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Lower Mississippi Valley yellow fever epidemic of 1878

In 1878, a severe yellow fever epidemic swept through the lower Mississippi Valley.

Events leading up to the epidemic edit

During the American Civil War, New Orleans was occupied with Union troops, and the local populace believed that yellow fever would only kill the northern troops.[1] These rumors instilled fear into the Union troops, and they actively practiced sanitation and quarantine procedures during their occupation in 1862 until the government pulled federal troops out of the city in 1877.[2] The withdrawal of Union troops resulted in the relaxation of sanitation and quarantine efforts in New Orleans.[2] Following the yellow fever epidemic in Shreveport, Louisiana, where 769 people died between August and November, the states in the Lower Mississippi Valley began to take precautions for any following epidemics.[3] After the epidemic in Shreveport, the Quarantine Act of 1878 was passed that allowed the United States federal government to assume control over the state in quarantines, but the law did not allow for the federal government to intercede on local medical authorities or health boards.[4] In March of that year, a virulent strain of Yellow Fever was found in Havana, Cuba, and New Orleans health officials ordered the detainment of all vessels from the Cuban and Brazilian regions.[4] It is unknown what exactly led to the outbreak in the Mississippi River Valley as causes range from unchecked vessels from the fruit trade to refugees from the Ten Years' War in Cuba, which was experiencing a rise in yellow fever cases, however, investigations at the time suggest that the epidemic originated from the steamer Emily B. Souder on May 22, 1878.[5]

Effects of the epidemic on the region edit

The entire Mississippi River Valley from St. Louis south was affected, and tens of thousands fled the stricken cities of New Orleans, Vicksburg, and Memphis. The epidemic in the Lower Mississippi Valley also greatly affected trade in the region, with orders of steamboats to be tied up in order to reduce the amount of travel along the Mississippi River, railroad lines were halted, and all the workers to be laid off.[6] Carrigan states that "An estimated 15,000 heads of households were unemployed in New Orleans, 8,000 in Memphis, and several thousands more in scattered small towns - representing a total of over 100,000 persons in dire need."[6]

New Orleans edit

When the epidemic broke out from the Emily B. Souder in May, roughly 40,000 residents that represent 20% of the city population fled the city, many of whom fled via the new railroads systems constructed during the Reconstruction period after the American Civil War, which further spread the virus across the Lower Mississippi Valley.[7] The city saw roughly 20,000 total infections during the epidemic with 5,000 resulting in deaths, and saw a loss of more than $15 million due to the disruptions in trade from the epidemic.[7]

Due to the struggles of the remaining citizens, numerous organizations formed relief committees that relied heavily on aid from the federal government in the form of relief rations and money donations from unaffected cities in the Northern United States.[8] The federal relief came with heavy restrictions, as they were only allowed to be given to households that had yellow fever and could provide proof via a doctor's certificate or given to people considered "destitute."[8] These restrictions led to many citizens having to go without federal aid, resulting in roughly 10,000 people receiving aid despite there being 20,000 cases of yellow fever alone.[9]

Memphis edit

 
Yellow Fever Burials in Memphis at Elmwood Cemetery

Memphis suffered several epidemics during the 1870s, culminating in the 1879 epidemic following the most severe bout of the fever, the 1878 wave. During this year, there were more than 5,000 fatalities in the city. Some contemporary accounts said that commercial interests had prevented the rapid reporting of the outbreak of the epidemic, increasing the total number of deaths. People still did not understand how the disease developed or was transmitted, and did not know how to prevent it.[10]

These misconceptions regarding the mechanism of the virus exacerbated the rising death toll in Memphis as people operated under false notions of safety in the fever-ridden zones of the city. According to J.M. Keating, renowned for his highly-referenced history of the 1878 yellow fever epidemic in Memphis, his text underscores the lack of consensus among medical professionals at this time.[11] He spends the first two chapters of his anthology explaining the conflicting theories regarding the epidemiology of the virus and makes no mention of what is now known to be the real culprit, the Aedes aegypti mosquito. Unknown to physicians at the time, yellow fever was spread through the bite of an infected mosquito which proliferated in warm, moist areas of high population density. Given its urban and largely unsanitary environment in a vital trading location on the Mississippi River, Memphis became the ideal locale for the virus to take root after spreading from its origin in New Orleans.[12]

Similar to the preventative measures taken in New Orleans was the implementation of the quarantine in Memphis. Once the spread of the virus to Memphis became imminent, a city-wide quarantine was instated which barred entry into the city. Unknown to public officials in Memphis, the virus had already arrived to the city by the time the quarantine went into effect, making this a futile approach to reducing spread.[12] Beyond the quarantine, other common precautions included avoiding coming in contact with the “excreta” or bodily fluids of fever victims due to the misconception that the virus could be transferred through these liquids.[13] While the impact of the mosquito remained unnoticed, ill-prepared citizens continued to operate unprotected under these poor defenses, adding to the ever-growing number of fever victims.

