Yellow Fever Epidemics Research Articles

Potential role of heterologous flavivirus immunity in preventing urban transmission of yellow fever virus

During the recent yellow fever (YF) epidemics in Brazil, human cases were attributed to spillover infections via sylvatic mosquito transmission. Despite YF virus (YFV) transmission in major urban centers with insufficient vaccination coverage and abundant populations of the domestic vector, Aedes aegypti, there was no evidence of human-amplified transmission. Furthermore, the historic absence of YF in Asia, despite abundant Ae. aegypti and an immunologically naive human population, is unexplained. We tested the hypothesis that pre-existing, heterologous flavivirus immunity, specifically from dengue (DENV) and Zika (ZIKV) viruses, limits YFV viremia and transmission by Ae. aegypti. We infected cynomolgus macaques with DENV or ZIKV, then challenged them 6–9 months later with YFV. We then measured viremia and disease and allowed Ae. aegypti mosquitoes to feed during peak macaque viremia. Although prior heterologous immunity had variable effects on disease, DENV and ZIKV immunity consistently suppressed YFV viremia. Despite no statistical difference due to a small sample size, the suppression in viremia led to a significant reduction in Ae. aegypti infection and a lack of transmission potential. These results support the hypothesis that, in DENV- and ZIKV-endemic regions such as South America and Asia, human flavivirus immunity suppresses YFV human amplification potential, reducing the risk of urban outbreaks.

Spatiotemporal Evolution of the Yellow Fever Epidemic in Southeast Brazil from 2016 to 2019.

Background: Yellow fever (YF) is a zoonotic disease transmitted by mosquitoes among humans and nonhuman primates. Although urban YF is eradicated, the sylvatic YF has reemerged in some areas of Brazil in the twenty-first century. From 2016 to 2019, a sylvatic YF epidemic occurred in Southeast Brazil, where it had been eradicated in the 1940s. Methods: This study's objective was to describe the epidemic in the states of the Southeast region, based on descriptive, cluster, and mobility analyses. Results: Both the descriptive and cluster analyses showed that the YF cases spread from the state of Minas Gerais southward, causing peaks in cases during the summer months. None of the state capitals was included in the clusters, but the connectivity between the municipalities in Greater Metropolitan São Paulo highlighted potential paths of spread. Despite differences in sociodemographic profiles between the Southeast and North of Brazil (the latter region considered endemic), the epidemiological profile was similar, except for patients' occupation, which was not related to rural work in the Southeast. Conclusion: The results contributed to our understanding of the paths by which YF spread across Southeast Brazil and the epidemiological profile in an area that had gone decades without autochthonous cases.

Analysis of Prevention, Detection, and Response Measures of Major Infectious Diseases by Modern Chinese Seaport Quarantine Institutions: A Case Study of Modern Tianjin Seaport Quarantine

During the late Qing Dynasty, Tianjin Customs gradually established the seaport quarantine system to prevent the spread of epidemics from Japan, Hong Kong, and the Northeast. The major infectious diseases inspected by the quarantine institution of Tianjin Port include cholera, plague, smallpox, typhus and yellow fever, of which cholera is the most frequent and influential infectious disease in modern Tianjin, followed by plague and smallpox, and no large-scale epidemics of typhus and yellow fever have been found.In the process of preventing the spreading of foreign infectious diseases, the quarantine institution of Tianjin Port has gradually developing. A set of business system has been established, which is based on ship inspection and takes preventive injection, rat flea research and disease diagnosis and treatment as the core.In conclusion,the seaport quarantine institutions in Tianjin played an active role in the prevention, detection, and response to major infectious diseases ,opened up a precedent for Chinese people to independently handle border health quarantine.Its historical practice and quarantine mode are a window for understanding the development history of quarantine infectious diseases in modern China, which has very important reference value.

