2014

Is dengue fever coming to Europe?

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OLYMPUS DIGITAL CAMERAThe mosquitoes are swarming. With the raising global temperatures, they are venturing away from their tropical countries of residence and exploring new territories. As the mosquitoes relocate themselves they also bring various diseases with them, including dengue fever. There are regular cases of dengue reported in China, Indonesia, Taiwan and Vietnam, but even these endemic zones are seeing an increase number of infections. For Europeans, dengue might seem distant and only concern themselves with it when planning holidays. However, climate change could see it closer to home.
Europe may only be the free dengue fever haven it was once considered to be for a little while longer. Generally speaking, dengue fever is non-existent in Europe. Any cases that have occurred were imported by tourists or holiday makers returning home from South-east Asia, the Far East, the Indian Subcontinent and the Caribbean. Yet, recent reports of dengue fever cases in Croatia and France have raised the alarm that the fever has the potential to make headway in Europe, according to research published in BMC Public Health.
Dengue is a common viral infection spread by its vector, an infected mosquito called the Aedes aegypti mosquito, as well as the lesser known Aedes albopictus. An infected human is bitten by a mosquito, the infected mosquito then bites another human, and the cycle continues.Infected individuals will usually suffer with fever, headache and muscle and joint pains. Rarely this will develop into more severe forms that can result in death. It is endemic in over 100 tropical and sub-tropical countries in Africa, the Americas, Eastern Mediterranean, and particularly in South-east Asia and West Pacific.
Dengue vectors are already present within Europe. Both the primary A.aegypti and secondary A. albopictus are comfortable living in and around human habitations, but A. albopictus has settled in many European countries; 16 in total, including Spain, France, Switzerland, Slovenia, Albania and Bulgaria. So far, A.aegypti has only been found in Maderia, the Netherlands, Georgia and southern Russia. This highlights that these regions are suitable for dengue transmission.
With limited European cases of dengue, there is no meaningful European dataset. Researchers wishing to investigate dengue risk in Europe had to look elsewhere for a good modelling tool. They used the Mexican dengue surveillance dataset as they claim, “(it) is without doubt the best alternate source of empirical data.” Given the fact that Mexico is a large country that is comprised of multiple climate zones it is also ideal to model the impact of dengue over a wide range of climatic conditions.
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Using a novel and unique modelling method, researchers from University of East Anglia, based their predictions on disease occurrence rather than mosquito presence. Estimates relied on clinical data from past, current and predicted distribution of A. albopictus. Analyses of climate and socioeconomic variables showed some regions are more appealing for the mosquitoes than others. Southern Europe will be a high risk dengue zone, A.aegypti and A. albopictus lured by the sub-tropical climates of the Mediterranean and Adriatic coasts. Other attractive regions include the Po Valley in North Eastern Italy and southern Spain, both predicted to be highly affected areas. Meanwhile, northern Europe, the British Isles and the Baltic states are unappealing, as analysis showed there is virtually no risk of dengue fever spreading to these regions.
Localised outbreaks could possibly occur elsewhere, but if they do occur, they are unlikely to be self-sustaining. It is difficult to predict the exact incidence as there are other factors that could come into play, such as vaccine development and adequate vector control strategies. Nevertheless, this study alerts public health agencies to the possibility of a greater number of dengue fever cases, enabling them to take the necessary steps to initiate effective awareness and surveillance campaigns.
Dengue fever may not be the only disease crossing into Europe. A warmer world is inviting for a great many diseases including West Nile fever, Chikungunka fever, Yellow fever, Rift valley fever and malaria, to name but a few. It is likely that these mosquito-borne diseases may follow similar transmission patterns.

Tuesday, September 2, 2014

Ebola fears, Ebola facts: Is the US under threat ?

