Researching Historical Fiction

‘Bad Air’ and Undertakers: Yellow Fever in 19th-Century America

I’ve been reading about the yellow fever outbreak in Angola and Democratic Republic of Congo and thinking about how deadly the disease used to be in the U.S. Fortunately, there is a vaccine now, although it is in short supply. A century and a half ago, people didn’t even understand how the disease spread.

Arch_Street_Ferry Philadelphia 1793
A yellow fever outbreak in Philadelphia in 1793 killed 5,000 people, about 10 percent of the city’s population. Among the thousands who fled was an infected Alexander Hamilton.

Deadly yellow fever outbreaks struck the U.S. beginning in the 1700s. In the 19th century, it was deemed one of the most dangerous infectious diseases.

In 1873, Shreveport, Louisiana, lost almost one-quarter of its population to yellow fever. A local newspaper printed a “List of the Dead” that numbered almost 800.

The worst outbreak was in 1878 in the Mississippi River Valley. About 20,000 people died—a staggering number, especially at the time. Memphis, Tennessee, was particularly hard hit. It was the fifth of six major yellow fever epidemics in the city.

The disease is carried by mosquitoes and likely came to this country via ships. But people didn’t know that at the time. After a woman in Memphis got sick and died, about half the town—25,000 people—fled within a week, leaving behind mostly poor people and blacks.

During yellow fever outbreaks in Memphis, victims were often quarantined on President’s Island just outside the city and sufferers “made to wear yellow jackets as a means of identification.”

Of those left in town, about 17,000 got sick, and 5,000 died. Most died within two weeks, according to, and “survivors can feel the effects for months.”

Symptoms include bleeding from the ears and eyes, black vomit (from digesting internal bleeding), fever, and yellowing of the skin and eyes. A doctor performing an autopsy in New Orleans said the victim’s skin was canary yellow.

It was unusually hot in Memphis that year. Flowers bloomed in January and February, and temperatures were over 100 degrees in the summer. But frightened people boarded up windows and stayed inside with fires burning to keep out “bad air.”

Also according to

An average of 200 people died every day through September. There were corpses everywhere and near continual ringing of funeral bells. Half of the city’s doctors died.

Nuns took care of the sick, often contracting the disease and dying themselves. Undertakers called “bring out your dead,” and were so overwhelmed that in some cases, they only dug 6 inches deep to bury the bodies.

yellow fever_10121878_Dodge Times
A news item from the Oct. 12, 1878, Dodge City (Kansas) Times describes the effects of yellow fever in graphic detail.

Although America had its last major outbreak in 1905 (in New Orleans), yellow fever is still endemic in 47 countries in Africa and South America. And it’s still a frightening disease.

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