Immunogenicity and protective activity of mRNA vaccine candidates against yellow fever virus in animal models

Despite the success of the widely used attenuated yellow fever (YF) vaccine, its global supply remains a substantial barrier to implementing vaccination campaigns in endemic regions and combating emerging epidemics. In A129 mice and rhesus macaques, we evaluated the immunogenicity and protective activity of messenger RNA (mRNA) vaccine candidates encapsulated in lipid nanoparticles, expressing the pre-membrane and envelope proteins or the non-structural protein 1 of YF virus. Vaccine constructs induced humoral and cell-mediated immune responses in mice, resulting in protection against lethal YF virus infection after passive administration of serum or splenocytes from vaccinated mice. Vaccination of macaques induced sustained high humoral and cellular immune responses for at least 5 months after the second dose. Our data demonstrate that these mRNA vaccine candidates can be considered an attractive addition to the licensed YF vaccine supply based on the induction of functional antibodies correlating with protection and T-cell responses; they could alleviate the limited supply of current YF vaccines, mitigating future YF epidemics.

Teaching in Black and White: The Sisters of St. Joseph in the American South by Barbara E. Mattick

Reviewed by: Teaching in Black and White: The Sisters of St. Joseph in the American South by Barbara E. Mattick James M. Woods Teaching in Black and White: The Sisters of St. Joseph in the American South. By Barbara E. Mattick. Washington, DC: Catholic University of Press, 2022, 275pp. $34.95. Barbara Mattick, a woman with a background in public history, has produced a welcome contribution on women religious orders and their impact on black and white pupils, patients, and orphans in the American South. My history of the Catholic Church in the American South from 1513–1900 did not deal directly with this topic and so this book is needed. This work starts when the Sisters of St. Joseph from France arrived in the mainly Catholic community of St. Augustine in 1866 until they affiliated with another order of women religious in 1922. [End Page 98] Her book follows no overall narrative but covers different aspects of their history. The first chapter covers the Irish Sisters of Mercy who came to Florida’s oldest city in 1859 and stayed a decade. The next chapter deals with the coming of the French Sisters of St. Joseph in 1886 and follows their ministry for the next quarter century to white and black students. The third chapter is on the intense religious rivalry between the Catholic sisters and the female Protestant missionary associations for the souls of “black folk” in Florida. The next chapter covers the sisters and their ministry during the Yellow Fever epidemics of 1877, 1888. The next two chapters deal with personnel and provincial changes, including the awkward situation when the sisters were ordered in late 1899 to sever their relationship with the motherhouse in France. The penultimate chapter is on anti-Catholicism and racism in early twentieth century Florida. The final chapter covers the Sisters of St. Joseph in Savannah, Washington, and Augusta until the early 1920s. The book draws upon a rich array of primary sources especially the hundreds of letters in French to the motherhouse in Le Puy, France. Such correspondence provide a rare look at these remarkable women “and their inner thoughts, struggles and hopes and even their sense of humor” (xiv). The work is augmented with pictures of the sisters and their ministry with white and black students in Florida and Georgia. This reviewer found it pleasing that the footnotes were located the bottom of the page. This book highlights areas of nineteenth century religion often overlooked; for example, ecumenism. As Mattick observes, “salvation was only possible through the Roman Catholic Church; Protestants were heretics . . . . The Protestant Missionaries . . . just as adamantly considered Roman Catholics to be lost souls” (82). When in 1913 a Florida bill passed forbidding whites from teaching in black schools, public or private, three sisters of St. Joseph were arrested on April 24, 1916, for violating this law. Two sisters were bonded out but Sister Thomasine Hehir refused and was put back into the convent for running a black Catholic school in St. Augustine. On May 21 a local judge [End Page 99] ordered her released as the law did not apply to private schools. While this was an interesting event, Mattick has three locations for this St. Benedict the Moor school. She once listed it near St. Augustine in Lincolnville, a picture of Sister Thomasine has the school in 1916 as being in St. Augustine, and another locates the school in Ybor City (185, 186, 249). This caveat aside, the Sisters of St. Joseph founded the “first recognized convent school in Florida, the first Roman Catholic white order to minister for freedmen after the Civil War, and the first Catholic orphanage in Florida” (235). Even after the religious order transferred its affiliation after 1922, it continued to minister with black and white students for decades later. With this book being published, it is hoped that their legacy will not be ignored or overlooked. [End Page 100] James M. Woods Georgia Southern University Copyright © 2023 American Catholic Historical Society

