Las epidemias en La Pampa (Argentina), en perspectiva histórica* / The epidemics in La Pampa (Argentina), from a historical perspective

Resumen Este artículo describe el inicio de las preocupaciones sanitarias vinculadas a las epidemias ocurridas durante el siglo XX en La Pampa, provincia argentina. Las epidemias, como las de la viruela, fueron un estímulo para estas políticas que frecuentemente tuvieron origen en Buenos Aires, la capital del país. El contagio de muchas epidemias dependía de carencias de infraestructura: agua, desagüe y desecho adecuado de basuras, de la ausencia de un número suficiente de trabajadores de salud, de la presencia de vectores transmisores de enfermedades como los mosquitos y, en última instancia, de la pobreza. La experiencia histórica descrita en este texto resalta la importancia de analizar el impacto del SARS-CoV-2 más allá de las grandes ciudades.

Abstract This article describes the emergence of health concerns relating to the epidemics that occurred during the twentieth century in La Pampa, a province in Argentina. Epidemics such as smallpox drove such policies, which frequently originated in Buenos Aires, the country's capital. The spread of many epidemics was due to shortages: water, sewage and adequate refuse disposal, an insufficient number of health care workers, the presence of disease transmission vectors such as mosquitos, and, ultimately, poverty. The historical experience described in this text highlights the importance of analyzing the impact of SARS-CoV-2 beyond the big cities.

[The epidemics in La Pampa (Argentina), from a historical perspective]. / Las epidemias en La Pampa (Argentina), en perspectiva histórica.

This article describes the emergence of health concerns relating to the epidemics that occurred during the twentieth century in La Pampa, a province in Argentina. Epidemics such as smallpox drove such policies, which frequently originated in Buenos Aires, the country's capital. The spread of many epidemics was due to shortages: water, sewage and adequate refuse disposal, an insufficient number of health care workers, the presence of disease transmission vectors such as mosquitos, and, ultimately, poverty. The historical experience described in this text highlights the importance of analyzing the impact of SARS-CoV-2 beyond the big cities.

Este artículo describe el inicio de las preocupaciones sanitarias vinculadas a las epidemias ocurridas durante el siglo XX en La Pampa, provincia argentina. Las epidemias, como las de la viruela, fueron un estímulo para estas políticas que frecuentemente tuvieron origen en Buenos Aires, la capital del país. El contagio de muchas epidemias dependía de carencias de infraestructura: agua, desagüe y desecho adecuado de basuras, de la ausencia de un número suficiente de trabajadores de salud, de la presencia de vectores transmisores de enfermedades como los mosquitos y, en última instancia, de la pobreza. La experiencia histórica descrita en este texto resalta la importancia de analizar el impacto del SARS-CoV-2 más allá de las grandes ciudades.

Demographic perspectives on the mortality of COVID-19 and other epidemics.

To put estimates of COVID-19 mortality into perspective, we estimate age-specific mortality for an epidemic claiming for illustrative purposes 1 million US lives, with results approximately scalable over a broad range of deaths. We calculate the impact on period life expectancy (down 2.94 y) and remaining life years (11.7 y per death). Avoiding 1.75 million deaths or 20.5 trillion person years of life lost would be valued at $10.2 to $17.5 trillion. The age patterns of COVID-19 mortality in other countries are quite similar and increase at rates close to each country's rate for all-cause mortality. The scenario of 1 million COVID-19 deaths is similar in scale to that of the decades-long HIV/AIDS and opioid-overdose epidemics but considerably smaller than that of the Spanish flu of 1918. Unlike HIV/AIDS and opioid epidemics, the COVID-19 deaths are concentrated in a period of months rather than spread out over decades.

[From "culprits" to "victims:" the expansion and professionalization of the healthcare system in the province of Mendoza in the late nineteenth and early twentieth century]. / De "culpables" a "víctimas": expansión y profesionalización del sistema de salud en la provincia Mendoza a fines del siglo XIX y principios del XX.

