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The 1802 Saint-Domingue Yellow Fever Epidemic and the Louisiana Purchase

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The 1802 Saint-Domingue Yellow Fever Epidemic and the Louisiana Purchase The 1802 Saint-Domingue Yellow Fever Epidemic and the Louisiana Purchase John S. Marr, MD; John T. Cathey, MS rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr pidemics have been pivotal in the history of the world as slave trade. Epidemics raged on the coastal Americas exemplified by a yellow fever epidemic in the Caribbean and Caribbean islands for more than 300 years, influ- that clearly altered New World geopolitics. By the end of encing the political landscape of 5 colonizing Euro- E pean countries. However, the largest recorded yellow the 18th century, yellow fever—then an “emerging fever epidemic with the highest case fatality rate oc- disease”—was widespread throughout the Caribbean and curred in 1802 in Saint-Domingue (Table 1).2 At that particularly lethal in Saint-Domingue (present day Haiti). From time, Saint-Domingue—the western third of the island 1793 to 1798, case fatality rates among British troops in the of Espanola˜ (Spanish)/Hispaniola (English)—had been retaken from England in 1798. The English had occu- West Indies (including Saint-Domingue) were as high as 70%. A pied the colony since 1793 to suppress slave rebellion worse fate befell newly arrived French armed forces in 1802, and to control buccaneers who had preyed on Euro- ostensibly sent by Napoleon to suppress a rebellion and to pean ships for more than a century (the Figure). In reestablish slavery. Historians have disagreed on why Napoleon a 6-year period, Great Britain had experienced more than 100 000 killed or made ill from the disease in their initially dispatched nearly 30 000 soldiers and sailors to the West Indian possessions.3 From 1793 to 1798, case fa- island. Evidence suggests the troops were actually an tality rates among British troops in the West Indies (in- expeditionary force with intensions to invade North America cluding Saint-Domingue) were as high as 70%. This through New Orleans and to establish a major holding in the devastating experience was a primary reason for their withdrawal, along with their defeat by Haitian revolu- Mississippi valley. However, lacking knowledge of basic tionaries, led by General Francois Dominique Toussaint prevention and control measures, mortality from the disease left L’Ouverture, who successfully abolished slavery on the only a small and shattered fraction of his troops alive, thwarting island. his secret ambition to colonize and hold French-held lands, which later became better known as the Louisiana Purchase. If ● The French Reinvasion of Saint-Domingue an event of the magnitude of France’s experience were to occur and the Epidemic of 1802 in the 21st century, it might also have profound unanticipated consequences. Although the French had earlier assisted the Haitians in fighting the British and Spanish and in freeing slaves, KEY WORDS: Aedes, dengue hemorrhagic fever, epidemics, Napoleon later resisted Toussaint’s attempt to take Haiti, history, 19th century, yellow fever. full control of the island. With secret intentions of ● Yellow Fever in the New World Author Affiliations: Department of Community and Public Health, Virginia Commonwealth University School of Medicine, Richmond, Virginia (Dr Marr); and King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (Dr Historians have speculated that New World yellow Cathey). fever epidemics began in the Caribbean basin in 1647- 1 The authors thank Alfred Crosby, Duane Gubler, Myron G. Schultz, Cabell 1648. Carter, a major yellow fever historian, con- Smith, and Jack Woodall, for their important comments and suggestions, and the cluded that its origin was West Africa and got im- reviewers, who improved the article with important suggestions. ported (along with malaria) as a result of the massive No conflicts of interests are declared. There were no sources of support. Correspondence: John S. Marr, MD, 6315 Pig Mountain Road, Free Union, J Public Health Management Practice, 2013, 19(1), 77–82 VA 22940 ([email protected]). Copyright C 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins DOI: 10.1097/PHH.0b013e318252eea8 77 Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 78 ❘ Journal of Public Health Management and Practice TABLE 1 ● Major New World Yellow Fever Epidemics qqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqq of the line carrying 31 131 troops and artilleries from its revolutionary armies, including a 5200-man Polish Estimated Estimated legion. However, the recent observations by the med- Date Duration, mo Place Mortality ical historian, McNeill,6 note “considerable confusion 1672-1673 24 Cuba 2000 