1
G. A. Martini and R. Siegert,
Marburg Virus
Disease (Frankfurt: Springer Verlag, 1971).
4
World Health Organization, “Viral Haemorrhagic Fevers: Report of a WHO Expert Committee,”
Technical Report Series
(1985): 721; and Anonymous, “Méthodes de Surveillance et de Prise en Charge du Monkeypox et des Fievres Hemorrhagiques d'Origine Virale,” CDS/80.1 (Geneva: World Health Organization, 1980).
5
Martini and Siegert (1971), op. cit.
6
Since 1980 Rhodesia has been called Zimbabwe, in recognition of the Shora culture that preceded the British colonization of the area, which was spearheaded by Cecil Rhodes.
7
J. S. S. Gear et al., “Outbreak of Marburg Virus Disease in Johannesburg,”
British Medical Journal
4 (1975): 489â93.
8
J. S. S. Gear, “Clinical Aspects of African Viral Hemorrhagic Fevers,”
Reviews of Infectious Diseases
11, Supplement 4 (1989): s777âs782.
9
L. Lapeyssonie,
An Outbreak of Meningococcal Meningitis in Brazil,
EM/BD/8 (Geneva: World Health Organization, September 1974).
10
The federal medical training program provided most of the physicians that staffed Public Health Service clinics in rural areas, on Indian Nation lands, and in inner-city areas. The Reagan administration would terminate the program in 1986, citing budgetary concerns and a physician surplus as reasons.
11
A. S. Benenson,
Control of Communicable Diseases in Man
(15th ed.; Washington, D.C.: American Public Health Association, 1990).
12
C. 0. Bastos et al., “Meningitis in S
o Paulo,”
Revue Associacion Medicale Brasiliera
19 (1973): 451â56.
13
The Type B meningococcus was more common in developed countries. Years later, as Brazil developed, it would experience Type B epidemics too. See J. C. DeMoraes, B. A. Perkins, M. C. C. Camarago, et al., “Protective Efficacy of a Serogroup B Meningococcal Vaccine in S
o Paulo, Brazil,”
Lancet
340 (1992): 1074â78.
14
Data from the International Air Transport Association, London. By 1980, 163 million people were flying annually between countries, and that figure reached 280 million by 1990. Within the United States, 42 million domestic tickets were sold in 1990.
15
World Health Organization,
Epidemic Report,
EM/EPID/39 (Geneva: World Health Organization, 1974).
16
L. Lapeyssonie,
Report on a Second Visit to Brazil
,
28 April to 28 May 1975,
EM/BD/11 (Geneva: World Health Organization, September 1975).
17
The methods used to make such vaccines were fairly standard by 1974. See E. C. Gotschlich, M. Rey, W. R. Sanborn, et al., “The Immunological Responses Observed in Field Studies in Africa with Group A Meningococcal Vaccines,”
Progress in Immunobiological Standards
5 (1972): 485â91.
18
In its 1976 summary of the Brazilian pestilence, PAHO concluded: “It has been shown that populations belonging to lower economic classes which are exposed to overcrowding, poor housing, and poor environmental sanitation, and which have low levels of personal hygiene, are the populations most affected. Improvement of living conditions, housing and personal hygieneâwhich should be coupled with general education and health educationâwould certainly be beneficial, although the effectiveness of such improvement has not been definitely assessed in quantitative terms.” See Pan American Health Organization,
Report on the Meeting on Meningococcal Disease, S
o Paulo-Bras
lia, Brazil, 23â28 February 1976
(Washington, D.C.: Pan American Health Organization, 1976).
