The last major outbreak in the US occurred in 1905 in New Orleans. Major outbreaks also occurred in Europe in the 19th century in Atlantic ports following the arrival of sailing vessels from the Caribbean, most often from Havana.[6] Outbreaks occurred in Barcelona, Spain, in 1803, 1821, and 1870. In the last outbreak, 1,235 fatalities were recorded of an estimated 12,000 cases.[7] Smaller outbreaks occurred in Saint-Nazaire in France, Swansea in Wales, and in other European port cities, following the arrival of vessels carrying the mosquito vector.[8][9]