In class, this semester we have taken a look into health factors, and disease agents that cause infections and diseases throughout societies worldwide, and the ways that they affected societies. We’ve looked at factors such as the globalization, to diseases such as the plague, syphilis, small pox, TB, cholera, sexually transmitted diseases, to emerging zoonotic diseases, to diseases such as P. infestans that caused the Irish Potato famine and how these diseases effected society at the time. Often times the public blamed immigrants, or certain social groups/classes for these diseases even at times when the germ theory had become accepted by scientists.

The first public health issue concern we examined in Artifact 1 was the health issues caused by a globalized world. Connected populations of humans at the dawn of civilization changed the way diseases where spread, grew and mutated. When humans lived as hunter gatherers fewer diseases existed. Those that did typically would infect a few individuals and then fail to infect a larger population. When humans began to live in fixed settlements, diseases where able to infect far more individuals and then had the ability to spread across trade routes. Diseases such as the black death, and syphilis where able to spread with travelers to new lands and cause far and wide-reaching devastation. In “The Price of Being Sedentary” I wrote about how the first plagues spread across Asia to Europe. Later I wrote about how syphylis was contracted by the Spanish and made its way back to Europe. This has a greater impact on human health than ever. Over 70% of diseases that affect humans today are zoonotic in origin. As human settlements encroach farther into jungles and wild habitats we will see more emerging zoonotic diseases.

The black death, Y. pestis, was the first epidemic level disease we looked at this semester. The disease was said to have killed off up to a quarter of the world’s population at the time. Y. pestis actually has spread to epidemic levels three times in human history. The first time during the roman empire it was known as the Plague of Justinian. Later in the Middle Ages in its most famous pandemic Y. pestis ravaged much of Asia and medieval Europe. Up to a quarter of the population died in this pandemic. Medieval European societies became more pessimistic and morbid as observed in their artwork depicting the grim reaper, and people made of skeletons instead of flesh. Most recently, the plague was able to spread through modern trade and shipping lanes and killed 12 million people. The disease is carried by fleas on rats, but can also be spread in the air if an individual’s lungs are infected. Today the black plague still exists and is actually endemic to the southwest of the U.S.

Syphilis was an endemic disease to the America’s that was brought to Europe by the Columbian exchange. The disease would actually end up killing the famous, or infamous if your and American Indian, explorer Christopher Columbus. Our focus on this disease turned to the ethics of modern medical testing. In our 3rd artifact we looked at the men of the Tuskegee Syphilis experiment and how their suffering has effected public trust of medicine in the American South even today. As I wrote about in “Volunteers for Syphilis?” the men of the Tuskegee experiments where misled and even lied to about their treatments. Many of the 400 men would go on to die because of their syphilis infection, and those who attempted to receive outside treatment where stopped from doin so.

Next, we turned out attention to how Small Pox shaped the world. When the conquistadors arrived in South America the natives had no immunity to the disease. When the Spanish first attacked the Aztecs, a highly militarized civilization, they were initially beaten. Many months later when the Spanish had regrouped and made a second attack they found the capital to appear disserted. The Aztec population had been decimated by the disease. It is estimated that as Small Pox spread throughout South and North America 90% of the population died. The massive loss of life due to this disease would allow European nations to colonize the new world. This disease was also one of the first times biological warfare was used. The British are recorded to have traded small pox infected blankets with Natives to kill them without having to engage them in battle.

Tuberculosis (TB) is known as the third world terror. This is a bacterial infection spread through the air that causes weight loss, coughing, and fever. Throughout the 19th and 20th centuries this disease ravaged western cities. Known as the poor man’s disease, the confined living spaces of slums allowed the bacteria to spread rapidly throughout populations. In “The Third World Terror, TB” I wrote about how immigrants and the poor where disproportionately affected by the disease so the upper classes began to associate the disease with poverty. As we examined in our 5th artifact we learned that patients recovering from TB have to take a stringent series of medicine for 6-12 months to prevent the strain they carry from mutating into a drug resistant strain. Since the disease causes the infected to become listless and lethargic it also was associated with laziness among the poor, and the immigrants. Today TB still exists and is estimated to live dormant in up to a quarter of the world’s population. It affects those who suffer from malnutrition or have inhibited immune function like those who suffer from HIV/AIDS.

