The American Plague, Book Review

“For the sake of humanity, men became inhuman.”

– Witness of the Yellow Fever epidemic of 1878 in Memphis.

Never have I been so glad to live in an age of antibiotics, proven germ theories, and immunizations than I am while reading this book. Six chapters in, “The American Plague” is a chilling tale of how Yellow Fever was brought to the US through open trade routes with Africa and the Caribbean and man’s need to make a profit no matter the danger to human life.

Endemic to Africa, where natives gained immunity to the disease, mosquitoes and their eggs would board ships contained in cargo. Or the virus would be injected into a sailor via mosquito bite. Eventually the infected eggs would hatch or the infected host would spread the disease to his shipmates. While it is easy to blame one ship, one ship’s captain, one cargo from West Africa for bringing the disease to New Orleans, where it spread northward on the Mississippi river… Trade routes between continents and countries have long been the best way for viruses to find new victims. Caldwell gave this example of how virulent Yellow Fever could be and why quarantine was the smartest option:

“… the tale of the Flying Dutchman is thought to be the story of a yellow-fever-infected ship repeatedly denied port until all on board perished of fever, and the ship was forced to sail endlessly, manned by a ghost crew, delivering detriment to other seafaring vessels.”

The poor sanitation practices of Memphis and the general dismissal of protocol of the New Orleans ports led to the death of 17,000 residents of Memphis when the population had been only 19,000 following the mass exodus when reports of Yellow Fever hit national news. Ninety percent of the recorded population died over a period of four months! Without enough doctors and nurses many died from starvation and dehydration that would have recovered, but the doctors, nurses, and priests died just as quickly as the general populace. Babies were found crying beside dead mothers, hundreds of children were orphaned each day, family trees were cut down: all by the little rounded viral cell full of its deadly RNA.


Caldwell writes of this destruction with the passion of someone who loves her city and its rich history. She sets the scene with quotes from locals’ diaries and letters, pertinent information about the city itself from historical records, and with staggering facts unbiased by our present knowledge of viral transmission. While I read her book I can picture the citizens of Memphis clearly, but I can also see Caldwell poring over records for hours to find just the right anecdote or that much needed bit of information to make her historical figures come alive.

In the third section of her book, Caldwell writes such a lively and detailed timeline of the events and people who contributed to the confirmation that Yellow Fever, otherwise known as Yellow Jack, was transmitted by mosquitoes. It was a pleasant adventure to learn so much about Walter Reed and why he’s so famous that he has numerous hospitals named after him. Sadly, most of his Yellow Fever Board members were not recognized by the government until after their deaths. They were all, even the voluntary human subjects, given the Congressional Medal of Honor.

In the Victorian era man discovered bacteria and parasites but could not find evidence of what caused such illnesses like yellow fever. The Latin word virus, which means venom, came to stand for those invisible instigators.

As I read this book I could not help but feel the fear of the healthy: that I will one day be ill. I hope yellow fever never reaches epidemic proportions in the U.S.

Caldwell brings the epidemics of old to today especially with this opening quote:

“In recent years, popular attention has been drawn to… Ebola as the most frightening emerging infection of humankind. However, patients with yellow fever suffer as terrifying and untreatable a clinical disease, and yellow fever is responsible for 1000-fold more illness and death than Ebola.”

-Lancet Infectious Disease, 2001


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