From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

Entre fines del siglo XIX y comienzos del XX, la provincia de Mendoza presentaba un estado sanitario marcado por el crecimiento demográfico y urbanístico, la escasez de los servicios públicos y la destrucción de la antigua ciudad colonial como consecuencia del terremoto de 1861, lo que propiciaba un ambiente favorable para el desarrollo de diversas enfermedades infectocontagiosas. El objetivo de este artículo es indagar cómo se fue profesionalizando y expandiendo el sistema de salud en la provincia de Mendoza a fines del siglo XIX e inicios del XX, y cómo esos factores, junto con las representaciones sobre la enfermedad que predominaban en el discurso de la elite gobernante, incidieron en las políticas públicas para combatir las dolencias de la época. Para ello se consultaron diversos documentos escritos y fotográficos que permitieron analizar las modificaciones del discurso y las políticas públicas implementadas.

Hotspot or blind spot? Historical perspectives on surveillance and response to epidemics in the Central African Republic.

OBJECTIVES: The Central African Republic (CAR), a site of recurrent disease emergence, developed a noteworthy epidemiological surveillance system from the colonial period, but its health measures have remained among the world's lowest. To understand this disparity between surveillance and public health, we examined selected moments in its history of surveillance and changing relations with public health structures. METHODS: We conducted archival research in CAR and French archives and 18 semi-structured interviews with key researchers working in CAR. RESULTS: We find long-term continuities in privileging surveillance over the health system and population health, making the CAR a "hotspot" for emerging diseases and a "blind spot" of primary health care. From the colonial period, the country attracted considerable support for surveillance, without concomitant investment in public health system. Political disputes and financial constraints have obscured real primary care needs on the ground. CONCLUSIONS: As both a hotspot and a blind spot for global health, the CAR signals the need to reorient health interventions to address the long-term health of Central African people.

La atención a la salud en Mesoamérica antes y después de 1519 / Health care in Mesoamerica before and after 1519

Resumen En este ensayo se discute la situación de la atención a la salud en Mesoamérica antes e inmediatamente después de 1519. En los primeros 50 años después de la Conquista, los españoles hicieron un uso muy extensivo de la medicina náhuatl. Sin embargo, con el tiempo, el ámbito de influencia de esta tradición se vio limitado debido a la rápida imposición de un sistema de atención muy diferente que poco aprovechó, entre otras cosas, la riqueza terapéutica de la medicina prehispánica.

Abstract This paper discusses the situation of healthcare in Mesoamerica before and immediately after 1519. In the first 50 years after the Conquest, the Spaniards made extensive use of Nahuatl medicine. However, the influence of this medical tradition was limited due to the rapid imposition of a very different medical system which took little advantage of, among other things, the therapeutic wealth of pre-Hispanic healing traditions.

Spectacles of Difference: The Racial Scripting of Epidemic Disparities.

This essay explores how epidemics in the past and present give rise to distinctive, recurring racial scripts about bodies and identities, with sweeping racial effects beyond the Black experience. Using examples from cholera, influenza, tuberculosis, AIDS, and COVID-19, the essay provides a dramaturgical analysis of race and epidemics in four acts, moving from Act I, racial revelation; to Act II, the staging of bodies and places; to Act III, where race and disease is made into spectacle; and finally, Act IV, in which racial boundaries are fixed, repaired, or made anew in the response to the racial dynamics revealed by epidemics. Focusing primarily on North America but touching on global racial narratives, the essay concludes with reflections on the writers and producers of these racialized dramas, and a discussion of why these racialized repertoires have endured.

Revisiting "What Is an Epidemic?" in the Time of COVID-19: Lessons from the History of Latin American Public Health.

This essay considers what thirty years of scholarship on the history of epidemics in Latin America and the larger hemisphere can bring to a current reading of Charles Rosenberg's influential 1989 essay, "What Is an Epidemic? AIDS in Historical Perspective." It advocates that taking a broader geographical view is valuable to understanding better the arc of an epidemic in society. In addition, it proposes that, to see the ways in which the United States is experiencing the COVID-19 pandemic, we need to place the United States alongside the experiences of other countries of the Americas rather than making comparisons to Europe.

[Health care in Mesoamerica before and after 1519]. / La atención a la salud en Mesoamérica antes y después de 1519.

This paper discusses the situation of healthcare in Mesoamerica before and immediately after 1519. In the first 50 years after the Conquest, the Spaniards made extensive use of Nahuatl medicine. However, the influence of this medical tradition was limited due to the rapid imposition of a very different medical system which took little advantage of, among other things, the therapeutic wealth of pre-Hispanic healing traditions.

