The American Plague: The Untold Story of Yellow Fever, The Epidemic That Shaped Our Nation (22 page)

At that point, the board had all but given up its hopes of the mosquito as the transmitter of yellow fever. Half a dozen volunteers had fed infected mosquitoes, including Lazear on a number of occasions. Not a single case of yellow fever had developed. Carroll had been skeptical from the start, and by then, believed that the mosquito theory was useless. James Carroll was just feeding one of Lazear’s pet mosquitoes to keep it alive; he never expected to get ill.

Two days later, Carroll, Lazear and Agramonte worked in the one-story Las Animas Hospital in Havana. Lazear’s sickly mosquito was robust and healthy again thanks to her blood meal from Carroll. Lazear went about his usual, careful routine of feeding his mosquitoes on the infected patients in the yellow fever ward, plugging the test tubes with cotton and making marks in his leather logbook. Instead of taking the train along the Marianao railroad that afternoon, the three doctors left the hospital by Doherty wagon. When they came to the fork in the road, Agramonte hopped down and headed toward the military hospital on foot; Carroll and Lazear continued the ride along the sun-washed road to Camp Columbia. Carroll seemed quiet and distracted.

The next day, on August 30, Carroll and a few of the officers swam in the bright water off the coast of Cuba; sea bathing had become a favorite pastime. The water, as warm as the air, created a strange, seamless sensation as one stepped from the beach into the sea. As Carroll glided through the water, looking toward the shore where the wide leaves of palms flapped in the breeze, he felt an unusual chill. He eased toward the shallow water and waded ashore. The sun had given him a piercing headache as if every ray of light drove a nail into his skull. One of the contract surgeons took one look at the ashen-colored man staggering out of the sea and said, “yellow fever.” “Don’t be a damned fool—I have no such thing,” Carroll grumbled.

News that Carroll showed symptoms reached Lazear at the camp. He was panic-stricken; his experiment may have produced the first case of yellow fever, but it had infected his colleague. Lazear used the camp telephone to call Agramonte in Havana, worry and fear shaking his voice. He explained that he himself had been bitten just two weeks before without falling ill. Flustered, he added that Carroll had held the tube himself when the mosquito fed. Though he said the words out loud and searched for excuses, his voice grew thin.

When Agramonte arrived at Camp Columbia the next morning, he found Carroll twisted over the microscope searching his own blood for the oblong shape of the malarial parasite. Carroll peered through the lens and tried to sound casual as he told him he caught a cold at the beach; but his bloodshot eyes and his pallid skin, beaded with perspiration, shocked Agramonte.

Carroll remained stubborn, finally having to be ordered to the hospital where his illness spiraled, and he soon became delirious. His temperature rose to 105 degrees, and his heart swelled under the pressure. James Carroll was forty-six years old, and yellow fever proved far more deadly in those over the age of forty.

Lena Warner was called in to nurse him. Warner, who as a child had the fever during the 1878 epidemic, knew exactly what Carroll was feeling. Weak and ill, he tried to tell her that he had been bitten by a mosquito before contracting the fever, but up to that point, it was still an unbelievable theory. His desperate attemptsto tell her what had happened were dismissed as fever-induced ravings, and Warner made notes on Carroll’s chart that he was delirious. She did, however, agree to Carroll’s pleas to go by the board’s laboratory on her rounds and drop a small bit of banana into the glass test tubes. Then, he gave very specific directions for replacing the cotton in the top of the tube to prevent the mosquito from escaping. Above all else, the insect was not to get out of its glass cage.

In the lab, Lazear and Agramonte continued to search smears of Carroll’s blood for parasites, or any substantial clue to the illness. Rain began to fall and would continue to deluge Cuba in the following days as a tropical storm settled over the mountains of Cuba gathering its dark energy. Lazear flipped through the pages of his notebook to the day that the mosquito had fed on Carroll’s arm. Since then, Carroll had visited the yellow fever wards at both Las Animas and Military Hospital No. 1, as well as an autopsy room that was so filthy Carroll refused to work until it was thoroughly disinfected. He had been exposed to yellow fever on several occasions, as he had every day over the last two months. As a case study, he was a decidedly poor one. The only way to prove that it was in fact the mosquito was to try the experiment again.

