John Snow Epidemiological Triangle

In two years between 1918 and 1919, A pandemic of influenza swept mercilessly over the planet, killing millions which stood in its path. Miraculously, the exact origin of the pandemic is unclear. What is exceedingly clear, however, is that often the actions of man aided in the spread of the virus, whether due to inadvertent endangerment, close quarters, religious principles, or failure to recognize the true threat that influenza posed.

The work of these two men changed the contemporary views on how disease was spread. By solving the cholera mystery, they helped contribute to making the world safe for bigger cities. Over the next few years a lot of changes were made. Both the medical and public health establishments latched onto Snow’s waterborne theory and through one of the greatest feats in engineering history, London started the process of making an entirely new sewer system. This, along with other precautions such as boiling water that was suspected to be contaminated, brought an end to city-wide choleric outbreaks. Besides the improvements in sewage, the improvements of sanitary conditions all around greatly diminished the spread of disease and held a major part in making the modern city possible. Overall, it turned out that something that was once horrendous and deadly for a massive amount of people, eventually turned out to be helpful for the future of mankind. (Johnson)

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.

Mr. Gawande starts his literature on washing hands. He introduces two friends a microbiologist and an infectious disease specialist. Both work hard and diligently against the spread of diseases just like Semmelweis who is mentioned in the chapter. Something I learned, that not many realize, is that each year two million people acquire an infection while they are in the hospital. Mainly because the clinicians only wash their hands one-third to one-half as many times as they should. Semmelweis, mentioned earlier, concluded in 1847 that doctors themselves were to blame for childbed fever, which was the leading cause of

He linked the common illness cholera to people whom drank from the wells. He observed those getting ill and which areas and pumps they drank from and recorded it on a map, he was then able to establish all those getting ill were in fact drinking from the same pump, and consequently in 1854 John Snow removed the handle of the Broad Street pump and ceased the epidemic of Cholera in Soho, London

In the early 1900’s medicine was making some steps closer into some great improvements for health and better understanding of the human body. Doctors with sufficient knowledge of the human body and cures for diseases and viruses were scarce. People were much more concerned with government and politics, than health and medicine, until one of the greatest and most grotesque lethal pandemics that’s struck the earth in human history. This pandemic the “Spanish Flu” spread so rapidly and had an extremely high mortality rate. This was caused by the close contact of humans and poor cleanliness and sanitation, and the host (virus) and the body taking harsh action

In document 3, the British colonial government of Sierra Leone reported on the epidemic of influenza in Sierra Leone in West Africa, 1918 where he points out that infected people are being neglected. He wants to inform the government of the capital Freetown, where this is happening, that as the epidemic spreads people are dying due to not having enough health care and treatment provided by the government. In most cases because they couldn't find help or because they were abandoned by other residents. In Rio de Janeiro, a Brazilian newspaper published in 1918 alludes how the public health agency hasn't done anything concerning the epidemic. He wants to inform both the Brazilians and the health agency that even though it is obvious that the illness is spreading since there has been much publicity, the agency is choosing to ignore it and the author is blaming them for not taking the actions necessary with when all the ships from unknown ports are arriving but there are no sanitary care measures being done, which can also be a cause of the spread (Doc 6).

Infectious epidemics and pandemics have happened all through mankind's history. “They remain the prime cause of death worldwide and will not be conquered during our lifetimes.” The flu of 1918 was one of the deadliest epidemics in history. “It infected an estimated 500 million people worldwide–about one-third of the planet’s population at the time–and killed an estimated 20 million to 50 million victims. More than 25 percent of the U.S. population became sick, and some 675,000 Americans died during the pandemic.” No one knew how the virus spread, there were no antibiotics to fight it, and no flu shots to prevent it. In the final year of World War I, it struck terror in the hearts of people all across Europe and left more death in its wake than the combined military actions of the combatants. “It killed more Americans in a few months than World War I, World War II, the Korean War, and the

