Epidemiology Course Summary

The book “The Great Influenza: The Story of the Deadliest Pandemic in History, written by John M. Barry, covers the progression of the Spanish influenza, especially in the United States. Barry focuses not only on the influenza itself, though, but also on the social influences that allowed the virus to flourish. The book covers how medical practices in the United States had risen up just in time to combat the virus, but, due to societal issues and the war, the doctors struggled in areas where they should have been successful.

John Snow's approach to explaining cholera and how it spread consisted primarily of morbid poison entering the alimentary canal through means of contaminated water consumption. Snow believed this to be the basis of how cholera was contracted by individuals and believed improper sewage filtration was to blame as well as a means of spreading the disease from person to person. However, previous explanations of how cholera was contracted consisted of the theory of airborne infection. This theory proposed that cholera was contracted by inhaling air at low levels of altitude by such people as workers in slaughterhouses and bone merchants. This theory also proposed that the foul-smelling odors associated with these occupations were closely

The pandemic struck the world and infected 1/3 of earth’s human population, killing over 50 million humans. The world’s top doctors have never witnessed anything of this killing magnitude besides the bubonic plague of 1348 but the transmissibility is of nothing they’ve ever seen in their lifetime or of recorded history. People abruptly became aware of the importance of health, and need of medicine and cleanliness.

Throughout history the human race has been faced with one key factor that no one civilization has even been able to beat, not the might of the Roman-Byzantine Empire, nor the combined efforts of the entirety of Europe and their scholars could defeat this recurring foe. Pandemics, from the Greek ‘pan’ meaning all, and ‘demos’ meaning people (Harper Etymonline.com), are these indiscriminate killers whom care not for your social standing be it wealth, fame, or glory. Humans have contested with disease ever since the infantile stages of the species, but the ability of it to spread was severely inhibited by the fact that humans stayed in small groups of 10-30 people at most, giving the virus or disease severely hampered virulence. It was not till humans began gathering in larger, more permanent settlements such as the early Classical cities of Athens, Ramses, and Rome, that the issue of sanitation and disease came into effect. This has not to say that our issues with sanitation and disease prevention have stopped, rather have they been brought forward into the limelight, many nations around the world today have issues with age old diseases and give rise to extremely deadly new viruses of their own. To fully understand the effect of pandemics in history, then one must consider three major plagues of our recorded history, the first pandemic ‘Plague of Athens’, the pivotal ‘Plague of Justinian’, and the infamous ‘Black Death’

Jim Murphy, in his nonfictional narrative An american Plague, describes in vivid detail the challenges faced by the citizens of Philadelphia during the devastating Yellow Fever Epidemic of 1793. During the dreadful and deadly time, there were many selfless volunteers to stepped forward to help. Mayor Matthew Clarkson was one of the brave individuals who chose to stay in Philadelphia to provide leadership, despite the danger. Through his strong sense of duty, his selflessness, and unwavering perseverance, Mayor Clarkson became a symbol of heroism for all the selfless volunteers who stayed and made a real difference in Philadelphia.

Whitehead’s personality allows him to transcend class barriers. Snow uses many techniques to produce his mapping of the cholera epidemic. He uses scientific reasoning to conclude that the cholera epidemic is caused by “something” that is ingested by victims through contact with waste matter that is in the contaminated drinking water. Snow used controlled studies, which form the basis of the scientific method. He also did investigative work by interviewing the local people involved with the help of Whitehead.

While there were a number of significant factors that majorly influenced the history of public health in Chicago, it was the threat of Cholera epidemic which was responsible for establishment of the first temporary board of health in 1834. Nonetheless, It wasn’t until 1849 when the disease had reached the heart of the city that the government took charge and appointed a district health officer in each district to facilitate the eradication of Cholera.

Creation of factories, which played a major role in mass production of goods, led to the rapid growth of towns. People, sensing the numerous job opportunities, flooded the towns from their different country sides. Towns quickly became overcrowded and did not have adequate social amenities to cater for their already large and growing population. Without important amenities such as proper drainage, clean living habitats due to the overcrowding and clean drinking water the 19th-century cities were sanctuaries for diseases such as typhoid, tuberculosis and cholera. It was during a cholera research outbreak in 1854 that London doctor John Snow produced his revolutionary work on disease transmission.

