CONTRIBUTION TO THE UNDERSTANDING OF THE HEALTH SITUATION WITHIN THE POPULATION IN SLAVONIA AND SRIJEM DURING THE SECOND WORLD WAR WITH AN EMPHASIS ON INFECTIOUS DISEASES / Prilog poznavanju zdravstvenih prilika stanovnistva u Slavoniji i Srijemu tijekom Drugoga svjetskog rata, s naglaskom na zarazne bolesti

During World War II, the population of agricultural areas of Slavonia and Srijem lived in privation, but there was no famine. A more serious threat was infectious diseases, such as malaria, typhoid fever, and dysentery, which were also present within the population in the post-war period. Major epidemics broke out mostly in areas under partisan control, especially in the areas of western and central Slavonia, where major epidemic typhus contagious broke out. Venereal diseases, less common in the Slavonian area before the war, were also on the rise. Two factors had an impact on the health situation within the population ­ state medical institutions and partisan medical corps. Health care and measures to combat infectious diseases were provided by state authorities, and that is still an insufficiently explored area in historiography. During the first years of the war, the partisan medical corps personnel, initially mostly semiskilled and lacking necessary medical equipment and medications, relied on the support from the population to a greater extent than they were able to provide medical care to them. With the arrival of professional staff and the acquisition of medicines and medical equipment, mainly sourced from medical institutions in areas under partisan control, they assumed a more active role in supporting civilian authorities under the "people's rule"­specifically, the people's liberation committees. Their focus shifted to healthcare for the civilian population, primarily aimed at suppressing and preventing infectious diseases. Further research on this topic will contribute to a more realistic perception of the civilian population's everyday life during the war, which was presented in memoir literature and historiography of the socialist period as a heroic act of resistance rather than a struggle for survival in the conditions of privation and diseases; it will also complete the picture of the human losses of the civilian population caused by infectious diseases.

O trem e a "senhorita espanhola": a epidemia de gripe em Diamantina, 1918 / The train and the "Spanish señorita": the flu epidemic in Diamantina, 1918

Resumo O artigo analisa a epidemia de gripe de 1918 em Diamantina, no interior de Minas Gerais. A partir de fontes bibliográficas e documentais, discute como o ramal ferroviário da Estrada de Ferro Vitória a Minas, inaugurado em 1914, contribuiu para a chegada da doença à cidade que, até então, era representada no discurso de suas elites como isolada e salubre. Aborda as imbricadas relações entre a expansão dos sistemas de transportes pelo interior do Brasil, o meio ambiente, o conhecimento científico e os processos saúde/doença.

Abstract The article analyzes the influenza epidemic in 1918 in Diamantina, a town in the Brazilian state of Minas Gerais. Bibliographic and documental sources are used to investigate the influence of the Vitória-Minas railroad (Estrada de Ferro Vitória a Minas), opened in 1914, on the arrival of the disease in the town, which had until then been represented in the discourse of its elites as insalubrious and isolated. The interrelations between the spread of transportation systems across Brazil, the environment, scientific knowledge, and health-disease processes are discussed.

Fauci looks back-and ahead.

Loved and hated, NIAID's chief plots life after government.

Los microbios de Linneo / Linnaeus' microbes

Resumen Uno de los grandes genios de la biología fue el médico sueco Carlos Linneo (1707-1778). Se lo denominó princeps botanicorum por su gran aporte a la clasificación de las plantas. Sin embargo, su fama imperecedera se debe a su obra Systema Naturae en que crea un sistema taxonómico binomial para clasificar a todos los seres vivos y no vivos en tres reinos: el reino mineral, el reino vegetal y el reino animal. En su esquema taxonómico, los animalículos o microorganismos descubiertos por el sabio neerlandés Antoine van Leeuwenhoek en 1676, fueron clasificados tentativamente en el reino animal, dentro de la clase Vermes o Gusanos. La idea de que estos animalitos fueran la causa de las enfermedades infecciosas fue planteada por Linneo y desarrollada en profundidad por Johannes C. Nyander y Johannes Carolus Roos, dos de sus discípulos, quienes publicaron esta idea en sus tesis Exanthemata viva en 1757 y Mundus invisibilis en 1767, respectivamente.

Abstract One of the great geniuses of biology was the Swedish physician Carlos Linnaeus (1707-1778). He was called princeps botanicorum for his great contribution to the classification of plants. However, his undying fame is due to his work Systema Naturae in which he creates a binomial taxonomic system to classify all living and non-living beings into three kingdoms: the mineral kingdom, the plant kingdom and the animal kingdom. In his taxonomic scheme, the animalicles or microorganisms discovered by the Dutch scholar Antoine van Leeuwenhoek in 1676, were tentatively classified in the animal kingdom, within the class Vermes or Worms. The idea that these little animals were the cause of infectious diseases was imagined by Linnaeus and developed in depth by Johannes C. Nyander and Johannes Carolus Roos, two of his disciples, who published this idea in their theses Exanthemata viva in 1757 and Mundus invisibilis in 1767, respectively.