‘The Breath of Destruction’

Abstract In the years 1823, 1829–1830, and 1837, West and West Central Africa had to contend with three devastating yellow fever epidemics that affected both slave dealers who had settled along the coast and anti-slave trade officials tasked with bringing the slave trade to an end. In this paper I argue that these epidemics had a profound impact on the actions of both sets of actors, and eventually on the expansion and demise of the slave trade in the region. By focusing on the actions of a myriad of Atlantic actors, I explore the ways in which cyclical epidemics of yellow fever were dealt with, emphasizing how prophylactic measures, treatments, and more generally, medical knowledge, were challenged, affected, and changed by the arrival of each of them.

Bury Me in the Sunshine: The Yellow Fever Epidemics of Memphis by John Vidmar, O.P

Reviewed by: Bury Me in the Sunshine: The Yellow Fever Epidemics of Memphis by John Vidmar, O.P Robert Wilson Bury Me in the Sunshine: The Yellow Fever Epidemics of Memphis. By John Vidmar, O.P. (Providence, R.I.: Cluny Media, 2020. Pp. [xiv], 311. Paper, $19.95, ISBN 978-1-952826-38-2.) The nineteenth-century yellow fever epidemics that afflicted southern cities have been chronicled many times by historians, but John Vidmar takes a different approach to the subject in his book, Bury Me in the Sunshine: The Yellow Fever Epidemics of Memphis. He has uncovered an interesting new primary source: the diary of Father Joseph Augustine Kelly, a Roman Catholic priest in Memphis who survived three major epidemics in the region. The main goal of Vidmar’s project is to address Catholic contributions during the epidemic, but the author also provides a glimpse of the triumphs and trials of many Memphis residents. The book provides a brief history of Memphis and the yellow fever virus, and it does a nice job of describing life during the epidemics of 1873, 1878, and 1879. The contributions of the Catholic Church have often been left out of nineteenth-century stories of a growing nation, and Vidmar’s work hopes to remedy this narrative of exclusion. The author has written an entire chapter on the leadership of Father Kelly before the epidemic, and also shares the heroic accomplishments of the many priests and nuns who stayed to help relieve the suffering of Memphians who could not get out of the city. Vidmar argues that, in part, “the Catholic clergy had to stay because of their commitment to the Sacrament of Extreme Unction” (p. 228). The challenges both Protestant and Catholic churches faced during the epidemics are discussed, but the large number of Catholic priests and nuns who went to Memphis to help in any way possible and died as a result stands out. The strength of the book lies in the information Vidmar has gained from his analysis of Memphis newspapers. He does an excellent job of explaining the delicate balance journalists struck as they reported on the epidemic, while also attempting to prevent human panic and financial ruin to the city’s economy. The job of a nineteenth-century newspaper editor often included promoting and supporting a city, and Vidmar explains how the papers “regarded themselves as watchdogs for the public good” (p. 218). Through the numerous newspaper headlines and editorials found in his research, he provides a glimpse of the confusion citizens must have felt until it was too late to avoid the epidemic. Vidmar even brings this point back to the contemporary story of the COVID-19 pandemic. He argues that things have changed little in this regard, as “countries and cities want to protect their reputation, their tourist industry, their economy—at all costs, even of human life” (p. 203). It is often easy to look back at people who lived in the past and judge them through a contemporary lens, but the author finds parallels in human behavior both past and present. [End Page 173] Bury Me in the Sunshine is a popular history of yellow fever in Memphis and the contributions made by the Catholic Church during the epidemics of the 1870s. The book provides new access to a diary of a man who not only survived three major epidemics but also risked his life to help those in need. The book is not a comprehensive story of yellow fever in southern cities, but in addition to the experiences of Catholic clergy, it does examine interesting topics including quarantine, sanitation, the disease’s connection to cholera, the Howard Association, and nineteenth-century medical care. Robert Wilson University of Missouri–St. Louis Copyright © 2023 The Southern Historical Association

Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom by Kathryn Olivarius

Reviewed by: Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom by Kathryn Olivarius Savannah L. Williamson (bio) Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom. By Kathryn Olivarius. (Cambridge: Belknap Press, 2022. Pp. 352. $35.00 cloth; $19.25 ebook) Approximately every two to three years during much of the nineteenth century, yellow fever epidemics terrorized the city of New Orleans. Without a clear understanding of the disease, the only sure way a person was protected from future yellow fever outbreaks was to survive infection. Once an individual was acclimated, they were no longer a stranger to the city and used their immunity as a source of social, economic, and political status, which Olivarius terms "immunocapital." This bio-social currency, which was denied to Black survivors of the disease, allowed the white residents of New Orleans to enter and strengthen the city's strict racial hierarchy and exacerbated inequality in an already violent and rigid slave society. Throughout the tropical Atlantic, Aedes aegypti mosquitoes—which thrive in tropical and subtropical climates—carried the viral disease and transmitted the infection to humans through a bite. The disease presents with fever, chills, body aches, nausea, headaches, appetite loss, abdominal and back pain, black vomit, and kidney and liver damage that can cause the skin to appear yellow—hence the name "yellow fever." In antebellum New Orleans, roughly half of those infected (or 8 percent of the population) died from an outbreak. By the end of the nineteenth century, yellow fever epidemics were responsible for as many as 150,000 deaths in the Crescent City. Rather than invest in public health initiatives, white elites profited from the chaos and instability caused by yellow fever outbreaks. Epidemics of malaria, yellow, and bilious fevers have often been called "great equalizers" because they undermine the privileges afforded to whiteness, making all demographics equal in the face of possible death. Olivarius argues that yellow fever epidemics did not weaken or dismantle the existing hierarchies of race and class. Instead, antebellum New Orleans became increasingly stratified between whites with immunity, whites who were not acclimated to the disease, and [End Page 78] free and enslaved Black populations. Surviving yellow fever was practically a requirement for white citizens hoping to enter elite society. For those with immunity, outbreaks were a source of economic opportunity to which white people felt entitled, since they viewed their survival as evidence of racial superiority. They monopolized on the fear, chaos, and instability caused by outbreaks to consolidate their power and wealth at the top of the cotton market, enact policies that furthered systematic inequality, enhance white supremacy, undercut the majority population, and weave epidemiological discrimination into law. Whereas immunity for white individuals provided prospects and social standing, "immunocapital" did not extend to Black individuals. Although they were protected from future yellow fever infections, their immunity provided social and economic opportunity to their white owners, rather than themselves. Antebellum whites argued, falsely, that Blacks were naturally immune to yellow fever infections to justify policies and laws that promoted slavery, racial and class inequality, and white supremacy. Necropolis provides a detailed and fascinating account of why so many unacclimated strangers died of yellow fever in nineteenthcentury New Orleans. Unlike other epidemics, which acted as socioeconomic equalizers, outbreaks of yellow fever, bilious fever, and malaria made for greater inequality. These diseases did not undermine existing hierarchies of class and race but served as the very foundation of such hierarchical structures. As yellow fever epidemics occurred more frequently throughout the nineteenth century, they contributed to greater racial and class stratification between "acclimated" whites with immunity, "unacclimated" strangers, and free and enslaved Blacks whose immune status provided social, economic, and political benefits to others, rather than themselves. "Immunocapitalism," therefore, highlights the ways in which antebellum political, economic, social, environmental, and immunological forces contributed to greater mortality and inequality in the Crescent City. [End Page 79] Savannah L. Williamson SAVANNAH L. WILLIAMSON is a historian at Sul Ross State University. Copyright © 2022 Kentucky Historical Society

Retrospective molecular investigation of Mayaro and Oropouche viruses at the human-animal interface in West-central Brazil, 2016-2018.

