Plague and local response in North China, 1900-28.

Breakthroughs in international biomedical science circa 1900 meant that plague could be contained through strict quarantine regulations. These measures were successfully deployed with help from local governments during outbreaks of pneumonic plague in Manchuria (1910-11), Shanxi (1918), and elsewhere in North China. This containment shows the effectiveness of uniting international knowledge and local cooperation in disaster response. Yet, in later outbreaks in similar locations, control measures identical to those instituted a decade earlier were rejected, and plague spread largely unchecked. Historical case studies of the control and spread of infectious disease in North China reveal the complexities of the relationship between global knowledge and its broader, local integration, variation in what constitutes effective 'local' cooperation in adopting international knowledge, and the paramount importance of the locality to the landscape of disaster response. History can reveal critical issues in localisation of disaster response still salient today.

Extreme mortality during a historical measles outbreak on Rotuma is consistent with measles immunosuppression.

Until the early twentieth century, populations on many Pacific Islands had never experienced measles. As travel to the Pacific Islands by Europeans became more common, the arrival of measles and other pathogens had devastating consequences. In 1911, Rotuma in Fiji was hit by a measles epidemic, which killed 13% of the island population. Detailed records show two mortality peaks, with individuals reported as dying solely from measles in the first and from measles and diarrhoea in the second. Measles is known to disrupt immune system function. Here, we investigate whether the pattern of mortality on Rotuma in 1911 was a consequence of the immunosuppressive effects of measles. We use a compartmental model to simulate measles infection and immunosuppression. Whilst immunosuppressed, we assume that individuals are vulnerable to dysfunctional reactions triggered by either (i) a newly introduced infectious agent arriving at the same time as measles or (ii) microbes already present in the population in a pre-existing equilibrium state. We show that both forms of the immunosuppression model provide a plausible fit to the data and that the inclusion of immunosuppression in the model leads to more realistic estimates of measles epidemiological parameters than when immunosuppression is not included.

Descripción del brote de poliomielitis en la Argentina de 1971 / Description of the 1971 poliomyelitis outbreak in Argentina

La poliomielitis es una enfermedad de antigua data que afecta exclusivamente a los humanos. Sus secuelas de parálisis se encuentran ya documentadas en escritos del antiguo Egipto. Es producida por el poliovirus y se transmite por vía fecal-oral. Uno de cada doscientos niños infectados sufre un ataque vírico a las neuronas motoras del sistema nervioso central, que deja como secuela una parálisis flácida muscular. En la Argentina, las últimas epidemias de poliomielitis ocurrieron entre 1955 y1957, en 1971 y en 1983. La epidemia de 1953 registró 2.700 casos, mientras que en la de 1956 hubo 6.490 casos, con una tasa de mortalidad del 33,7%. Durante 1971, 46 pacientes fueron internados con diagnóstico de poliomielitis en las salas que dependían de la cátedra de Enfermedades Infecciosas de la Facultad de Ciencias Médicas de la Universidad de Buenos Aires, en el predio del Hospital Francisco Javier Muñiz. La cohorte estaba compuesta por 26 varones y 20 mujeres. Hemos realizado una revisión de las historias clínicas de aquellos pacientes, obrantes en el archivo de la cátedra. (AU)

Poliomyelitis is a human disease of ancient origin. Evidence of sequelae of paralysis is documented in ancient Egyptian writings. It is caused by the poliovirus and is transmitted through the fecal-oral route. One out of 200 infected children suffers a viral attack on the central nervous system´s motor neurons, which results in flaccid muscle paralysis. In Argentina, the last polio epidemics occurred between 1955 and 1957, in 1971 and in 1983. The 1953 poliomyelitis epidemic reported a total of 2,700 cases, while in the 1956 outbreak 6,490 cases were recorded with a mortality rate of 33.7%. In 1971, 46 patients were diagnosed with poliomyelitis and admitted to the wards of the Department of Infectious Diseases at the Faculty of Medical Sciences, University of Buenos Aires, located in the Javier Muñiz Hospital. The cohort consisted of 26 men and 20 women. We reviewed the medical records of those patients, recorded in the Department´s archive. (AU)

Some lesser-known facts on the early history of syphilis in Europe.

At the end of the 15th century, an epidemic outbreak occurred in Europe for which the cause was previously unknown. Clinical findings included numerous ulcerations and condylomas as well as disorders of the cardiovascular and neurologic systems. The disease, which had many names at the time and killed about 5 million people, is referred to as syphilis in today's medical terminology. The epidemiology of syphilis is complex and represents an important issue, not only historically but also scientifically, in the development of medicine. Several theories emerged about the origin of this disease, including pre-Columbian and Columbian ones. This contribution aims to present the history of the origin of syphilis, with particular emphasis on the first reports of the disease in Poland.