WASHINGTON, August 26, 2014 – A Harvard School of Public Health poll taken between August 13 and 17 finds that 39 percent of Americans are concerned that there will be a major outbreak of Ebola hemorrhagic fever in the U.S. within a year.
Twenty-six percent fear that a member of their immediate family could get sick from Ebola within a year.
According to the Centers for Disease Control, those fears don’t match reality. The threat of an Ebola outbreak in the United States is extremely low. The U.S. has the resources to quickly isolate suspected cases of Ebola and to stop its spread through a community.
The Ebola virus is not airborne. It is highly infectious through blood, vomit and diarrhea, but it requires direct bodily contact with those fluids or an open sore. “Highly infectious” does not mean “easily transmitted.”
Fears of Ebola are heightened by several factors. One is intensive media coverage, which has made people highly aware of Ebola without making them aware of the low odds of spread. A common psychological phenomenon is that we become more risk sensitive when we hear news of an accident or disaster. After an airline disaster, for instance, subjective estimates of the likelihood of being killed in an airplane crash rise.
The same phenomenon is at play now. News of the outbreak has given it an immediacy that makes the odds of contracting the virus seem much greater than they are.
The impact of news reporting is heightened by popular entertainment. There have been a number of movies and TV programs involving the spread of a virus – everything from deadly flu to hemorrhagic fever to zombie viruses – that make the development of an epidemic seem much easier than it is.
Outbreak, a 1995 film starring Dustin Hoffman, dealt with the spread of a hemorrhagic fever from Africa to the United States. Death by the Ebola-like virus in that film (and in the book it came from, “The Hot Zone”) was much more spectacular than in real life, and the virus was much more contagious, being carried on aerosols.
“Executive Orders,” a 1996 book by Tom Clancy also dealt with an Ebola outbreak, this one engineered by foreign terrorists and Iran. The 2011 film “Contagion” looked at the explosive spread of a lethal flu. “The Last Ship,” a series playing on TNT, involves a global pandemic that wipes out most of the world’s population.
Ebola doesn’t spread like flu, nor does it liquefy the victim’s internal organs. While it is deadly, almost half the people infected in this outbreak have not died. Even in conditions that seem almost designed to maximize the spread of the virus, fewer than 3,000 people in four countries have been infected since the outbreak began in March.
People who have paid close attention to this story understand that Ebola doesn’t spread like wildfire, but viral epidemics remain terrifying. There is no cure, and in the case of Ebola, catching the disease is still usually fatal. Watching the news about the Ebola outbreak is a look at something genuinely scary, the next worst thing to actually being in a horror movie.
Dr. Tom Frieden, director of the CDC, was recently in Liberia, one of the nations hardest hit by the Ebola outbreak. He pointed out that progress is being made, but added, “the virus still has the upper hand.” He said on Liberian TV, “Ebola doesn’t spread by mysterious means, we know how it spreads, so we have the means to stop it from spreading, but it requires tremendous attention to every detail.”
Ebola is a terrible disease, but it isn’t a horror movie. It can be contained. Were it not hitting nations with very few doctors and very few resources, it would have been contained by now.
According to the World Health Organization, Ebola at the last count had sickened 2,615 people, killing 1,427. That includes 240 health care workers infected and more than 120 killed.
About the Ebola virus and Ebola fever
Ebola virus was discovered in 1976, near the Ebola River in Congo. It is one of a group of viruses that cause hemorrhagic fevers. Others are Lassa fever virus, Hantavirus, Marburg virus, yellow fever virus, and dengue fever virus. Some, like Hantavirus and yellow fever virus occur in the Americas. Hantavirus is harbored among rodents in Colorado and New Mexico.
Every case of Ebola fever contracted outside a medical lab has occurred in Africa. Ebola virus has an incubation period in humans of 2 to 21 days, with an average of about 8 days. When symptoms hit, they include a fever greater than 101.5 degrees F, severe headache, diarrhea, vomiting, weakness and loss of appetite.
Healthcare workers and family members are at the greatest risk of infection from someone who already has the virus. This is because infection is spread through body fluids – blood, sweat, semen, urine, vomit and feces – or through equipment contaminated with those fluids. If healthcare workers don’t wear protective clothing, or if contaminated materials aren’t sterilized or properly disposed of, the disease can spread very rapidly through a hospital.
If proper containment procedures are followed, the spread can always be stopped.
The best way to prevent infection is to wear protective clothing and isolate patients. If you must travel where Ebola is present, practice careful hygiene. Don’t contact bodily fluids from others, or touch items that might be contaminated. Don’t come into contact with bats or nonhuman primates.
The outbreak of Ebola in Africa is a slow-motion disaster, but if international agencies can provide enough assistance, it will be stopped. It has almost zero chance of becoming a disaster anywhere else.
Comment: While similar concerns have been expressed by some travelers who are traveling to Africa from India, we are advising people coming to Travelsafe Clinics branches in Chandigarh, Delhi & Mumbai that the risk is minimal almost all african countries excluding Sierra Leone, Liberia & Guinea at the present point of time. Cases in the other countries like Nigeria & now DR Congo are very few, and do not pose a public health risk at the present point of time. The most important thing I am telling people to make sure that you do not catch Malaria (far more people are dying daily due to this disease in Africa than any other) and to avoid visiting large government health facilities since this is the most practical way of avoiding contact with potential cases of Ebola & similar diseases.

