1793 Philadelphia yellow fever epidemic immune to the fever. Many of the slaves in Charleston in 1742 could have gained immunity before having been transported from Africa, by having been exposed to yellow fever in a mild case. People who survived one attack gained immunity. A total of 240 blacks died, in proportion to their population at the same rate as whites. Given the limited resources and knowledge of the times, the city's response was credible. The medical community did not know the natural history of yellow fever, a viral infection spread by the "Aedes aegypti" mosquito. Efforts to clean the city did not defeat
Yellow fever blood, hence the Spanish name for yellow fever, "vómito negro" ("black vomit"). There may also be kidney failure, hiccups, and delirium. The toxic phase is fatal in about 20% to 50% of cases, making the overall fatality rate for the disease about 3.0 to 7.5%. However, the fatality rate of those with the toxic phase of the disease may exceed 50%. Surviving the infection provides lifelong immunity, and normally no permanent organ damage results. Yellow fever is caused by the yellow fever virus, a 40– to 50--wide enveloped RNA virus, the type species and namesake of the family "Flaviviridae". It