The Relationship Between Epidemics and Society – Monitoring the Wellbeing of the Earth

Through even the most basic research, the relationship between epidemics and societies is an easy one to see. There’s almost a sort of ongoing battle between the two, with a different winner every week. Because of this phenomena, there will never be a single winner (or so we hope). Throughout history, diseases have been constant. They have evolved as we have evolved, changed as we’ve changed, and even mutated themselves to remain as strong as ever. In one form or another, diseases have always been with us. We try to change or get rid of them, while simultaneously, they are coming up with new ways to do the same to us humans.

Throughout history, man has learned and invented ways to make Earth most beneficial to us. Selfishly acting, he or she has often thought not of the repercussions or consequences of his or her choices. We see this time and time again – almost like we’ll never learn all that we should from our lessons. In man’s first years on Earth, we tended to live as hunter-gatherers, widely spread out and continuously moving from one location to the next. Because of this, no disease could spread past a single civilization. However, when man drifted away from the lifestyle of constant motion, the emergence of diseases and plagues began to show up. Denser populations and societies, the building of cities and civilizations, the domestication of animals, and agriculture aided the emergence and spread of crowd diseases, including TB, malaria, cholera, influence, and small pox. Many of these diseases sprung from close contact and interaction with many animals. Urbanization has provided perfect pockets for growth and development of disease; this problem has drifted from man’s first settlements to today’s daily destruction of land and wildlife. Because we continue to encroach on lands that we do not “yet” belong on, the chance of new, lethal emergences of diseases becomes more likely with every step farther.

Travelers have served as a great mode of transportation around the world for microbes. Globalization, especially in recent times, has allowed for diseases to become pandemic in no more than a couple of hours. Different parts of the world are exposed to different organisms in their everyday life, leading to different levels of immunity towards a specific disease depending on where geographically one stands (Artifact 1).

The cause of diseases has struck many as a mystery throughout history. Many populations believed sickness to be a punishment from God(s) onto the people. This way of thinking led to scapegoating groups of people (e.g. Jewish population, the “immoral” population, the different population). Thinking like this has allowed disease to strike and wipeout as much of half of a continent’s population. Specifically, the Plague, originated in China and quickly spread throughout all of Europe, with the actual cause and legitimate treatments unknown at the time. We now are aware that this lethal disease was due to gram negative bacillus Yersinia pestis.

In comparing the then and the now with respect to this disease and its gram negative bacteria, the virulence of the bacteria has not changed much. However, our ways of dealing and coping with the disease has changed. We now resort to immediate medical attention, though fear and social distancing from the infected and supposed causing agent remain. (Artifact 2). In modern years, we can look at how people with HIV or AIDs are treated with respect to the stigmatism that accompanies the disease. The cause of the disease, of course, at first was unknown. However, many jumped to conclusions of labeling it a “Gay Man’s Disease,” and this label, along with other negative connotations paired with the disease, stuck for a very long time.

Fear raised through the public, and the government did practically nothing to calm the people. Attitudes of prejudice and denial flew high, and distribution of information about the disease was not spread in a timely fashion. In comparison to how people of old Europe felt about the affects on people with the Bubonic Plague as a punishment, the process of thinking towards this disease was not terribly different. Bumper stickers such as “AIDS – it’s killing all the right people” became popular, and people were reluctant to help those who they viewed to have brought the disease upon themselves. While this argument could remain somewhat valid in debate, it’s no excuse to not offer any sort of help, assistance or aid. This situation shows the importance of education and awareness among populations about diseases. Because man was scared and mislead, we were not able to deal with the circumstances as quickly and effectively as possible. When information about the disease was disseminated to the public, much of the tension disappeared. People with the disease had been exiled from school or work and mistreated, while people without the disease were too worried about catching the disease. Knowing how diseases are spread and effective preventative measures could have aided this entire situation, for the curing of the disease and wellbeing of both the public and individuals (Artifact 8 and 2).

