For others, however, the fever quickly returned, bringing "frequent vomiting of matter resembling coffee grounds in color and consistence," which was stale blood hemorrhaged in the stomach. For many survivors, this proved the end of the disease. After three or four days, the symptoms normally diminished. William Currie, one of the founders of Philadelphia's College of Physicians, described how patients first experienced weakness, chills, headaches, and shortness of breath, followed by frequent vomiting. Physicians readily agreed on the symptoms that characterized yellow fever. After treating a number of cases, the three met on August 19, 1793, and agreed that they were witnessing an outbreak of the 'bilious remitting yellow fever' in Philadelphia for the first time since 1762. By mid-August, however, the fever had spread beyond Water Street to wealthier Philadelphians where it came to the attention of esteemed doctors such as John Foulke, Hugh Hodges, and Benjamin Rush. Water Street’s residents consisted primarily of poor laborers who worked at the city’s docks, sailors, and recent immigrants, a segment of the city rarely cared for by Philadelphia’s medical elite. Isaac Weld, an Irish writer who visited Philadelphia in 1795, described Water Street as a cramped space "with the air very confined," with "stenches … owing in part to the quantity of filth and dirt that is suffered to remain on the pavement" amid puddles of stagnant rain and river water. Running parallel to the Delaware River, Water Street was a muddy, narrow lane, no wider than thirty feet, hemmed in on the east by the city’s wharves and on the west by a high embankment. The earliest cases of yellow fever appeared around Water Street. In 1793, doctors and scientists in Philadelphia did not understand the causes of yellow fever, and this lack of knowledge resulted in confusion and thousands of deaths during the summer and autumn of 1793. There is a vaccine for yellow fever, but there is no known cure. Though rare in the United States, yellow fever still exists, especially in Africa and Central and South America. The virus spreads through the human bloodstream via bites from infected mosquitos. We know today that yellow fever is a virus that belongs to a subset called flaviviruses, which includes other diseases such as West Nile virus and dengue fever.
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