The Irish Potato Famine was caused by the fungus P. infestans HERB-1. The fungus decimated potato crops throughout Europe. The Irish at the time were forced to trade all exports with Great Britain. When there staple crop, the potato was depleted by the infestation for the better part of a decade over 1 million Irish died to starvation, and diseases associated with poverty and malnutrition. The Irish still blame the British for the toll in lives that this fungus took. Today genetic engineering is looking to solution to develop strengthened immune responses for crops to defeat plights and pests.

Next, we turned our attention to Cholera. This disease results from populations drinking contaminated water. The bacteria responsible for causing cholera lives in water and excrement. When drinking water is contaminated with this bacteria those who consume it suffer from severe dehydration as their body expels all fluids. In “Cholera the Classless Killer” I wrote about how modern cities have advanced water treatment, and sewage systems designed to keep cities clean, and provide their inhabitants with clean drinking water to prevent modern outbreaks of cholera.

Today the world suffers from a sexually transmitted epidemic, HIV/AIDS. The disease causes immunodeficiency in individuals and can lay dormant for decades. Many who have contracted the disease have no idea that they have become infected and are at risk of passing the disease on to others. The disease does not normally lead to death, instead it suppresses the immune system so that other infections that would not normally be fatal kill the patient. Modern health organizations work to distribute information about HIV and help spread knowledge about the disease to prevent the disease from being spread further.

Artifact 1 “The Price of Being Sedentary”
Artifact 3 “Volunteers For Syphilis”
Artifact 5 “The Third World Terror, TB”
Artifact 7 “Cholera The Classless Killer”

Today approximately 70% of all diseases that affect humans are the result of zoonotic spillover. Zoonotic diseases are those that originated in a different species, and through contact with humans have mutated so that they can infect humans. Modern examples include the Zika and Ebola viruses, both of which originated in nature but did not infect humans. Deforestation and climate change have led to many encounters with disease causing agents that lead to spill over. Climate change is affecting the ranges that species inhabit. For example Zika carrying mosquitos are migrating farther north into North America, outside of their historical ranges. Deforestation causes species that historically inhabit jungles or forests to venture into towns and cities which brings them into contact with humans. Diseases that have historically only existed in remote parts of nature are now being exposed to heavily populated and connected villages, towns, and cities. Globalization allows these diseases to spread more rapidly and infect a larger amount of people. Battling diseases that traditionally would kill 90% of a village and then fail to spread anymore in a globalized world poses a serious challenge to health agencies around the globe. Today, early detection, and exhaustive efforts by healthcare workers to prevent the spread of infectious disease is becoming the most important factor in the fight against the next global pandemic.

In the United States HIV/AIDS has long been associated with homosexual males. At first it was believed that the disease had to do with the homosexual lifestyle, which led some to believe that it was a punishment for moral sins. The Reagan administration did little to assuage citizens fears, neglecting to educate the public which led to societal stigmatization of those with AIDS. Hemophiliac children who carried HIV where forced to leave school by protesting parents.

The disease originated in the jungles of Central Arica as SIV. The disease mutated from SIV to HIV most likely through contact while hunters butchered a chimpanzee sometime in the 1930’s. It is believed that the disease may have been spread during widespread Pox vaccinations that would inoculate many individuals with the same needle. The first confirmed death from AIDS was determined to happen in the Congo in 1959. From Africa the disease spread to Europe and then the rest of the world either by African immigrants carrying HIV or by Europeans working in Africa that carried HIV when they returned home. The disease remained a mystery until the summer of 1983 when the virus was finally isolated. At the time it was believed that a vaccine could be found within 2 years.