Mayaro virus (MAYV, Togaviridae) and Oropouche orthobunyavirus (OROV, Peribunyaviridae) are emerging enzootic arboviruses in Latin America. Outbreaks of febrile illness associated with MAYV and OROV have been reported among humans mainly in the northern region of Brazil since the 1980s, and recent data suggest these viruses have circulated also in more populated areas of western Brazil. MAYV shares mosquito vectors with yellow fever virus and it has been historically detected during yellow fever epidemics. Aiming to investigate the transmission of OROV and MAYV at the human-animal interface during a yellow fever, chikungunya and Zika outbreaks in Brazil, we conducted a retrospective molecular investigation in 810 wild and domestic animals, 106 febrile patients, and 22.931 vectors collected from 2016 to 2018 in Cuiaba and Campo Grande metropolitan regions, western Brazil. All samples tested negative for OROV and MAYV RNA by RT-qPCR. Findings presented here suggest no active circulation of MAYV and OROV in the sampled hosts. Active surveillance and retrospective investigations are instrumental approaches for the detection of cryptic and subclinical activity of enzootic arboviruses and together serve as a warning system to implement appropriate actions to prevent outbreaks.

Applying Commemorative Museum Pedagogy to Public Music Studies

Applying Commemorative Museum Pedagogy to Public Music Studies

Arbovirus Epidemiology: The Mystery of Unnoticed Epidemics in Ghana, West Africa.

It is evident that all the countries surrounding Ghana have experienced epidemics of key arboviruses of medical importance, such as the recent dengue fever epidemic in Burkina Faso. Therefore, Ghana is considered a ripe zone for epidemics of arboviruses, mainly dengue. Surprisingly, Ghana never experienced the propounded deadly dengue epidemic. Indeed, it is mysterious because the mosquito vectors capable of transmitting the dengue virus, such as Aedes aegypti, were identified in Ghana through entomological investigations. Additionally, cases may be missed, as the diagnostic and surveillance capacities of the country are weak. Therefore, we review the arbovirus situation and outline probable reasons for the epidemic mystery in the country. Most of the recorded cases of arbovirus infections were usually investigated via serology by detecting IgM and IgG immunoglobulins in clinical samples, which is indicative of prior exposure but not an active case. This led to the identification of yellow fever virus and dengue virus as the main circulating arboviruses among the Ghanaian population. However, major yellow fever epidemics were reported for over a decade. It is important to note that the reviewed arboviruses were not frequently detected in the vectors. The data highlight the necessity of strengthening the diagnostics and the need for continuous arbovirus and vector surveillance to provide an early warning system for future arbovirus epidemics.

Yellow fever virus disease: a systematic review of reemergence, incidence and mortality in Isiolo county, Kenya

Yellow fever is an endemic arboviral disease caused by yellow fever virus (YFV), with high fatality. WHO (Eliminate Yellow Fever Epidemics) is a plan to control YFV, with strategies to be carried out from 2017 to 2026. YFV outbreaks occurred in nine African countries in 2021. The burden was estimated in 2013 to be between 84,000 and 170,000 severe cases and 29,000 to 60,000 deaths. Most of the world’s cases were reported in West and East Africa. Understanding the occurrence of yellow fever epidemics is critical for targeted interventions and control efforts to reduce the burden of disease. A systematic review study design was used to review existing literature and data on the yellow fever incidence and mortality rates in the region. Predictors of occurrence of yellow fever outbreaks were identified to include; local mosquito populations and specific yellow fever virus strain, eco climatic conditions, sociopolitical and demographic factors including population size, density, mobility, and vaccine coverage. Kenya declared an outbreak of yellow fever in Isiolo County after the death of three people. About 20 cases were reported in Isiolo in February. Counties bordering Isiolo were placed in the high-risk bracket. A national incident management structure to manage the outbreak was established. The team visited the epicenter of the outbreak in Merti and Garbatulla. Active case search and surveillance was done. It was noted that there was delay in case investigation. This was attributed to low index of suspicion among clinicians. It was concluded that there could be a possibility of both malaria and yellow fever outbreak in the county. The county health team was advised to heighten continued active case search and surveillance, case management and improve on risk communication to the community.