As the second part of this reflection paper, I selected a book ‘A Short History of Disease’ by Sean Martin. He is a writer and filmmaker also known for his other famous books like The Knights Templar, Alchemy and alchemists, the Gnostics. His films include Lanterna Magicka: Bill Douglas & the secret history of cinema. The most alluring thing which conceives me to cull this book is a history of the disease, as a medical professional, it's always tantalizing to know from where all these begins and this book reaches up to my expectations as it started from the first ever recorded disease in the history of mankind. He isn’t lying when he say this a history of the disease. He starts from the earliest bacteria to evolve on the earth, long before there was anything around to infect. This book is divided into seven chapters, each chapter describes the history of diseases in a particular era. Chapter One: Prehistory, Chapter Two: Antiquity, Chapter Three: The Dark and Middle Ages, Chapter Four: The New World, Chapter

The book The Great Influenza by John Barry takes us back to arguably one of the greatest medical disasters in human history, the book focuses on the influenza pandemic which took place in the year 1918. The world was at war in the First World War and with everyone preoccupied with happenings in Europe and winning the war, the influenza pandemic struck when the human race was least ready and most distracted by happenings all over the world. In total the influenza pandemic killed over a hundred million people on a global scale, clearly more than most of the deadliest diseases in modern times. John Barry leaves little to imagination in his book as he gives a vivid description of the influenza pandemic of 1918 and exactly how this pandemic affected the human race. The book clearly outlines the human activities that more or less handed the human race to the influenza on a silver platter. “There was a war on, a war we had to win” (Barry, p.337). An element of focus in the book is the political happenings back at the time not only in the United States of America but also all over the world and how politicians playing politics set the way for perhaps the greatest pandemic in human history to massacre millions of people. The book also takes an evaluator look at the available medical installations and technological proficiencies and how the influenza pandemic has affected medicine all over the world.

The hygiene movement helped in the avoidance of communicable diseases, diseases for example cholera, tuberculosis and water illnesses in large part by modifying the people surroundings. In the 1850s, John Snow assisted in recognized the importance in data collection and documentation. His actions terminated an outbreak of cholera in a district of London. Using the same methodology Ignaz Semmelweis, applied it to restraint fever of childbirth a major source of maternal mortality. The reason that this was happening was that after physicians worked on the death bodies, usually they did not wash their and delivered babies and contaminating both, the mother and the baby.

Consequently, the Rockefeller Foundation was more concerned with medical innovation rather than a sanitary, social means of reform; ironically enough, the disappearance of the yellow fever in the US was largely in part due to the sanitation of water supplies. This error in judgment is retrospectively apparent in the Rockefeller Foundation’s belief in Dr. Noguchi’s sole commitment to vaccination. Soper’s later review of Noguchi’s efforts demonstrates his perceived futility in the over-confidence in vaccination and the resulting negation of alternative causes to vector

The epidemiology triangle has three sides. The sides consist of the host, the agent and the environment. The host is the person who is affected by the disease. The agent is the organism causing the disease. “In the case of type II diabetes, the agent could be the absence of a substance.” (McMurray, 2006). The agent interacts with the host and the environment to cause the disease. The environment is all the outside conditions that make the host susceptible to the agent. One condition of the environment could be the health of the host.

“In 1872, Alfred Haviland stated that ‘typhoid fever is now a national disgrace; we ought not to rest until we reduce it to one simply local or personal; its existence will then become punishable’” (Journal of the History of Medicine and Allied Sciences [JHMAS], 2010). Typhoid was not the only disease that plagued London at the time, cholera was also very widespread. “Before the cholera outbreak of 1849, it was believed that Thames water abstracted between the bridges in London was perfectly safe, as testified by the evidence of many experts, but that belief cost London 25,000 lives in 1849 and 1854.” There are two reasons why these diseases were so prevalent during this time. One was due to having little knowledge in the subject of diseases and how the microorganisms that caused them functioned. Dr. George Turner provided some insight into this subject. In regard to the bacillus of typhoid and cholera “That, he said, which kills one does not affect another; that which favours the propagation of one does not favour the propagation of another.” He goes on to say that if the filtration system can mechanically hold back the smaller germs of typhoid, it should also be able to hold back the larger microbes of cholera. Although, he follows it up with he distinctly thought this argument could not be carried from one bacillus to another until it was actually

“Only yesterday mankind lived in fear of the scourges of smallpox, cholera, and plague………….. Today we are concerned with a different kind of hazard that lurks in our environment—a hazard we ourselves have introduced into our world as our modern way of life has evolved.”