Since there was no cure and little public understanding of the disease HIV patients where stigmatized by the public and shunned by their family and friends. Slowly through public education the stigma has been reduced and more individuals have voluntarily received testing for the disease. Even today however an estimated 14.5% of individuals who carry the virus do so unknowingly, a group that causes 40% of new infections annually.

https://aidsaction.net/aa/aa33.html

Cholera is a disease that causes severe dehydration that can result in death within 24 hours. The disease is known as “King Cholera” because it affects all social classes. Usually spread by infected drinking water the disease can rapidly affect entire villages, or neighborhoods as all that consume the contaminated water can become infected. The disease is a gram negative bacteria that looks like a comma under a microscope. Cholera exists naturally in fresh water and is salt tolerant as well.

Typically those who are infected experience muscle cramps with diarrhea and vomiting. Patients lose water and electrolytes which may result in shock. Their stool is a rice water color that flows almost continuously from the patient. This disease is especially prevalent in sub saharan Africa and South Asia. Of the 200 different strains of V. cholorae, 2 are known to produce the enterotoxin that affects cells of the small intestine and causes cholera.

Historically there have been 7 cholera pandemics. Cholera spread from Calcutta to the rest of India aboard British vessels shortly after Great Britain colonized the nation. Then the disease spread along trade routes to China, Japan, the Philippines, Africa, and Russia. After the first Pandemic had died down a second emerged which spread to Europe, and from Europe to the America’s on board ships carrying Irish Immigrants.

Because of these outbreaks cities have become cleaner and society has learned the importance of proper sanitation. John Snow along with the help of Henry Whitehead discovered that communities that drank out of less polluted wells experienced lower rates of Cholera, and where able to convince city officials to remove the handles of contaminated water pumps. Today Cholera outbreaks are rare in Western cities because sewage and waste water treatment facilities clean water before it enters your household.

Today Cholera outbreaks still persist in Haiti and Yemen due to their lack of sanitation. Cholera was likely brought to Haiti by U.N. workers experiencing mild symptoms of the El Tor strain. There is no sewage in Haiti and many people openly dedicate, allowing for the contamination of water supplies and the transmission of cholera on flies.

https://msu.edu/~williss2/carpentier/part2/cholera.html

The Irish Potato Famine was caused by a strain of fungus called P. infestans HERB-1. This fungus spread up from Mexico to Mediterranean Europe to Ireland. From 1845-1852 the Irish potato crop was decimated. In 1846 three quarters of the crop was destroyed by this blight. After this especially horrid year seed potatoes where scarce so it took several years for the crop to return to former yields, especially as the fungus P. infestans did not go away until the 1970’s. The potato famine would lead many in Ireland to immigrate to the United States aboard “coffin ships” where TB, life in the slums and the Civil War awaited them.

In the 1840’s and 1850’s Ireland was forced to trade all produce with Great Britain. Because of the poor soil and poor economic conditions many of the Irish where dependent on the potato harvest to support their families. When the potato famine struck many where forced to work in Workhouses to pay off their debts.

The Irish ate potatoes for almost every meal at the time. Loss of this crop led to wide spread malnourishment which caused a number of health concerns, as well as weakened the malnourished immune systems. TB, measles, diarrhea, respiratory conditions, and cholera plagued the Irish as this famine went on. To make matters worse British health officials sent to remedy the solution encouraged the Irish to bake away the rot on the potatoes, or to make them into soups to consume the rancid food. This only led to more disease among the Irish.

Today the HERB-1 strain has gone extinct but has been replaced by the US-1 strain. Farmers in Ireland must spray their crops 12 times a year to prevent growths of P. infestans from destroying crop yields. Research is underway and a new strain of potato has recently been approved by the FDA that has been genetically modified to be resistant to the US-1 strain.

