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The Great Fever
Teacher's Guide: Suggestions for Active Learning

Doctors visit Carlos Finley in Havana The film The Great Fever and this companion website offer insights into topics in American history including the history of medicine and yellow fever, the Spanish American War, the occupation of Cuba, the story of Walter Reed, and the science and future of yellow fever. You can use part or all of the film, or delve into the rich resources available on this Web site to learn more, either in a classroom or on your own.

The following activities are grouped into 4 categories: history, civics, geography, and science. You can also read a few helpful hints for completing the activities.

History | Civics | Geography | Science

  1. The "splendid little war." Learn more about the Spanish American War, during which more than 2,000 American soldiers contracted yellow fever, by dividing the class into six groups and assigning each group one of the following topics: (a) the Cuban independence movement of the 1890s and Spain's response to it, including the "reconcentration" policy; (b) the "yellow press" in the United States and the push for war with Spain; (c) the sinking of the Maine and the coming of war; (d) the course of the war in the Caribbean and the Pacific; (e) the debate in the United States over annexing the Philippines; (f) the U.S. war against rebels in the Philippines. Have each group research its topic and prepare a five-minute oral report on it for the class.

    When groups have finished, ask the class: Even if you disregard the yellow fever outbreak among U.S. soldiers, do you think the Spanish-American War really was a "splendid little war," as American diplomat John Hay famously called it?

  2. Other threats to Americans' health. Review this timeline of yellow fever outbreaks in the United States. Divide the class into small groups and have each group select another major communicable disease (i.e., a disease that can be spread directly or indirectly through human contact) the United States has faced. Possible choices include influenza, smallpox, cholera, tuberculosis, and HIV/AIDS. Each group should prepare a similar timeline of that disease that lists where and when its largest outbreaks in the United States took place, how many victims these outbreaks claimed, and successes in the effort to combat the disease.

    Combine the material from these timelines into one large, multi-strand timeline and review it as a class. What does it tell you about the history of disease in the United States -- are we winning or losing the battle against communicable diseases?

History | Civics | Geography | Science

  1. Are you protected? Ask your parents or doctor to provide you with the record showing what vaccinations you have received. Then ask your school nurse to give a presentation to the class on the vaccinations children should receive, as well as any followup "booster" shots that may be needed later in life. Compare your record against the information from the school nurse: Are there any important vaccinations you have missed? Why is the yellow fever vaccine not part of the standard set of vaccinations provided to American children?

  2. Fighting myths about disease. As this 1898 report on how to prevent the spread of yellow fever on trains shows, for many years, efforts to fight the disease were undermined by mistaken ideas about how yellow fever was spread. This was hardly the first time that ignorance about a frightening disease created harmful myths, and unfortunately, it wasn't the last time either, as the recent experience of HIV/AIDS shows.

    As a class, prepare a handbook on HIV/AIDS aimed at students in middle school. The handbook should explain the truth behind some of the common myths that were spread about the disease, such as the belief that it affects only homosexuals or can be transmitted by a handshake. The handbook should also list the ways to prevent HIV/AIDS. Present your handbook to school officials for their review and, with their permission, distribute copies to middle-school students in your community.

History | Civics | Geography | Science

  1. Have disease, will travel. Have advances in transportation over the last two centuries made humanity more vulnerable to the spread of disease? To explore this issue, divide the class into three groups and assign each group one of the following years: 1793 (the year of the yellow fever outbreak in Philadelphia, 1878 (the year of the yellow fever outbreak in the Mississippi Valley, and today (when public-health officials around the world are seeking to prevent the spread of "bird flu".

    Have each group find out how far a person -- and thus, potentially, a disease -- could travel in (a) one day, (b) one week, and (c) one month in the group's assigned year, using the methods of transportation available at that time. Show these results by creating three maps, each of which uses your community as the epicenter of the possible disease outbreak. In the first map, have each of the three groups draw a ring around your community showing how far a person could likely travel in one day during its assigned year. Then create two other maps showing how far a person could likely travel in one week and one month. Is it fair to say that the term "globalization," which is generally applied to the rapid movement of goods and ideas around the world today, applies to disease as well?

  2. A continuing threat. Though yellow fever outbreaks have been eliminated in the United States, they still occur in South America and Africa. Visit this web page from the U.S. Centers for Disease Control and Prevention to find out more about yellow fever today, and examine this map of the areas of yellow fever activity. List the countries shown on the map as having a continuing problem with yellow fever, and find out the population of each country. How many people live in countries that have not yet eradicated yellow fever?

History | Civics | Geography | Science

  1. Medical miracles. The various treatments for yellow fever described by this 1848 document included bleeding, or deliberately draining some of the patient's blood. Many forms of medical treatment used in the past, though based on the best information and technology available at the time, would shock us today. Explore this issue by creating a class exhibit entitled "Thank Goodness for Modern Medicine!"

    Working alone or with a partner, select a form of medical treatment and find out how it was handled at some point in the past, compared to how it is handled today. You may want to select anything from a relatively minor problem, such as tooth decay, to major issues such as cancer or mental illness. Write up your findings on an index card in a "Then . . . and Now" format that contrasts the previous and current forms of treating the condition. To display your findings, draw an outline figure of the human body on a large surface such as poster paper and attach the index cards to the relevant parts of the body.

  2. Human guinea pigs? In 1900, researchers deliberately exposed paid volunteers in Cuba to mosquitoes infected with yellow fever in order to test the theory that mosquitoes spread the disease.

    Hold a class debate on whether researchers should be allowed to pay people to act as subjects in potentially harmful medical tests. Do you think researchers could find enough subjects for important clinical trials if they did not provide some sort of payment? On the other hand, should people who are poor or disadvantaged have to put their health at risk in order to obtain money for necessities? What about prisoners (who have been used in past clinical trials): would you consider it acceptable to pay prisoners or reduce their sentences in return for their participation in potentially dangerous trials?

    In their arguments, both sides should address issues raised by the infamous "Tuskegee Experiment," in which African American subjects in a government clinical trial were lied to and given inadequate treatment, as well as a controversial 1950s trial of birth control pills in Puerto Rico. Are abuses such as these bound to occur in medical trials involving humans, or is there a way to design a system that provides enough volunteers for these trials without sacrificing their rights? See if both sides in your debate can agree on rules that would achieve this goal.

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