Laboratory evaluation of RealStar Yellow Fever Virus RT-PCR kit 1.0 for potential use in the global yellow fever laboratory network.

BackgroundEarly detection of human yellow fever (YF) infection in YF-endemic regions is critical to timely outbreak mitigation. African National Laboratories chiefly rely on serological assays that require confirmation at Regional Reference Laboratories, thus delaying results, which themselves are not always definitive often due to antibody cross-reactivity. A positive molecular test result is confirmatory for YF; therefore, a standardized YF molecular assay would facilitate immediate confirmation at National Laboratories. The WHO-coordinated global Eliminate Yellow Fever Epidemics Laboratory Technical Working Group sought to independently evaluate the quality and performance of commercial YF molecular assays relevant to use in countries with endemic YF, in the absence of stringent premarket assessments. This report details a limited laboratory WHO-coordinated evaluation of the altona Diagnostics RealStar Yellow Fever Virus RT-PCR kit 1.0.Methodology and principal findingsSpecific objectives were to assess the assay’s ability to detect YF virus strains in human serum from YF-endemic regions, determine the potential for interference and cross-reactions, verify the performance claims as stated by the manufacturer, and assess usability. RNA extracted from normal human serum spiked with YF virus showed the assay to be precise with minimal lot-to-lot variation. The 95% limit of detection calculated was approximately 1,245 RNA copies/ml [95% confidence interval 497 to 1,640 copies/ml]. Positive results were obtained with spatially and temporally diverse YF strains. The assay was specific for YF virus, was not subject to endogenous or exogenous interferents, and was clinically sensitive and specific. A review of operational characteristics revealed that a positivity cutoff was not defined in the instructions for use, but otherwise the assay was user-friendly.Conclusions and significanceThe RealStar Yellow Fever Virus RT-PCR kit 1.0 has performance characteristics consistent with the manufacturer’s claims and is suitable for use in YF-endemic regions. Its use is expected to decrease YF outbreak detection times and be instrumental in saving lives.

Wandering epizootics and zones of emergence: Constructing yellow fever endemicity in Africa.

This paper examines the distinction drawn between endemic and epidemic yellow fever in the twentieth century and the policy implications of conceptualizing yellow fever as distinct in different world regions. The history of yellow fever research in Africa reveals how particular perceptions of place undergirded evolving scientific knowledge of yellow fever epidemiology. Efforts to map yellow fever endemicity in Africa and to understand the endemic threat of "jungle" yellow fever unfolded within a colonial framework that viewed Africa and Africans as "diseased." The study explores how the notions of place embedded in endemic versus epidemic disease translated into differential prevention strategies and access to vaccines leading to highly unequal burdens of yellow fever. The history of yellow fever research in Africa is potentially instructive for a range of health threats that have historically been mapped onto places and peoples in ways that privilege differential policy pathways.