Tuberculosis (TB) is a strain of bacteria that is transmitted from individual to individual through the air. The disease is spread when infected individuals cough, sneeze, talks, or even sings. Spores travel through the air and cause latent infections in individuals who breath in the spores. A latent infection is an infection in which TB is not active, instead is still dormant. Individuals with a latent infection are still treated for TB to prevent the disease from becoming active. If the disease becomes active an individual will experience symptoms such as feelings of sickness or weakness, weight loss, fever, and night sweats. When the lungs become infected symptoms include coughing, chest pain, and the coughing up of blood. When the disease becomes active patients are capable of spreading the disease. The disease is treated by taking multiple drugs for 6 to 12 months. If a patient does not finish their drug regimen then it is possible that the TB inside of them will develop an immunity to the medication.

Historically TB has affected the poor, especially those living in slums, the most. Places where individuals share close proximity or tight living quarters are perfect for spreading the disease. The disease originated in Europe in the 17th century, but grew to epidemic proportions in the 18th and 19th centuries as overcrowded European and colonial cities where perfect for the spread of the disease. Many immigrants coming to the United States in the 1850’s where susceptible to the disease in the day working in sweatshops, and then could spread the disease in their homes as most lived in windowless slums. Many were removed from their homes to live in sanitariums where they would not spread the disease to their families.

Today TB still exists despite the discovery and developments in antibiotics. The HIV/AIDS epidemic as well as malnutrition and poverty give the disease a population to strike. HIV, and malnutrition weaken individuals immune systems and poverty leads to close living spaces. Although it is rare in Western nations TB is still a danger in many 3rd world countries.

When the conquistadors came to conquer the New World they came with a weapon unknown to the Aztecs, smallpox. In their initial invasion the conquistadors were badly beaten by the heavily militaristic Aztecs. After regrouping, months later on their second attack the conquistadors found a civilization devastated by disease. Dead bodies laid in the streets and the Aztecs could mount no defense to the Spanish invasion. An estimated 90% of the population of the Americas succumbed to the disease. After smallpox had brought this devastation to the New World the Spanish, and other European nations were able to conquer and colonize the American Indian Civilizations.

Despite being able to conquer the New World, the Europeans found that they had a very small, and inefficient work force as the American Indians they had enslaved succumbed to European diseases they were not immune to. To find laborers to harvest the natural resources from the colonies the Europeans turned to the West African slave trade. West and North African slaves had already been exposed to European diseases and did not succumb to infection the same way that the American Indians did and were a more economically viable source of labor to power the North Atlantic triangle trade.

Not only was smallpox spread by accident to the natives, it was also used as a means of biological warfare. In North America the British army traded smallpox infected rags with Native American tribes as a way to kill their warriors without having to engage them in combat. This tactic was both effective as it was far reaching as smallpox and other European diseases spread across the American continent decimating Native American populations even before settlers had moved west.

There is a dark yet repeated history of health officials infecting uninformed patients, or denying them care for the advancement of scientific knowledge. The first “vaccine” for small pox was created after a poor mans daughter was forcibly infected by the pox. The men of the Tuskegee study were subjected to false medical attention in order for researchers to research syphilis. Prison inmates and members of the military have also been subjected to infectious disease or experimental drugs without their knowledge or full understanding. These abuses of power by medical professionals serve to better the understanding of scientists so that they can go on to better understand, develop cures, and eventually cure patients from disease. However, their unethical practices have led some to fear medical professionals.

The men of the Tuskegee study were black males living in Alabama that had contracted syphilis. The U.S. government sent healthcare workers to study their infections believing that blacks carried a different strain of syphilis and that they would not succumb to its symptoms. After learning this was not true the researchers discovered that in order to keep white populations which they cared about, free from syphilis they must also keep black populations healthy. For 40 years a group of 400 men infected with syphilis were told they were receiving treatment while they in fact were given placebos. Many of the men died none were told that they were all participants in a racially based study, that was not meant to cure, or even help them.

It is believed that men of Attica Prison in NY were infected with polio in an experiment without prior understanding of the disease and what they were agreeing to undergo. Furthermore the other inmates and guards of the prison would have also been exposed to polio. Experiments like this have led many to distrust medical professionals and some now avoid receiving treatment from genuine medical professionals who follow appropriate medial ethics.