Samuel A.

Gum
406 South Pugh Street
State College, PA 16801

June 1, 2010

Jeannette Novakovich
256 Burrows Building
University Park, PA 16802

Dear Ms. Novakovich:

An eerie chill bestows the streets of Philadelphia. They were completely

empty with the exception of the sound of carriages making their rounds to
pick up the dead. It was the summer of 1793 and a ghastly epidemic of
Yellow fever gripped the largest city of America and the nation’s capital.
Yellow fever tore through the city like wildfire causing the death of one-sixth
of the population. Though many tried to flee the city, the effects of such a
devastating epidemic could not be avoided. Out of the death and decay,
several of history’s greatest doctors such as Benjamin Rush became
combatants against the plague and consequently advanced medicine. The
growth of Philadelphia and the history of Pennsylvania were forever altered
by this tragedy endured by the residents of Philadelphia. The Yellow fever
epidemic of 1793 can be considered a crucial part of not only Pennsylvania’s
history, but of the history of human strength and fortitude during
unbelievably difficult times. Therefore, the subject of Yellow fever of 1793
would be an indispensable topic for publication in the PA Center for the Book.

My credentials to write such an article stem from a thorough research of

Yellow fever epidemics, especially that of 1793 in Philadelphia, including
more than twenty-five primary references. I also have an extensive
background in cellular processes and pathology of infectious diseases from
my education at Penn State University. In my class work, I learned about
similar viruses in the flaviviridae family of virus such as West Nile Virus and
other vector transmitted diseases.

Resources used to conduct my investigation include journals, letters,

newspapers, and personal statements from 1793 from influential individuals
who observed the spread, infection, turmoil, and treatment of Yellow fever.
In addition, I have read several books written on the subject from 1794 to
present including those written by Benjamin Rush.
Technical Description:
Yellow Fever
Yellow fever is an acute, infectious, hemorrhagic (bleeding) viral
disease transmitted by the bite of a female mosquito native to tropical and
subtropical regions of South America and Africa.

epidemics. Those that survive get

immunity from future infections.

Image from
http://www.cdc.gov/mmwr/preview/mmwrh
tml/mm5144a1.htm
Symptoms
After being infected from the bite of a
female mosquito, there are three to six
days of incubation, after which the virus
begins its destruction of its host. The
symptoms of the virus are characterized
by sudden onset of fever, bradycardia
(slow heart beat), and headache. In severe
cases, jaundice (yellow discoloration of the
skin) from liver damage (hence “yellow”
fever) and hemorrhaging in the mouth,
the eyes and in the gastrointestinal tract
can occur. Vomiting blood is common with
gastrointestinal bleeding. Once liver cells
and other organ cells are affected, multi-
organ failure can take place. Fatality of
the severe cases is approximately 20%.
Fatality can increase to 50% during
Transmission
Yellow-fever, a flaviviridae family
member, is an enveloped, positive sensed
RNA virus of about 11,000 nucleotides in
length. It is transmitted mainly by Aedes
aegypti and other mosquitoes of the
genus Aedes. These are frequently found
in tropical and subtropical regions on most
continents. Members of this genus serve
as the primary vector of many infectious
diseases of humans including Dengue
fever, West Nile Virus, Chikungunya,
Filariasis, and Yellow fever. Yellow fever,
though endemic to Africa, was brought to
the Americas by tradeships and slaveships
resulting in severe epidemics. It is
believed that infected mosquitos laid their
eggs in water casks and barrels in ships
that voyaged to the New World.
Imagef
rom http://www.s-
union.com.tw/Download/Insect/image/Aed
es.jpg
Image from http://www.gg.rhul.ac.uk/ict4d/yellowfever/yellowfever.htm

Transmission originates in the monkeys of the rainforest regions of

Africa which serve as an animal reservoir for replication and the survival on
Yellow fever. Slyvatic (or Jungle) Yellow fever transfers to mosquitoes when
mosquitoes bite an infected monkey. Next, the infected mosquitoes transfer
the virus to humans in the humid and semi-humid savannahs in Africa.
Yellow Fever can then be transmitted from human to human via Aedes
aegypti mosquitoes. This can lead to epidemics in urban areas if the
conditions are suitable and if people are not vaccinated. Larger outbreaks of
Yellow Fever can occur in population dense areas.