19
Since the Brazilian epidemic, other outbreaks of equally mysterious origins have occurred in Mali, Niger, Papua New Guinea, Senegal, Nigeria, Finland, Norway, Cuba, Mongolia, Vietnam, South Africa, Sudan, Gambia, and the United States. In January 1993 panic developed in the largely Dominican Washington Heights section of New York City when a six-year-old boy died of Type A meningococcal meningitis. The boy left school on a Thursday feeling fine, and was dead a day later. See Pan American Health Organization (1976), op cit; B. M. Greenwood, “Selective Primary Health Care: Strategies for Control of Disease in the Developing World. XIII: Acute Bacterial Meningitis,”
Reviews of Infectious Diseases
(Chicago: University of Chicago Press, 1984), 374â89; and M. Howe, “After a Meningitis Death, Striving to Calm the Fears of Other Pupils' Parents,
New York Times,
January 29, 1993.
20
Centers for Disease Control,”Yellow Fever Vaccine: Recommendations of the Immunization Practices Advisory Committee,”
Morbidity and Mortality Weekly Report
39 (1990): 1â6.
21
M. S. Pernick,”Politics, Parties and Pestilence: Epidemic Yellow Fever in Philadelphia and the Rise of the First Party System,” in J. W. Leavitt and R. L. Numbers, eds.,
Sickness and Health in America
(Madison: University of Wisconsin Press, 1985), 356â71.
22
W. H. McNeill,
Plagues and Peoples
(New York: Doubleday, 1977).
23
Roughly translated, one such tune repeats these lines:
Only mosquito can save Nigeria.
Only mosquito can save South Africa.
Only mosquito can save Zimbabwe
Only mosquito can save Namibia.
Only mosquito can save Africa.
Only malaria can save Africa.
Only yellow fever can save Africa.
Translation courtesy of Bunmi Makinwa, John F. Kennedy School of Politics and Government, Harvard University.
24
R. M. Taylor, “Epidemiology,” in G. K. Strode, ed.,
Yellow Fever
(New York: McGraw-Hill, 1971), 442.
25
G. Strode,
The Conquest of Yellow Fever
(New York: McGraw-Hill, 1951).
26
F. L. Soper et al., “Yellow Fever Without
Aedes aegypti
: Study of Rural Epidemic in Valle do Chanaan, Espirito Santo, Brazil, 1932,”
American Journal of Hygiene
18 (1933): 555.
27
J. Boshell, “Marche de la Fievre Jaune Sylvatique vers les Regions du Nordouest de l'Amérique Centrale,”
Bulletin of the World Health Organization
16 (1957): 431.
28
M. E. Wilson,
A World Guide to Infections
(Oxford, Eng.: Oxford University Press, 1991), 697â700.
29
T. P. Monath, “Yellow Fever: Victor, Victoria? Conqueror, Conquest? Epidemics and Research in the Last Forty Years and Prospects for the Future,”
American Journal of Tropical Medicine and Hygiene
45 (1991): 1, 43.
31
Scientists in these outposts investigated eight more yellow fever outbreaks during the 1960s, ranging in size from those involving fewer than twenty people (Zaire) to massive epidemics involving 20,000 people (Senegal, 1965), and to a West African pandemic which struck well over 100,000 people (Nigeria, Mali, Burkina Faso, Togo, and Ghana, 1969). In these epidemics 25 to 35 percent of those infected with the virus perished. See ibid.
32
V. H. Lee et al., “Arbovirus Studies in Nupeko Forest, a Possible Natural Focus of Yellow Fever Virus in Nigeria. II: Entomologic Investigations and Viruses Isolated,”
Transactions of the Royal Society of Tropical Medicine and Hygiene
68 (1974): 39â47.
33
T. P. Monath et al., “The 1970 Yellow Fever Epidemic in Okwoga District, Benue Plateau State, Nigeria. 2: Immunity Survey to Determine Geographic Limits and Origins of the Epidemic,”
Bulletin of the World Health Organization
49 (1973): 123â28.
34
T. P. Monath et al., “The 1970 Yellow Fever Epidemic in Okwoga District, Benue Plateau State, Nigeria. 1: Epidemiological Observations,”
Bulletin of the World Health Organization
49 (1973): 113â21.
35
Monath (1991), op. cit.