AAAS Resolution: Death of Dr. James Carroll from Yellow Fever Experimentation

Professional society resolution

By: American Association for the Advancement of Science

Date: December 30, 1907

Source: American Association for the Advancement of Science, Washington, D.C.

About the Author: Founded in 1848, the American Association for the Advancement of Science (AAAS) is the world's largest scientific society, serving ten million individuals. It is affiliated with 262 scientific societies and academies around the world. Its mission is to promote the understanding of science nationally and globally through education, leadership, and acting as spokesperson. AAAS publishes the weekly journal Science, as well as many books, reports and newsletters.

INTRODUCTION

Yellow fever is an acute, infectious viral disease that is transmitted by the bite of two species of female mosquito, Aedes aegypti and Hemogogus. Now rare, but not unknown, yellow fever originated in central Africa. The slave trade and increased commerce brought it to the New World beginning in the fifteenth century through to the nineteenth century. In the United States, there were thirty-five epidemics occurring between 1702 and 1800, and from 1800 to 1879 there was an epidemic almost every year. In 1878, the U.S. Marine Hospital Service, the forerunner of today's U.S. Public Health Service, was charged with collecting data on yellow fever and other infectious diseases. The service also had responsibility for introducing quarantine methods at ports of entry to stop the introduction and spread of these diseases into the United States.

Yellow fever can be mild or so severe as to be potentially fatal. In mild cases, the symptoms are similar to those of influenza. More severe cases are marked by internal bleeding and liver and kidney damage. Jaundice may occur, which gives the disease its name. Mortality can be as high as 50 percent in populations that have no immunity to the disease, which is why it hit the Spanish, French, and English armies invading the New World so hard.

Opinion was divided over the causes of yellow fever. Some thought it was bacterial. Others favored the fomite theory—that items such as clothing and bedding touched by an infected person were contagious. A Cuban doctor, Carlos Juan Finlay (1833–1915), believed mosquitoes spread the disease. He put this idea forward as early as 1881 but was not taken seriously.

The Spanish-American War of 1898 led to a U.S. Army presence in the Carribean and Cuba. An epidemic of yellow fever in Cuba led to the infection of 1,200 soldiers in 1900. Something had to be done and the Army Surgeon General George Miller Sternberg (1838–1915) set up the Yellow Fever Commission in Havana, headed by Major Walter Reed (1851–1902), to investigate the cause and prevention of yellow fever. Surgeon James Carroll (1854–1907) was his second-incommand and the two proceeded to work with a group of other doctors, including Finlay who gave them mosquito larvae to use in experiments. Carroll was one of the volunteers who put himself forward to be bitten by a mosquito "loaded" with yellow fever to see if he would contract the disease. He did contract the disease, but seemed to recover. However, he died of heart valve disease, thought to be a late complication of the yellow fever, in 1907. The resolution below describes a call for a pension to be given to his widow, Jennie, to help her support their seven children, in recognition of her loss and Carroll's contribution to medical science.

PRIMARY SOURCE

AAAS RESOLUTION: DEATH OF DR. JAMES CARROLL FROM YELLOW FEVER EXPERIMENTATION

Whereas, The late Major James Carroll, M.D., USA, was the first to submit voluntarily to the bite of an infected stegomyia, and from the bite of this mosquito, suffered a severe attack of yellow fever, the effects of which led to his ultimate death, and

Whereas, This was the first experimentally produced case of yellow fever leading to the present knowledge of this disease, which has practically enabled its complete control, therefore, be it

Resolved, That the American Association for the Advancement of Science now in session in Chicago, Illinois recommends to the Senate and House of Representatives of the United States of America the passage of a bill securing to Mrs. Jennie Carroll, widow of the late Major James Carroll of the Yellow Fever Commission, of the United States Army, a special pension for the support of herself and her seven children.

[Adopted by the AAAS Council, December 30, 1907.]

SIGNIFICANCE

Carroll's widow was awarded a pension of $125 a year by the government from the date of his death. So, too, was the widow of Dr. Jesse Lazear (1866–1900), another member of the board, who contracted and died of yellow fever early on in the investigation. Fortunately, none of the recruited volunteers died during the experiments with the mosquitoes.

The work of the Yellow Fever Board established that mosquitoes were the vector (intermediate insect or animal that transmits a disease to humans) for the transmission of yellow fever. Their findings led to the control of mosquitoes in Havana from 1901, and yellow fever was soon all but eradicated from Cuba. This was the first example in history of preventing a disease through control of its vector. Soon mosquito control measures were similarly applied in Panama. Both malaria and yellow fever were thus brought under control, opening the way for the construction of the Panama Canal.

Although the board's experiments were risky, they were commended for the ethical way in which they sought informed consent from all the volunteers (who were, in turn, praised for their courage). Reed and Carroll began the U.S. Army's tradition of medical research, which aims to protect the health of the military. Today the Army investigates both infectious and non-infectious disease, and is involved in vaccine research. Other programs cover blood products, trauma medicine, and surgical techniques.

FURTHER RESOURCES

Books

Lock, Stephen, John M. Last, and George Dunea, eds. The Oxford Illustrated Companion to Medicine. Oxford: Oxford University Press, 2001.

Periodicals

Pierce, John R., and James V. Writer, eds. "Solving the Mystery of Yellow Fever: The 1900 U.S. Army Yellow Fever Board." Military Medicine 166 supplement (2001): 1-82.