“A splendid little war”–that’s how ambassador John Hay described the Spanish-American War in a letter to Theodore Roosevelt. The phrase stuck, and in many ways it’s fitting. When the fighting ended, the United States secured control of Cuba, Guam, the Philippines, and Puerto Rico. Casualties were surprisingly low: Less than 400 American soldiers died from combat wounds.
Yet more than six times that number fell to disease, and many of them hadn’t even left the United States when they perished. There were several culprits, including typhoid fever and malaria. But the one that people feared the most was yellow fever.
Nobody knew for certain what caused it or how it spread. There was no cure. Americans understood it only as a deadly curse. In 1793, an eruption in Philadelphia wiped out some 4,000 people–from a population of about 55,000–and forced George Washington’s government to flee what was then the national capital. In 1878, Memphis recorded 16,000 deaths. By the time of the Spanish-American War, “yellow jack,” as the disease came to be called from quarantined ships flying yellow flags, probably killed more than 100,000 Americans. “There is not a single disease today that can terrorize a community the way yellow fever did,” write John R. Pierce and James V. Winter in their forthcoming book, Yellow Jack. “The closest one could get to the dread that gripped a community visited by yellow fever is bioterrorism.”
What is war good for? Well, the Spanish-American War was good for medical science because it resulted in a concentrated effort to understand and eradicate yellow fever. The man who led this fight against old-school bioterrorism was Walter Reed.
Reed was born on September 13, 1851, in Gloucester County, Virginia. (The house is now a historic site.) He was the fifth and final child of a Methodist minister. A precocious boy, Reed entered the University of Virginia at the age of 15 and graduated with a medical degree at 17. (He remains the youngest-ever graduate of Virginia’s School of Medicine.) He received further training in New York and joined the Army Medical Corps in 1875. Serving at lonely outposts in Arizona, the Dakotas, Minnesota, and more than a dozen other places, he learned all about family doctoring. The Apache chief Geronimo once fell under his care. Yet nobody marked Reed for fame. A fellow officer called him “the greatest wag and joker that I ever saw.” At a stop in Baltimore, however, Reed attended lectures at John Hopkins and became familiar with emerging field of bacteriology. He eventually wound up in Washington, D.C., where he was noted for his ability to diagnose illnesses and conduct sanitary inspections–skills he learned on the frontier. In 1900, Major Reed was appointed president of the Yellow Fever Board.
The Army understood that if it didn’t learn to beat yellow jack, its new garrisons in Cuba and elsewhere would turn into crowded infirmaries. Even soldiers who stayed healthy would suffer severe morale problems because the disease was so feared. Yellow fever begins with headaches, chills, and nausea. Then it wracks the body with fever and vomiting. Jaundice often sets in, giving the malady its name. At this point, the fever generally drops. The afflicted either begin to recover–or the fever returns with greater fury. For the unlucky, the final stage of the disease involves massive internal bleeding and “black vomit.” Death comes as a relief.
When Reed joined the Yellow Fever Board, his first task was to solve a mystery: How did the disease spread? Nobody knew, though there were plenty of theories. A popular one held that the soiled clothing and bedding of sufferers was responsible. But a Cuban doctor, Juan Carlos Finlay, believed mosquitoes were the perpetrators. To test this idea, several members of Reed’s team, based near Havana, allowed themselves to be bitten–and one of Reed’s top deputies, Jesse W. Lazear, actually fell sick and died. Further research convinced Reed that the disease spread from mosquitoes sucking the blood of people victimized by yellow fever and then biting others. He eventually constructed two special buildings to perform a conclusive experiment at a place he named Camp Lazear.
The “Infected Clothing Building” was heated to temperatures above 90 degrees and draped with clothes worn by yellow fever victims. Volunteers slept on bedding drenched in the blood and vomit of the diseased. The inhabitants endured an incredible amount of discomfort, but none of them contracted yellow fever.
The “Infected Mosquito Building” was populated by volunteers who agreed to let the bugs bite them. Several contracted the illness. Additional work revealed that the mosquito was merely a host for the disease, which also could spread if infected blood was injected into a healthy person.
These brave volunteers were essential to Reed’s work. The major took what was then the unusual step of securing each man’s informed consent–the volunteers understood that by participating in Reed’s research they risked contracting yellow fever. To advance science, they flirted with death. Mortality rates fluctuated from outbreak to outbreak, but generally about 20 percent of those who contracted yellow fever could expect to die from it. The volunteers’ courage is perhaps best embodied in the words of Private William Dean of Lucas, Ohio, who insisted that he wasn’t “afraid of any little old gnat.” (Dean became the first man to let an infected mosquito bite him. He developed yellow fever and recovered.)
Reed was the mastermind who demonstrated the cause of yellow fever beyond any doubt–and his work inspired a program of eradication that began saving an untold number of lives almost immediately. The first task was to eliminate mosquito hatcheries. Workers drained puddles, emptied receptacles, and instructed families not to let standing water accumulate in their homes. Mosquito screens were installed at hospitals and barracks. Within a year, Havana was free from the illness for the first time in memory. By 1905, the disease was almost completely controlled. Among other things, its successful containment made possible the construction of the Panama Canal.
Yellow fever didn’t vanish the way smallpox did. It still exists in the jungle. But cases of it are rare, and they almost never occur in the United States. Three years ago, when a man who had vacationed on the Amazon River showed up in a Texas emergency room with a bad fever, the doctors didn’t recognize that they were dealing with one of America’s first instances of yellow fever in seven decades. A century ago, a good doctor would have known right away.
Although Reed was immediately hailed for his accomplishment, he didn’t have much time to enjoy his legacy. Complications arising from appendicitis killed him in 1902. Seven years later, the Walter Reed Army General Hospital opened in Washington, D.C. It eventually became part of a vast complex known as the Army Medical Center, which was renamed the Walter Reed Army Medical Center in 1951, on the hundredth anniversary of Reed’s birth. Reed himself is buried at Arlington National Cemetery, where his gravestone is inscribed with these words: “He gave to man control over that dreadful scourge, yellow fever.”