This however, brings up another point that was a strong topic in this course: the ethics of dealing with infectious diseases. Some argue, as the people discussed above did, that interfering with diseases interferes with God’s plan. Others may argue that preventative measures are just a hoax from the government to get more money from its people. Ways and methods of testing drugs, antibiotics, and vaccines also pose moral and ethic debate. In testing human subjects, though seemingly painfully obvious, it is now required that no intentional human harm be conducted and for subjects to be fully aware of what risks they might be taking by trying to get involved or help advance medical research. The Tuskegee Syphilis Study proved that rules like these be put in place (Artifact 3).

Because of experiments like this, different political views, or events in history, the public may lose trust in the government. This happened with the victims of HIV, as well as Syphilis, and other cases as well. Trust in the government is essential, but it’s a two-way street. It is up to the government to earn the respect from its people; it’s human nature to question or be curious. Government officials and health care operators need to be careful of everything they do and say in order to promote a healthier, stronger society.

It is up to the people of the public as well as government officials to stay up to date and aware of how we interact with our environment, any changes being made, either by us, different disease pathogens, or in climate, and to seek out preventative measures to restrict the growth of diseases within our populations. It is important for the educated to become the educators in these situations – to promote getting vaccinated for the good of an entire community, not just protection of one-self. When it comes to diseases and their spread, we cannot be selfish. Our actions should be for the population as a whole, because whether we realize that or not, an outbreak with probably end up affecting us personally in one way or another. Ignorance and carelessness will lead to outbreaks and re-emergences, as it has been proven time and time again. Modern societies should to remain alert to promote the healthiest, strongest Earth, with peace among its inhabitants.

Help received: artifacts

AIDS has been noted as one of the most controversial pandemics in history. Originating from primates, this virus, also known as HIV, or human immunodeficiency virus, spreads through sexual contact or contact with infected blood. For months, the sickness is basically asymptomatic, giving the carrier the opportunity to spread the pathogen through either blood donations, sharing needles (i.e. injecting drugs), or having sex, completely unaware of the harm he or she is spreading. This virus causes immune deficiencies that can lead to lethal cases of certain diseases such as pneumonia. As the film in class described, the virus almost acts like a creature with “nine head” whereas when you cut off one head, the virus continues to operate. It is able to destroy the immune system and multiply within its host as it is about 150 times smaller than that of the white blood cell it attacks.

The virus was labeled as a “new unexplained disease in gay men” but was soon discovered to affect more than just the population of gay men. Drug users were vulnerable, especially with the sharing of needles and syringes, as well as individuals giving or receiving blood transfusions, because the virus was not widely known when it first began to spread. The disease instilled fear and questions of moral, along with a huge shield of deniability.

Reagan was especially distant from the seriousness of the disease. People of the communities most vulnerable to the disease had trouble trusting the CDC government organization because of their mistrust of the government itself. HIV is one of the most political diseases in history; activists fighting for attention from government officials and medical professions were literally fighting for their lives. Reagan’s secretary commented, “I really don’t think another dollar would make a difference… [HIV is] not a problem money could solve.” Reagan and his team cut funding and budgets to all government involvement, including the CDC, which lead to no money for traveling.

Bumper stickers such as “AIDS- it’s killing all the right people” and thoughts about people’s own tax dollars going to help those affected by aids became popular among the conservative, republican population of America. They saw it as a way of God intentionally wiping out sinners. Reagan, specifically, turned his head away from and practically ignored the situation.

However, the death of the first famous person from AIDS, Rock Hudson, led to more of a national consciousness of the disease. It could officially no longer be ignored or denied. People were frightened and ignorant; people began wearing rubber gloves everywhere because they didn’t understand how the disease was spread. The government and health organizations did not distribute information or education about the disease at first. People with AIDS or HIV were labeled, judged, mistreated, and even exiled from their schools and work. Information should have been spread sooner about how the disease was spread (not by casual contact).

HIV affects everyone from baby newborns to grown men and women. It became the job of families and friends of those affected, as well as officials, to fight the prejudice of the disease. Drugs to aid the symptoms and knowing one’s personal status, as well as a sense of hope, will help society concur the sickness. Challenges of prejudice and denial still exist among some people within the United States, but attitudes have improved. Awareness has limited the ability of the organism to drastically spread further and further within the US.

Help received: class notes from film

Zoonotic infections are diseases that originate from animals and are able to jump from species to species. As the human race continues to evolve and expand, we make ourselves more vulnerable to both new and old diseases and infections. “Spillover” refers to our continuous increase in exposure to these hidden diseases as we explore and expose ourselves to new places, especially places when humans are not traditionally found in or used to.

