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Epidemiology:
doi: 10.1097/EDE.0b013e31822e18fa
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William Gorgas: Yellow Fever Meets Its Nemesis

Faerstein, Eduardo; Winkelstein, Warren Jr.

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In 1891, Carlos Finlay and Walter Reed made the landmark discovery that yellow fever was transmitted by mosquitoes.1 Unfortunately, this discovery did not immediately lead to the eradication of the disease—not only because the virus was extremely widespread in tropical communities, but also because sanitary officials were reluctant to recognize the importance of mosquitoes as the disease vector.

The task of putting this knowledge to effective use fell to a young US Army captain by the name of William C. Gorgas. Yellow fever had been a presence in Gorgas' life from early adulthood, when he had acquired immunity through a mild case of the disease.2 In 1898, soon after the end of the Spanish-American War, Gorgas was detailed to Havana, where yellow fever had been endemic for centuries. Gorgas directed a control strategy to identify and destroy mosquito breeding places, and after only a few months of a strict mosquito control program, yellow fever was eradicated from Havana.

When Gorgas learned of the US government's decision to build the Panama Canal, he requested assignment to Panama. There he again tackled the eradication of yellow fever through mosquito control—despite vigorous opposition by US officials who believed yellow fever was caused by environmental filth, and who made efforts to discredit his work.3 President Theodore Roosevelt supported Gorgas′ efforts, and the Canal Zone was free of yellow fever by 1906, followed by eradication of malaria a few years later.

Gorgas' enlightened leadership in public health did not go unrecognized. He was elected as the president of the American Medical Association in 1908, and in 1914 he was appointed by President Woodrow Wilson as the Surgeon General of the Army. Even so, public health measures that he promulgated during the First World War were often opposed by his superiors, who objected to their cost.

After the First World War, Gorgas continued to agitate for more effective control of infectious diseases, consulting with a number of foreign governments. He was on his way to Africa in 1920 when, at the age of 66, he suffered a stroke. He was knighted by King George V on his deathbed in London, and lay in state in St. Paul's Cathedral before being returned to the US for burial.

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REFERENCES

Figure. William Gorg...
Figure. William Gorg...
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1.Faerstein E, Winkelstein W Jr. Carlos Juan Finlay: rejected, respected, and right. Epidemiology. 2010;21:158.

2.Gorgas MD, Hendrick BJ. William Crawford Gorgas: His Life and Work. New York: Doubleday; 1924.

3.Gorgas WC. Sanitation in Panama. New York and London: D. Appleton & Co; 1915.

© 2011 Lippincott Williams & Wilkins, Inc.

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