Lest we forget: Odunbaku Oguntona Sapara William (1895-1935) beyond the demystification of deity.

Oguntola Odunbaku Sapara Williams (born Alexander Johnson Williams, 1861-1935) was a Fellow of the Royal Institute of Public Health. This paper attempts to highlight the effort of an African doctor to fight disease outbreaks during the African colonial era. His uninterrupted 32 years career as a colonial medical officer in one of the British colonies in West Africa, provided superintendence for the eradication of smallpox as a result of this, he was credited with the demystification of metaphysical involvement in the smallpox epidemic and thus eradication of smallpox in the Lagos colony. He also provided leadership for the control of bubonic plague, and tuberculosis epidemics and pioneered initiatives to reduce maternal and infant mortality by vaccination, enactment of public health law, environmental sanitation, and health education in Southwest Nigeria.

Las epidemias de viruela y la introducción de la vacuna en el Virreinato del Río de la Plata / Smallpox epidemics and vaccine introduction in the Viceroyalty of the Río de la Plata

La viruela fue una de las enfermedades epidémicas más temidas desde la antigüedad debido a su alta mortalidad y a las secuelas que dejaba en aquellos que lograban sobrevivir. En el presente trabajo se abordará el ingreso de esta enfermedad en nuestro continente, así como su manifestación a través de epidemias, brotes y focos endémicos. Al mismo tiempo se verá qué reacciones provocó dentro del ámbito médico durante los años del Virreinato del Río de la Plata. Se analizarán los problemas que surgieron con el uso de la vacuna importada, así como el hallazgo de nuestra vacuna local, finalizando con los comienzos de la organización de los servicios de vacunación obligatoria. (AU)

Smallpox was one of the most feared epidemic diseases since ancient times due to its high mortality and the sequelae caused in those that managed to survive. In the present work, the introduction of this disease into our continent will be addressed as well as its manifestation through epidemics, outbreaks, and endemic foci. At the same time, the reactions this disease caused inside the medical field during the years of the Viceroyalty of the Río de la Plata will be observed. The problems that arose from the usage of the imported vaccine and the discovery of our local vaccine will be analyzed, and it will finish with the beginnings of the organization of the mandatory vaccination services. (AU)

Histories of Medieval Plague in Renaissance Italy.

During the sixteenth century, Italian scholars revised their conception of the field of history so that its purposes went beyond providing political and morally edifying narratives. These scholars contended that history must also account for culture and nature in an encyclopedic fashion. In the same years, numerous newly available texts from antiquity, the Byzantine empire, and the Middle Ages provided insight into the character of earlier outbreaks of plague. Italian physicians, embracing new visions of the field of history, the culture of humanism, and an inductivist epistemology, used these texts to argue that there were continuities among ancient, medieval, and Renaissance epidemics. They catalogued plague and formed historical categories based on severity and perceived origins, leading to the rejection of the conclusions of fourteenth-century western Europeans who viewed the plague of 1347-1353 as unprecedented. These erudite physicians saw medieval plague to be one example of the extreme epidemics that have regularly occurred throughout history.

Open Secrets: Silence, Suppression, and Memory in the History of Canada's 1918-20 Influenza Pandemic.

For several decades, the 1918-20 global influenza outbreak has been called "the forgotten pandemic." Although recent scholarly and public interest in the pandemic has complicated the narrative of forgetting, the label has stuck. Highlighting historical evidence of influenza's long-term impact upon survivors, family, and community in Canada, the flu stories presented here, diverse in form and content, verify that a key question in pandemic influenza history is not whether the pandemic was forgotten or remembered, but by whom, and in what ways, it has been suppressed - or foregrounded. By moving beyond the classic epidemic plot line, with beginning, middle, and end, historians can find new methodologies and evidence with which to more fully understand the influenza pandemic's unfolding intersection with colonialism, war, social inequality, and labour struggles in the 20th century.

Spanish Flu in Tehran from 1918 to 1920.

The Spanish flu spread from September 23, 1918 to 1920. This disease was one of the historical catastrophes in Iran, and a large number of people in Tehran were infected. Evidence also shows that 5000-10000 out of the 250000 infected people died in Tehran over three years. Besides, an increase was detected in the prevalence of other diseases such as pericarditis, orchitis, mastoiditis, meningitis, optic neuritis, paralysis of the palate, mania, cholera, and dysentery. Overall, five percent of the city were destroyed, and the population and economic development were severely damaged. This study aims to evaluate the importance of the history of local medicine in Tehran, the spread of Spanish flu, World War I, and presence of Russian, Ottoman, and British troops in Iran during the flu outbreak. The critical role of Britain in artificial famine, malnutrition, and drug embargo was assessed, as well.