Examples of emerging infectious diseases that we have been exposed to via exposure/ interactions with animals include Zika, Ebola, Chikungunya, Marburg virus, HIV, and influenza. Not all zoonotic diseases are infectious. The film watched in class focused specifically on Zika and Ebola virus.

Zika is transmitted by mosquitoes and spread by sex and blood transfusions. It first emerged around the 1950s in Africa and symptoms can be mild or even nonexistent. Zika leads to birth defects in babies, specifically microcephalin, poor brain development, triangular faces, and no foreheads. As Darwin theorized, species survive best when they begin to diversity populations. Ebola is transmitted by bats. Bats contain antibodies against Ebola in their blood, serving as a perfect natural living reservoir and host for the virus. In its early days in Central Africa, it would not cause huge damage, as the societies were isolated from each other. However, in West Africa, it spread quickly through the densely packed, connected civilizations. This disease spreads from person to person, contact with body fluids, and dead bodies. It is described to be “spread through love… when people realize they can’t care for their loved ones, that’s how the disease slows down” (film in class). Cases could be tracked to bats eating or urinating on fruits consumed by the people, or consuming infected animals themselves.

As humans keep exploring and expanding, there is little to be done about the zoonotic “spillover” infectious diseases, except to be aware and knowledgeable about the past and the present. We become more and more vulnerable as we continue to encroach on new places. It’s human nature to continue to want to expand and proceed with the search for more than what we have – we’ll never be content. For these reasons, we are more vulnerable now than ever; it is important for us to be aware of the potential consequences and to be ready to combat any pathogen thrown on our path before it becomes out of control.

Help received: in class worksheet, notes, film in class

“…tuberculosis is not only an infectious disease but a societal one as well…in order for ‘the people’s plague’ to be eradicated, the subtle interplay between disease and society must be fully appreciated. Until that time, TB remains a disease that could re-emerge to threaten us once again.”

Tuberculosis (TB) was identified by Robert Koch. TB’s causative agent is the pathogenic bacterium Mycobacterium tuberculosis, which is neither gram negative nor positive. Acid-fast staining is required for identification. Throughout its history, it has had effects on aspects of society from fear of disease, to how society plans or maps cities, and even to one’s clothing style and fashion. In the 1850s, large cities such as Philadelphia, Boston, and New York City, became more and more crowded as immigrants came over looking for work. This promoted crowded tenements and living areas, poor working conditions, and poor air ventilation. This allowed TB to spread quickly. Lack of sunlight and hygienic practices allowed the pathogen to grow and spread. As the disease became more and more of a threat, people stopped wearing as much clothing in hopes that they wouldn’t pick up and drag the disease back to their homes: women, especially, stopped wearing such long dresses.

This infectious disease, though not as much of a threat now, could come back to bite us in the butt if we are not careful. In the US, according to the CDC, about 9,287 cases were identified in 2016, most being imported by immigrants (US Born: 31.6%). Globally, about one-third of the world is infected, with a total of 10.4 million identified cases in 2015. In order to resolve the disease, public health education should be provided to keep communities on the watch and aware. Identified cases can be treated, but only if identified soon enough and properly treated. As we evolve and change, so does bacteria. As we constantly search for and find new ways of treatment, the causative agent Mycobacterium tuberculosis is constantly working to become resistant to the antibiotics or treatments. The battle should not be given up by either side, meaning that we cannot turn our heads to it as it might become less and less of a problem to today’s communities. We need to work on keeping the public up to date on what to be looking for and make suggestions on practices of prevention, including the promotion of good hygiene and lifestyle choices. If given the opportunity, TB could grow and become a disease that could re-emerge to threaten us and our societies again.

