Cuban Interior - 1900

Carlos Juan Finlay (1833 - 1915)

Son of a Scottish doctor and a Parisienne, born in Cuba but received early schooling in France

Jefferson Medical College Graduate

Practiced medicine and ophthalmology in Havana

Became fascinated with the transmissibility of yellow fever, and that the agent of disease was in the air

Finlay in Havana

Aedes aegypti & Carlos FinlayFinlay hypothesizes that the common house mosquito transmits Yellow Fever by directly injecting the blood from an infected person.

He does not appreciate the need for an extrinsic incubation period in the mosquito after it takes an infected blood meal.

In retrospect, at most only 1 of his 104 experiments from 1881-1898 demonstrates mosquito transmission of Yellow Fever. Many thought that Finlay has disproved his hypothesis.

USS Maine entering Havana Harbor, January 25, 1898

USS Maine - 2/15/98

"Burial of the dead" [1899?]

20,738 cases of typhoid fever, and 1,500 deaths in the first 171,000 American soldiers

Yellow fever outbreaks in occupation troops spurs formation of the Commission

The United States Army Yellow Fever Commission (1900 - 1901)

Walter Reed• Born in Virginia in 1851, MD at age 17 from

UVA, then to Bellevue, official of NY Board of Health

• 1874-1890 in US Army as physician• Sabbatical at Hopkins with Osler and trained

in bacteriology under Welch• 1893 Professor of Bacteriology at the Army

Medical School• Established importance of human to human

transmission of typhoid fever in Cuba

 Jesse William Lazear (1866 -9/25/ 1900)

• Born to wealthy family in Baltimore.• Attended Hopkins, Columbia, trained in

bacteriology in Europe.• Medical resident & later head of clinical

microbiology Hopkins• Assigned to Camp Columbia Feb. 1900 as

Asst Surgeon, studies malaria and yellow fever.

• Entomologist, makes Reed aware of Ross’ work on malaria, meets Finlay and discusses his hypothesis on mosquito transmission, and who gives him mosquito eggs for experimentation

James Carroll

• Born in Woolwich, England 6/5/1854; served in US Army starting in 1874 as a private

• Medical School at the U. City of NY, UMD, & bacteriology with Wm Welch at Hopkins

• First works with Reed at the Army Medical School 1893

• Reed’s assistant at the Bacteriology Labs at Colombian University

Aristides Agramonte

• Born in Cuba and brought in 1870 to NY as infant after father killed fighting against Spain.

• MD from Columbia, bacteriologist with NY City Health Department

• Assigned to Military Hospital #1 in Havana as pathologist in charge of the laboratories

• Cuban scientist who had worked in Reed's lab at the Columbian University in 1898,

• Thought to be immune to Yellow Fever from a childhood infection

• An accomplished pathologist who performed most of the autopsies of suspected cases of Yellow Fever

George Miller Sternberg (1838-1915)Member of Chaille Commission to Havana Cuba in 1879 that met with Carlos Finlay and concluded the Yellow Fever was perhaps a living entity in the atmosphere

Appointed Surgeon General in 1893.

Impressed with Walter Reed’s work with Welch at Hopkins, appoints him a Professor at the new Army Medical School.

1900 he establishes the Yellow Fever Commission to Cuba

• Military Orders Establishing the Yellow Fever Commission - May 14, 1900

• This was the 4th Commission to attempt to deal with Yellow Fever along the US coast & Caribbean

Giuseppe Sanarelli

• Italian bacteriologist who had worked at the Pasteur Institute

• 1897 working in Brazil & Uruguay he reports the identification of Bacillus icteroides in 58% of autopsies of cases of Yellow Fever, but almost always in association with other bacteria.

• He claims to have reproduced the disease by injecting formic aldehyde-inactivated broth cultures into 5 humans (3 of whom died)

Colombia Barracks, CubaJune 25, 1900 Studies Begin

Hospital Corps, Camp Columbia, Cuba, September 1900

Lazear’s Impatience with Reed

 Dr. Reed had been in the old discussion over Sanarelli's bacillus and he still works on that subject. I am not all interested in it but want to do work which may lead to the discovery of the real organism. However I am doing as much as, I can.Letter fragment from Jesse W. Lazear to Mabel H. Lazear, July 15, 1900

Reed, Caroll & Agromonte & Lazear disprove B. icteroides as cause of Yellow Fever

Proceedings 28th Annual Meeting of the American Public Health Association, Indianapolis IN, October 22-26, 1900