For this artifact on HIV/AIDS, I am going to do the historical focus. HIV has been a huge problem throughout the world since it was discovered. HIV was discovered in San Francisco when 5 men came in complaining about the same symptoms. More patients continued to come in with the same problems in many major cities throughout the United States. One doctor in Miami ended up finding a connection between these major cities and how all the symptoms were the same. However, there became a stigmatism for the gay community, as these were the people that mainly decided to go to the doctor with their symptoms. Eventually, t was found that HIV could be spread amongst all populations.

HIV is thought to come from monkeys. There are similar strains between SIV, simian immunodeficiency virus, and HIV. This attacks the immune system, much like it does in humans. The thought is that HIV was transmitted through humans through undercooked meat, a lot like cholera was passed into humans. Due to this, HIV is thought to have originated in Africa, near the Democratic Republic of Congo. Sexual Transmission is the key in transmitting the virus amongst the world. Some believe that the sex trade and human trafficking is what caused the virus to become so rampant amongst the community.

HIV has had a major impact on today’s culture. Many people still have a stigmatism toward the gay community, as well as the heroin community. There is no known cure for HIV/AIDS as of now. The treatments for society are also hard to come across now, and are very expensive to treat. Many people live with HIV/AIDS with no complications, however, are still at large for transmitting the virus among the population. Research is being very heavily done and hopefully a cure or effective treatment will be found to counteract the virus.

Cholera is an aquatic or food-borne illness. It spreads much faster in regions of the world that do not have the access to clean foods and water like many of the upper level countries do. This allows it to now spread through the nation, as once it has gotten to its human host, it can spread through the symptoms. It has two types, the classical version and the El Tor version. The classical cholera was responsible for the pandemics during the 19^th and early 20^th centuries, while the El Tor is responsible for the pandemic occurring today. The classical seems to be a much deadlier version of the virus, as many people would die in 24 hours of showing symptoms. The El Tor, while it can kill people, usually only shows minor to mild symptoms, which allows it to spread far greater as it doesn’t immediately kill its victims.

Cholera was originally coincided with Hindu pilgrimages. However, it got in with some of the traders in the Asian continent, allowing it to spread throughout Asia. Europe, however, was not affected by the first Cholera epidemic. The second epidemic, reached pandemic levels, as immigrants from Russia brought it to Europe where it spread like wildfire. These Europeans eventually immigrated to the western hemisphere, where it had contaminated worldwide.

The third Cholera pandemic was the deadliest of them all with the most deaths being recorded during the 1852-1863 timespan. During this pandemic John Snow published his work on Cholera. John Snow suggested that the disease was spread through water contamination instead of the miasma that was popularly accepted by the community. However, the miasma theory was not that far off since it was what was infecting the water, which helped spread the cholera. Cholera helped sparked the influence into researching the germ theory, which would be discovered by Dr. Robert Koch.

Cholera is still a problem today. It is mostly a problem in 3^rd world countries, as again they have problems getting the uncontaminated food and water. It still kills a great number of people. Oral Rehydration Salts are one of the only treatments today for Cholera and is used greatly in the 3^rd world countries that are being affected by this disease.

This class has allowed me to explore some of the various diseases that have occurred throughout time. There have been some major diseases, some lasting centuries like smallpox or just a few years like Ebola or each strand of Influenza. I have enjoyed the getting to explore these diseases, as epidemiology has always been a field that interests me. In this reflection essay, I am going to talk about the vectors between diseases, and how they jump from either animal-human or from human-human.

Many of the diseases that cause catastrophic death tolls throughout the world were enzootic to begin with, or animal born viruses/bacteria. The most notable throughout history has been the Black Death, which still ravages the world today in Madagascar (Artifact 2). The Black Death completely devastated the world in the 14^th century, wiping out a large majority of the European continent. With the germ theory, which wasn’t discovered until Dr. Robert Koch (Artifact 8), not being around, doctors had no idea what to do when it came to trying to prevent this disease. Many were struggling to believe that the disease came from God due to the nature of how deadly it truly was, and others believed it came from the way the planets were aligned in that year, giving the atmosphere a certain type of poisonous gas (Artifact 2). In reality, fleas were the vectors that originally got the Black Death started. Many of these small insects are devastating in the fact that they can wipe out entire countries from biting just one infected animal. The fleas bit some infected rodents and would then hitch on to humans, thereby transferring the disease across species. From that point, the Black Death became a human-human transmission, spread through the air and wiping out many civilizations. While it became an areal transmission, it would not have gotten its start without its vector, the flea, transmitting the bacteria into humans.