Help received: Handout worksheet, powerpoint, CDC website

Potatoes are nutritious and full of vitamins. Because of this, a person could be fine living off of solely potatoes. In the 1800s, a person in Europe might eat an average of five pounds of potatoes a day, from breakfast to dinner. It’s been noted to be the only crop “hardy enough” for a poor population to live off of. The dependence on milk and potatoes grew specifically in Ireland as the population grew from around 3.5 million to 8 million from the 1700s to around the 1840s/50s. Over two-fifths of the population were dependent on the potato crop as their only source of food. In 1845, potato fields of Dublin experienced failure. It turned out that the weather of Ireland was ideal for the growth and flourishing of an infectious fungus that ruined potato growth for years to come. As a result, the poor suffered from famine, fever, and disease. They became even more vulnerable to other diseases as they became weaker and lived with poor hygiene and lack of sanitation.

This yeast-like fungus, Phytophthora infestans, infected potatoes and their seeds for years to come, serving as the pathogen for the blight and changing the potato plantations overnight. As most farmers did not actually own the land and only tended to it to stay, the rich who owned the land were upset. The farmers, in many cases, because homeless and hungry, eventually dying of starvation. The potato blight lead to a great famine, which in turn lead to migration to the United States. Consequences resulted from this exploration as well. Foreign diseases were spread onto those who inhibited United States from across the ocean.

Evidence suggests that the pathogen, Phytophthora infestans, originated in the soils of Mexico. They were transported from Mexico to North America (United States), and over to Europe. Two strains have been identified: HERB-1 and US-1. HERB-1 infected Ireland, where, as previously stated, optimal weather was provided for the highly infectious strain. Even today, this pathogen still can affect the growth of potatoes.

To combat Phytophthora infestans, however, scientists have genetically modified the DNA of potatoes to be resistant to the pathogen. These genetically engineered potatoes have been approved by both the EPA and the FDA to ensure safety of both the environment and health. Potatoes were modified by adding genes that were resistant to the blight in order to create the overall resistance for the potato. Potential harms of genetically modified potatoes or other foods could include include less nutrients, antibiotic resistance, and an increased toxicity of the foods (ENHS).

Help received: powerpoint, class notes, film, http://bmcbiotechnol.biomedcentral.com/articles/10.1186/1472-6750-14-50, http://enhs.umn.edu/current/5103/gm/harmful.html

Smallpox has been called one of the most devastating diseases known to humanity. It spread easily and quickly, being highly contagious. One could acquire the disease from simple face to face interaction, contaminated objects, or touching infected body fluids or scabs. The disease traveled through war, exploration, and migration. It’s reported to have killed around 75% of the Aztecs, Incas, and New World Indians after European’s arrival in the Americas. Smallpx was identifiable by its small postules that would cover anywhere from one section of a limb to an entire body, and would leave crater-like scars over the skin, that is, if the individual survived.

Living during a smallpox epidemic would be absolutely terrifying. I don’t think I’d be tough to handle being around the death, the smell, the visuals of the disease, or losing friends or family to the disease. I couldn’t imagine having or seeing the pain of the rashes, blisters, scabs and bumps covering the body. The disease also causes vomiting, of blood, fever, and even loss of eye sight. Living around this would be both emotionally and physically taxing, whether a witness to or a victim of the disease. Even thinking about putting myself in this situation makes me cringe and hurt.

In the 12^th century, treatment and prevention options for the “Speckled Monster” included heat or cold therapy, leeches or bloodletting, fasting, laxatives, purgatives, and diuretics (slide 50 power point). In the late 19^th century, red light treatment was used, as the color red was believed to heal infected individuals faster. In the 18^th century, inoculation, or variolation, and vaccination began to be used as confrontation to smallpox. Treatments of “dubious nature” were mostly ineffective, as they were all just speculations and had no real target. Inoculation allowed for a target, but, because it was mostly arm-to-arm treatment, also spread contagious blood diseases amongst groups of treated patients. Inoculations were a huge step in the right direction, despite the unsanitary methods. It became a social occasion, in which wealthy would throw inoculation parties where everyone would come to be inoculated together. One better hope no one in their friend group has a blood disease though. Vaccination, however was the safest option once it was discovered by Edward Jenner in 1796. By exposing individuals to cowpox, he learned they became resistant to smallpox inoculations, confirming immunity to disease. There’s no measure of how long this immunity lasts, however.