Typhus Disease in Iran during the Qajar Period (1725 to 1925 AD); a Brief Historical Review.

Typhus is an acute febrile disease caused by a series of bacteria called Rickettsia that is transmitted by insects such as lice, fleas, and ticks. This disease has appeared several times in Iran and caused many casualties. There were some therapeutic measures taken by European physicians in Tehran and medical graduates of the Dar al-Fonun school or expatriates who had studied medical courses in Western countries, even though the taken steps were not enough. Due to the lack of sanitation and cleaning products after the outbreak of World War I in March 1917 and its synchronization with the swift outbreak of Typhus in 1918, heavy casualties followed. In this study, we first examine the prevalence of Typhus in the Qajar dynasty in Iran, and will then focus on the pathological importance of this disease history in Iran. After that, we will study the role of Typhus prevalence and World War I in the Persian famine, malnutrition, and food poverty. Moreover, we investigated the role that this great war had in strengthening the spread of this disease and its role in the death of many Iranian people.

Historical Investigation of Fowl Adenovirus Outbreaks in South Korea from 2007 to 2021: A Comprehensive Review.

Fowl adenoviruses (FAdVs) have long been recognized as critical viral pathogens within the poultry industry, associated with severe economic implications worldwide. This specific group of viruses is responsible for a broad spectrum of diseases in birds, and an increasing occurrence of outbreaks was observed in the last ten years. Since their first discovery forty years ago in South Korea, twelve antigenically distinct serotypes of fowl adenoviruses have been described. This comprehensive review covers the history of fowl adenovirus outbreaks in South Korea and updates the current epidemiological landscape of serotype diversity and replacement as well as challenges in developing effective broadly protective vaccines. In addition, transitions in the prevalence of dominant fowl adenovirus serotypes from 2007 to 2021, alongside the history of intervention strategies, are brought into focus. Finally, future aspects are also discussed.

Bioarchaeological insights into the last plague of Imola (1630-1632).

The plague of 1630-1632 was one of the deadliest plague epidemics to ever hit Northern Italy, and for many of the affected regions, it was also the last. While accounts on plague during the early 1630s in Florence and Milan are frequent, much less is known about the city of Imola. We analyzed the full skeletal assemblage of four mass graves (n = 133 individuals) at the Lazaretto dell'Osservanza, which date back to the outbreak of 1630-1632 in Imola and evaluated our results by integrating new archival sources. The skeletons showed little evidence of physical trauma and were covered by multiple layers of lime, which is characteristic for epidemic mass mortality sites. We screened 15 teeth for Yersinia pestis aDNA and were able to confirm the presence of plague in Imola via metagenomic analysis. Additionally, we studied a contemporaneous register, in which a friar recorded patient outcomes at the lazaretto during the last year of the epidemic. Our multidisciplinary approach combining historical, osteological and genomic data provided a unique opportunity to reconstruct an in-depth picture of the last plague of Imola through the city's main lazaretto.

The enigma of Pacini's Vibrio cholerae discovery.

During the 1854 cholera outbreak in Florence, Italy, Filippo Pacini documented that the cause of the infection was a bacterium. This conclusion was also independently reached by John Snow during the 1854 cholera outbreak in London. By using an epidemiological method, Snow found that the infection spread through a polluted water network. Snow identified a water pump as the source of the disease. After removing the infected handle of this pump, the cases of cholera rapidly began to decrease. A microscopic examination of the water showed organic impurities but no bacteria. This discovery was ignored during Snow's lifetime. In contrast, through microscopy during the autopsies of cholera victims, Pacini observed that the disruption of their intestinal mucosa was closely associated with millions of the bacteria that he called Vibrio cholerae. Via histological techniques, Pacini detected that intestinal mucosa reabsorption dysfunction was the cause of debilitating diarrhoea, vomiting, severe dehydration and death. Nevertheless, his discovery of Vibrio cholerae was ignored during Pacini's lifetime. A survey of Pacini's autographic manuscripts suggests that Pacini and Snow may have shared mutual knowledge within their respective seminal papers. This survey also facilitates, for the first time, the creation of maps that illustrate the worldwide distribution of Pacini's cholera papers from 1854 to 1881. The consistent neglect of Pacini's discovery remains a true enigma.

A grim anniversary - 20 years since burning pyres marred our landscape.

Georgina Mills reflects on the 2001 foot-and-mouth outbreak and the lessons that have been learned since then.

The 1942 Massive Contamination of Yellow Fever Vaccine: A Public Health Consequence of Scientific Arrogance.

