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Introduction
Epidemics have produced a range of mixed feelings among
people as well as among social groups as a whole
[1]. Such
feelings include fear, hate and over-exaggerated spirituality
to name but a few.
Humans also have a part to play in the development and pro-
pagation of and epidemic. Social, as well as economic fac-
tors (including commercial, political and military), related
to our lives, bring about the appearance, modification and
disappearance of diseases [2].
Some people think that history is static; a grave error which
leads them to the point of not understanding the present and
understanding the past as a static or fixed image, removing
themselves from the current paradigm: things move but at
the same time they experience change.
The hygienic and health conditions in the region of Extrema-
dura throughout the XIX Century were by character highly
deficient; the streets were a sorry sight, the sewage systems
were non-existent which meant that dirty water flowed di-
rectly onto the streets. Neither was there a system of rubbish
collection which led people to dump their waste wherever
they chose to do so within the boundaries of the municipal
area [3]. The atmosphere in the main cities at the time was
a focal point of bad health and infection. Sewage systems,
in places where they did exist, were inadequate, inefficient
or inoperative. Furthermore, there was little or no health
control or cleaning of septic tanks which contaminated the
under soil and often overflowed, allowing the stagnant water
to cause bad health. Unsightly piled up animal manure was
to be found everywhere.Waste material, rubbish, dirty wa-
ter and other residual products thrown onto the streets on a
daily basis turned the public areas of the towns into dunghills
and rubbish dumps [4]. All these factors combined together
caused vile smells, unhealthy fumes and vapours and emis-
sions of dangerous gases which put Public Health in grave
and permanent danger [5].
Yellow fever, also known as Siam sick, Barbados fever [6] or
black vomit [7], was a disease which was believed to have
spread from Africa to equatorial and tropical America du-
ring the time of the slave trade [8].These claims were proven
true by the use of molecular techniques through which it
was seen that the strains of yellow fever found in America
had lost part of a repetitive sequence of the genus in coded
region 3´, a phenomenon which does not occur in the Afri-
can strains thereby clearly showing its African origin [9].
It was one of the most feared contagious diseases which cau-
sed major epidemics in Africa and America from the XVIII
to the XX centuries [10].Today the number of deaths due to
yellow fever in people who haven’t received the vaccination
may reach the 50% mark. It is estimated that in the world
there are 200,000 new cases of yellow fever each year which
lead to 30,000 deaths, 90% of these being recorded inAfrica
alone [11].
Carlos Finlay, in his speech made for the Royal Academy of
the Sciences and published in Habana in 1881, stated that,
with respect to yellow fever, that are false the theories whi-
ch claim: “…that the origin or propagation of the disease is
due to atmospheric influences, miasmic or meteorological
influences lack of personal hygiene or the absence of general
hygienic measures...” [12:395]. He attributed to the mosqui-
to the spread of the disease, by biting a healthy person after
doing it a sick. This is a huge advance in knowledge of the
disease [13].
Objectives
The objective here is to carry out a study of the epidemics
of yellow fever in the south-west of Extremadura and to
analyze the measures adopted by the different towns in the
struggle to combat the illness.
Material and method
A study has been done of the minutes books of the plenary
sessions of the different town halls as well as their respective
death registers of the corresponding local parishes.
Pathogenesis of the disease
Yellow fever is an acute viral hemorrhagic disease which
is transmitted by infected female mosquitoes, of the Aedes
genus [14]. The term yellow alludes to ictericia or jaundice
which some patients experience [15]. Its symptoms include
high temperature, albuminuria, hemmorhage, blood vomit
or vómito negro as well as ictericia [16].
The virus is endemic in the tropical areas of Africa and Latin
America with a population of 900 million inhabitants. The
number of cases of yellow fever has risen in the last two de-
cades due to the decrease in immunity of the population,
deforestation, urbanization of rural areas, population migra-
tion and climate change [11].
The virus responsible for yellow fever belongs to the genus
known as Flavivirus, belonging to the family of the Flaviviri-
dae [17]. It constitutes the prototype of the genre, with the
whole family containing more than 70 different, yet related
viruses, most of which are passed on by arthropods [18].
The means of transmission of the yellow fever virus is through
an arbovirus of the Flavivirus type and its main vector is the
mosquito which passes the virus on from one host to another,
mainly between monkeys or between monkeys and humans as
well as from one human to another [19].
There are several different species of the Aedes and Haemo-
gogus mosquito that transmit the virus. Mosquitoes breed
near homes (domesticated), wooded areas (wild) or in both
Medicina tropical e ambiente