Epidemiological Isolation May Explain Differences in Historical Respiratory Infectious Disease Mortality.

Indigenous and aboriginal peoples of the Americas and Pacific died at enormous rates soon after joining the global pathogen pool in the seventeenth to nineteenth centuries from respiratory infections such as smallpox, measles, and influenza. It was widely assumed that this represented a selection process against primitive societies. Darwinian selection for specific genetic resistance factors seems an unlikely hypothesis given that some populations stabilized quickly over two to three generations. European-origin populations whose childhood was marked by epidemiological isolation also suffered high infectious disease mortality from respiratory pathogens. American soldiers with smallpox, South African (Boer) children with measles, and New Zealand soldiers with influenza suggest that epidemiological isolation resulting in few previous respiratory infections during childhood may be a consistent mortality risk factor. Modern studies of innate immunity following Bacillus Calmette-Guérin (BCG) in infancy point toward rapid immune adaptation rather than evolutionary selection as an explanation for excessive first contact epidemic mortality from respiratory pathogens.

Infectious disease and nutritional deficiencies in early industrialized South Africa.

OBJECTIVE: Real industrialization was late to arrive in South Africa and was associated with the development of mining in its northern regions. This paper explores the development and spread of infectious diseases (particularly tuberculosis), against the backdrop of metabolic disease. MATERIALS: Published data regarding skeletons from various mining sites and historical information are collated, including information from the early accessions into the Raymond A. Dart Collection. METHODS: While findings from several sites (e.g., Gladstone at Kimberley, Koffiefontein, Witwatersrand Deep Mine and Lancaster Mine) have been described individually, they have not been assessed collectively. This paper provides a broad overview by collating information from these sites, in comparison with a rural, pre-industrialized population. RESULTS: Malnutrition, including scurvy, was common in most mining groups. Tuberculosis was rare in earlier mining groups, and the first possible skeletal cases only occurred after the establishment of closed housing compounds. From there it spread rapidly across the subcontinent. CONCLUSIONS: Nutritional insufficiencies / metabolic disease and high death rates, due to trauma and infectious diseases, were common. Tuberculosis in South Africa is closely associated with development of the mining industry. SIGNIFICANCE: This research highlights the development of tuberculosis in South Africa and its association with the mining industry. The role of migrant labor and the associated housing practices is elucidated. LIMITATIONS: Sample sizes are limited, but the findings of this study are supported by documentary evidence. FUTURE RESEARCH: Sample sizes should be increased, and the association between closed compound living and the development of disease further explored.

Pandemics: Historically Slow "Learning Curve" Leading to Biomedical Informatics and Vaccine Breakthroughs.

BACKGROUND: The worldwide tragedy of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic vividly demonstrates just how inadequate mitigation and control of the spread of infectious diseases can be when faced with a new microorganism with unknown pathogenic effects. Responses by governments in charge of public health, and all other involved organizations, have proved largely wanting. Data infrastructure and the information and communication systems needed to deal with the pandemic have likewise not been up to the task. Nevertheless, after a year of the worldwide outbreak, hope arises from this being the first major pandemic event in history where genomic and related biosciences - relying on biomedical informatics - have been essential in decoding the viral sequence data and producing the mRNA and other biotechnologies that unexpectedly rapidly have led to investigation, design, development, and testing of useful vaccines. Medical informatics may also help support public health actions and clinical interventions - but scalability and impact will depend on overcoming ingrained human shortcomings to deal with complex socio-economic, political, and technological disruptions together with the many ethical challenges presented by pandemics. OBJECTIVES: The principal goal is to review the history of biomedical information and healthcare practices related to past pandemics in order to illustrate just how exceptional and dependent on biomedical informatics are the recent scientific insights into human immune responses to viral infection, which are enabling rapid antiviral vaccine development and clinical management of severe cases - despite the many societal challenges ahead. METHODS: This paper briefly reviews some of the key historical antecedents leading up to modern insights into epidemic and pandemic processes with their biomedical and healthcare information intended to guide practitioners, agencies, and the lay public in today's ongoing pandemic events. CONCLUSIONS: Poor scientific understanding and excessively slow learning about infectious disease processes and mitigating behaviors have stymied effective treatment until the present time. Advances in insights about immune systems, genomes, proteomes, and all the other -omes, became a reality thanks to the key sequencing technologies and biomedical informatics that enabled the Human Genome Project, and only now, 20 years later, are having an impact in ameliorating devastating zoonotic infectious pandemics, including the present SARS-CoV-2 event through unprecedently rapid vaccine development. In the future these advances will hopefully also enable more targeted prevention and treatment of disease. However, past and present shortcomings of most of the COVID-19 pandemic responses illustrate just how difficult it is to persuade enough people - and especially political leaders - to adopt societally beneficial risk-avoidance behaviors and policies, even as these become better understood.