Mechanisms of Replication
There are several steps to the infection and replication of the Yellow
fever virus. First, the RNA virus binds to monocytes, macrophages, or
dendritic cells via specific receptors and are internalized in an endosomal
vesicle (See Figure Below). Next, the envelope and the vesicle fuse together
due to a pH decrease resulting in the protein shell of the virus (capsid) to
release its genome into the cytoplasm of the cell. The proteins encoded by
the virus genome are then replicated by using the host cell transcription
processes to make the necessary proteins for the new yellow virus. The new
viral genome is replicated in the endoplasmic reticulum (ER) and then
packed into vesicles in the Golgi apparatus via the host protein furin. Lastly,
the vesicle is release from the host cell as a mature virus.
Image from http://bilbo.bio.purdue.edu/~viruswww/Kuhn_home/flaviprojtxt.html

Treatment & Prevention

Treatment includes rehydration and pain relief, but there is no cure.
Therefore, prevention remains to be the primary means of management.
There are three major ways to prevent infection of Yellow Fever. First,
vaccination is highly recommended to non-native people who travel to
endemic regions as they are more susceptible to severe symptoms. In
addition, the WHO (World Health Organziation) recommends vaccination of
children from 9 to 12 months of age who lived in high risk areas. Several
countries in Asia at risk for Yellow Fever outbreaks require compulsory
vaccination to avoid the spread of the virus. Secondly, insecticides can be
used to kill larvae and adult Aedes aegypti mosquitoes help to reduce their
numbers and control the pest. Lastly, prevention of Yellow Fever can be
achieved by the avoidance of mosquitoes in endemic areas by using with
mosquito nets, bug spray, and avoiding being out during early morning and
early evening when mosquitoes feed the most.

Conclusion
Yellow fever has long been a major concern for regions of Africa and
South America due to the severity of the symptoms and mosquito
infestations. However, spread to non-endemic regions remains a constant
threat. The replication of Yellow Fever in its host causes a variety of
unpleasant symptoms which can lead to death. However, the spread of the
virus human to human by mosquito vectors in dry, humid regions can be
limited by vaccination, pest control, and mosquito avoidance.
In summary, I formally request permission to proceed with writing an article
for PA Center for the Book on the Yellow fever epidemic of 1793 in
Philadelphia. I would greatly enjoy the chance to publish in the PA center for
the Book website. Thank you for your consideration.

