Historical studies of disease

The fever hit suddenly in the form of a piercing headache and painful sensitivity to light, like looking into a white sun. At that point, the patient could still hope that it was not yellow fever, maybe just a headache from the heat. But the pain worsened, crippling movement and burning the skin. The fever rose to 104, maybe 105 degrees, and bones felt as though they had been cracked. The kidneys stopped functioning, poisoning the body. Abdominal cramps began in the final days of illness as the patient vomited black blood brought on by internal hemorrhaging. The victim became a palate…
Though there still may be some lingering doubt about the cause of the Black Death and subsequent outbreaks of plague, the pathogen behind the outbreaks that have taken place in the last 150 years or so is much less ambiguous. While Koch and Pasteur ushered in the golden age of microbiology, an outbreak of plague began in China and spread from there. In 1894, while plague was raging in Hong Kong, the Pasteur Institute sent Alexandre Yersin, a physician who had trained with both Pasteur and Koch, to investigate. Yersin was able to access material from a corpse, and inoculated material he…
In parts one and two of the "What caused the Black Plague?" series, I discussed objections that had been raised to the conclusion that the bacterium Yersinia pestis was the cause of this pandemic, and the weaknesses with those criticisms. In today's installation, I'll discuss actual molecular evidence that Y. pestis indeed caused this--and does this research shut the door on alternative hypotheses? More after the jump... Much of the evidence for or against hypotheses supporting any pathogen as a cause of an ancient disease are based on symptoms and historical records. While we can…
Yesterday I introduced criticisms that have been raised against Y. pestis causation of the Black Death and subsequent plague outbreaks. Today I'll discuss what I see as weaknesses in these criticisms, after the jump. Selective quoting and interpretation of evidence First and foremost, a big issue I have with the claims by Duncan and Scott are that they are rather selective in what evidence they choose. For example, they selected several quotes from medieval manuscripts and diaries that suggest that people at the time "knew" it was directly contagious from person to person, and…
As I noted last week, Shelley mentioned a topic that's been brought up here a few times in the comments section: alternative theories for causes of the Black Plague (the devastating plague that ravaged Europe beginning in ~1347 and eventually killed more than a third of the population). Though the bacterium Yersinia pestis is almost universally accepted as the causative organism, like many areas of science, there are a few individuals who disagree with the consensus. To this end, several alternative etiologies for Black Plague have been put forth, and shortcomings with the mainstream Y.…
Did Yersinia pestis really cause Black Plague? Part 1: Objections to Y. pestis causation Did Yersinia pestis really cause Black Plague? Part 2: Examination of the criticisms Did Yersinia pestis really cause Black Plague? Part 3: Paleomicrobiology and the detection of Y. pestis in corpses Did Yersinia pestis really cause Black Plague? Part 4: Plague in modern times.
Some infectious agents, it seems, have been with us since the rise of humanity. Bacteria like E. coli or salmonella don't appear to have one moment enshrined in history where they first appeared on the scene. They've probably long been with us, causing disease sporadically but not spectacularly. Other agents, however, seem to make their presence known. Syphilis is one of these. The first recorded outbreaks of syphilis (caused by the bacterium Treponema pallidum subspecies pallidum) were documented in Europe in 1495. These weren't syphilis as we know it today. Currently, syphilis is…
I'll have new posts up here next week, but meanwhile, over at Retrospectacle, Shelley's made this week plague week. She introduces the topic here, and next dishes about plague fashion. Also in the comments, it's asked: I recently heard that there is some doubt now that the Black Death may not have been bubonic plague. The doubt based on the speed of transmission, but no alternate disease was mentioned. Is there any other disease that matches the symptoms that could be a likely alternative? Long time readers know that I've referred to this previously and promised to post on it, so if even…
I asked yesterday what readers considered the most important diseases in history. This was prompted by a new ASM Press book, Twelve Diseases that Changed Our World, written by Irwin Sherman. As I mentioned, Sherman included many diseases readers expected--plague, cholera, tuberculosis, smallpox, syphilis, malaria, influenza, yellow fever, and AIDS. He didn't include a few that popped up repeatedly in the comments--leprosy, measles, and typhoid (or typhus, for that matter). While I think a study of these could have been illuminating (especially leprosy, since much of the stigma…
I'll have a review up tomorrow of a new ASM press book, Twelve Diseases that Changed Our World. However, I'm interested first in what readers would nominate as the most important diseases in history. Sure, some are "gimmies," but the author, Irwin Sherman, makes a few choices I'd not have considered. What would you include on your list?
