The American Plague - Molly Caldwell Crosby [100]
Tom McCullough had told his wife that he could not remember being bitten by a mosquito during the trip. He slept in an air-conditioned boat and had worn DEET. Still, a mosquito had apparently found him, following the scent of carbon dioxide in the tropical air, perhaps hovering unnoticed around his ankles or legs, biting several times as he moved. But it only took one bite, a pinprick he never even noticed, and the lethal virus made its way into his bloodstream. McCullough’s body had never come in contact with this virus before. He had not had a yellow fever vaccine, and his blood came from stock that had not seen this virus in over a century.
Had an Aedes aegypti mosquito in Texas bitten McCullough in the days before he checked into the hospital, hundreds more could have been infected. The virus would have been unleashed on a virgin population. In the mild Corpus Christi winter, virulent eggs could survive to the next summer when even more Aedes aegypti mosquitoes would carry the virus through another muggy Texas summer.
At first, the virus would move quietly into the population. People would begin showing up at local emergency rooms with high fevers and flu-like symptoms. They would be released when they showed signs of improvement—yellow fever’s convalescent period. But as many as 50 percent of those people, and possibly many more than that, would enter the toxic phase of the disease and die.Their deaths might be blamed on any number of diseases—pneumonia, hepatitis, influenza, West Nile. Though mosquito bites, swollen and pink, might appear on the skin, no one would think to investigate further. After all, these patients live in the United States. They had not traveled to a tropical country; they had just spent a summer evening outdoors, or found a striped mosquito trapped in their car, or missed a few places of skin when they sprayed Off! on their children playing in the backyard.
As the death toll began to mount, doctors in the local hospitals would begin reporting them to the state health department. Perhaps malaria or dengue had made its way from Central Americanorth. Health officials would be concerned. Resistant strains of malaria have been reported in recent years, and the CDC estimates that as many as 3,800 cases of dengue have appeared in the United States since the 1970s. Dengue is spread by the same mosquito that carries yellow fever. At last, the dead arriving from their homes or on gurneys in emergency rooms would begin to yellow, their skin taking on a bronze color, their eyes like sunflowers.
The state health department would contact the CDC, which, under international law, must contact the World Health Organization within twenty-four hours to report any disease with jaundice and bleeding. Since its inception in the 1950s, the WHO’s International Health Regulations have required reporting of only three diseases: plague, cholera and yellow fever. All three diseases are subject to international quarantine.
But in America, these diseases are so rare that doctors would doubtfully even recognize the symptoms in twenty-four hours. Americans traveling to the coastal areas of Texas for vacation would pick up the virus and fly home to cities like Houston, Dallas, Memphis and New Orleans, where entire colonies of Aedes aegypti live.
In 2005, the CDC published a detailed response to an epidemic of yellow fever in Africa and the Americas. Field investigators, border officials and vector control would arrive. They would contact the Global Alliance for Vaccines and Immunization to report an epidemic and request that mass vaccines be delivered within the week. Those who already have the virus would have little chance for survival—they would be part of the nonimmune population, the kindling that the virus relies upon to spread. Vaccines would be given to hospital personnel and military first, but postexposure, it would do little good. In the time it would take the vaccine to prompt the production