the genus haemagogus, which is indigenous to the americas, have been known to carry the disease. the first definitive outbreak of yellow fever in the new world was in 1647 on the island of barbados. an outbreak was recorded by spanish colonists in 1648 in the yucatán peninsula, where the indigenous mayan people called the illness xekik ("blood vomit"). in 1685, brazil suffered its first epidemic in recife. the first mention of the disease by the name "yellow fever" occurred in 1744. (john mitchell) (1805) (mitchell's account of the yellow fever in virginia in 1741–2) archived 2017-02-23 at the wayback machine, the philadelphia medical museum, 1 (1) : 1–20. (john mitchell) (1814) "account of the yellow fever which prevailed in virginia in the years 1737, 1741, and 1742, in a letter to the late cadwallader colden, esq. of new york, from the late john mitchell, m.d.f.r.s. of virginia," archived 2017-02-23 at the wayback machine american medical and philosophical register, 4 : 181–215. the term "yellow fever" appears on p. 186. on p. 188, mitchell mentions "… the distemper was what is generally called yellow fever in america". however, on pages 191–192, he states "… i shall consider the cause of the yellowness which is so remarkable in this distemper, as to have given it the name of the yellow fever." however, dr. mitchell misdiagnosed the disease that he observed and treated, and the disease was probably weil's disease or hepatitis. mcneill argues that the environmental and ecological disruption caused by the introduction of sugar plantations created the conditions for mosquito and viral reproduction, and subsequent outbreaks of yellow fever. deforestation reduced populations of insectivorous birds and other creatures that fed on mosquitoes and their eggs. sugar curing house, 1762: sugar pots and jars on sugar plantations served as breeding place for larvae of a. aegypti, the vector of yellow fever. in colonial times and during the napoleonic wars, the west indies were known as a particularly dangerous posting for soldiers due to yellow fever being endemic in the area. the mortality rate in british garrisons in jamaica was seven times that of garrisons in canada, mostly because of yellow fever and other tropical diseases. both english and french forces posted there were seriously affected by the "yellow jack". wanting to regain control of the lucrative sugar trade in saint-domingue (hispaniola), and with an eye on regaining france's new world empire, napoleon sent an army under the command of his brother-in-law general charles leclerc to saint-domingue to seize control after a slave revolt. the historian j. r. mcneill asserts that yellow fever accounted for about 35,000 to 45,000 casualties of these forces during the fighting. only one third of the french troops survived for withdrawal and return to france. napoleon gave up on the island and his plans for north america, selling the louisiana purchase to the us in 1803. in 1804, haiti proclaimed its independence as the second republic in the western hemisphere. considerable debate exists over whether the number of deaths caused by disease in the haitian revolution was exaggerated. although yellow fever is most prevalent in tropical-like climates, the northern united states were not exempted from the fever. the first outbreak in english-speaking north america occurred in new york city in 1668. english colonists in philadelphia and the french in the mississippi river valley recorded major outbreaks in 1669, as well as additional yellow fever epidemics in philadelphia, baltimore, and new york city in the 18th and 19th centuries. the disease traveled along steamboat routes from new orleans, causing some 100,000–150,000 deaths in total. the yellow fever epidemic of 1793 in philadelphia, which was then the capital of the united states, resulted in the deaths of several thousand people, more than 9% of the population. one of these deaths was james hutchinson, a physician helping to treat the population of the city. the national government fled the city to trenton, new jersey, including president george washington. headstones of people who died in the yellow fever epidemic of 1878 can be found in new orleans' cemeteries the southern city of new orleans was plagued with major epidemics during the 19th century, most notably in 1833 and 1853. a major epidemic occurred in both new orleans and shreveport, louisiana in 1873. its residents called the disease "yellow jack". urban epidemics continued in the united states until 1905, with the last outbreak affecting new orleans. at least 25 major outbreaks took place in the americas during the 18th and 19th centuries, including particularly serious ones in cartagena, chile, in 1741; cuba in 1762 and 1900; santo domingo in 1803; and memphis, tennessee, in 1878. in the early nineteenth century, the prevalence of yellow fever in the caribbean "led to serious health problems" and alarmed the united states navy as numerous deaths and sickness curtailed naval operations and destroyed morale. one episode began in april 1822 when the frigate uss macedonian left boston and became part of commodore james biddle's west india squadron. unbeknownst to all, they were about to embark on a cruise to disaster and their assignment "would prove a cruise through hell". secretary of the navy smith thompson had assigned the squadron to guard united states merchant shipping and suppress piracy. during their time on deployment from 26 may to 3 august 1822, 76 of the macedonian's officers and men died, including john cadle, surgeon usn. seventy-four of these deaths were attributed to yellow fever. biddle reported that another 52 of his crew were on sick-list. in their report to the secretary of the navy, biddle and surgeon's mate charles chase stated the cause as "fever". as a consequence of this loss, biddle noted that his squadron was forced to return to norfolk navy yard early. upon arrival, the macedonian's crew were provided medical care and quarantined at craney island, virginia. a page from commodore james biddle's list of the 76 dead (74 of yellow fever) aboard the uss macedonian, dated 3 august 1822 in 1853, cloutierville, louisiana, had a late-summer outbreak of yellow fever that quickly killed 68 of the 91 inhabitants. a local doctor concluded that some unspecified infectious agent had arrived in a package from new orleans. in 1854, 650 residents of savannah, georgia, died