Because cholera was one of the most deadly diseases, the transmission of the disease not only left a strong impact on Europe during the 19th century, but it conceivably also killed Montresor’s family. Moreover, the living conditions and poor health habits of Europeans added to the deadliness of the disease. One contribution to the spread of the disease was the living conditions of the lower class. The

In order to understand the epidemics which dominated the nineteenth century one must listen to the voices of the time. These voices speak of factory workers being forced to work incredibly long hours in filthy conditions for very little money, several families living together in one room apartments with no running water.

Epidemiology, the branch of medicine that deals with the incidence, distribution, and possible control of a disease. Epidemiology is used through out the world, whether that be to protect a country from a lethal disease or educating the people about the common cold, epidemiologist protect the world from disease as a whole. This is highlighted in the most recent outbreak of the Zika Virus in Brazil and the Ebola Sudan outbreak illustrated in the Hot Zone. Even though these disease have there similarities and differences epidemiologists have done that is possible to protect the populous of the world. Though both disease have common ground, both are extremely different from one another based on the symptoms and over effect on the human body.

The first Cholera epidemic in England appeared in October of 1831. Symptoms of Cholera include dehydration, diarrhea, fever, and vomiting. Soon the disease would take over the patient's body and kill them. The second epidemic took place in 1848 through 1849 and killed almost 70,000 people throughout England and Wales. Doctors could not figure out the source of the illness or how to cure it. The living conditions made this illness spread like wildfire. People were living in cramped living areas and did not have proper sewage systems. Human waste was thrown into ditches and alleyways. When the city would flood the sewage would flow into houses, marketplaces, streets, and eventually made its way into streams and the Thames river. Doctor

One of the first pioneers of epidemiology was John Snow, a British physician responsible for discrediting the predominant theory of disease transmission in the early to mid-nineteenth century called the “Miasma theory”. It referred to the idea that many contagious diseases such as cholera, chlamydia and the black death were spread by miasma or “bad air” coming from suspended particles of organic decaying matter thought by sanitary reformers to arise from sewers, bogs, trash pits, open graves, and other foul-smelling sites. Cholera, a widely feared disease’s origin of transmission was largely debated during this time period. It wasn’t until John Snow’s research studies furthering Fillipo Pacinis’ discovery of Vibrio cholera bacteria by reasoning on pathological evidence and disease pattern surveillance was Cholera exposed as a water-borne illness spread throughout local areas from contaminated water sources. John Snow’s research lead him to theorize that cholera was causing digestive problems from drinking polluted water and eating contaminated foods with the Vibrio cholera bacterium which could spread very easily from contaminated public water supplies. As first symptoms appeared upon examination to have been found to harm a person’s digestive tract causing the extreme diarrhea that characterized the disease and not first effecting a person’s nose or lungs as it would if cholera was absorbed from breathing in “bad airs”, as was though with the miasma theory. Although John

The late 19th century saw an increase in the spread of infection and a radical change in the knowledge of disease causation. Some key contributions to public health are the Chadwick report in 1842 on “The Sanitary Conditions of the Labouring Population” of Great Britian and soon after in 1848 Public Health Act was introduced (Fee & Brown, 2005). At this time, public health was organized efforts with the primary purpose of improving sanitary conditions of towns. In 1854, British physician John Snow’s “Cholera Map” as a result of his investigation of the distribution of waterborne cholera in London led to the removal of the Broad Street pump. This study showed the impact of socio-environmental factors on health (Morris, 2007) and marked the beginning of the modern epidemiology and a shift from reliance on quarantine which was prominent in that time to proactive action to protect health and prevent diseases. In Canada, provinces passed public health acts, which was modeled after the UK Public Health Act of 1875, that required municipalities to appoint a permanent local board of health, medical officers of health and sanitary inspectors to deal with communicable diseases,

John Snow’s study of Cholera and where it originated from was one of the first signs of a true study of epidemics, and shows how important it is to focus on not only the disease and the patient, but on how the disease is transmitted, and the properties of the disease. During that time, Cholera, a disease caused by bacteria, was rampant, and killed many people, and the idea of germs was nonexistent. Through observation and research, Snow theorized that Cholera was in the digestive system, and that Cholera came from dirty or “infected” water. To test his theory, he went from door to door, asking questions about who had been infected, and where they had gotten their water. He learned in his first test that those who drank from one specific water