En este ensayo se discute la situación de la atención a la salud en Mesoamérica antes e inmediatamente después de 1519. En los primeros 50 años después de la Conquista, los españoles hicieron un uso muy extensivo de la medicina náhuatl. Sin embargo, con el tiempo, el ámbito de influencia de esta tradición se vio limitado debido a la rápida imposición de un sistema de atención muy diferente que poco aprovechó, entre otras cosas, la riqueza terapéutica de la medicina prehispánica.

De "culpables" a "víctimas": expansión y profesionalización del sistema de salud en la provincia Mendoza a fines del siglo XIX y principios del XX / From "culprits" to "victims": the expansion and professionalization of the healthcare system in the province of Mendoza in the late nineteenth and early twentieth century

RESUMEN Entre fines del siglo XIX y comienzos del XX, la provincia de Mendoza presentaba un estado sanitario marcado por el crecimiento demográfico y urbanístico, la escasez de los servicios públicos y la destrucción de la antigua ciudad colonial como consecuencia del terremoto de 1861, lo que propiciaba un ambiente favorable para el desarrollo de diversas enfermedades infectocontagiosas. El objetivo de este artículo es indagar cómo se fue profesionalizando y expandiendo el sistema de salud en la provincia de Mendoza a fines del siglo XIX e inicios del XX, y cómo esos factores, junto con las representaciones sobre la enfermedad que predominaban en el discurso de la elite gobernante, incidieron en las políticas públicas para combatir las dolencias de la época. Para ello se consultaron diversos documentos escritos y fotográficos que permitieron analizar las modificaciones del discurso y las políticas públicas implementadas.

ABSTRACT From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

L'épidémiologie entre le terrain des épidémies et l'approche populationnelle, XIX-XXe siècle.

TITLE: L'épidémiologie entre le terrain des épidémies et l'approche populationnelle, XIX-XXe siècle. ABSTRACT: L'émergence d'une épidémiologie moderne est fréquemment associée au basculement de la discipline, d'une science des épidémies vers une science des populations. L'avènement et le développement d'une épidémiologie fondée sur une approche statistique et mathématique n'exclut cependant pas la persistance d'une épidémiologie sur le terrain des épidémies, dans le sillage de l'hygiène publique et de la bactériologie triomphante du tournant des XIXe et XXe siècles. De plus, l'histoire de l'épidémiologie ne saurait être cantonnée à une histoire de savoirs scientifiques ou de savoir-faire techniques et organisationnels. Elle doit intégrer, plus sans doute encore que d'autres branches de la médecine, les dimensions économiques et politiques qui participèrent à l'institutionnalisation et au développement de la discipline et à son inscription dans les processus de décision.

[HOW HEALTH SERVICES IN ISRAEL COPED WITH THE POLIO EPIDEMIC OF THE 1950'S].

INTRODUCTION: Today, the introduction of a new medicine or vaccine or the clinical trial of some new potion requires the approval of a variety of bodies in accordance with Helsinki Agreement rules, National Health Laws and Health Ministry regulations. The creation of the World Health Organization (WHO) in 1946 added another essential layer to the firm base of principles governing the conduct of clinical trials that exist today. Its main contribution was to create a new reality following The Second World War and the subsequent Nuremberg Trials. The Declaration of Helsinki was only adopted eighteen years later, in 1964. In its first years of independence the infant State of Israel was attacked by a serious outbreak of polio which claimed many victims - mostly children and youngsters. Infantile paralysis - poliomyelitis (polio) was then considered as being untreatable. The disease affected 0.1% of the population of Israel. In 1950, out of a total population of 1.2 million, 1,500 were infected by polio. The epidemic struck over three successive seasons and affected more than 3,000 victims. The mortality rate stood at 10%. Experts, charlatans and fame seekers all presented their inventions to the country - creams, medicines and research projects all designed to bring relief to the sick children. Against all these stood the newly formed Ministry of Health, determined to bring order to the chaos. The only trial conducted by the Health Ministry was unsuccessful, but it was accompanied by the most stringent controls that would not have shamed even today's researchers. The clinical trials of Zibaline were conducted in the early 60's, after the polio vaccine had been introduced and the epidemic had passed. The purpose of this paper is to examine the influence of medical ethics, norms and morals on the way that medical practice dealt with the epidemic at a time when there were no laws or rules.

