Ev27n1p65.Pdf
Feature 444 Oswald0 Cruz and the Flowering of Public Health in Brazil1 umanity’s penchant for neglecting from further harm; but all vulnerable adult H the unpleasant has helped us to for- visitors, immigrants, and nonimmune get that as recently as 1900 the city of Rio residents afoot in Rio during yellow fever de Janeiro was a running sore. Sanitation season ran a high risk of quick and horrid was poor, medical knowledge limited, death. public health weak.3 There, as elsewhere While it may seem surprising that this in Brazil, the ordinary run of diseases like health picture has been forgotten, the tuberculosis, diarrhea, and measles took really surprising thing is how it changed. their toll, while certain more dramatic Beginning in 1903, a broad public health killers like smallpox and bubonic plague campaign began. Some measures, like were rife. widening of narrow streets and im- But the great terror of Rio in those days, proved sanitation, were fairly general. the ill that slew waves of immigrants and Others, like destruction of plague-bear- really gave the city its bad name, was ing rats and yellow fever mosquitoes, were yellow fever. Also known as the “black more specific. Al1 in all, the results were vomit,” yellow fever reached Rio in 1849, startling. As if some enchanter had waved erupted into a fearsome epidemic that a magic wand, plague retreated, yellow killed some 4 000 residents, and for the fever vanished, the death rate fell, and next half-century lingered as a shadowy Rio’s health, happiness, international assassin claiming hundreds or thousands prestige, and self-esteem began to rise.
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