Breaking the Blockade: The Bahamas during the Civil War by Charles D. Ross

Reviewed by: Breaking the Blockade: The Bahamas during the Civil War by Charles D. Ross Stephen D. Engle Breaking the Blockade: The Bahamas during the Civil War. By Charles D. Ross. (Jackson: University Press of Mississippi, 2021. Pp. xviii, 235. Paper, $30.00, ISBN 978-1-4968-3135-4; cloth, $99.00, ISBN 978-1-4968-3134-7.) As the Union and Confederate governments scrambled to put people in the right places to win the Civil War, maintains Charles D. Ross, few could imagine that Nassau, the largest city and capital of the Bahamas, would become a "mixture of Sodom, Gomorrah, and the Dutch tulip craze of the 1600s" thanks [End Page 568] to the transformative wealth that poured into the tiny island between 1861 and 1865 (p. 5). Night and day, the ships rolled in and out of the harbor, generating an illicit trade between the British and the Confederates that not only made islanders richer than they could have imagined but also kept the Confederacy alive. In Breaking the Blockade: The Bahamas during the Civil War, Ross, whose works in the past have enlightened us about technology, acoustical shadows, and gunpowder, now brings forth an underexplored aspect of maritime trade in the Bahamas and its international implications. It is a wartime story that investigates the complex interplay (economic, social, and political) present in a tiny community nearly forgotten in Civil War lore. Torn between economic riches and political loyalty, residents motivated by profits often failed to interfere with a trade that was both lucrative and divisive. In this account, Ross singles out Nassau's pivotal role in participating in a trading system that sustained the Confederate war effort through most of the conflict. What contemporaries characterized as the "Great Carnival" became a wartime history rich in its significance to the people and place of the tiny islands (p. xi). He explores the motivations behind the appreciable growth that transformed into the great wealth that the war brought to these islands, which were ideally situated for the establishment of an oceanic transshipment point. The pro-Confederate population, Ross maintains, turned a blind eye to British neutrality, which allowed massive wealth into the city that not only generated significant internal improvements that left their mark on the local society but also brought crime and corruption. He explores in detail the daily drama that defined the changing culture and describes how local government and business merchants both cooperated and collided in establishing trade and commercial relationships. Yet, as the war endured, and yellow fever epidemics and changing governing structures went in a new direction, the new Bahamian governor was more committed to the United States than to the British, and more committed to following British and international law. However, the Union success by the end of 1864 brought the Great Carnival to an abrupt end, followed two years later by a devastating hurricane that destroyed the island and the wealth generated by the war. Beyond illuminating the international crossroads between the United States, the Bahamas, and the United Kingdom, Ross is perhaps best when he devotes his attention to exploring the daily life of those shaped by the war's transformative life and economic boom. In the streets and shops, he argues, Confederate sympathy existed among the commoners and merchants alike, and the Union's blockade further contributed to the political and cultural mindset that drove them into a greater hostility toward the Union. Deeply and impressively researched in several repositories in the United States, the Bahamas, and the United Kingdom, Breaking the Blockade uses a broad lens and a deft pen to capture an important and compelling story that sheds light on the perils and rewards of blockade-running in the Civil War. Students and enthusiasts alike will find Ross's book to be a model work in every regard, and readers will come away with a better understanding of how and why the Confederacy lasted as long as it did. [End Page 569] Stephen D. Engle Florida Atlantic University Copyright © 2022 The Southern Historical Association

Epidemiology of yellow fever virus in humans, arthropods, and non-human primates in sub-Saharan Africa: A systematic review and meta-analysis.

Yellow fever (YF) has re-emerged in the last two decades causing several outbreaks in endemic countries and spreading to new receptive regions. This changing epidemiology of YF creates new challenges for global public health efforts. Yellow fever is caused by the yellow fever virus (YFV) that circulates between humans, the mosquito vector, and non-human primates (NHP). In this systematic review and meta-analysis, we review and analyse data on the case fatality rate (CFR) and prevalence of YFV in humans, and on the prevalence of YFV in arthropods, and NHP in sub-Saharan Africa (SSA). We performed a comprehensive literature search in PubMed, Web of Science, African Journal Online, and African Index Medicus databases. We included studies reporting data on the CFR and/or prevalence of YFV. Extracted data was verified and analysed using the random effect meta-analysis. We conducted subgroup, sensitivity analysis, and publication bias analyses using the random effect meta-analysis while I2 statistic was employed to determine heterogeneity. This review was registered with PROSPERO under the identification CRD42021242444. The final meta-analysis included 55 studies. The overall case fatality rate due to YFV was 31.1% (18.3-45.4) in humans and pooled prevalence of YFV infection was 9.4% (6.9-12.2) in humans. Only five studies in West and East Africa detected the YFV in mosquito species of the genus Aedes and in Anopheles funestus. In NHP, YFV antibodies were found only in members of the Cercopithecidae family. Our analysis provides evidence on the ongoing circulation of the YFV in humans, Aedes mosquitoes and NHP in SSA. These observations highlight the ongoing transmission of the YFV and its potential to cause large outbreaks in SSA. As such, strategies such as those proposed by the WHO's Eliminate Yellow Fever Epidemics (EYE) initiative are urgently needed to control and prevent yellow fever outbreaks in SSA.