surrounds the numbers of French military personnel 1793 5 Philadelphia, Pennsylvania 5000 sent to St. Domingue with totals in the literature rang- 1798 4 New York, New York 2100 ing from 60,000 to 82,000.” Ships landed in 3 different 1802-1803 14 Saint Domingue 29 000-55 000 ports in the spring of 1802. Twenty thousand soldiers 1853 4 New Orleans, Louisiana 7800 and sailors followed in later months. (In comparison, 1853 3 Norfolk, Virginia 3000 40 000 soldiers, 10 000 sailors, 14 frigates, 13 ships of the 1873 2 Philadelphia, Pennsylvania 5000 line, and 400 transport ships were used in Napoleon’s 1873 6 Memphis, Tennessee 2000 failed 1799 Egyptian campaign.)7 After arrival of his 1878 6 New Orleans, Louisiana 4046 troops, LeClerc was faced with fighting a guerrilla war 1878 6 Mississippi Valley 13 000 against Toussaint for several months along the coast From Kohn2 and immediate inland enclaves but eventually suc- ceeded in restoring trade. Toussaint, faced with increas- reoccupying the island and reinstituting slavery, in the ing defections from his own followers, eventually was late fall of 1801, Napoleon sent an initial force under tricked by LeClerc into a meeting where he was ar- his brother-in-law, General Victor Emmanuel Charles rested and exiled to Europe to die in a French jail. But LeClerc, which led to war.4 Napoleon’s strategic plans the struggle against the French was taken up by his were to eventually include a force of 60 000 soldiers and successor, Jean-Jacques Dessalines. The conflict contin- sailors to subdue and co-opt the Haitian military,which ued, resulting in a Haitian declaration of independence numbered less than a militia of 55 000 soldiers and in 1804. 100 000 irregulars.5 The largest fleet France had ever Within a year of LeClerc’s arrival in Haiti, he was mounted consisted of a total of 86 frigates and ships faced with a more serious problem than the rebellious FIGURE ● Portion of Map Created by French Explorer Louis Hennepina qqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqq aShowing the Louisiana territory and portions of the Caribbean, including the island of Saint-Domingue located immediately east of “I de Cuba” (map originally entitled Carte de la Nouvelle France et de la Louisiane Nouvellement decouverte, ca. 1683). Reproduced with permission from the Louisiana State Museum, New Orleans, Louisiana. Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Yellow Fever and the Louisiana Purchase ❘ 79 Haitians. His troops were succumbing in droves to TABLE 2 ● Arthropod-Borne Disease by Vector and Case Fatality Rate the most grievous epidemic of yellow fever in history. qqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqq Forts with garrisoned troops and offshore ships pro- Disease Vector Case Fatality Rate, % vided suitable environments for mosquito breeding. Estimates of the death toll vary along with estimates of Yellow fever Mosquito 20-50 the number of troops sent to Saint-Domingue. McNeill Dengue hemorrhagic fever Mosquito 40-50 reports that 50 000 to 55 000 (80%-85%) French soldiers Crimean-Congo hemorrhagic fever Tick 2-50 died, predominately because of yellow fever with only Epidemic typhus Louse 10-40 a few related to combat (along with more than 20 000 Rocky Mountain spotted fever Tick 20-80 deaths among civilians). By any standards, the number Systemic bartonellosis (Oroya fever) Sand fly 10-90 of deaths and case fatality rate are difficult to compre- Bubonic plague Flea 50-60 hend unless one takes into account a convergence of Malaria Mosquito 1-20 environmental and ecological factors ideal for an epi- From Heymann.9 demiological disaster. McNeill documented how tem- perature, rainfall, and ecological changes all favored Aedes propagation, and mosquito density and longevity been synchronized in such a way as to create the condi- in the Caribbean, all conducive to the spread of yellow tions for the epidemic. In addition, an element absent fever in the Caribbean between 1620 and 1914.6 in other yellow fever outbreaks of the era was ongo- The epidemic began in the spring of 1802. In April ing warfare and the presence of an opponent with an and May of that year, LeClerc wrote to Denis Descres,` understanding of how the fevers differentially affected the French Minister of Marine:8 the Europeans, particularly those newly arrived. In ad- dition to being a guerrilla tactician, Toussaint had med- A man cannot work hard here without risking his life ical knowledge and an awareness of when and where and it is quite impossible for me to remain here for the fevers would strike his European enemies.6 He ap- more than six months . my health is so wretched that I parently knew that by maneuvering the whites into would consider myself lucky if I could last for that time! The
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