Protection against severe infectious disease in the past.

Before the 20th century many deaths in England, and most likely a majority, were caused by infectious diseases. The focus here is on the biggest killers, plague, typhus, smallpox, tuberculosis, cholera, typhoid, dysentery, childhood infections, pneumonia, and influenza. Many other infectious diseases including puerperal fever, relapsing fever, malaria, syphilis, meningitis, tetanus and gangrene caused thousands of deaths. This review of preventive measures, public health interventions and changes in behavior that reduced the risk of severe infections puts the response to recent epidemic challenges in historical perspective. Two new respiratory viruses have recently caused pandemics: an H1N1 influenza virus genetically related to pig viruses, and a bat-derived coronavirus causing COVID-19. Studies of infectious diseases emerging in human populations in recent decades indicate that the majority were zoonotic, and many of the causal pathogens had a wildlife origin. As hunter-gatherers, humans contracted pathogens from other species, and then from domesticated animals and rodents when they began to live in settled communities based on agriculture. In the modern world of large inter-connected urban populations and rapid transport, the risk of global transmission of new infectious diseases is high. Past and recent experience indicates that surveillance, prevention and control of infectious diseases are critical for global health. Effective interventions are required to control activities that risk dangerous pathogens transferring to humans from wild animals and those reared for food.

Historia y futuro de las pandemias / History and future of pandemics

Este artículo presenta una historia general de las epidemias históricas y de las nuevas enfermedades emergentes, señalando sus factores desencadenantes. Se afirma que las epidemias son inevitables, y que su riesgo aumenta en proporción al tamaño, la complejidad y el poder tecnológico de nuestras sociedades. La historia enseña que las epidemias han sido casi siempre desencadenadas por cambios en el ambiente ocasionados por las propias actividades humanas. Las enfermedades infecciosas son manifestación de una interacción ecológica entre la especie humana y otra especie de microorganismos. Y las epidemias son resultado del cambio en algún factor ambiental capaz de influir en esa interacción. Las catástrofes epidémicas son inevitables: en primer lugar, porque no podemos evitar formar parte de cadenas tróficas en las que comemos y somos comidos por los microbios; en segundo lugar, porque las infecciones son mecanismos evolutivos y factores reguladores del equilibrio ecológico, que regulan sobre todo el tamaño de las poblaciones; y, en tercer lugar, porque las intervenciones técnicas humanas, al modificar los equilibrios previos, crean equilibrios nuevos que son más vulnerables. De este modo las sociedades humanas son más vulnerables cuanto más complejas. Y los éxitos humanos en la modificación de condiciones ambientales conservan, o más bien aumentan, el riesgo de catástrofes epidémicas. Todas las necesarias medidas de vigilancia y control epidemiológico imaginables pueden disminuir los daños que producen las epidemias, pero nunca podrán evitarlas.

This article presents a general history of historical epidemics, and new emerging diseases, pointing out their triggers. It is claimed that epidemics are inevitable, and that their risk increases in proportion to the size, complexity, and technological power of our societies. History teaches that epidemics have almost always been triggered by changes in the environment caused by human activities themselves. Infectious diseases are manifestations of an ecological interaction between the human species and another species of microorganisms. And epidemics are the result of a change in some environmental factor capable of influencing that interaction. Epidemic catastrophes are inevitable: firstly, because we cannot help but be part of trophic chains in which we eat and are eaten by microbes; secondly, because infections are evolutionary mechanisms and regulatory factors of ecological balance, which regulate especially the size of populations; and thirdly, because human technical interventions, in changing previous balances, create new balances that are more vulnerable. In this way human societies are more vulnerable the more complex. And human successes in modifying environmental conditions retain, or rather increase, the risk of epidemic catastrophes. All necessary epidemiological surveillance and control measures imaginable can lessen the damage caused by epidemics, but they can never prevent them.

Dusseldorf autopsies 1914-1918.