Another major vector in society has been the mosquito. Many people know that the mosquito is one of the deadliest creatures on the planet, solely due to the diseases that it carries from either human-human or animal-human. A disease that has been a problem throughout the world is malaria, which is carried by mosquitos. Malaria was originally a enzootic virus, but the mosquitos allowed it to transfer from animal to humans. There are many other diseases like this, with the one I researched being West Nile Virus (Research Paper). This virus is different in that it is solely avian in nature, so that when mosquitos contract the virus from the birds, it infects humans, but in the migratory patterns in birds. This allows for multiple types of mosquitos to infect the human race throughout the world.

While many of the main vectors are known to be insects, such as mosquitos and fleas, vectors are described as being anything that can transmit a disease. Typhoid is a different case, as it is an illness from ran or undercooked meat. Food is actually a common vector for typhoid, such as the case of the infamous Typhoid Mary (Artifact 3)(Contagion). In the movie contagion, it was shown that the virus had infected a pig, which while it was being prepared, had not yet been cooked. The chef, who would have had the virus/bacterium on his hands, did not wash his hands when he went to meet one of his customers. There, he transmitted the virus/bacterium to her and she began to spread it through aerial transmission. This allowed for the disease to continue the spread, but it showed how insects are not always the vectors for transmitting diseases. Typhoid Mary was another case, as she would serve food to the people that employed her, which were rich families, which in some cases was raw or undercooked. After they consumed the meal, they would for some reason come down with Typhoid (Artifact 3). This was strange at the time, because again people did not know about the germ theory and believed that Typhoid was a disease that spread about the common people. Typhoid was in fact another food born illness and was a good vector in transmitting the disease into humans.

There has been some talk about how to eradicate the vectors that transmit the worst diseases, specifically the mosquitos. There is potential for mosquitos to be eradicated from the world, but scientists don’t know what will happen if mosquitos do become eradicated. There might be a chance that something worse comes to take its place, which is not something the world needs. Or maybe it will just find another vector to transmit its disease, and this vector could be far worse in increasing the numbers of spreading the disease. There has also been talk of a gene drive-taking place to stop the spread of certain diseases that mosquitos can spread, while also keeping them alive. This is talking about how to alter the DNA of the mosquitos to where they can still contract the virus, but it does not allow them to transmit the disease after contracting it. Again, scientists just do not know the effects of what will happen, but the debate is alive now.

Vectors are terrible in the fact that they allow for diseases to be spread amongst the world, but knowing how to control them is effective in not allowing these diseases to spread amongst humans. Certain chemicals or insecticides like DDT have been effective in not allowing the mosquitos to get into the food supply or transmit the viruses into humans. Other practices like wearing sleeves has also proven effective in slowing the spread of the diseases. There are many ways to prevent the vectors from infecting humans, however, there is no way to completely eradicate all diseases and all vectors from getting to humans, and that is just something that human nature is going to have to live with.

Tuberculosis was absolutely devastating on the world. TB, as deadly as it was, is known to be the “forgotten plague” or the “silent killer.” TB was anything but silent for many years. TB had no favorites as in continued to infect everyone. As stated at one point in the first film, mothers were prepping their children to live without parents or siblings because it was so deadly to the global population. While TB was a more significant problem in the past, it is still very relevant today as MDR-TB, or drug resistant TB, has infected over two billion people, or one third of the global population.

TB is a very slow killer, although if lucky it can kill you fast. TB is known to take months or even years to kill its victims. And thanks to its air-air transmission, it was very transmissible and contagious. It wasn’t until Robert Koch discovered the Germ theory through TB and further studies by Edward Trudeau that TB could even be combated. TB was known to kill at will, much like smallpox or influenza. The only difference is that TB didn’t end quickly as a pandemic unlike those two diseases. TB was relevant in all societies for many years, even in present day. Thanks to research done by these two doctors, TB was finally able to be combated, or helped treated. Until a vaccination was discovered, Trudeau learned that natural air and nature in general was very effective and helped him and many patients. This led to him creating the first TB sanatoria in the USA. This allowed for patients to be isolated with other patients of TB, without getting themselves or other patients sicker. These patients could know that they would stay at these sanatoriums for long amounts of time until either death or they were shown to be cured of TB. Sanatoria were the only source of treatment until Streptomycin was found and used to be able to act as an antibiotic to TB. While not a permanent solution, it created a breakthrough for many other antibiotics to be found and used to help allow TB victims to live normal lives.

In modern day, TB has evolved into something of a problem in many low-income countries, mainly in Africa. TB has mutated into MDR-TB or EDR-TB, also known as drug resistant TB and extensively drug resistant TB respectively. This is causing a large problem, since this TB is still just as deadly as it has always been, however, it is resistant to many of the drugs that are usually used to combat this disease. The patients are sent to isolation places, or a modern day sanatorium. The only problem is nowadays; these places are known to be where patients go to die. TB is still being researched and hopefully another drug comes into play that is effective on these mutations, but the future still looks bleak.

