Yellow Fever’s Visibility in the Historical (Bio)archaeological Record

From an archaeological perspective, yellow fever is an understudied disease; there are few known skeletal assemblages associated with yellow fever mortality, and the disease is not known to present skeletally. The objective of this article is to provide an overview of the disease, as well as its etiology and presentation, and to examine possible bioarchaeological and biomolecular analyses that present the best methods for identifying yellow fever in the past. Historically, yellow fever killed thousands of people in the Americas from the 1600s to the early 1900s, and despite modern medical advances, it remains deadly in some parts of the world today. Yellow fever does not kill indiscriminately, and this article reviews age, sex, and biogeographical selectivity of the disease. This article also details the challenges associated with correlating non-specific stress indicators to yellow fever morbidity and mortality. Given yellow fever’s as-yet unknown skeletal presentation, a bioarchaeological understanding of the selectivity of the disease derived from modern clinical and past ethnohistoric and archival sources may be the only nondestructive method of assessing mortality and survivorship in the skeletal record. In concert with understanding the disease’s selectivity, we propose that proteomics may have the best ability to identify the presence of the yellow fever virus in archaeological human remains, although destructive analysis should be approached cautiously. This work is positioned as the first exploration of yellow fever from a bioarchaeological perspective and is a first step in larger explorations of the disease in the archaeological and bioarchaeological records.