The Health of the Commonwealth: A Brief History of Medicine, Public Health, and Disease in Pennsylvania

The Health of the Commonwealth: A Brief History of Medicine, Public Health, and Disease in Pennsylvania

Dominicans in the American Plague: Catholic Ministry During the Yellow Fever Epidemics in Memphis, Tennessee, 1873–1879

Yellow fever visited Memphis, Tennessee, in three unforeseen epidemics during the 1870s, bringing human and civic destruction. One of the epidemics’ untold stories is the Catholic priests and religious who remained to tend to the sick and dying—a heroism that cost forty-five members their lives. Dominican men and women found themselves in the maelstrom, serving a parish, two female academies, and an orphanage in the epidemics’ epicenter. Rather than flee the city, as so many others did, they remained and adapted to the realities of widespread death and suffering, turning academies into hospitals, protecting and even moving orphans under their care, and helping St. Peter’s Church become the focus of sacramental and physical care for the stricken. One Dominican pastor survived all three epidemics—and kept a diary of the event as it unfolded, accompanied throughout by an intrepid African-American maintenance man. The story of Catholic religious, and Dominicans in particular, in the yellow fever years has been largely untold or, still worse, ignored. Recognition of their work and sacrifices offers a more complete understanding of the “American plague.”

Protocolo diagnóstico del síndrome febril con afectación hematológica en áreas geográficas de riesgo endémico de infecciones tropicales

In viral hemorrhagic fevers caused by Arenavirus, the clinical manifestations are initially indistinguishable from other hemorrhagic fevers produced by bacteria, parasites, and other viruses. It is a public health problem and therefore, a differential diagnosis must be made using serological and molecular techniques.Hematologic abnormalities are considered a hallmark of malaria. Statistical analyses have demonstrated that many of these hematologic values can lead to an increase in clinical suspicion of malaria, thus leading to an immediate intervention with specific treatment even in the absence of a positive smear report for malaria. In recent years, the world has experienced significant yellow fever epidemics, such as the epidemic in Africa, particularly in Angola. Typhoid fever tends to be caused by S. typhi and, to a lesser extent, by S. paratyphi and S. choleraesuis. Dengue can present with hemorrhagic manifestations and is a challenge for physicians because a quick, correct diagnosis must be made.

Risk assessment of urban yellow fever virus transmission in Kenya: is Aedes aegypti an efficient vector?

ABSTRACT The absence of urban yellow fever epidemics in East Africa remains a mystery amidst the proliferation of Aedes aegypti in this region. To understand the transmission dynamics of the disease, we tested urban (Mombasa, Kisumu, and Nairobi) Aedes mosquito populations in Kenya for their susceptibility to an East African yellow fever virus (YFV) genotype. Overall, 22% (n = 805) of the Ae. aegypti that were orally challenged with an infectious dose of YFV had a midgut infection, with comparable rates for Mombasa and Kisumu (χ2 = 0.35, df = 1, P = 0.55), but significantly lower rates for Nairobi (χ2 ≥ 11.08, df = 1, P ≤ 0.0009). Variations in YFV susceptibility (midgut infection) among Ae. aegypti subspecies were not associated with discernable cytochrome c oxidase subunit 1 gene haplotypes. Remarkably, no YFV dissemination or transmission was observed among the orally challenged Ae. aegypti populations. Moreover, Ae. aegypti mosquitoes that were intrathoracically inoculated with YFV failed to transmit the virus via capillary feeding. In contrast, dissemination (oral exposure) and transmission (intrathoracic inoculation) of YFV was observed among a few peri-domestic Ae. bromeliae mosquitoes (n = 129) that were assessed from these urban areas. Our study highlights an inefficient urban Ae. aegypti population, and the potential for Ae. bromeliae in sustaining an urban YFV transmission in Kenya. An assessment of urban Ae. aegypti susceptibility to other YFV genotypes, and vector potential of urban Ae. bromeliae populations in Kenya is recommended to guide cost-effective vaccination.