Thwarting Yellow Fever - a fascinating history of a few heroic doctors

By Carl M. Cannon - August 27, 2014

Good morning. It’s Wednesday, August 27, 2014. On this date in 1900, two U.S. Army physicians performed an experiment that saved the South, prevented the deaths of thousands of Americans, and restored the reputation of an unfairly blamed Florida saloonkeeper -- all in a single experiment.
What those Army doctors did in their lab at the Columbia Barracks Hospital outside Havana, with help from a heroic Cuban colleague, was solve the terrible mystery of Yellow Fever. And it came at considerable personal cost.
More than a century later, it’s difficult to imagine the level of panic that Yellow Fever outbreaks induced in the Deep South in the late 19th century. It was a disease that spread quickly, particularly during the summer months, with a mortality rate approaching 10 percent. No one knew how it was contracted, or what it really was. Only that it came on without warning.
Take the case of the maligned saloonkeeper I mentioned above. His name was Richard D. McCormick. He left Tampa in the summer of 1888 for Jacksonville, probably before suffering from the flu-like symptoms of Yellow Fever, which had devastated Tampa in both 1887 and 1888.
McCormick checked into Jacksonville’s Mayflower Hotel, but after he was diagnosed, city officials banished him to a quarantine station out of town, disinfected his clothing, and burned the Mayflower Hotel to the ground. The health workers who dealt with him were also sent, in secret, to the quarantine facility in Sand Hills.
None of this slowed the epidemic, which ended up infecting some 5,000 Jacksonville residents (out of a population of 13,000) and claiming at least 427 lives. The reason is that poor Mr. McCormick, despite being accused by the New York Times of “having willfully endangered the whole state,” had nothing to do with spreading this frightening disease.
Hardly anyone, even top researchers within the medical profession, understood then that it is very difficult for Yellow Fever to be communicated from one human being to another.
Failing to understand this, other communities denied access to fleeing Jacksonville residents -- and did so at the point of a gun, turning away scared and often hungry people in city after city, including St. Augustine, Savannah, Ga., and Charleston, S.C. Armed citizens in towns as far away as Chattanooga, Tenn., threatened to fire on train engineers bringing Jacksonville refugees to their town. A few cities, including Atlanta, didn’t succumb to panic, and accepted these frightened pilgrims.
In Jacksonville, most health officials and other civic leaders stayed at their posts. Among them was Edwin Martin, editor of the Jacksonville Times-Union. “I fully appreciate the dangers we incur here,” he wrote to a friend. “But I [would] rather fall at the post of duty than to live with the conscience of having deserted it.”
Weeks later, he contracted Yellow Fever and died.
Heroism was also the order of the day a dozen years later at the Columbia Barracks Hospital in Cuba. The work of Louis Pasteur had convinced U.S. government officials that infectious diseases could be isolated, and perhaps defeated, and in the last decade of the 19th century a concerted campaign was launched against Yellow Fever.
Medical research teams were dispatched to the tropics, including Brazil and Mexico but most notably Cuba. It was there that a U.S.-led team tested the theories of Italian researcher Giuseppe Sanarelli, who asserted that he had discovered the cause, a bacterium called Bacillus icteroides.
The Americans, led by English-born Army pathologist James Carroll, assistant surgeon Jesse Lazear, and U.S. Army Maj. Walter Reed could not replicate Sanarelli’s finding. Lazear, in particular, grew frustrated with their attempts to do so. This was because it was becoming apparent that Dr. Sanarelli was wrong. Yellow fever is a virus, not a bacterium.
The culprit, as Cuban researcher Carlos Juan Finlay had postulated years before, was mosquitos. To prove it -- on this date in 1900 -- Dr. Carroll allowed mosquitos to feed on him. Lazear, without telling his colleagues, did the same thing. Both of them contracted Yellow Fever. Lazear was gone by the end of September. Carroll survived, but suffered lasting heart damage. He died in 1907 and is buried, fittingly, at Arlington National Cemetery. 
Carl M. Cannon