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 vaccine shortages in vaccine supplies. Demand for yellow vaccine for preventive campaigns has increased from about 5 million doses per year to a projected 62 million per year by 2014. UNICEF reported in 2013 that supplies were insufficient. Manufacturers are producing about 35 million of the 64 million doses needed per year. Demand for the yellow fever vaccine has continued to increase due to the growing number of countries implementing yellow fever vaccination as part of their routine immunization programmes. Recent upsurges in yellow fever outbreaks in Angola (2015), Democratic Republic of Congo (2016), Uganda (2016), and more recently in Nigeria