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In late August 1900, Dr. James Carroll, a member of the Yellow Fever Board led by Major Walter Reed, became seriously ill with yellow fever in Cuba. As Carroll convalesced, he received a letter from Reed, who had been temporarily recalled to the United States, which ended, “Did the mosquito do it?” Unknown to them at the time, the mosquito had done it. Indeed, disease-transmitting mosquitoes (Aedes and Anopheles species) had been doing it for a very long time. In Mosquito Empires, mosquitoes, yellow fever, malaria, and dengue are the main characters playing against a backdrop of political, military, economic, and human endeavors. It is history from a different perspective, but the one that was, and remains, entirely pertinent in the twenty-first century. In Chapter 1, McNeill constructs his hypothesis that mosquitoes, the diseases they transmit, and ecological changes significantly influenced the exploration, settlement, and development of the coastal regions of North, Central, and South America and the Caribbean Islands between 1620 and 1914. The next two chapters present a multidimensional framework upon which to develop his argument. The political and economic desires of a handful of European nations clashed, with each other and the native populations, in the Greater Caribbean which required military and naval intervention. Sugar and indigo drove economic hopes, and eventually wholesale deforestation, but the cultivation of both required slave labor, much more than could be procured locally. Hence, slaves were brought from the West Coast of Africa and with them came Aedes and Anopheles species laden with yellow fever, malaria, and dengue. The mosquitoes found comfortable niches undisturbed by significant ecological pressures and the diseases found sufficient nonimmunes to flourish endemically and, if presented with enough nonimmune hosts, also epidemically. Physicians, found in the cities, outposts, and aboard ships of the Greater Caribbean, struggled to prevent, control, and cure these fevers with the only medical knowledge and a therapeutic armamentarium they had. Regrettably, and retrospectively, it was inadequate to the task.
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