Yellow fever on the Panama Canal: when the epidemic beats the economy


William Crawford Gorgas (1854-1920), US Army surgeon

Epidemic versus economy is a game with a foregone conclusion. But few times in history has the impact been as destructive as it has been yellow fever in the construction of the Panama Canal.

At the end of the nineteenth century the cut of the isthmus of earth that divides Atlantic and Pacific is a company designed to change the face of commercial exchanges. Full positivism, the advancement of technology already seemed capable of overcoming every obstacle of Nature. The rocks that kept two oceans separate would have been swept away by the power of the machines and the money needed to build them.

This calculation did not sin of arrogance except for a minimum detail: the presence in the Central American forest of an animal almost invisible but belonging to the most lethal species for man. This insect it would turn the triumphal ride into an ordeal.

As with malaria, the yellow fever vehicle is the mosquito, in the variants Aedes Aegypti is Haemagogus, which spreads a family virus Flaviviridae single strand of rNA, with a genome schematically similar to Cov-Sars-2.
The infection, with effects similar to other mosquito-borne ones such as zika, dengue and chikungunya, comes in the form severe in 15% of cases. Half of the seriously ill die in 7-10 days.

The shortcut dream

The adventure of the construction of the Panama canal began to materialize in 1876 when the Geographical Society of Paris and the international civil society of the interoceanic channel of Darién entrusted themselves in the hands deemed safe to Ferdinand de Lesseps, the entrepreneur and diplomat who just seven years earlier (1869) had managed to build the Suez canal on a project by the Italian engineer Luigi Negrelli.

But the idea of ​​opening a gap between the Atlantic and the Pacific in the narrowest language of land in the Americas, theisthmus of Panama or Panamá in the local pronunciation, is shortly after the first explorations of Christopher Columbus and gods conquistadores Spaniards. At the beginning of the sixteenth century the said road was built Camino Real between the towns of Panama (Pacific) and Nombre de Dios (Atlantic).
In 1529 excavation of a canal is proposed for the first time to prevent ships from following the very long route of Magellan with the circumnavigation of Cape Horn in Patagonia.

In the following century (1690) the Company of Scotland attempts to establish a colony in the province of Darién, on the border with today’s Colombia, with the aim of exploiting the isthmus. The attempt ends in a financial and political disaster that leads, in 1707, to the two Acts of Union between England and Scotland and the birth of the United Kingdom.

From then on, the area becomes a no man’s land in the hands of the pirates up to the French idea of ​​replicating the Egyptian engineering enterprise in America.

The French project

On October 20, 1880 the Compagnie universelle du canal interocéanique de Panama, chaired by De Lesseps on a budget of 600 million francs to be collected through subsequent bond loans for institutional investors and small savers.
The French concession is opposed by the U.S. government which believes it has a say in the isthmus in application of the Monroe doctrine, the principle of US continental supremacy defined about half a century earlier.

Politically Panama is a Colombian province after being part of the Grande Colombia by Simón Bolívar with the current Venezuela and Ecuador until the dissolution in 1880.
Washington he is unable to exploit the situation because in the United States the situation is made unstable by one of the most uncertain and contested presidential elections in history. Plus the winner, the Republican James Garfield, will be assassinated after a few months in office in the White House (September 1881).

The canal works begin on January 10, 1881. TO June of 1881 there is the first death of yellow fever. The spread of the epidemic is very rapid and already in the March 1882 in Colón, the starting town of the shipyards on the Atlantic shore, the nuns of San Vincenzo they equip the first hospital dedicated to what is called in English Yellow Jack.

In the first phase of the epidemic, the French make catastrophic errors that turn yellow fever into a nosocomial disease like Covid-19.
Building on the miasmatic theory, the same that tried to explain malaria, cholera and bubonic plague with unhealthy effluvi, the first wards are richly decorated with plants which, with the stagnation of irrigation water, become nurseries for insect larvae. The windows of the rooms, kept open with the intention of guaranteeing the exchange of air, only favor the coming and going of the mosquitoes that sting the sick in the shelter and then go out to spread the virus outside.

Yet precisely in 1881 Cuban doctor Carlos Finlay has speculated that yellow fever is spread by mosquitoes. His discovery remains on the margins of the prophylaxis of a disease of difficult interpretation and impossible treatment.

Therapeutic champagne

The disease presents with joint and muscle pain, headache, fever, vomiting and bleeding internal. The most characteristic trait is the yellowish complexion that makes one think of a patient affected by jaundice. The symptomatological picture it is difficult to diagnose because it is confused with other diseases such as leptospirosis, viral hepatitis and malaria which, with theanopheles, is present in Panama but is less lethal.

The remedies are practically non-existent. Patients are prescribed bed rest, also because they would not be able to stand. The privileged are given the phenacetin, an antipyretic patented by Bayer in 1887, and some sip of champagne to counteract dehydration. Chic but not very effective.