Anopheles gambiae in Brazil: the background to a "silent spread," 1930-1932. / Anopheles gambiae no Brasil: antecedentes para um "alastramento silencioso", 1930-1932.

The article analyzes the arrival and identification of the African mosquito Anopheles gambiae in Brazil in 1930, and the initial reactions of scientists and public health authorities against the epidemics of malaria caused by this species. Although this mosquito was recognized as a dangerous vector of malaria, its presence in Brazil was neglected after initial emergency actions in the city of Natal in 1932; this encouraged it to spread silently, resulting in a major malaria epidemic in 1938. This article examines scientific and political issues which caused the fight against mosquitoes to be pushed into the background until 1937 in cooperative efforts between the Rockefeller Foundation's International Health Division and the Brazilian authorities.

O artigo analisa a chegada e identificação do mosquito africano Anopheles gambiae no Brasil em 1930 e as primeiras reações de cientistas e autoridades de saúde pública contra as epidemias de malária causadas por essa espécie. Apesar de ter sido reconhecido como perigoso vetor da malária, sua presença em território nacional foi negligenciada a partir de 1932, após ações emergenciais na capital do Rio Grande do Norte, favorecendo um alastramento silencioso que resultou em uma grande epidemia de malária em 1938. São abordadas questões científicas e políticas que contribuíram para que o combate ao mosquito fosse colocado em segundo plano nas articulações entre a Divisão Sanitária Internacional da Fundação Rockefeller e autoridades brasileiras até 1937.

Anopheles gambiae no Brasil: antecedentes para um " alastramento silencioso ", 1930-1932 / Anopheles gambiae in Brazil: the background to a " silent spread, " 1930-1932

Resumo O artigo analisa a chegada e identificação do mosquito africano Anopheles gambiae no Brasil em 1930 e as primeiras reações de cientistas e autoridades de saúde pública contra as epidemias de malária causadas por essa espécie. Apesar de ter sido reconhecido como perigoso vetor da malária, sua presença em território nacional foi negligenciada a partir de 1932, após ações emergenciais na capital do Rio Grande do Norte, favorecendo um alastramento silencioso que resultou em uma grande epidemia de malária em 1938. São abordadas questões científicas e políticas que contribuíram para que o combate ao mosquito fosse colocado em segundo plano nas articulações entre a Divisão Sanitária Internacional da Fundação Rockefeller e autoridades brasileiras até 1937.

Abstract The article analyzes the arrival and identification of the African mosquito Anopheles gambiae in Brazil in 1930, and the initial reactions of scientists and public health authorities against the epidemics of malaria caused by this species. Although this mosquito was recognized as a dangerous vector of malaria, its presence in Brazil was neglected after initial emergency actions in the city of Natal in 1932; this encouraged it to spread silently, resulting in a major malaria epidemic in 1938. This article examines scientific and political issues which caused the fight against mosquitoes to be pushed into the background until 1937 in cooperative efforts between the Rockefeller Foundation's International Health Division and the Brazilian authorities.

Childhood health shocks, comparative advantage, and long-term outcomes: Evidence from the last Danish polio epidemic.

This paper examines the long-term effects of childhood disability on individuals' educational and occupational choices, late-career labor market participation, and mortality. We merge medical records on children hospitalized with poliomyelitis during the 1952 Danish epidemic to census and administrative data, and exploit quasi-random variation in paralysis incidence in this population. While childhood disability increases the likelihood of early retirement and disability pension receipt at age 50, paralytic polio survivors are more likely to obtain a university degree and to go on to work in white-collar and computer-demanding jobs than their non-paralytic counterparts. Our results are consistent with individuals making educational and occupational choices that reflect a shift in the comparative advantage of cognitive versus physical skills. We also find that paralytic polio patients from low socioeconomic status backgrounds are more likely to die prematurely than their non-paralytic counterparts, whereas there is no effect on mortality among polio survivors from more advantaged backgrounds.

Evolution of the national opioid crisis.

Opioid use disorder (OUD), addiction, and overdose have become a national public health and socioeconomic crisis. This article explores the evolution of substance abuse in the US, specifically OUD.