Smallpox is a great microcosm of human interaction with diseases. We see real treatments being developed, a systematic approach to dealing with the disease, and even understanding how it spreads enough to use it as a weapon, as well as understanding of building up an immunity.

The understanding of how immunity is developed without knowing what is causing it or anything about germ theory is impressive. Slaves from Africa were brought over and were sought after because they had already had smallpox and survived. They knew that once someone was infected they had an immunity to it. So, if you buy a slave that lived through it already, you don’t have to worry about your investment dying later from smallpox. The Chinese also started insufflation in the early 1500s in where the infectious scabs were inhaled through the nose. Later the practice was perfected with vaccination in where a bifurcated needle was used to make a prick of the skin and develop a cow pox strain. This would cause a localized infection that had a higher survival rate and was invented by Edward Jenner in 1796.

Compulsory vaccination and surveillance and containment were used to completely eradicate the disease in 1980. While some people did die from the vaccination and everyone who received it had a small localized infection that might end up scarring, it was warranted due to the estimated 300 million people who died from this disease and being able to get rid of something so deadly is worth the side effects of the vaccine. To truly eradicate the disease in India, with its high population, it was going to be impossible to vaccinate everyone for smallpox, so instead what they did is surveyed the areas for active cases. They offered bounties for anyone to tell them who is infected, and then the World Health Organization vaccinated everyone in the immediate area of the person infected. With this strategy the disease was able to be contained and eventually eliminated.

The potato is nutrient packed enough to sustain life with a few added supplements. The Irish at the time would live off potatoes and dairy products derived from milk. They relied on the potato to the point where it was their main source of food. The type of potato that they were eating was a GMO where the Mexican potato and Irish potato were crossbred to create a potato that was larger and produced a greater yield. However, one side effect was that it became susceptible to a blight which destroyed the leaves and tubules of the potato plant killing it and making the potatoes growing inedible. Since potatoes were the main food source of Ireland at the time, many people starved, and the Irish potato famine ended up killing over one million people. The British were dicks at the time and didn’t do anything to help the Irish out with the famine and just let them die, kind of like a natural genocide.

While this is definitely a bad mark on GMO’s in general, it really says a lot more about being dependent upon only one food source. GMO’s are everywhere and most people don’t know what corn used to look like before it was selectively bred to create what we eat today. Without GMO’s we wouldn’t be able to sustain and feed our current population. GMO’s however aren’t perfect because the genome of anything is a lot more complicated than big potato + big potato = bigger potato like with the Irish potato. They were breeding for size and yield, which they got, but they also bread out a resistance to the blight that they used to have. So, while I believe GMO’s are essential to feed todays population, it is also important to be careful with them. Making sure to understand the traits of the strain before implementing them fully or depending upon them, because things can and will go wrong that is hard to impossible to determine in lab tests. The side effects could be anywhere from extinction of a species, a new crop disease, or having a negative impact on the environment.

TB is relatively simple to cure today with modern treatment. However, after people have stopped taking the treatment mid-way through, it has given rise to new forms of TB such as XDR or MDR TB where the resistance is a lot higher and the treatment becomes a lot more intensive. Immunosuppressive diseases such as HIV have been introduced recently that increase the spread of the disease. Even with HIV one of the biggest factors to TB thriving even today is living conditions. In first world countries there is small risk of being infected with TB unless you are immunosuppressed such as a small child, someone undergoing chemotherapy, or someone infected with HIV. That’s mostly because we have good basic hygiene as well as enough room to get away from somebody who is sick and coughing to avoid the aerial spread of the disease. However, when we were learning about the outbreak of TB in Swaziland there was also a epidemic of HIV going through the area as well as everyone lived in small homes and usually in the same room as everybody else in their family. Most of the people we saw in the video “The Silent Killer” were infected by their own family from close contact with them. Swaziland also has barriers, societal and physical, in place that prevent people from getting proper treatment. TB and HIV both have a stigma surrounding them making people not want to come forward and get treated or let other people know about it, so some people try to hide it and continue working, spreading the disease even more. Getting treatment is also difficult because the treatment centers are far away, and you need to stay there until your treatment is complete or you become no longer contagious because treatment for TB is monitored. This means that you are separated from your family for a very prolonged period. About 6 months for MDR and up to 2 years for XDR.