from yellow fever. in 1858, st. matthew's german evangelical lutheran church in charleston, south carolina, had 308 yellow fever deaths, reducing the congregation by half. a ship carrying persons infected with the virus arrived in hampton roads in southeastern virginia in june 1855. the disease spread quickly through the community, eventually killing over 3,000 people, mostly residents of norfolk and portsmouth. in 1873, shreveport, louisiana, lost 759 citizens in an 80-day period to a yellow fever epidemic, with over 400 additional victims eventually succumbing. the total death toll from august through november was approximately 1,200. in 1878, about 20,000 people died in a widespread epidemic in the mississippi river valley. that year, memphis had an unusually large amount of rain, which led to an increase in the mosquito population. the result was a huge epidemic of yellow fever. the steamship john d. porter took people fleeing memphis northward in hopes of escaping the disease, but passengers were not allowed to disembark due to concerns of spreading yellow fever. the ship roamed the mississippi river for the next two months before unloading her passengers. major outbreaks have also occurred in southern europe. gibraltar lost many lives to outbreaks in 1804, 1814, and 1828. barcelona suffered the loss of several thousand citizens during an outbreak in 1821. the duke de richelieu deployed 30,000 french troops to the border between france and spain in the pyrenees mountains, to establish a cordon sanitaire in order to prevent the epidemic from spreading from spain into france. causes and transmission a painting depicting yellow fever in buenos aires, 1871 carlos finlay walter reed ezekiel stone wiggins, known as the ottawa prophet, proposed that the cause of a yellow fever epidemic in jacksonville, florida, in 1888, was astrological. the planets were in the same line as the sun and earth and this produced, besides cyclones, earthquakes, etc., a denser atmosphere holding more carbon and creating microbes. mars had an uncommonly dense atmosphere, but its inhabitants were probably protected from the fever by their newly discovered canals, which were perhaps made to absorb carbon and prevent the disease. in 1848, josiah c. nott suggested that yellow fever was spread by insects such as moths or mosquitoes, basing his ideas on the pattern of transmission of the disease. carlos finlay, a cuban doctor and scientist, proposed in 1881 that yellow fever might be transmitted by previously infected mosquitoes rather than by direct contact from person to person, as had long been believed. since the losses from yellow fever in the spanish–american war in the 1890s were extremely high, army doctors began research experiments with a team led by walter reed, and composed of doctors james carroll, aristides agramonte, and jesse william lazear. they successfully proved finlay's "mosquito hypothesis". yellow fever was the first virus shown to be transmitted by mosquitoes. the physician william gorgas applied these insights and eradicated yellow fever from havana. he also campaigned against yellow fever during the construction of the panama canal. a previous effort of canal building by the french had failed in part due to mortality from the high incidence of yellow fever and malaria, which killed many workers. although reed has received much of the credit in united states history books for "beating" yellow fever, he had fully credited finlay with the discovery of the yellow fever vector, and how it might be controlled. reed often cited finlay's papers in his own articles, and also credited him for the discovery in his personal correspondence. the acceptance of finlay's work was one of the most important and far-reaching effects of the u.s. army yellow fever commission of 1900. applying methods first suggested by finlay, the united states government and army eradicated yellow fever in cuba and later in panama, allowing completion of the panama canal. while reed built on the research of finlay, historian françois delaporte notes that yellow fever research was a contentious issue. scientists, including finlay and reed, became successful by building on the work of less prominent scientists, without always giving them the credit they were due. reed's research was essential in the fight against yellow fever. he is also credited for using the first type of medical consent form during his experiments in cuba, an attempt to ensure that participants knew they were taking a risk by being part of testing. like cuba and panama, brazil also led a highly successful sanitation campaign against mosquitoes and yellow fever. beginning in 1903, the campaign led by oswaldo cruz, then director general of public health, resulted not only in eradicating the disease but also in reshaping the physical landscape of brazilian cities such as rio de janeiro. during rainy seasons, rio de janeiro had regularly suffered floods, as water from the bay surrounding the city overflowed into rio's narrow streets. coupled with the poor drainage systems found throughout rio, this created swampy conditions in the city's neighborhoods. pools of stagnant water stood year-long in city streets and proved to be a fertile ground for disease-carrying mosquitoes. thus, under cruz's direction, public health units known as "mosquito inspectors" fiercely worked to combat yellow fever throughout rio by spraying, exterminating rats, improving drainage, and destroying unsanitary housing. ultimately, the city's sanitation and renovation campaigns reshaped rio de janeiro's neighborhoods. its poor residents were pushed from city centers to rio's suburbs, or to towns found in the outskirts of the city. in later years, rio's most impoverished inhabitants would come to reside in favelas. max theiler during 1920–1923, the rockefeller foundation's international health board undertook an expensive and successful yellow fever eradication campaign in mexico. the ihb gained the respect of mexico's federal government because of the success. the eradication of yellow fever strengthened the relationship between the us and mexico, which had not been very good in the years prior. the eradication of yellow fever was also a major step toward better global health. in 1927, scientists isolated the yellow fever virus in west africa. following this, two vaccines were developed in the 1930s. max theiler led the completion of the 17d