As Lazear stood in the lab with a test tube in each hand trying to coax a mosquito from one glass house to the other, a soldier walked by the doorway and saluted him. His hands full of test tubes and a stubborn insect, Lazear cheerfully answered, “Good morning,” instead of returning the salute. The soldier, curious and encouraged by Lazear’s approachable manner, stepped into the room.

“You still fooling with mosquitoes, Doctor?”

“Yes,” Lazear said, balancing the tubes, end to end, “will you take a bite?”

“Sure, I ain’t scared of ’em.” The soldier, like most others, found the work of the Yellow Fever Commission fairly amusing. The mosquito theory, just the thought that these tiny insects as frail and inconsequential as lint with wings could transmit illness, seemed ludicrous.

The soldier had never lived in the tropics before and had not left the base for two months; he was the ideal candidate. Agramonte came into the lab and scribbled the name onto a piece of paper:
William E. Dean.
He would also be known as patient XY. Several days later, Dean became the second known case of experimental yellow fever.

The moon had been brush-marked with clouds all night, and by early morning, as Dean’s fever climbed, red light rose like embers off the ocean water. The tropical storm that had been shelling the island with rain all week was making its way out of Cuba and heading toward the Gulf of Mexico with much more energy and intensity than it had previously shown. It would claim 8,000 lives in Galveston, Texas, during that September weekend in 1900.

Warner continued to nurse Carroll, relying on many of the same techniques used over twenty years before in Memphis—the patient was kept very quiet, no food or solids could be given, only small sips of water or lemonade. Cold saline enemas were administered. Though acetylsalicylic acid, or aspirin, had just been created at Germany’s Bayer company, the loose powder was not yet in general use for fevers.

In the medical chart, Warner recorded his temperature and pulse every three hours and sent urine samples to the lab twice a day. Carroll’s health continued to decline, and his wife received a daily telegram reporting the condition of her husband. His fever hovered around 104 degrees, his skin reddened by the heat; but for visitors, the most disturbing part was watching his body writhe and lurch in the bed.

Reed was finally notified by telegram as to what was happening in Cuba during his absence. He immediately wrote to Kean: “I cannot begin to describe my mental distress and depression over this most unfortunate turn of affairs. We had all determined to experiment on ourselves and I should have taken the same dose had I been there.”

After a week of delirium and high fever, Carroll’s temperature seemed to subside though his eyes remained saffron yellow. His wife received a telegram that day:
Carroll out of danger.
He had shown none of the telltale black vomiting, and the doctors felt confident that he would eventually recover. When Reed heard the news, he telegrammed Carroll.

Reed sealed the letter, but before he sent it, he flipped the envelope over and scrawled in his large, curled handwriting, onto the back: “Did the
Mosquito
DO IT?”

With Carroll on the mend, and Dean recovering from his case of yellow fever, the board decided to stop any further experiments. As Agramonte, whose immunity could not be guaranteed, described it, “We felt that we had been called upon to accomplish such work as did not justify our taking risks which then seemed really unnecessary.” Besides, with one colleague down and Reed still in the U.S., the Yellow Fever Board couldn’t afford to lose another member now that they had their first real break in solving a disease that had plagued people for centuries.

One member of the board did not heed the warning.

Lazear wrote to his wife, Mabel, from the Columbia Barracks on September 8, “I rather think I am on the track of the real germ, but nothing must be said as yet . . . I have not mentioned it to a soul.”

The events that followed and the resulting tragedy would be debated for the next five decades.