The Black Plague occurred during the budding of modern culture, where world trade, large cities, and large agricultural farms are just starting. The black plague came over from East Asia due to the increased interaction between Europe and Asia through war and trade. It was able to stay and prosper in Europe for centuries due to crowded cities which provided multiple hosts, and a lack of sanitation where waste disposal was an issue. The Black Plague likely rose up in Asia from a zoonotic disease. Because of the increased human interaction with domesticated animals, the zoonotic disease was able to transfer over to humans and infect them.

Once the Black Plague made it into Europe, there wasn’t much helping citizens from becoming infected since germ theory wasn’t around yet and what was around was about balance of the four elements of the body and miasmas. Because of the lack of understanding of the disease, medical treatment didn’t do anything to help and sometimes would just make it even worse. So, without being able to go to doctors or science, many turned to religion for help or an explanation. Many also turned away from religion, mostly the catholic church and sought their own answers, either by establishing their own private church or by becoming a flagellate. Flagellates during the black plague probably made it a lot worse as they did many of the things we know not to do during an epidemic because it could spread the disease. They would travel from town to town and interact with the people, sometimes having sex while there. They would also whip themselves and cause self-harm which was bad because the plague could be spread through blood contact. Not only were the flagellates possible carriers of the plague, their radical and extreme antics caused widespread panic throughout Europe making the people lash out and lynch and burn Jews, which they blamed to be the cause of the plague.

The most interesting part for me about the Black Plague is what happens in the aftermath. For the lower class, although they were hit the hardest by the plague, they benefited greatly from the aftermath because the population was so low that they had a deficit of manual labor, making their living wages increase and they were able to buy their own land and food was much more plentiful because there was less mouths to feed. For the upper class however, while they weren’t heavily impacted because they could move away from plague infected areas and seal themselves away, after the plague they lost their cheap labor force to run the castles and farms. Some nobles even had to work their own land to survive because the old workers could afford to move away.  This also meant that there was in increase in war and fighting as the nobles were trying to maintain their power.

The knowledge of germ theory today makes a widespread plague a lot harder to occur unless its hard to detect or has a high drug resistance. Even though we have basically the perfect set up for a pandemic to occur with fast global transport and a high population density, the understanding of what germs are and how they are spread means that we have a lot of safe guards in place to try and stop pandemics from occurring. We also have Vaccines for many of the diseases that are around today such as small pox, polio, mumps, and measles. In developed countries where most of the population has these vaccines the country has heard immunity where there aren’t enough viable hosts for a disease to survive and spread. However in undeveloped countries with poor healthcare is where we still see epidemics occurring such as the bubonic plague still in Madagascar or Polio surviving in India, the Middle East, and parts of Africa. A lot of this has just as much to do with education in these areas as poor healthcare. In Madagascar where the bubonic plague is still occurring you have people interacting with the dead and stealing their infected bodies to talk to. You also have eating of animals (bush meat) which have died from the plague or natural causes and then they get it from that. And they also have a lot of people living in basically a junk yard that is full of trash and dead bodies with very low hygiene practices.

The development of cities, homes, and farms and other permanent settlements allowed the human population to increase and advance to where it is today. However, that is not without a price. As population density increases sanitation problems rise. Waste management has always been a problem of society. With fecal matter in the streets fecal borne pathogens can be easily spread. Another thing about population density is that a pathogen doesn’t need to travel as far to keep infecting new hosts. Additionally, as we become more sedentary, we also become more mobile as well by trading across long distances. This is how the Black Death was theorized to spread. Traveling from China to Europe along the silk road, the plague was able to travel hundreds of miles where as before people developed cities, such a migration was impossible. Also, as we domesticated and raised more species and in greater quantity our interaction with animals increased allowing zoonotic diseases to more easily spread to humans. This new contact with animals along with increased population density meant that diseases had more chances of developing a mutation that allows it to jump to humans or increases the severity of it. Normally when this would happen when we were hunter gatherers the mutation would die out since it would run out of hosts, but cities and towns provide it a path to expand and travel and thrive.