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 It should not be given to those with very poor immune function. Yellow fever vaccine came into use in 1938. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale price in the developing world is between US$4.30 and US$21.30 per dose as of 2014. In the United States it costs between US$50 and US$100. The vaccine is made from weakened yellow fever virus. Some countries require a yellow fever vaccination certificate before entry from a country where the disease is common. People most at risk