In the late 1930s, the 17D vaccine against yellow fever was produced in record time. 17D was and is an excellent vaccine. Its rapid diffusion led, however, to several problems, the most important among them being the 1942 massive contamination of the vaccine distributed to the US Army by the hepatitis B virus. The US part of this story is relatively well-known, but its Brazilian part much less so. In 1940, scientists who were producing the 17D vaccine in Rio de Janeiro found that it was contaminated by an "icterus virus" that originated in normal human serum. They solved this problem through the exclusion of human serum from vaccine production, but failed to persuade their US colleagues to do the same. The Rio experts, aware of the potential pitfalls of a new technology, carefully supervised the consequences of their vaccination campaigns. They were thus able to rapidly spot problems and eliminate them. By contrast, US scientists, persuaded of their technical superiority and distrustful of warnings that originated from a "less developed" country, neglected to implement basic public health rules. A major disaster followed. (Am J Public Health. 2021;111(9): 1654-1660. https://doi.org/10.2105/AJPH.2021.306313).

Chronicle down memory lane: India's sixty years of plague experience.

BACKGROUND: This perspective documents the historical aspects of outbreaks of plague of last six decades, establishment of plague surveillance network in India with detailed insights about its activities and recent developments requiring focus on plague surveillance. Human plague was reported in Mulbagal area of Karnataka in 1966-67 only to re-emerge in the country in 1994 in Beed district (Maharashtra) and subsequently in Surat (Gujarat). Later Plague outbreak has been reported in the year 2002 with index case from Village Hatkoti, Shimla District in Himachal Pradesh. The last outbreak reported from India was in 2004 from Village Dangaud, Uttarkashi District in Uttarakhand followed by a period of quiescent since last 17 years. OBJECTIVES: During the last few decades, at least three geographical areas experienced outbreaks of plague after silent period of 28 years. We recapitulate the response mechanism for containing outbreaks during the last three outbreaks of plague held in Maharashtra & Gujarat (1994), Himachal Pradesh (2002) and Uttarakhand (2004). We also document the Plague surveillance network of India and its activities which is a comprehensive surveillance system comprising of rodent, flea, canine and human surveillance whose foundation was started in 1964. The recent developments of last decade in terms of revised Human plague surveillance case definitions, Plague surveillance sites, vector control, novel diagnostics and vaccines in our country are also mentioned. CONCLUSION: The thrust areas in control of plague outbreak are early detection and isolation of cases, timely effective antibiotic treatment, chemoprophylaxis to contacts, strengthening of surveillance system and massive IEC campaign in infected areas. Yersinia pestis (causative agent of Plague) also being an important bioterrorism agent, clinicians need to pay special attention to diagnose and microbiologists must be provided skilled training for laboratory confirmation to this pestilential disease for effective and timely management.

The spatiotemporal distribution of historical malaria cases in Sweden: a climatic perspective.

BACKGROUND: Understanding of the impacts of climatic variability on human health remains poor despite a possibly increasing burden of vector-borne diseases under global warming. Numerous socioeconomic variables make such studies challenging during the modern period while studies of climate-disease relationships in historical times are constrained by a lack of long datasets. Previous studies have identified the occurrence of malaria vectors, and their dependence on climate variables, during historical times in northern Europe. Yet, malaria in Sweden in relation to climate variables is understudied and relationships have never been rigorously statistically established. This study seeks to examine the relationship between malaria and climate fluctuations, and to characterise the spatio-temporal variations at parish level during severe malaria years in Sweden 1749-1859. METHODS: Symptom-based annual malaria case/death data were obtained from nationwide parish records and military hospital records in Stockholm. Pearson (rp) and Spearman's rank (rs) correlation analyses were conducted to evaluate inter-annual relationship between malaria data and long meteorological series. The climate response to larger malaria events was further explored by Superposed Epoch Analysis, and through Geographic Information Systems analysis to map spatial variations of malaria deaths. RESULTS: The number of malaria deaths showed the most significant positive relationship with warm-season temperature of the preceding year. The strongest correlation was found between malaria deaths and the mean temperature of the preceding June-August (rs = 0.57, p < 0.01) during the 1756-1820 period. Only non-linear patterns can be found in response to precipitation variations. Most malaria hot-spots, during severe malaria years, concentrated in areas around big inland lakes and southern-most Sweden. CONCLUSIONS: Unusually warm and/or dry summers appear to have contributed to malaria epidemics due to both indoor winter transmission and the evidenced long incubation and relapse time of P. vivax, but the results also highlight the difficulties in modelling climate-malaria associations. The inter-annual spatial variation of malaria hot-spots further shows that malaria outbreaks were more pronounced in the southern-most region of Sweden in the first half of the nineteenth century compared to the second half of the eighteenth century.