The plague wiped out up to an estimated amount of 60% of the entire European population. The plague was one of the worst catastrophes known to mankind and unfortunately science had not developed enough to stop it from occurring or progressing. As with almost all epidemics societal factors played a large role in the spread and continuation of the plague, but the societal factors that contributed to the spread of the plague in medieval times differed greatly compared to today’s. As displayed in the film people who became sick were taken care of by their family members and they did not use protective gear whatsoever, so many caretakers were infected. The way societies in medieval times handled food also was a huge factor, people handled food with their bare hands. One factor that contributed to the virulence of the plague was that many people were already sick or had weakened immune systems from the conditions that they lived everyday life in, making the plague much more deadly. Each society handled the way they dealt with the plague differently, for example, in Germany Jewish people were persecuted and burnt at the stake because people needed something (someone) to blame, of course this did nothing to stop the plague, it just escalated the spread of disease. A reasonable action that societies took to decrease the severity of the plague was that they stopped throwing bodies into mass graves, but instead made it mandatory that bodies be sealed in wooden boxes. Another action that not as many cities took was to quarantine (not let anyone in or out) their cities, but the cities that did participate in quarantine did have lower rates of death. Overall the plague took a huge toll on every society, it not only killed millions, but changed the way people viewed death and how people interacted with one another. The church was shattered in the way that people no longer really looked towards the church for answers as much as they did before the plague, people looked to other things. Economies and social orders were left in shambles due to the loss in population (work force). Although mostly negative things came out of the devastation of the plague, an increase in practical medication did occur, a move away from traditional methods to more scientific methods.

Through advancements in science we now know that plague is spread by fleas that then infect other animals (small rodents) which people come in contact with or fleas make direct contact with people. Cases in the United States generally occur because of a run in with an infected animal, generally in the mid and south west. With the improvement of knowledge of the plague we have figured out that to control the plague we can use antibiotics. Other things like disease-resistant suits and better quarantines have been made to combat the transmission to others. However, these measures seem to not have been fully utilized in some places like Madagascar. In Madagascar poverty and poor sanitation is the norm and children play in essentially “toxic garbage”. Children have been seen playing with dead animals which could carry the plague, also feces and other vectors of transmission are scattered throughout the streets. Another big problem that health authorities came across in Madagascar was that people would steal their relative’s dead bodies from hospital grounds to bury them themselves and would not use protective gear, so the plague would spread to families.

Help Received: The film, articles, CDC website

To understand the importance of zoonotic diseases and emerging/re-emerging diseases one must understand the definition of the terms. Zoonotic diseases “are caused by infections that are shared between animals and people” according to the CDC. “Emerging infectious diseases are those whose incidence in humans has increased in the past 2 decades or threaten to increase in the near future” as defined by the CDC. Re-emerging diseases are diseases that keep popping back up after it was thought that they were eliminated. An example of a zoonotic disease in history was that of the “black plague” or the bubonic plague. It was passed from pest (rats etc.) to person and killed an estimated 75 million people in a world of only about 350 million people, so it is clear to see how important/significant it is to stop or control the outbreak of these diseases. An example of an emerging/re-emerging disease is Nipah virus, Nipah virus persists to this day and seems to be difficult to control. It is especially deadly in more impoverished nations due to poor health care systems, around 3/4 of people who contract it die. It is important to monitor these diseases, so we can mitigate the effects they have on the world. An interesting social/cultural issue associated with the disease Ebola is that many parts of Africa are still uneducated on how to prevent/avoid Ebola and/or many people prefer “eastern” practices to treat/prevent Ebola. Many of the practices that are performed are not entirely grounded in science, so it is important that more privileged nations help with the transference of education on the topic of Ebola and other diseases in Africa.

With the increase of industrialization/globalization throughout most of the world it has made diseases much more easily transmissible due to things like airplanes, public transportation, and major cities to say the least. These different factors have made responding to new epidemics very difficult and increasingly more confusing/harder to figure out. Also, the concept of “outbreak culture” has not made it any easier to treat epidemics. Outbreak culture is defined in the book as “a collective mindset that develops among responders and communities in the initial response to disease outbreaks which can inhibit initial action and worsen the severity of an epidemic”. It is important that we change this toxic outbreak culture to more of a “collective mindset” where it can promote honesty and transparency because if we can change it, it will benefit the people that live in impoverished nations greatly by reducing deaths and overall increasing life expectancy in those nations.

On the topic of pandemic readiness, we are prepared for the next pandemic, but not entirely prepared as we could be. Many advances in science have increased preparedness for pandemic such as vaccines, anti-viral drugs, and global surveillance systems. Although we have the previously mentioned advancements, to be effective we need to develop more broadly effective tools to prevent and treat diseases, also we need to increase the surveillance of viruses in animals aka zoonotic diseases.

Help Received: https://healthjournalism.org/blog/2018/10/how-outbreak-culture-can-hinder-infection-control/ CDC website, Powerpoint slides, Articles provided in class

To discuss the affects that culture/society has had on the appearance of plagues throughout history one must first understand how humans have developed (societal wise) from the start up to this point in time. Humans first began as what is know as hunter gatherers, as in they had to hunt and gather their food to survive. They had to move from location to location to find food and water, so they never stayed in one place for too long. The population groups in hunter gatherers societies were also small, so diseases were not as easily spread. Since they moved around constantly they did not accumulate feces and rotting meats as much as humans began to do once they discovered agriculture and animal domestication. Once humans began to plant food and domesticate animals the need to roam was eliminated, they could stay in one place and build up a population and all of the other negative consequences that came with it. Some of those negative consequences were that humans and animals lived together and shared the same water supply, the deterioration of human diet due to concentration on growing and eating a single crop, and poor living conditions lead to rats and other pesky insects/animals passing pathogens. Animal domestication was an entire problem itself because the waste that animals produced piled up creating a breeding ground for different diseases, also the waste attracted other disease carrying pests like rats. An environmental factor that was imposed by society that lead to increase disease transmission rates was the clearing of forests for the planting of crops because it created new ecological niches for insects and rodents. An example in history of a disease spreading because of the domestication of animals was the Nipah virus in 1998. Bats spread the disease to pigs then to humans because of the close contact they had with civilization which would be less likely if the pigs were not kept in close contact with one another.

As with today we face similar, but also differing challenges in the realm of economics, politcs, and climate change on health. With respects to globalization which includes economics, politics, and climate change, many things have changed since the hunter gatherer age. Demographics have changed dramatically including population growth, urbanization, aging, increased mobility, and family structures. An example of dramatic population growth can be seen in large cities such as New York city, having such a dense population in one are can make it easier for crowd diseases to spread like influenza (as it did in 1918). Economic activity has also changed resulting in increased trade and capital mobility. The establishment of free flowing trade and capital can make it easy for pathogens to spread person to person. Environmental issues that people have accelerated have also started to play a large part in the ease of infection due to the degradation of land and water, depletion of resources, and ecosystem disturbances. An example of a disease that is transmissible through dirty water would be cholera. Most importantly would be the issue of climate change and how globalization has essentially sped up the process. The interaction between the two can lead to poor air quality and water quality leading to more campylobacter infection, cholera, cryptosporidiosis, harmful algae blooms, and leptospirosis. Overall globalization leads to a spreading of infectious diseases more easily, while climate change exasperates the issue.

Help Received: The articles and PowerPoint slides