In 19^th century Ireland, a very significant portion of the population was solely dependent on the potato as its main source of nourishment. This mixed with milk were enough to keep the population sustained and nourished, as well as the potato being a cheap food, as many could plant potatoes on their own. So when the potato blight struck Ireland, many were now starving, looking for new foods. The biggest problem, Ireland didn’t grow much else when it came to food, and thanks to potatoes, domesticated animals were not as popular as the rest of Europe. This caused a nation wide famine, leading to terrible diseases like Measles, TB, and eventually cholera.

Many Irish decided to immigrate to the United States attempting to escape the famine of Ireland. This caused a huge influx In the population, mainly in New York City. This influx, along with the diseases many Irish contracted above, caused a problem in America, with many Americans getting sick. This led to the persecution of Irish Americans spreading diseases and being scapegoats for many diseases, i.e. Typhoid Mary.

An origin for the Irish Potato Famine lies in the potato leaves. These leaves have a strain of bacteria attached to it that was fatal to the potato crop. This bacterium, Phytophtora Infestans, completely disallowed growth of the potatoes, leading to the famine and disease ravaging the country of Ireland.

Smallpox was one of the worst diseases human history has ever seen. Throughout much of history, 12^th to 19^th centuries, smallpox has completely ravaged Europe, leaving people dead in its wake. Smallpox has thankfully been combated today, but it still posed one of the worst threats as a disease that the world has ever seen.

Smallpox was a large epidemic that constantly kept coming back in Europe. Many families would be split apart due to this disease killing loved ones, and those were the families that were lucky smallpox didn’t infect the entire family. In those days, being infected with smallpox was basically just a death sentence, with those infected just waiting for the disease to pass through their system and kill them. Living in those times would have been very tough. Knowing everyday that you or someone you love could be infected and definitely die from this disease is heavy to carry on ones conscious. For much of the middle ages there weren’t many treatments that were effective. These treatments included bloodletting, leeches, fasting, laxative, purgatives, diuretics, and red therapy. These efforts were futile as many victims died anyways. It wasn’t until the late 18^th century that a treatment became effective.

Inoculation was very effective when it came to preventing smallpox from spreading. While being practiced in the early 18^th century England, it didn’t become a mainstream idea until later that century. Edward Jenner had heard stories of how it was an effective treatment and decided to do his own research. In his research he found that those who had previously had cowpox and who had a smallpox inoculation were resistant to getting smallpox. He decided to test the theory on his son and it worked. This led to the vaccine for smallpox being led mainstream by 1803; the same year vaccine was coined as a term.

Many were initially against the vaccine, as it was basically giving yourself a disease, but it had continued to become effective in combating smallpox. Smallpox victim numbers went down significantly. However, due to it being a new idea, many were still opposed to the idea. It eventually would become a very mainstream idea, but the initial response was skeptic.

Up until the mid 20^th century, there were many ethical issues in the medical world, especially with infectious diseases. With the treatment of anyone who was not wealthy, or anyone who was an immigrant being poor, public institutions were soon put in place in order to help those in need. The biggest problem was the treatment of immigrants and black people in big cities and in the city.

Individual rights were constantly put into question when people who had these infectious diseases were put in either quarantine or isolation. In the early 20^th century, the germ theory was still not a widely accepted idea, with many questioning the authority of putting people into quarantine. Due to the living conditions of the poor and immigrants, they were assumed to be the problem, so not many people had a problem with isolating them, but when it started to happen to the wealthy individuals, specifically in New York, public health officials were challenged to make better decisions on their isolation and quarantine victims. This led to the creation of departments to improve the conditions of disease victims.

One of the biggest ethical developments in American history happened in Tuskegee, Alabama. A group of black men were told that they would be getting a vaccination for syphilis and that they were the “guinea pigs” for the vaccine. Little did they know that the “vaccine” was actually the syphilis disease. These doctors were now injecting the black community in Tuskegee with syphilis without telling them, causing a very wrong moral and ethical development. However, the problem was not many people wanted to speak up about it because black people were still largely discriminated against in the south during the early 20^th century. With medical release forms and other documents being passed in order to assure the patients of what they are doing in the medical field, this scenario is not likely to happen again, although it still could.

The first Syphilis epidemic started around 1494, but it was not like the syphilis that we know today. In 1494, it was so bad that people even described it as “flesh falling off people’s faces.” It was very deadly and not kind to human nature. However, in modern times syphilis is not extremely deadly and is very treatable. This is due to the inherited immunity that the modern day culture has. In 1494, syphilis had never traveled into Europe, so there was no immunity to the disease. No one even knew what it was, causing it to spread like wildfire and had a high mortality rate for the time. Syphilis still has no known origin, and still affects many today, although not even close to as deadly it was 500 years ago.