For those who wished to avoid the grip of the fever in the city, flight from Memphis was appealing to a majority of the city’s population. The news of deaths in New Orleans and in the nearby town of Hickman in August led to the mass withdrawal of an estimated 25,000 residents from the city of Memphis within four days, which led to further spread of the virus across the Lower Mississippi Valley.[14] This exodus of a large proportion of the population of Memphis consisted primarily of those of the white Protestant class who possessed the means to leave the city for safety. Left behind were African American residents and a large circle of Irish Catholics who lacked the wealth to uproot from their homes located in the poorest sectors of town. The departure of white Protestants not only fueled the animosity that existed between the Catholics of the city and themselves, but also left Memphis ill-equipped in the manpower needed to sustain fever relief efforts.[15] Consequently, the integral role Catholic clergy came to play in aiding fever victims was largely a product of the gap left by white Protestant flight.[13]

In light of this reality, Catholic intervention in the path of the fever in Memphis becomes crucial to understanding the story of these devastating months. Catholic clergy opened their churches and convents to render aid on a non-discriminatory basis, aiding a community that would have remained insufficiently aided otherwise.[16] Despite their extensive service during the epidemic years in Memphis, the involvement of Catholic clergy in fever relief efforts has largely gone undocumented. No explanation for their absence from fever records is confirmed. However, the death the Catholic community experienced was a blow from which their population would never recover, effecting a change in the character of Memphis felt deeply in the years after the fever had run its course.[15]

In addition to extensive mortality, Memphis also saw an economic crisis during the epidemic, where trade was halted entirely in the city, and the lack of commerce led to mass starvations throughout the city, inciting riots and looting.[17] All in all, Ellis states that " of the approximately 20,000 persons remaining in the city, an estimated 17,000 contracted the fever, of whom 5,150 died. There were at least 11,000 cases among 14,000 blacks, resulting in 946 deaths. By contrast, virtually all of the 6,000 whites were stricken, and 4,204 cases proved fatal. The disaster's economic cost to the city was later calculated to be upward of fifteen million dollars."[18]

Mississippi edit

The 1878 epidemic was the worst that occurred in the state of Mississippi. Sometimes known as "Yellow Jack", and "Bronze John", devastated Mississippi socially and economically. Entire families were killed, while others fled their homes for the presumed safety of other parts of the state. Quarantine regulations, passed to prevent the spread of the disease, brought trade to a stop. Some local economies never recovered. Beechland, near Vicksburg, became a ghost town because of the epidemic. By the end of the year, 3,227 people had died from the disease.[19]

In the town of Grenada located in northern Mississippi, about 1,000 people of the town's population fled while the remaining population suffered "approximately 1,050 cases and 350 deaths."[20] The town was a known railroad town, and it was found that the refugees from railroad towns often spread the illness with them along the railroads.[21]

Aftermath edit

The epidemic lasted until late October when lower temperatures drove off the A. Aegypti mosquitoes, the primary carrier of yellow fever, away or into hibernation.[22] It was not until November 19 when the epidemic was officially declared to be over.[22] Ellis states that "according to estimates, there were around 120,000 cases of yellow fever and approximately 20,000 deaths."[22] The Lower Mississippi Valley also experienced roughly $30 million in economic losses due to the disruption of commerce caused by the epidemic.[7]

