1793 Philadelphia yellow fever epidemic Philadelphia forced evacuation of certain neighborhoods and placed refugees in supervised camps. After the epidemic, the city inspected all houses and destroyed those it deemed unhealthy. American doctors did not identify the vector of yellow fever until the late nineteenth century. In 1881 Carlos Finlay, a Cuban doctor, argued that mosquito bites caused yellow fever; he credited Rush's published account of the 1793 epidemic for giving him the idea. He said that Rush had written: "Mosquitoes (the usual attendants of a sickly autumn) were uncommonly numerous..." In the late 1880s, Finlay's theories were confirmed in Cuba by experiments of the
Yellow fever vaccine Foundation to improve the vaccine from the "Asibi" strain, discovered that a favorable chance mutation in the attenuated virus had produced a highly efficacious strain that was named 17D. After field trials in Brazil, over one million people were vaccinated by 1939, without severe complications. For his work on the yellow fever vaccine, Theiler received the 1951 Nobel Prize in Physiology or Medicine. Only the 17D vaccine remains in use today. The outbreak of yellow fever in Angola in January 2016 has raised concerns about whether the global supply of vaccine is adequate to meet the need during a large