For roughly 30 years, syphilis ravaged the European continent, until it was suggested that syphilis was spread through sexual intercourse. Although not knowing, Alexander Benedictus would end up being right about syphilis being an STD. With this association, many people decided that those contracted with syphilis had not deemed themselves worthy before God, and doctors who were religious would not treat their patients. Luckily, immunities began to form, and the symptoms of syphilis seen in 1494 boiled down to the symptoms that we see in modern day syphilis.

Unfortunately, there is no known origin of syphilis, although many believe that Christopher Columbus brought it back with him from the Americas. The evidence from skeletons shows a high probability that syphilis had originated in pre-Columbian areas. Many of these skeletons show the lesions connected with syphilis, causing many historians to accredit Columbia as the origin of syphilis.

The evolution of syphilis is something that historians and scientist still argue about today. Why was it so much worse in Europe than it was in the Americas? Or why did this flesh eating version of syphilis evolutionize to be much more human friendly so to speak? I agree along the lines of the different culture as well as climate of the New World versus the Old World. The people contracting syphilis in the Americas had obviously been doing so, creating a sort of immunity leading up to exposing it with the Europeans. When the Europeans contracted it and brought it back to Europe, it ravaged the continent. It continued to ravage until an immunity was built up, to where it eventually slowed down and stopped killing so much. Known as the “Great Pox,” to separate it from smallpox, it killed many people, just like smallpox killed many Native Americans when Europeans brought it across the Atlantic. Smallpox killed many Native Americans, but not Europeans thanks to the immunity that they already had. Syphilis might have had the same affect on the Native Americans centuries before and we just don’t know it yet, but they had built immunity by the time the Europeans arrived. Another reason could also be due to the sexual tendencies of the Americas versus the Europeans. Native Americans, who wore little to no clothes, could visually see when a venereal disease had started, whereas the Europeans raped and pillaged cities and towns that they took over, contracting the disease, and then bringing it home and spreading it to more cities as they continued to rape many women during that time period. Unfortunately, the cause may never be known, but I attribute it to the culture between the two worlds as to why it was so bad in Europe, but not the Americas at that time.

Environmental conditions in New York City were very poor, especially in the slums. In these communities, the slums would have trash lining up the streets, no water pressure which caused no showers and a very widespread lack of hygiene. These conditions are perfect for infectious diseases to spread, as shown by diseases like Typhoid Fever or Influenza. Immigrants were typically the people thrown into these slums, not allowing them to be hygienic and would contract these diseases.

Immigrants were quite often the scapegoats for many of the infectious diseases that came to the United States. In some cases, they were right and in other cases they were wrong. Sometimes they would bring the infectious diseases with them from their home countries, and would bring it to the US when immigrating. Other instances would be that they would infect from the US since the US also had some diseases immigrants were not used to. In either case, the living conditions for these people were so poor that it was very easy for infectious diseases to spread throughout the communities. Mary Mallon was one of the people who quickly became a scapegoat for many, as she spread Typhoid Fever throughout many communities.

The NYC Health Department was much different from today. There was no CDC around the time the NYC health department was formed, so they almost had free reign to do what they wanted among New York City. They were very harsh in some of their treatments on people who contracted the diseases, mainly immigrants. Many of these people were sent to quarantine or isolation, whereas people of higher standing were not sent there. Today, these people would still not be treated as well as people who have money, but they would be given better medical care and not just thrown to islands like they were 100 years ago.

We know that the plague today stems from the bacteria Yersinia Pestis. It has been mostly controlled in the United States, now only occurring in the rural regions of the US (southwest and along the Pacific coast). The plague is known to mostly affect animals, but will sometimes make the interspecies leap and infect humans, causing normally small outbreaks, now called epizootic outbreaks. Rarely it gets out of hand, much like what is happening in Madagascar now. The shock to most of these scientists is that the plague has not mutated very much compared to the same bacteria that caused the Black Death in the 14^th century.

Plague transmission stems mainly from rodents. The transmission requires a vector, which in the case of Black Death are typically fleas that jump from rodents to humans. Sometimes, the fleas will jump to other species of animals before coming around to humans, which causes slight mutations and will have a different effect on the human body. Other types of transmission include coming into contact with fluids associated with the plague, mainly butchered animals that had plague. The butchers get it, and then eventually begin to spread it among the rest of the town. In order to spread it through town, many people must have contact with plague, or through infectious droplets. Pneumonic plague is not very common anymore, but this is the only way that plague can be transmitted among humans.

The Plague in Madagascar is hugely caused to the pneumonic plague infecting humans.   Madagascar is still a developing country, which is why pneumonic plague is able to spread so easy. Many don’t know what they have, which allows for the spread to continue. Madagascar is also a very traditional country, with much of the culture dealing with the dead. In many instances, they consult with the dead, so unburying someone who died of plague will also help the transmission of plague among families. And due to knowing if they bring the sick to the hospital, many will not bring their relatives to the hospital in fear of not being allowed to bury their family members.