See also edit

References edit

  1. ^ Willoughby, Urmi Engineer (2017). Yellow Fever, Race, and Ecology in Nineteenth-century New Orleans. Baton Rouge, Louisiana: Louisiana State University Press. p. 97. ISBN 978-0-8071-6774-8.
  2. ^ a b Willoughby, Urmi Engineer (2017). Yellow Fever, Race, and Ecology in Nineteenth-century New Orleans. Baton Rouge, Louisiana: Louisiana State University Press. p. 97. ISBN 978-0-8071-6774-8.
  3. ^ Smith, Henry (1874). "Report of the Yellow Fever Epidemic of 1873" (PDF). Louisiana Equitable Life Insurance Company.
  4. ^ a b Ellis, John H. (1992). Yellow Fever and Public Health in the New South. Lexington, Kentucky: The University Press of Kentucky. p. 37. ISBN 0-8131-1781-X.
  5. ^ Ellis, John H. (1992). Yellow Fever and Public Health in the New South. Lexington Kentucky: The University Press of Kentucky. p. 39. ISBN 0-8131-1781-X.
  6. ^ a b Carrigan, Jo Ann (1963). "Impact of Epidemic Yellow Fever on Life in Louisiana". Louisiana History: The Journal of the Louisiana Historical Association. 4 (1): 5–34. JSTOR 4230697 – via JSTOR.
  7. ^ a b c Willoughby, Urmi Engineer (2017). Yellow Fever, Race, and Ecology in Nineteenth-century New Orleans. Baton Rouge, Louisiana: Louisiana Statue University Press. p. 108. ISBN 978-0-8071-6774-8.
  8. ^ a b Willoughby, Urmi Engineer (2017). Yellow Fever, Race, and Ecology in Nineteenth-century New Orleans. Baton Rouge, Louisiana: Louisiana State University Press. p. 124. ISBN 978-0-8071-6774-8.
  9. ^ Willoughby, Urmi Engineer (2017). Yellow Fever, Race, and Ecology in Nineteenth-century New Orleans. Baton Rouge, Louisiana: Louisiana State University Press. p. 125. ISBN 978-0-8071-6774-8.
  10. ^ Crosby, M. C. (2006), The American Plague: The Untold Story of Yellow Fever, the Epidemic That Shaped Our History.
  11. ^ Keating, J.M. (1879). history of the yellow fever: the yellow fever epidemic of 1878, in Memphis, Tenn. Memphis: Howard Association. Retrieved 29 November 2022.
  12. ^ a b Kennedy, S. Wright (2015). "Historic Disease Data as Epidemiological Resource: Searching for the Origin and Local Basic Reproduction Number of the 1878 Yellow Fever Epidemic in Memphis, Tennessee". Annals of the Association of American Geographers. 105 (5): 989–990. doi:10.1080/00045608.2015.1059167. JSTOR 24537966. S2CID 132497340. Retrieved 29 November 2022.
  13. ^ a b Baker, Thomas H. (1968). "YELLOWJACK: The Yellow Fever Epidemic of 1878 in Memphis, Tennessee". Bulletin of the History of Medicine. 42 (3): 257. JSTOR 44450733. Retrieved 29 November 2022.
  14. ^ Ellis, John H. (1992). Yellow Fever and Public Health in the New South. Lexington, Kentucky: The University Press of Kentucky. p. 43. ISBN 0-8131-1781-X.
  15. ^ a b Tracy, Sterling. "The Immigrant Population of Memphis". West Tennessee Historical Papers. Shelby County Register of Deeds. Retrieved 29 November 2022.
  16. ^ Kalmer, Leo (1928). Stronger than death; Historical notes on the heroic sacrifices of Catholic priests and religious during the yellow fever epidemics at Memphis in 1873, 1878 and 1879. Memphis: Franciscan Herald. p. 3.
  17. ^ Ellis, John H. (1992). Yellow Fever and Public Health in the New South. Lexington, Kentucky: The University Press of Kentucky. p. 47. ISBN 0-8131-1781-X.
  18. ^ Ellis, John H. (1992). Yellow Fever and Public Health in the New South. Lexington, Kentucky: The University Press of Kentucky. p. 57. ISBN 0-8131-1781-X.
  19. ^ Stephens Nuwer, Deanne (1999). "The 1878 Yellow Fever Epidemic along the Mississippi Gulf Coast". Gulf South Historical Review. 14 (2): 51–73.
  20. ^ Ellis, John (1992). Yellow Fever and Public Health in the New South. Lexington, Kentucky: The University Press of Kentucky. p. 43. ISBN 0-8131-1781-X.
  21. ^ Willoughby, Urmi Engineer (2017). Yellow Fever, Race, and Ecology in Nineteenth-century New Orleans. Baton Rouge, Louisiana: Louisiana State University Press. p. 96. ISBN 978-0-8071-6774-8.
  22. ^ a b c Ellis, John H. (1992). Yellow Fever and Public Health in the New South. Lexington, Kentucky: The University Press of Kentucky. p. 56. ISBN 0-8131-1781-X.

