The Secret of the Yellow Death

by Suzanne Jurmain

  This picture, taken in Cuba before the Reed team began work, shows Dr. Lazear holding his son, Houston, as the child’s nanny stands by. Another child, a daughter, was born in the United States while Lazear was doing yellow fever research.

  No one ever knew exactly how it happened. Later, Lazear said that the incident had taken place at Las Animas Hospital in Havana. He was holding a test tube containing a mosquito against a patient’s belly when a wild mosquito flew down and landed on his hand. The whole thing was an accident, he said.

  And maybe that was true.

  But if that was how it happened, then why did Jesse Lazear write a mysterious note in the team’s lab notebook on September 13, 1900? Why did he write the following?

  Guinea pig No.1–red

  Sep. 13 This guinea pig bitten today by a mosquito which developed from egg laid by a mosquito which bit Tanner–8/6.

  This mosquito bit Suarez 8/30

  Hernandez 9/2

  De Long 9/7

  Fernandez 9/10

  And who—or what—was “Guinea pig No. 1”?

  It wasn’t a four-footed animal; that much was plain. Lazear didn’t use guinea pigs in his experiments because they were immune from yellow fever. No healthy human volunteer ever claimed to have been bitten in a mosquito experiment that day. In fact, the only healthy person who seemed to have been bitten on September 13 was Dr. J. Lazear himself.

  So was “Guinea pig No. 1” actually Lazear? Did Dr. Lazear deliberately let an infected mosquito bite him? And, if his bite was really part of an experiment, why did he tell a tale about a wild mosquito? Why didn’t he identify himself as “Guinea pig No. 1”?

  Did he lie because his family might disapprove of such a dangerous experiment?

  Did he think his life insurance company would cancel out his policy if he admitted that he’d dared to take a deadly risk?

  Nobody will probably ever know the answers. But the results of that mosquito “accident” were immediate and clear. Five days later, on the morning of September 18, Jesse Lazear just didn’t feel well. At six p.m. the doctor had a chill. Later that same evening, Private John Kissinger found the scientist sitting at his desk and busily writing up his research notes. To Kissinger, Lazear seemed “nervous.” The doctor’s face looked “flushed,” and his eyes were red.

  “Doctor, are you sick?” the soldier asked.

  ‘Yes, Kissinger, I do feel sick.”

  “Have you reported to Dr. [Ames]?”

  “No, Kissinger,” Lazear replied, and kept on working.

  By midnight, Lazear must have wanted to lie down, but it was morning before he had all the facts on paper. By then he was much too sick to struggle. At eleven a.m. Dr. Jesse Lazear was carried to the hospital on a stretcher. His temperature was high, and he told the attending nurse that he had yellow fever.

  Two days later, his temperature had risen to 104. His attack was clearly worse than Carroll’s, but Lazear was young. He was strong. There was still a good chance that he might recover.

  Reed, far away in Washington, tried to be optimistic. “I can but believe Lazear will pull through,” he wrote to Carroll. “I hope & pray that he does.” But Carroll, who stopped by to visit, was alarmed. As he sat beside the hospital bed, the older scientist saw a flash of panic in Lazear’s eyes. Then, suddenly the sick man’s belly heaved and a stream of thick black vomit shot out of his mouth. It was the worst possible sign, and both Carroll and Lazear knew that patients who vomited black, partially digested blood usually died of yellow fever.

  For the next day or so, Lazear’s temperature stayed high. Frantic with delirium, he leaped out of bed and raced around his hospital room until two female nurses and a hospital corpsman forced him back onto his cot.

  On September 24, a nurse noted that Dr. Lazear’s temperature was getting lower. By morning on September 25, it hovered just below 100. Then, late that afternoon, the doctor’s pulse began to quicken. His breath began to come in desperate pants. By 8:45 that evening, it was over. At age thirty-four, the scientist had died of yellow fever.

  On the following day, friends, officers from headquarters, and all the members of the Camp Columbia medical staff turned out to watch as Dr. Lazear was buried in a flag-draped coffin with full military honors.

  On that same day, far away in Massachusetts, Mabel Lazear, the doctor’s wife and the mother of their two small children, opened a telegram and stared at seven terrible words scrawled on the printed form: “Dr. Lazear died at 8 this evening.”

  The news was cruel. It was also particularly shocking because no one had ever told Mrs. Lazear that her husband had been taken sick.

  Coffins of U.S. soldiers killed in 1898 during the Spanish-American War. Dr. Lazear, who sacrificed his life in the war against yellow fever, was given a soldier’s funeral and buried in a flag-draped coffin that probably looked like one of these.

  September 27–November 2, 1900

  Lazear was dead. Carroll was an invalid. Agramonte was on vacation in the United States. And in Washington, D.C., Reed—who was “terribly depressed” by the dreadful loss of Lazear—was very frustrated.

  Three men—Lazear, Carroll, and Dean—had been bitten by mosquitoes. Each had developed yellow fever; but, as Reed pointed out in a letter he wrote to Carroll, the first two cases didn’t “prove” that infected bugs had actually caused the illness. Lazear might have picked up yellow fever from the patients he was seeing at Las Animas Hospital. Carroll might have been infected by the remains of yellow fever victims when he visited the autopsy lab. That left the third case: Dean.

