Disinfection areas – as shown in the picture – in Campinas, in the countryside of Sao Paulo State, were set up to try to curb the spread of yellow fever
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Little-known infectious diseases spread and cause death. Because of its repercussions, government bodies often come into conflict. Frantic reaction to the epidemic hurts business. Society starts to pressure authorities to expand health and sanitation services, and companies facing economic challenges urge the government to ease the tax burden. Politicians are accused of unnecessary spending amid the emergency.
All these elements, present in current coronavirus crisis, also occurred in the last decade of the 19th century, the first of the Republican Regime in Brazil. They were associated, as today, with an accelerated movement of people among different regions, which caused pathogens to be carried from an area in which they were prevalent to new areas.
In the early years of the Republican Period, the State of Sao Paulo saw a movement of economic and demographic growth towards the countryside: coffee production, expansion of railroads and the immigration of thousands of European to work in these coffee plantations. These factors were also responsible for the spread of different epidemics across the country.
The yellow fever virus reached the Americas between 400 and 300 years ago, coming from West Africa – where it is endemic – through the Atlantic slave trade. However, for centuries the disease outbreaks were contained to the Brazilian Coast. In 1889, this started to change when the virus broke through the Serra do Mar barrier and reached the country inland, being carried mainly by European immigrants, who arrived originally at the coast of Sao Paulo and then took the train headed to the state countryside to work in the coffee plantations.
Railroad and river navigation routes in Sao Paulo State, 1896
The railroad branches, which were being expanded to reach new agricultural lands, were also spreading outbreaks of yellow fever disease along their routes. During the same period, the state of Sao Paulo was undergoing a process of redefinition of its boundaries, right after the Proclamation of the Republic and the 1891 Constitution. The federalist model, which replaced the Empire’s provinces with Republican states, coupled with a scheme that transferred export taxes back to the states, allowing regional governments more resources and autonomy, boosted this transformational movement.
Although scientific research about microbes and the transmission mechanisms of contagious diseases was advancing at the time (1890s), the scientific community did not yet know that the Aedes aegypti mosquito was the vector of yellow fever virus. Nor was the protection of individual health considered a responsibility of the Federal State. The Social Hygiene Movement was still on its way to be consolidated among research institutes and public administration.
After a first wave of infection in cities like Campinas and Sorocaba in 1889, deadly outbreaks of yellow fever were reported in towns and cities along the railroads in the countryside of Sao Paulo in 1895 and 1896. According to the work of doctor Rodolpho Telarolli Junior, a physician and historian, these outbreaks put everything to the test: immigration policies, the formation of a new political-administrative model, the expansion of railroads and the scientific knowledge.
The 1896 Sao Paulo State Demographics Bulletin shows records of 788 deaths caused by yellow fever in Campinas, one of the first cities to be affected in inland Sao Paulo. This number represents 29% of total yellow fever deaths, although it is likely to be an underestimate, since that year the rity records show a 45% increase in overall deaths, compared to the previous year.
The responsibility to cope with the epidemics lay with state-level bodies and committees, which, in the light of the Social Hygiene Movement, began to intervene in cities and towns affected by yellow fever. This was the case of Araraquara, one of the focus locations of doctor Telarolli Junior’s study.
At the height of the worst epidemic wave, between late 1895 and mid-1896, officers sent by the state government to Araraquara encountered resistance from the town authorities to enforce disease-preventive measures, such as fines for those who failed to comply with sanitary regulations. The local opposition used the situation as an opportunity to criticize the excessive intervention from state administration.
Forced isolation of patients, suspension of classes, the establishment of a new cemetery, drainage works and the construction of a water supply system and sewage networks were some of the measures implemented in Araraquara, with the support of the Sao Paulo State administration.
Nevertheless, rapid spread of the yellow fever infection disrupted city’s life. Residents abandoned their homes, there was a wave of looting, street shops closed down, election arrangements were hampered and the City Hall had to be moved to a neighboring location.
The local government attempted to enforce new taxation – as a move to make up for its fiscal deficit – but the trade industry rejected it and demanded a reduction in tax burden, claiming that their business had already suffered from plummeting sales. Representatives of this sector went on to accuse the City Council of increasing unnecessary spending with civil servants in the midst of a health crisis.