lower, mississippi, valley, yellow, fever, epidemic, 1878, 1878, severe, yellow, fever, epidemic, swept, through, lower, mississippi, valley, contents, events, leading, epidemic, effects, epidemic, region, orleans, memphis, mississippi, aftermath, also, refere. In 1878 a severe yellow fever epidemic swept through the lower Mississippi Valley Contents 1 Events leading up to the epidemic 2 Effects of the epidemic on the region 2 1 New Orleans 2 2 Memphis 2 3 Mississippi 3 Aftermath 4 See also 5 ReferencesEvents leading up to the epidemic editDuring the American Civil War New Orleans was occupied with Union troops and the local populace believed that yellow fever would only kill the northern troops 1 These rumors instilled fear into the Union troops and they actively practiced sanitation and quarantine procedures during their occupation in 1862 until the government pulled federal troops out of the city in 1877 2 The withdrawal of Union troops resulted in the relaxation of sanitation and quarantine efforts in New Orleans 2 Following the yellow fever epidemic in Shreveport Louisiana where 769 people died between August and November the states in the Lower Mississippi Valley began to take precautions for any following epidemics 3 After the epidemic in Shreveport the Quarantine Act of 1878 was passed that allowed the United States federal government to assume control over the state in quarantines but the law did not allow for the federal government to intercede on local medical authorities or health boards 4 In March of that year a virulent strain of Yellow Fever was found in Havana Cuba and New Orleans health officials ordered the detainment of all vessels from the Cuban and Brazilian regions 4 It is unknown what exactly led to the outbreak in the Mississippi River Valley as causes range from unchecked vessels from the fruit trade to refugees from the Ten Years War in Cuba which was experiencing a rise in yellow fever cases however investigations at the time suggest that the epidemic originated from the steamer Emily B Souder on May 22 1878 5 Effects of the epidemic on the region editThe entire Mississippi River Valley from St Louis south was affected and tens of thousands fled the stricken cities of New Orleans Vicksburg and Memphis The epidemic in the Lower Mississippi Valley also greatly affected trade in the region with orders of steamboats to be tied up in order to reduce the amount of travel along the Mississippi River railroad lines were halted and all the workers to be laid off 6 Carrigan states that An estimated 15 000 heads of households were unemployed in New Orleans 8 000 in Memphis and several thousands more in scattered small towns representing a total of over 100 000 persons in dire need 6 New Orleans edit When the epidemic broke out from the Emily B Souder in May roughly 40 000 residents that represent 20 of the city population fled the city many of whom fled via the new railroads systems constructed during the Reconstruction period after the American Civil War which further spread the virus across the Lower Mississippi Valley 7 The city saw roughly 20 000 total infections during the epidemic with 5 000 resulting in deaths and saw a loss of more than 15 million due to the disruptions in trade from the epidemic 7 Due to the struggles of the remaining citizens numerous organizations formed relief committees that relied heavily on aid from the federal government in the form of relief rations and money donations from unaffected cities in the Northern United States 8 The federal relief came with heavy restrictions as they were only allowed to be given to households that had yellow fever and could provide proof via a doctor s certificate or given to people considered destitute 8 These restrictions led to many citizens having to go without federal aid resulting in roughly 10 000 people receiving aid despite there being 20 000 cases of yellow fever alone 9 Memphis edit nbsp Yellow Fever Burials in Memphis at Elmwood CemeteryMemphis suffered several epidemics during the 1870s culminating in the 1879 epidemic following the most severe bout of the fever the 1878 wave During this year there were more than 5 000 fatalities in the city Some contemporary accounts said that commercial interests had prevented the rapid reporting of the outbreak of the epidemic increasing the total number of deaths People still did not understand how the disease developed or was transmitted and did not know how to prevent it 10 These misconceptions regarding the mechanism of the virus exacerbated the rising death toll in Memphis as people operated under false notions of safety in the fever ridden zones of the city According to J M Keating renowned for his highly referenced history