  As far as anyone knew, the young soldier couldn’t have gotten yellow fever from anything except the mosquito. He definitely hadn’t been in contact with yellow fever victims before his bite. But what about the few days afterward? Had Dean come close to any yellow fever patients or the remains of yellow fever victims between the time that he’d been bitten and the time he’d gotten sick? Had he been in Havana, where the disease was raging? Was there anything except the mosquito that could possibly have given him the illness?

  Reed had to find out; and, a few days after Lazear’s death, he headed back to Cuba. This time the sea voyage was pleasant, and Reed was soon greeting James Carroll and the rest of the medical staff at Camp Columbia.

  Although it had been about a month since Carroll’s illness, the bacteriologist was still feeble and unwell. There was no chance he’d be able to do much work, and Reed promptly ordered his colleague to go back home to the United States for a rest. Agramonte was still away, so Reed plunged into the work on his own—and one of the first items on his agenda was investigating the interesting case of Private Dean.

  On one October day he met Dean on the patio outside the Officers’ Quarters. There, according to one of the young doctors who was stationed at Camp Columbia, the two men held the following discussion.

  Dr. Walter Reed aboard ship during one of his trips to Cuba.

  “My man,” Reed said, “I am studying your case of yellow fever and I want to ask you a few questions.” Then, to test Dean’s honesty, Reed held up a coin. “I will give you this ten dollar gold piece if you will say you were off this [base] at any time . . . until you returned sick with yellow fever,” he told the soldier.

  Dean probably could have used the money, but he apparently wasn’t interested in telling lies.

  “I’m sorry, sir,” the private replied truthfully, “but I did not leave the post at any time during that period.”

  That was exactly what Reed had been hoping to hear. If Dean truly hadn’t left Camp Columbia before or after his mosquito bite, there was no way he could have been exposed to the yellow fever epidemic in Havana. There was no way he could have had contact with the patients in the military yellow fever ward just outside the army base. As far as Reed could tell, young Dean had never been close to any yellow fever victims. It seemed that the mosquito really had given Private Dean a case of the disease.

  But Reed was still cautious. He told Dean to
sit down and tell him the whole story of his experiences. When the young man finished, Reed was impressed. Dean seemed honest. The case looked watertight; still, Reed had lots of questions. Why, for instance, if a mosquito bite had caused Dean’s attack, had Dr. Carlos Finlay failed to produce a batch of yellow fever cases when he’d let infected bugs bite humans? Why had some of Lazear’s volunteers stayed healthy when they were bitten by infected bugs? Why did some bites from infected insects cause the disease when others didn’t?

  Sitting at the long wooden table in his quarters, Reed plowed through material and tried to find an explanation. He went through Lazear’s painstaking notes on the experiments. He read and reviewed scientific articles. Carefully, he counted the days between the time the mosquitoes were infected and the time they seemed to be able to pass the disease to others. Carroll, he noticed, had been bitten by a mosquito that had been infected twelve days before it bit him, while the mosquito that bit Dean had been infected sixteen days before his bite. That was interesting. And, Reed noted, it fit in with other facts. Recently, a scientific article had stated that there was always a space of about fourteen days between the appearance of the first group of cases and the appearance of the second group in yellow fever outbreaks.

  Twelve days. Fourteen days. Sixteen days. The numbers whirled around Reed’s brain, and gradually the data began to make some sense.

  There seemed to be a reason that some mosquito bites produced yellow fever and some did not. And perhaps that reason was timing.

  To Reed it seemed that after a mosquito sucked in yellow fever germs, those germs had to stay in the mosquito’s body for at least twelve days before the insect could pass the illness to another victim.

  If Reed was right, then Dr. Finlay’s earlier experiments had failed probably because the Cuban scientist hadn’t let the yellow fever germs remain inside his insects long enough. And Lazear’s early experiments? Well, they too hadn’t succeeded probably for that reason.

  By the middle of October, Reed was pretty sure that he was onto something. But in science “pretty sure” isn’t good enough. If Reed was going to prove absolutely that mosquitoes carried yellow fever, if he was going to demonstrate exactly how the insects did it, he was going to have to confirm his hunches with experiments. And experiments cost money.

  On the morning of October 12, Reed climbed into a carriage and headed to Havana for an appointment with Major General Leonard Wood, the governor-general of Cuba. As the two men stood by a window that looked out toward the bustling Cuban harbor, Reed came directly to the point. “General Wood,” he said, “will you give me $10,000 to continue and complete these [yellow fever] experiments?”

  General Wood had started his military career as an army doctor. He understood that the team’s work was important, and he answered very quickly. “I will give you $10,000, and if that proves insufficient, I will give you $10,000 more.”

  The sum of ten thousand dollars in 1900 was roughly equivalent to two hundred and fifty thousand dollars in today’s money. It was a huge commitment, and to celebrate, Reed went out to lunch with his old friend Jefferson Kean, the chief U.S. medical officer for western Cuba. Together the two men drank a toast to success with a bottle of red wine. Then it was back to work—and Reed was busy.

