The American Plague - Molly Caldwell Crosby [101]
A live vaccine, yellow fever can also have adverse effects. Infants, patients with depressed immune systems or anyone over the age of seventy-five cannot receive the vaccine. Though pregnant women are usually denied the attenuated vaccine for the safety of the fetus, the CDC would make an exception in the case of an epidemic. In the hospitals where yellow fever patients arrive, rooms would have to be screened and strictly quarantined. Lab technicians handling blood samples would have to follow strict procedure with gloves, masks and air purifiers.
A general panic would settle into the city and surrounding ones as educational warnings on television and radio recommended that people cover their beds in netting. Informational pamphlets would instruct people to empty any outdoor water containers around their homes. In spite of the summer heat, people would wear pants, long sleeves and socks with shoes. Store shelves would be cleared of Off! and any other DEET products. Windows would be screened. Water and food stockpiling might occur as people prepared to board themselves up in their homes, keeping their children indoors. Public pools and parks might close. Chemicals would be pungent in the air as people sprayed insecticides on their lawns and in their homes. Vector control units would send out patrols of trucks and crop dusters to mass spray.
The panic would worsen.
Vaccines from the Global Alliance for Vaccines and Immunization would arrive, but not enough in the event of a full-scale outbreak. The GAVI only recently began stockpiling the yellow fever vaccine. Six million doses are reserved each year for an epidemic, and they could take a few million more from their reserves for routine vaccine usage. The CDC would assess which portions of the population are most in need of the vaccine, reserving several for the personnel, military and hospital staff. Even if all six million vaccines arrived in a town like Corpus Christi, there would not be enough to inoculate cities the size of Houston and Dallas, much less other southern cities where the mosquitoes or infected people may have made their way.
Cases would continue to appear well into December, spiking every time another warm front moves through the country. At long last the epidemic would subside, though it would live on in the news and on the covers of magazines for months. Major vaccine production programs would begin, grown in chicken eggs over the next six months. And, hopefully, there would be enough vaccines ready for the approach of warm weather the following spring when yellow fever season arrived once again. That is not always the case—especially in underdeveloped countries. After an outbreak of yellow fever that killed thousands in Nigeria during the 1990s, it took ten years to clear the population of the virus. In order to prevent an epidemic, at least 80 percent of a country must have immunity to yellow fever.
According to the World Health Organization, even a single case of yellow fever must be treated as epidemic.
CHAPTER 25
A Return to Africa
Dr. Adrian Stokes bound a monkey onto a cushioned board with gauze, keeping his head firmly strapped. For an hour, Stokes allowed Aedes aegypti mosquitoes to bite the monkey on his face, lips, ears. Then, he returned the monkey to its cage. It seemed a little cruel, but it was too dangerous for the doctors to hold the monkeys while loaded mosquitoes fed. Even with leather gloves on, the insects could bite through the stitching. Across the lab from the monkeys, in a cage with roughly six screens dividing it, mosquitoes hummed in their wire prison.
A forty-year-old doctor who worked in pathology at Guy’s Hospital Medical School in London, Stokes was a part of the Yellow Fever Commission sent to West Africa in 1920—the one William C. Gorgas was to be a part of when he died in London. Stokes was a graying Englishman—charming, a tennis player, loved by all those who worked with him. Stokes rarely wore gloves when he worked