of the 1878 yellow fever epidemic in Memphis his text underscores the lack of consensus among medical professionals at this time 11 He spends the first two chapters of his anthology explaining the conflicting theories regarding the epidemiology of the virus and makes no mention of what is now known to be the real culprit the Aedes aegypti mosquito Unknown to physicians at the time yellow fever was spread through the bite of an infected mosquito which proliferated in warm moist areas of high population density Given its urban and largely unsanitary environment in a vital trading location on the Mississippi River Memphis became the ideal locale for the virus to take root after spreading from its origin in New Orleans 12 Similar to the preventative measures taken in New Orleans was the implementation of the quarantine in Memphis Once the spread of the virus to Memphis became imminent a city wide quarantine was instated which barred entry into the city Unknown to public officials in Memphis the virus had already arrived to the city by the time the quarantine went into effect making this a futile approach to reducing spread 12 Beyond the quarantine other common precautions included avoiding coming in contact with the excreta or bodily fluids of fever victims due to the misconception that the virus could be transferred through these liquids 13 While the impact of the mosquito remained unnoticed ill prepared citizens continued to operate unprotected under these poor defenses adding to the ever growing number of fever victims For those who wished to avoid the grip of the fever in the city flight from Memphis was appealing to a majority of the city s population The news of deaths in New Orleans and in the nearby town of Hickman in August led to the mass withdrawal of an estimated 25 000 residents from the city of Memphis within four days which led to further spread of the virus across the Lower Mississippi Valley 14 This exodus of a large proportion of the population of Memphis consisted primarily of those of the white Protestant class who possessed the means to leave the city for safety Left behind were African American residents and a large circle of Irish Catholics who lacked the wealth to uproot from their homes located in the poorest sectors of town The departure of white Protestants not only fueled the animosity that existed between the Catholics of the city and themselves but also left Memphis ill equipped in the manpower needed to sustain fever relief efforts 15 Consequently the integral role Catholic clergy came to play in aiding fever victims was largely a product of the gap left by white Protestant flight 13 In light of this reality Catholic intervention in the path of the fever in Memphis becomes crucial to understanding the story of these devastating months Catholic clergy opened their churches and convents to render aid on a non discriminatory basis aiding a community that would have remained insufficiently aided otherwise 16 Despite their extensive service during the epidemic years in Memphis the involvement of Catholic clergy in fever relief efforts has largely gone undocumented No explanation for their absence from fever records is confirmed However the death the Catholic community experienced was a blow from which their population would never recover effecting a change in the character of Memphis felt deeply in the years after the fever had run its course 15 In addition to extensive mortality Memphis also saw an economic crisis during the epidemic where trade was halted entirely in the city and the lack of commerce led to mass starvations throughout the city inciting riots and looting 17 All in all Ellis states that of the approximately 20 000 persons remaining in the city an estimated 17 000 contracted the fever of whom 5 150 died There were at least 11 000 cases among 14 000 blacks resulting in 946 deaths By contrast virtually all of the 6 000 whites were stricken and 4 204 cases proved fatal The disaster s economic cost to the city was later calculated to be upward of fifteen million dollars 18 Mississippi edit The 1878 epidemic was the worst that occurred in the state of Mississippi Sometimes known as Yellow Jack and Bronze John devastated Mississippi socially and economically Entire families were killed while others fled their homes for the presumed safety of other parts of the state Quarantine regulations passed to prevent the spread of the disease brought trade to a stop Some local economies never recovered Beechland near Vicksburg became a ghost town because of the epidemic By the end of the year 3 227 people had died from the disease 19 In the town of Grenada located in northern Mississippi about 1 000 people of the town s population