This article presents an evaluation of 4255 autopsy cases recorded at the Dusseldorf Pathology Institute in the years 1914 to 1918. Diagnoses were coded according to the International Classification of Diseases, 10th edition (ICD-10), and the contemporaneous history of the Pathology Institute was reviewed. We found a proportion of 54.1% adults and 45.5% children in our cohort, with a male predominance of 63.9%. Infectious diseases account for the majority of all cases (35.5%), among which tuberculosis is the most frequent, reported in 22.7% of all cases. The second largest diagnosis group is the one of respiratory diseases (16.9%), including pneumonia and influenza. Cases of perinatal conditions account for 10.5% of the collective, followed by neoplasms, injuries, intoxications, or external causes, each representing 6.6%. Cardiovascular diseases account for 5.3% of the cases. In 4.4% of the pediatric and 0.8% of adult cases, a diagnosis of the ICD-10 group "nutritional and endocrine diseases" was made. No diagnosis of hunger edema is reported. Parts of the cohort are 272 war pathology cases (6.4%), made up by soldiers who mainly had died of shotgun injuries. The whole cohort represents the disease spectrum of a German big city population at times of World War I. The data exemplify the epidemiological shift that has occurred in industrialized countries over the last 100 years, from infectious to neoplastic and cardiovascular diseases.

Insights from ancient DNA analysis of Egyptian human mummies: clues to disease and kinship.

The molecular Egyptology field started in the mid-eighties with the first publication on the ancient DNA (aDNA) analysis of an Egyptian mummy. Egypt has been a major interest for historians, archeologists, laymen as well as scientists. The aDNA research on Egyptian biological remains has been fueled by their abundance and relatively well-preserved states through artificial mummification and by the advanced analytical techniques. Early doubts of aDNA integrity within the Egyptian mummies and data authenticity were later abated with studies proving successfully authenticated aDNA retrieval. The current review tries to recapitulate the published studies presenting paleogenomic evidence of disease diagnosis and kinship establishment for the Egyptian human remains. Regarding disease diagnosis, the prevailing literature was on paleogenomic evidence of infectious diseases in the human remains. A series of reports presented evidence for the presence of tuberculosis and/or malaria. In addition, there were solitary reports of the presence of leprosy, diphtheria, bacteremia, toxoplasmosis, schistosomiasis and leishmaniasis. On the contrary, paleogenomic evidence of the presence of rare diseases was quite scarce and mentioned only in two articles. On the other hand, kinship analysis of Egyptian human remains, including that of Tutankhamen, was done using both mitochondrial DNA sequences and nuclear DNA markers, to establish family relationships in four studies. It is clear that the field of molecular Egyptology is still a largely unexplored territory. Nevertheless, the paleogenomic investigation of Egyptian remains could make significant contributions to biomedical sciences (e.g. elucidation of coevolution of human host-microbe interrelationship) as well as to evidence-based archeology.

Estudio comparativo de las crisis de mortalidad en Montevideo y Ciudad de Buenos Aires y su relación con las epidemias por enfermedades infecciosas (1850-1919)

El artículo presenta un estudio comparativo del desempeño de la mortalidad en Buenos Aires y Montevideo, capitales de los países que se adelantan en el descenso de la mortalidad en América Latina. Se analiza el comportamiento característico de la mortalidad en las fases más tempranas de la transición epidemiológica entre 1850 y 1919. Para medir la intensidad de las crisis de mortalidad se utilizó una metodología propia de la demografía histórica, el índice de Dupâquier. En los años de registros extraordinarios se realiza un análisis de causas de muerte. A su vez, se revisan brevemente las instituciones sanitarias y las medidas que las autoridades adoptaron frente a las crisis. Nuestros resultados identifican similitudes y diferencias. Ambas ciudades fueron golpeadas por sucesivas crisis de mortalidad, y en este período se observa el inicio de su espaciamiento y reducción, propio de las primeras etapas de su descenso. No obstante, la tendencia al descenso de las crisis de mortalidad presenta particularidades: por un lado una situación más ventajosa para Montevideo ­menos años de mortalidad extraordinaria hasta 1890­, y por otro, la paulatina equiparación de Buenos Aires desde la última década del siglo XIX, así como un menor peso relativo de las defunciones por enfermedades transmisibles. (AU)

A brief introduction of Xiangya's anti-epidemic history in a century. / ç™¾å¹´æ¹˜é› æŠ—ç–«ç®€å².

Based on archival materials, the Xiangya's anti-epidemic history in a century from its establishment to 2020 is divided into 4 stages. The first stage (1906-1926), Edward Hicks Hume and YAN Fuqing, the founders of Xiangya, prevented and controlled smallpox and plague. The second stage (1929-1953), during the resumption of Xiangya, students prevented and controlled cholera, plague, dysentery, typhus, and other infectious diseases. In the third stage (1953-1999), in a peacetime, Xiangya actively fought against schistosomiasis, hydatidosis, malaria, leprosy, tuberculosis and other epidemics. The fourth stage (2000-2020), the era of Central South University. Medical staff in Xiangya fight SARS, influenza A (H1N1) flu, Ebola hemorrhagic fever, coronavirus disease 2019, etc. Over the past hundred years, Xiangya people joined together to spread benevolence and love, apply medical knowledge and skills, combat the epidemic and rescue people in difficulties, which made a great contribution to the motherland and the people.