  He couldn’t yet prove that yellow fever was always caused by a mosquito bite, but he could tell the scientific world that in one case—Dean’s—a mosquito bite had caused a single, clear-cut attack of yellow fever. And that was big news. It was news that could make scientific history. Most important, it was news that might save lives—and Reed wanted to present it at once.

  The governor-general of Cuba, Leonard Wood, a former army doctor and friend of Theodore Roosevelt’s, enthusiastically supported the Reed team’s work.

  In the space of eight days Reed wrote a five-thousand-word report stating that his team had found evidence that clearly indicated that the bite of a mosquito could cause a case of yellow fever. Then he packed his bags and boarded a ship headed for the United States. When the ship docked, he traveled west, and at three thirty on the afternoon of October 23, 1900, Major Walter Reed stepped up to the podium in an Indianapolis lecture room and began to read his report to the members of the American Public Health Association.

  First, Reed thanked Dr. Finlay for suggesting the mosquito theory and for providing the mosquito eggs that the team had used for research. He carefully described the team’s experiments. Then, finally, he read the most important words:

  From, our study thus far of yellow fever, we draw the following conclusions:

  1. Bacillus icteroides stands in no causative relation to yellow fever. . . .

  2. The mosquito serves as the intermediate host [the carrier] for the . . . [germ] of yellow fever.

  It was an exciting, groundbreaking statement, but not everyone believed it. The Philadelphia Medical Journal called Reed’s report “pure speculation.” The Washington Post just scoffed. In an article on November 2, 1900, the Post said:

  Of all the silly and nonsensical rigmarole about yellow fever . . . the silliest beyond compare is to be found in the arguments . . . engendered by the mosquito hypothesis [theory].

  The trouble was that Reed didn’t have much evidence. At the moment he could show that one single case of yellow fever had been caused by a mosquito. But a single case didn’t prove anything. It could be an accident, a fluke. And good scientists believed only facts that had been tested and proved time after time in carefully set-up experiments.

  If Walter Reed was going to convince the scientific world that mosquitoes were the cause of yellow fever, he clearly had a lot more research work to do.

  November 1900

  As soon as he returned to Cuba at the beginning of November, Walter Reed started to use the ten thousand dollars that General Wood had provided to make arrangements for a brand-new series of experiments.

  The first job was setting up a new camp where the team could carry out the tests, and Reed knew exactly how he wanted it to be constructed. The new camp had to be built on a site that had absolutely no mosquitoes. It had to be located in a place that had never been inhabited by yellow fever patients. And it had to be set up in a lonesome, isolated area—an area that strangers (who might be carrying the yellow fever germ) weren’t likely to visit.

  Of course, that list of requirements sounded picky. But each of those conditions was important. Each was designed to guarantee that there would be no accidental cases of yellow fever in the new station. To prove that mosquitoes carried yellow fever, Reed knew that he would have to show that each case of the disease in the new camp was deliberately caused by the team’s own insect experiments and not by some chance infection or contamination.

  Dr. Agramonte had just returned from his vacation; and, at Reed’s request, the Spanish-speaking scientist took charge of searching for a campsite. After scouting the countryside around Camp Columbia, he found a bare, isolated two-acre patch of land that the team could rent for twenty dollars a month. It was a dry, wind-blown place where mosquitoes didn’t live or breed. It had never been inhabited by yellow fever victims, and it seemed perfect. Reed drew up plans. Workers started to put up tents and buildings on the spot, and someone named the brand-new station Camp Lazear in honor of the scientists’ dead colleague.

  But that was only the beginning.

  While workers hammered nails at the new campsite, Reed focused his mind on other problems. And one of the biggest was mosquitoes.

  The tents used to house volunteers and medical personnel at camp Lazear, the site where the Reed team performed its most important experiments.

  Keeping the insects alive had always been difficult. Now it was harder than ever. The autumn months brought cooler weather. The lower temperatures killed mosquitoes. And while Reed was struggling to keep a few bugs alive for his experiments, a huge tropical storm hit the island of Cuba. Gale-force winds knocked over trees. Rain poured down. Temperatures plummeted into the low sixties. And, when Reed walked
into the officers’ mess hall for lunch on November 15, he told the other Camp Columbia doctors that there was bad news. Most of the laboratory mosquitoes that Lazear had raised from Finlay’s eggs had died of the cold. Worst of all, there were very few dried mosquito eggs left. Work on the new experiments would have to stop until the team could breed more bugs. That could take weeks, and Reed sounded so upset that the other Camp Columbia doctors tried to cheer him up. The weather was sure to get warmer, they told him. There were lots of mosquitoes left in Cuba. And to prove that point a bunch of young doctors left the mess hall and went bug hunting in a nearby dump. There, among the piles of rusty old containers, they saw a flock of striped Aedes aegypti mosquitoes buzzing around a can. The can was full of water, and floating in that water were enough mosquito eggs and mosquito larvae (immature mosquitoes) to keep the team supplied for months.