Sincerely,

Samuel Gum

Samuel Gum Annotated Bibliography for Yellow fever 1793

May 24, 2010

1. Arnebeck, Bob. "A Short History of Yellow fever in the US". Benjamin Rush, Yellow
fever and the Birth of Modern Medicine. 2008. 20 May 2010
<http://bobarnebeck.com/history.html>.
a. Excellent source. Good writer.
b. A contemporary account of the event of 1793 based on publications of the
time.
c. This article caught my attention on the subject of Yellow fever and
provides an excellent account.
2. Barnard, Bryn. Outbreak! Plagues That Changed History. New York: Crown
Publishers, 2005.
a. All right source, a bit brief on the subject of Yellow fever.
b. Describes Yellow fever in 1793 and its affect on history.
c. The emphasis on the effects of the Yellow fever will provide a good closer
for my paper.
3. Benjamin Rush. 20 May 2010
<http://www.nps.gov/history/history/online_books/declaration/bio42.htm>
a. Good image source with a good caption.
b. Portrait of Benjamin Rush.
c. Will add flavor and visuals to my paper.
4. Birkerts, Sven. “The Fever Days.” The New York Times 3 November 1996: 20.
Academic: LexisNexis. Yellow fever 1793. 20 May 2010 <
http://www.lexisnexis.com/us/lnacademic>.
a. NYT can be considered the best historical newspaper.
b. Short, provocative summary of Yellow fever in 1793.
c. A few provocative facts could help my paper.
5. Burling, Stacey. “Nation’s first hospital, marking 250 years, was founded to aid
the poor.” The Philadelphia Inquirer 17 May 2001. Academic: LexisNexis.
Yellow fever 1793. 20 May 2010 < http://www.lexisnexis.com/us/lnacademic>.
a. Good source
b. Provides a timeline of events that occurred in America’s first hospital
and tells of Benjamin’s profound effect on it.
 c. Describes the importance of the first hospital and how it related to
Benjamin Rush and Yellow fever
6. Carey, Matthew. A short account of the malignant fever, lately prevalent in
Philadelphia :with a statement of the proceedings that took place on the subject,
in different parts of the United States, to which are added, accounts of the
plague in London and Marseilles, and a list of the dead, from August 1, to the
middle of December, 1793. Philadelphia: Matthew Carey, 1794. 20 May 2010
<http://pds.lib.harvard.edu/pds/view/7374219>..
a. Great personal source.
b. Another personal account of the plague.
c. More great quotes of the devastation with a broader grasp of how the
fever spread and affected a large number of people worldwide.
7. College of Physicians of Philadelphia. Proceedings of the College of Physicians of
Philadelphia, Relative to the Prevention of the Introduction and Spreading of
Contagious Diseases. Philadelphia: Thomas Dobson, 1798. 20 May 2010
<http://pds.lib.harvard.edu/pds/view/7319084> .
a. Hard read but great direct source.
b. Historically interesting piece of early infectious disease control.
c. These men believed the disease was contained on the clothes of people
from the west indies.
8. Currie, William. A Description of the Malignant, Infectious Fever Prevailing at
Present in Philadelphia With an Account of the Means to Prevent Infection, and
the Remedies and Method of Treatment, Which Have Been Found Most
Successful. Thomas Dobson, 1793. 20 May 2010
<http://pds.lib.harvard.edu/pds/view/7468293> .
a. Another great direct source. I love this Harvard websearch.
b. Direct account of the Yellow fever, its symptoms, and treatments.
c. A profoundly important source of the symptoms and treatments of Yellow
fever and the conclusions that were made at the time.
9. Dr. Benjamin Rush mistakenly traced the origin of the 1793 epidemic in
Philadelphia to rotting coffee dumped on the Arch Street wharf. Arnebeck, Bob.
"A Short History of Yellow fever in the US". Benjamin Rush, Yellow fever and the
Birth of Modern Medicine. 2008. 20 May 2010
<http://bobarnebeck.com/history.html>.
a. Great source.
b. Portriat of arch street wharf
c. Incredibly important to my paper as it shows how the pathology of Yellow
fever was misunderstood.
10. Garret, Laurie. The Coming Plague: Newly Emerging Diseases in a World Out of
Balance. New York: Farrar, Straus and Giroux, 1994.
a. A good resource.
b. An interesting prospective on how hard earlier times were on the new
colonies of America.
c. This article should add to a more humanistic approach of my paper.
11. Hocker, Edward. Germantown 1683-1933: The Record That a Pennsylvania
Community Has Achieved in the Course of 250 Years, Being a History of the
People of Germantown, Mount Airy and Chestnut Hill. Philadelphia: Edward
Hocker, 1933. 20 May 2010
<http://collection1.libraries.psu.edu/cdm4/document.php?
CISOROOT=/digitalbks2&CISOPTR=11169&REC=2>.
a. A good resource, but not the greatest.
 b. The author focuses a lot on Germantown and people of importance to
Germantown and less on the plague.
c. However, there are still good quotes and accounts of the Yellow fever of
1793.
12. Kolata, Gina. “When Bioterror First Struck The U.S. Capital.” The New York Times
6 November 2001: 1. Academic: LexisNexis. Yellow fever 1793. 20 May 2010 <
http://www.lexisnexis.com/us/lnacademic>.
a. NYT can be considered the best historical newspaper.
b. A look back at the first epidemic and its devastation.
c. Great source which describes the Yellow fever of 1793.
13. Kopperman, Paul E. “‘Venerate the Lancet’: Benjamin Rush’s Yellow fever
Therapy in Context.” Bulletin of the History of Medicine, 2004, 78: 539–574.
a. Excellent source from a medical prospective.
b. How Benjamin Rush treated Yellow fever among other illnesses
c. A very close look of how the plague was treated in such a chaotic time can
given insightful information.
14. Jones, Absalom and Richard Allen. A Narrative of the Proceedings of the Black
People, During the Late Awful Calamity in Philadelphia, in the Year 1793: and a
Refutation of Some Censures, Thrown Upon Them in Some Late Publications.
Philadelphia: William W. Woodward, 1794. 20 May 2010
<http://pds.lib.harvard.edu/pds/view/6483355>.
a. Great source as slavery as use of blacks during the plague occurred often.