Guinea Pig No. 1

On September 13, Jesse Lazear sat in the yellow fever ward of the Las Animas hospital in Havana pressing a glass test tube against the abdomen of a bedridden soldier. The patient’s skin was the color of smeared iodine, and his body burned from the fever lit within. Dark, wooden shutters were open, and sunlight streamed across the Spanish tile floor of the hospital room as Lazear held the tube steady and waited for one of his “birds” to take a blood meal from the sick patient.
Aedes aegypti
are particularly sensitive to movement and will flutter away at the slightest twitch. As a vector, it makes the mosquito all the more deadly as during this dance of lighting, then lifting off, she’ll bite several times in a short time span trying to get a full meal. With each bite, more of the virus is passed into the host’s bloodstream.

Somewhere in the room, Lazear heard the wing beats of a mosquito, as many as 500 beats per second. It was a tinny whine in the stagnant hospital air. He saw the insect flickering like candlelight on the edge of his vision, and then he watched it light onto his arm, its legs crooked, and he felt a pinch. Lazear, who stalked, captured and kept mosquitoes with meticulous obsession, probably first thought to imprison the winged prey in one of his test tubes. But, he was still waiting for the other mosquito, confined beneath glass, to feed on the infected patient. If he moved now, the other one would surely refuse to finish.

Regardless of the many things that consumed his thoughts at that moment, the mosquito had its fill of blood and flitted away before Lazear could capture it for his collection. He had not even gotten a good look at this particular insect. It was probably one of the many malaria mosquitoes that hovered around the hospital for fresh supply.

At least that was the story he told his colleagues.

In his logbook, however, Lazear wrote an unusual entry on September 13. In all cases before that, page after page of records, Lazear had used the soldier’s name and simply the date he was bitten, with no other attention to the mosquito. A one-line entry with a name and date. On that day, however, in his elegant hand, Lazear did not write the soldier’s name, but instead wrote: “Guinea Pig No. 1.” He went on to write that this guinea pig had been bitten by a mosquito that developed from an egg laid by a mosquito that fed on a number of yellow fever cases: Suarez, Hernandez, De Long, Fernandez. It was a precise, detailed history that proved beyond doubt that the mosquito was loaded with the virus when it bit the healthy soldier. The guinea pig’s name was never used.

For the next few days, Lazear’s life continued much as it had over the last few months in Cuba. He fed and cared for the mosquitoes in the lab. He carefully documented in his logbook Carroll’s illness, as well as Dean’s, recording blood counts every day. He went sea bathing and ate in the officer’s mess hall; he read books by the light of a candle before bed.

Then, he began to lose his appetite. He skipped a few meals in the mess hall. He didn’t mention it to anyone, nor did he ask to see one of the yellow fever doctors; instead, he worked hard in the lab trying to ignore the oncoming headache.

On September 18, he complained of feeling “out of sorts” and stayed in his officer’s quarters. His head pounded, and Lazear decided to write a letter. Maybe occupying his thoughts with more cheerful things would take his mind off the pain. He wrote to his mother: “Dear little Houston must be very cute. How I wish I could see him . . . Mabel is probably with you now or at any rate will be by the time this reaches you. I wish I could be there too . . . Please don’t stop writing often because Mabel has come.” He made no mention of feeling ill, nor did he ever mention to his mother or Mabel that James Carroll had fallen ill with yellow fever. That night, Lazear started to feel chilled as the fever came on. He never went to sleep; he worked at his desk through the night, trying to get all the information about his mosquitoes organized. By morning, he showed all the signs of a severe attack of yellow fever. The camp doctors made the diagnosis, and Lazear agreed to go to the yellow fever ward. He asked Albert Truby to look after his belongings during his illness.

Lazear was carried by litter out of the two-room, white pine-board house in which he had lived since he and Mabel first arrived in Cuba. His clear blue eyes were alert as the soldiers held him, and he seemed to fully understand what was happening. The house was fumigated with sulfur dioxide, and Truby removed any valuables, including all books and photographs, as well as a small notebook he found in the blouse of Lazear’s army uniform.