The budget is very heavy. During the French construction period (1881-1889) 85% of workers engaged in the excavation of the Canal were affected by yellow fever. The dead are 22 thousand and to these are added 12 thousand deaths between the workforce involved in the construction of the railroad through the rain jungle.

La Compagnie du Canal, opposite the panic of the workers who flee the construction sites in the first case of infection, tries to remedy by improving the harsh working conditions in a climate that alternates torrential rains with infernal heat. The qualified technical staff is welcomed in wooden houses. The workers end up piled up in tents on the edges of the jungle amid swarms of mosquitoes.

The workforce is mainly composed of African Americans hired, if you do not want to say deported, from the nearby islands of the Caribe, the Indies Western. Most of it comes from Jamaica, British crown colony where the slavery was abolished only in 1834 and replaced byapprentice system, a vaguely attenuated slavery.

But the yellow fever does not share the classism of the Compagnie du Canal and rages at all levels.

When in 1883 Jules Dingler (first sitting from left in the photo) accepts the post of general manager of the Company and arrives in Panama with Charles de Lesseps, son of the president, does not imagine the personal tragedy that awaits him.

In 1884 he first loses his daughter, a month after his brother, then his son – in – law and, in 1885, to the peak epidemic, the wife.

Dingler remains in his place and tries to carry on the work, weighed down by delays and growing financial burdens. In 1888 we begin to introduce the lock system designed by Gustave Eiffel who, the year before, started building a strange metal tower on the banks of the Seine that the Parisians look with disgust.

But the French adventure in Panama is coming to an end, together with the investment money that has more than doubled from the 600 million forecast (1.33 billion).

February 4, 1889 the French parliament denies yet another funding. In the year ofUniversal Expo in Paris, the Compagnie du Canal is dissolved, put in liquidation is 85 thousand savers they put a cross on their investment.
The old De Lesseps ends under process for corruption and embezzlement of funds. In 1893 is sentenced to five years in prison that does not discount because he is already 89 years old. Winner in Suez and loser in Panama, he died shortly after in 1894.

The Roosevelt Brigades

For fifteen years, everything stands still. The United States strengthens its control over Central America by defeating the Spain in the war of 1898, when the thousand US soldiers killed in combat are joined by five thousand killed by Yellow Jack. For a while there is talk of building a new channel in Nicaragua but the secession of Panama’s independence from Colombia, fomented by the United States, proposes the solution followed by the French.
The project and the concession pass to the US led by the president Theodore Roosevelt.

The May 4, 1904 construction sites reopen.

Meanwhile, the miasmatic theory has ended up in the trash of history and the major Walter Reed showed, using human guinea pigs, that mosquitoes spread the virus.
The United States has already had yellow fever at home. Between 1839 and 1860 the disease was endemic to New Orleans with 22 thousand cases and hundreds of deaths.

In Panama William Gorgas, chief sanitary officer, declares war onAedes Aegypti, atHaemagogus and anopheles. It is a war in name and in fact. The “Mosquito brigades” they are made up of four thousand sanitizers which pour 120 tons of pyrethrum, 300 tons of sulfur, they dry up the flooded surfaces and, when it is not possible, sprinkle them with oil to prevent the eggs from hatching.
Only for the safety of the environment, 20 million dollars are spent (576 million at today’s values).

The results are excellent. TO November 1906 the last death of yellow fever is counted. The channel comes open to ship traffic on August 5, 1914, eight days after the declaration of war of Austria-Hungary on the kingdom of Serbia which kicks off the first world war.

Yellow fever today

Widespread three thousand years ago in African rain forests and passed to America with conquistadors and slavers, the yellow fever will be blocked by the vaccine in the two years 1937-1939, after years of researchInstitut Pasteur and US scientists funded by the Rockefeller Foundation, the same one that undertakes to eradicate
                                                                      malaria in Sardinia
                                                                       in the fifties.

The vaccine, produced with a weakened version of the virus, is the work of the South African doctor Max Theiler who in 1951 received the award Nobel.

Today yellow fever is still lethal although the vaccine in 2016 evolved from a ten-year lifespan to lifelong coverage without recalls. The data Who-Oms of 2013 refer to 200 thousand cases in 47 nations (34 in Africa and 13 in Latin America) where the infection is still endemic. THE deaths they are valued between 29 thousand and 60 thousand per year.

In 2016, when the doubling of the Panama Canal, WHO reports an epidemic in angola and in the Democratic Republic of the Congo with thousands of cases. The following year the program was launched Eye (eliminate yellow fever epidemics) strategy with the participation ofUnicef and fifty other private partners.
Very active in the struggle with 1 billion dollars of funding is Bill and Melinda Gates Foundation.
The very rich of today follow in the footsteps of the very rich of yesterday, the Rockefellers, so that we can vaccinate the very poor of today, the same as yesterday.

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