b. Black prospective of fever of 1793.
c. Since blacks were thought to be immune to the illness, this provides an
excellent source for my paper.
15. Minutes of the Proceedings of the Committee Appointed on the 14th September,
1793, by the Citizens of Philadelphia, the Northern Liberties and the District of
Southwark, to Attend to and Alleviate the Suffering of the Afflicted with the
Malignant Fever, Prevalent in the City and Its Vicinity, With an Appendix.
Philadelphia: R. Aitken & Son, 1794. 20 May 2010
<http://pds.lib.harvard.edu/pds/view/6395244>.
a. Great source!
b. Very focused article on the how to alleviate the Yellow fever epidemic in
1793.
c. An interesting prospective on how the plague was treated and “problem”
solved.
16. Murphy, Jim. An American Plague: The True and Terrifying Story of the Yellow
fever Epidemic of 1793. New york: Clarion Books, 2003.
a. Often cited book on the subject.
b. A historical point of view of this event.
c. A historical account of the events that occurred with some very good
quotes.
17. Peale, Charles. Benjamin Rush. 1818. 20 May 2010
<http://www.biographicon.com/view/tjeez>.
a. The website seems reliably and the picture is most used for Benjamin
Rush.
b. The picture is of Benjamin Rush
c. As Benjamin Rush was of great importance to the outbreak, a picture of
him will add to my paper.
18. Powell, J.H. Bring Out Your Dead: The Great Plague of Yellow fever in Philadelphia
in 1793. Philadelphia: Philadelphia University Press, 1914.
 a. The author had a Ph D. in American History and used original sources such
as letters to and from Dr. Benjamin Rush and the Federal Gazette which
was published daily during the plague.
b. This book provides an accurate summary of the events that transpired
during the Yellow fever outbreak of 1793.
c. This book is a direct link to original sources and direct quotes which
illustrate and describe Yellow fever, and though it may be hard to read, it
will undoubtedly be an awesome source of information.
19. Quinn, Edward. “Signers of the Declaration: the Great and Small.” The New York
Times 5 July 1981: 21. Academic: LexisNexis. Yellow fever 1793. 20 May 2010 <
http://www.lexisnexis.com/us/lnacademic>.
a. NYT can be considered the best historical newspaper.
b. This article provides a description of Benjamin Rush among other signers
of the declaration.
c. In particle, this article describes Rush’s work with the mentally ill and the
relationship with his mentally ill son.
20. Rhoades, Lillian. The Story of Philadelphia. New York, Cincinnati, Chicago:
American Book Company, 1900. 20 May 2010
<http://collection1.libraries.psu.edu/cdm4/document.php?
CISOROOT=/digitalbks2&CISOPTR=11275&REC=1 >.
a. A great source.
b. The content has a broad history of philly with some very good explanation
of the Yellow fever outbreak.
c. The few pages that discuss Yellow fever gives me a better insight in the
plague for my paper.
21. Rush, Benjamin. Observations Upon the Origin of the Malignant Bilious, or Yellow
fever in Philadelphia, and Upon the Means of Preventing It: Addressed to the
Citizens of Philadelphia. Philadelphia: Budd and Bartram, 1799. 20 May 2010
<http://pds.lib.harvard.edu/pds/view/6483213>.
a. Benjamin Rush’s views may be bias but historically very significant.
b. Benjamin Rush’s experience in 1793 is a great source.
c. The direct account for the treatment, discovery, and spread of Yellow
fever is priceless to my paper.
22. Stearns, Samuel. An Account of the Terrible Effects of the Pestilential Infection in
the City of Philadelphia; With an Elegy on the Deaths of the People; also, A Song
of Praise and Thanksgiving, Composed for Those Who Have Recovered, After
Having Been Smitten with that Dreadful Contagion. Providence: William Child. 20
May 2010 <http://pds.lib.harvard.edu/pds/view/6486492>.
a. Personal accounts may be bias, but can be very helpful since this event
occurred in 1793.
b. This book is a personal account of 1793 and Yellow fever.
c. Samuel’s account of the Yellow fever can give my paper a deeper and
more personal perspective as well as direct description of the event.
23. Watson, John and Willis P. Hazard. Annals of Philadelphia and Pennsylvania, in
the olden time being a collection of memoris, anecdotes, and incidents of the
city and its inhabitants, and of the earliest settlements of the inland part of
Pennsylvania; intended to preserve the recollections of olden time, and to exhibit
society in its changes of manners and customs, and the city and country in their
local changes and improvements. Philadelphia, Edwin S. Stuart, 1891. 20 May
2010 <http://collection1.libraries.psu.edu/cdm4/document.php?
CISOROOT=/digitalbks2&CISOPTR=12008&REC=7>.
a. The quality of the source is superb as you can identify by the lengthy title.
 b. This book covers a great scope of Philadelphia’s history which includes the
Yellow fever of 1793.
c. There is a great description of the devastation caused by Yellow fever and
the movement of people due to the fear and devastation is also described.
24. "The Yellow fever epidemic". Africans in America. PBS Online. 1998. 20 May 2010
<http://www.pbs.org/wgbh/aia/part3/3p1590.html>.
a. PBS is a great public source for a variety of information.
b. A collection of important people and events of Yellow fever of 1793.
c. This will provide good general and some specific information (mortality)
for my paper.
25. Yellow fever, Philadelphia, 1793. 20 May 2010
<http://sortor.com/benjamin_rush/source/yellow_fever_philly_1793.html>
a. The picture comes from an illustration of the Yellow fever in 1793 most
likely from that time period.
b. This picture shows the death and tragedy from Yellow fever.
c. This picture will definitely bring a humanistic look on the Yellow fever
plague.
America Historical Newspapers, America Historic Periodicals
History:

1762 Cuba. 1793 Philly PA. 1802 Haiti. 1853 New Orleans. 1855 Virginia.
1878 Lower Mississippi River Valley. Recovery, Pain, Benjamin Rush, PA, How
did Yellow fever get to Pennsylvania from Africa and South America?