Managing an epidemic in imperfect times: encampment and immunity passes in 19th century Gibraltar

• Published in: BMJ global health Vol. 6; no. 8; p. e006713
• Main Authors: Sawchuk, Lawrence Alexander, Tripp, Lianne
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01-08-2021; BMJ Publishing Group
• Subjects: 19th century; Aquatic insects; Breeding sites; Coronaviruses; COVID-19; Disease transmission; Donations; Epidemics; Fever; Health administration; Infectious diseases; Mortality; Mosquitoes; Pandemics; Population; Public health; Quarantine; Vector-borne diseases; Spain
• ISSN: 2059-7908; 2059-7908
• DOI: 10.1136/bmjgh-2021-006713

Yellow fever ravaged Gibraltar and Spain in greater numbers than all the countries in Europe combined.6 The yellow fever death rate was 128.83 per 1000 in the lower Iberian Peninsula, in other words by the end of the epidemic in December 1804, about one-eighth of the population had died of the virus.7 In January of 1805, a Board of Public Health was established, but there was not a resolution to the mode of transmission because there was considerable debate revolving around miasmatic and contagionist perspectives. [...]health authorities implemented a series of novel and transformative measures. [...]the encampment served as a centre for aid relief. Furthermore, the Spanish King donated a substantial contribution of wheat and flour for feeding the poor.12 The encampment appeared to control the spread of the disease as the yellow fever death rate at the hospital in the encampment was 19.75 per 1000, while yellow fever mortality was 103.90 per 1000 living in the town.15 The limited spread of the disease was largely attributed to the lack of the mosquito (Aedes aegypti), because there was not abundance of standing water at the Neutral Ground, which would have served as breeding sites for as well the fact that the winds would have hampered the flight of mosquitoes.