Regular readers may have seen me mention on occasion my father's rather large family. My dad is the youngest of a family of 13 children--12 of whom survived to adulthood. Before my dad was born, he lost a brother to complications from infection with chicken pox; he had a severe infection and developed a fatal secondary pneumonia at just a year old. This was back in the early 1940s, prior to the widespread use of modern antibiotics and certainly long before vaccination for chicken pox. Still, despite the availability of effective chicken pox vaccines today, people still knowingly…
Those familiar with the history of influenza probably know about the 1918 outbreak of swine influenza in Cedar Rapids, Iowa. In the fall of that year, the National Swine Show and Exposition in Cedar Rapids opened, bringing people and their hogs from miles around. Soon after it opened its doors, people noticed their swine were becoming sick--and the symptoms looked suspisciously like those of human influenza. When the virus was characterized years later, it was indeed found to be the influenza virus--and it was very similar to ones that were isolated from humans. This characterization of…
As I've noted before, filoviruses are some of my favorite pathogens. I don't work on them myself--though in the pre-children era I certainly thought about it--but I find them absolutely fascinating to read about and follow the literature. Mostly, I think, this is because after knowing about them for so many years (Marburg was discovered in 1967), and so much research (over 1500 papers in Pubmed, or roughly a paper for every person these viruses have killed), we still know relatively little about the most basic questions--such as where there viruses are maintained in nature, and how they…
XDR-TB has been in the news quite a bit lately, largely thanks to Andrew Speaker's notoriety. Even though his TB was later re-classified as "just" multi-drug resistant (MDR-TB) instead of the initial extremely drug resistant (XDR) type, it did serve to raise awareness about the issues public health authorities face when dealing with something like tuberculosis--and where the gaps are in the control of its spread. (Indeed, a breaking story out of Taiwan shows how difficult it can be to enforce a travel ban). However, while XDR-TB is rather new on the radar of the general public (and even…
One of the most famous stories in all of epidemiology revolves around the very birth of the science, in the midst of a London cholera outbreak in 1854. At the time, the scientific community was divided over the cause of cholera and other diseases. The majority of them accepted the miasma theory, the idea that disease was due to corrupted air ("all smell is disease," noted sanitation commissioner Edwin Chadwick). This idea dates back to antiquity, and increased in popularity in the Victorian era. It's a great example of something that logically made sense, even though it was wrong.…
Syphilis is a disease frequently shrouded in many levels of mystery. It appeared suddenly in Europe in the late 1400s as a highly virulent and often fatal disease, a disease that could give Ebola a run for its money when it comes to sheer grotesque-ness. Victims may be covered with pustules from head to toe, diseased flesh peeled from their bodies, and patients may be in agonizing pain for weeks or months prior to death. However, after this inauspicious beginning, syphilis seems to have become less virulent, and instead shifted in presentation to more of the chronic disease that we know…
Today is the kids' last day of school, and just happens to be an early dismissal as well, so I'll be busy with them and not tied to the computer this morning/afternoon. However, there are tons of good things to read elsewhere. First, Orac has a long-awaited update on the Tripoli Six: the group of nurses and doctors accused of killing children in Libya by deliberately infecting them with HIV. The science exonerated them, but that didn't change the court outcome, and I've not seen updates until now. Next, Revere writes about the H7N2 influenza outbreak in Wales, reminding us (as as I've…
I think it must be difficult to study infectious disease without having some kind of interest in history. The field is so rich in stories from decades and centuries past, and infectious disease has played an enormous role in shaping our societies today. As with many fields, I believe our understanding of the present can be improved if we view it through the lens of the past--realizing as much as we can the historical influences and legacies that have brought us to where we are today. I mentioned a few weeks back that, despite its eradication in the natural world, the smallpox virus still…
Last month I noted the story of Robert Daniels, a patient with drug-resistant tuberculosis who's been held in isolation in Arizona in order to prevent spread of the deadly pathogen. While some patient's rights advocates have been outraged, Mr. Daniels' treatment pales in comparison to what Mona at Science Notes writes about: News has broken that the Canadian government continued to require Native Canadian children to attend residential schools where they could learn "civilized," Christian, European ways, for years after they knew that tuberculosis was rampant in those schools, and they…
Smallpox is, without a doubt, the biggest success story in all of vaccination. The practice of variolation, or the purposeful inoculation of naïve individuals with material from scabs of smallpox victims, was practiced for years prior to Edward Jenner's substitution of cowpox for the smallpox (Variola) virus. The vaccinia virus, thought to be a derivative of cowpox, has been used in the 20th century in smallpox vaccination campaigns. Vaccina elicits antibodies that protect from smallpox infection, yet typically causes an asymptomatic or only mildly symptomatic infection. This…