fled while the remaining population suffered approximately 1 050 cases and 350 deaths 20 The town was a known railroad town and it was found that the refugees from railroad towns often spread the illness with them along the railroads 21 Aftermath editThe epidemic lasted until late October when lower temperatures drove off the A Aegypti mosquitoes the primary carrier of yellow fever away or into hibernation 22 It was not until November 19 when the epidemic was officially declared to be over 22 Ellis states that according to estimates there were around 120 000 cases of yellow fever and approximately 20 000 deaths 22 The Lower Mississippi Valley also experienced roughly 30 million in economic losses due to the disruption of commerce caused by the epidemic 7 See also editList of notable disease outbreaks in the United States 1853 yellow fever epidemicReferences edit Willoughby Urmi Engineer 2017 Yellow Fever Race and Ecology in Nineteenth century New Orleans Baton Rouge Louisiana Louisiana State University Press p 97 ISBN 978 0 8071 6774 8 a b Willoughby Urmi Engineer 2017 Yellow Fever Race and Ecology in Nineteenth century New Orleans Baton Rouge Louisiana Louisiana State University Press p 97 ISBN 978 0 8071 6774 8 Smith Henry 1874 Report of the Yellow Fever Epidemic of 1873 PDF Louisiana Equitable Life Insurance Company a b Ellis John H 1992 Yellow Fever and Public Health in the New South Lexington Kentucky The University Press of Kentucky p 37 ISBN 0 8131 1781 X Ellis John H 1992 Yellow Fever and Public Health in the New South Lexington Kentucky The University Press of Kentucky p 39 ISBN 0 8131 1781 X a b Carrigan Jo Ann 1963 Impact of Epidemic Yellow Fever on Life in Louisiana Louisiana History The Journal of the Louisiana Historical Association 4 1 5 34 JSTOR 4230697 via JSTOR a b c Willoughby Urmi Engineer 2017 Yellow Fever Race and Ecology in Nineteenth century New Orleans Baton Rouge Louisiana Louisiana Statue University Press p 108 ISBN 978 0 8071 6774 8 a b Willoughby Urmi Engineer 2017 Yellow Fever Race and Ecology in Nineteenth century New Orleans Baton Rouge Louisiana Louisiana State University Press p 124 ISBN 978 0 8071 6774 8 Willoughby Urmi Engineer 2017 Yellow Fever Race and Ecology in Nineteenth century New Orleans Baton Rouge Louisiana Louisiana State University Press p 125 ISBN 978 0 8071 6774 8 Crosby M C 2006 The American Plague The Untold Story of Yellow Fever the Epidemic That Shaped Our History Keating J M 1879 history of the yellow fever the yellow fever epidemic of 1878 in Memphis Tenn Memphis Howard Association Retrieved 29 November 2022 a b Kennedy S Wright 2015 Historic Disease Data as Epidemiological Resource Searching for the Origin and Local Basic Reproduction Number of the 1878 Yellow Fever Epidemic in Memphis Tennessee Annals of the Association of American Geographers 105 5 989 990 doi 10 1080 00045608 2015 1059167 JSTOR 24537966 S2CID 132497340 Retrieved 29 November 2022 a b Baker Thomas H 1968 YELLOWJACK The Yellow Fever Epidemic of 1878 in Memphis Tennessee Bulletin of the History of Medicine 42 3 257 JSTOR 44450733 Retrieved 29 November 2022 Ellis John H 1992 Yellow Fever and Public Health in the New South Lexington Kentucky The University Press of Kentucky p 43 ISBN 0 8131 1781 X a b Tracy Sterling The Immigrant Population of Memphis West Tennessee Historical Papers Shelby County Register of Deeds Retrieved 29 November 2022 Kalmer Leo 1928 Stronger than death Historical notes on the heroic sacrifices of Catholic priests and religious during the yellow fever epidemics at Memphis in 1873 1878 and 1879 Memphis Franciscan Herald p 3 Ellis John H 1992 Yellow Fever and Public Health in the New South Lexington Kentucky The University Press of Kentucky p 47 ISBN 0 8131 1781 X Ellis John H 1992 Yellow Fever and Public Health in the New South Lexington Kentucky The University Press of Kentucky p 57 ISBN 0 8131 1781 X Stephens Nuwer Deanne 1999 The 1878 Yellow Fever Epidemic along the Mississippi Gulf Coast Gulf South Historical Review 14 2 51 73 Ellis John 1992 Yellow Fever and Public Health in the New South Lexington Kentucky The University Press of Kentucky p 43 ISBN 0 8131 1781 X Willoughby Urmi Engineer 2017 Yellow Fever Race and Ecology in Nineteenth century New Orleans Baton Rouge Louisiana Louisiana State University Press p 96 ISBN 978 0 8071 6774 8 a b c Ellis John H 1992 Yellow Fever and Public Health in the New South Lexington Kentucky The University Press of Kentucky p 56 ISBN 0 8131 1781 X Retrieved from https en wikipedia org w index php title Lower Mississippi Valley yellow fever epidemic of 1878 amp oldid 1180797415, wikipedia, wiki, book, books, library,

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