There were many people against vaccines, especially right after its discovery. Socially, people involved with inoculations feared unemployment as vaccinations became more popular. They viewed it as inoculation’s competition. Some people were also against these vaccinations because they believed that the disease was a way to reduce the poorer population. Religious folk argued that vaccinations interfered with God’s plan for His people. People also questioned the safety of vaccinations as well as the source, because it came from an animal. Numbers support the vaccination’s effectiveness. Countries that endorsed vaccination laws had lower mortality rates, along with less incidences/outbreaks comparatively.

Smallpox was eradicated using surveillance and containment in order to find all existing cases possible in order to vaccinate the victim and prevent the disease’s spread. In addition to vaccinating the victim, those around the victim were also quickly vaccinated to promote immunity to the gruesome disease. Methods of vaccination were made easy and cheap so anyone could perform it. Difficulties encountered by the medical professionals of this time included the lack of cooperation by some individuals of the time, along with defending themselves against rumors that the vaccination could be a trick to kill specific groups of people.

Even now, many people believe that vaccinations are a jip or solely a way for medical organizations to make money. Because they haven’t experienced the disease, or seen anyone else with the specific disease for that matter, they don’t see any point in vaccinating against it. Prescription drugs, however, are most likely different to people who think like this, as prescription drugs are a way of dealing with the “here and now,” and don’t see vaccinations as a legitimate option of prevention. Certain religious groups could also have problems towards both forms of medication if they believe so much that the medication would upset their God. There is also a trust issue between many individuals and their government health organizations, prompting them to distrust the vaccination. These people fail to believe that a vaccination is more about benefiting an entire population rather than just a single individual.

help received: class notes, power point

There are many ethical issues that can rise when dealing with ways of treating or testing how to treat infectious diseases. Medical professionals must be very careful in their selection of who is tested, what is tested, and how whatever that is is tested. We have seen problems in history where certain groups of people are singled out or chosen as test-subjects because of their race, gender, religion, etc…  In many cases people seem to be chosen as test subjects because their lives were less valued than others. Along with this, many populations of specific races or religions automatically associated as the cause or carriers of certain illness, and thus were isolated, thrown into quarantine, or exiled. Medical professionals, especially today, must give and receive informed consent from all participants of any study, whether in developing countries or in established. All persons’ rights should not be infringed upon. It is up to professionals to educate and inform, but the ultimate right to partake in any vaccination or test research remains in the hand of the individual or the individual’s guardian.

According to “The Rationalization of Unethical Research: Revisionist Accounts of the Tuskegee Syphilis Study and the
New Zealand ‘Unfortunate Experiment,’” researchers of the time defended themselves by stating that there were no actual medical codes in place relating to their actions, therefore they did not violate any law of medicine. The researchers of the experiment also argued that the participants knew what other treatments were available to them. The idea of consent from the patient had not been formally addressed or written out as rules that could have been violated, so the researchers of the Tuskegee experiment justified themselves in this (e15). However, the research was unethical. The researchers had medical professionals purposefully injecting horrifying diseases into specifically African American males without their knowing. The researchers were aware that they themselves were persistently infringing harm onto others.  They should have foreseen the legislation and respected all human lives, not just the whites’ as this seemed to be a target of race and gender.

Results of this experiment, and any like it, affect people’s willingness to trust and contribute to health organizations. Participants of the research study did so voluntarily. Betrayed, and exposed, the public of anywhere at any time in history would be hesitant and relunctant to participate in any health study that could even have the potential to change the world for the better. This experiment lead to the placement of actual legislation relating to the treatment of patients and outlined ethical procedures (that should be commonly known out of respect for all persons and the will to better all of society today).

Help received: class notes, reference page (The Rationalization of Unethical Research: Revisionist Accounts of the Tuskegee Syphilis Study and the
New Zealand ‘Unfortunate Experiment’)

Three waves of the plague have been recorded throughout history: Justinian; the Black Death; and the Modern Plague. The plague is a lethal disease caused by bacteria Yersinia pestis, a gram negative bacillus. Originating in ancient China/Central Asia, the first wave of the plague quickly spread throughout all of Europe in the 14^th Century, wiping out over half of Europe’s entire population. Factors that aided the disease’s quick spread include growth and expansion of populations, global climate change, and ongoing wars of the time, along with the collapse of the Golden Age.

Symptoms of the plague, called the “Black Death” at this time, included swollen lymph nodes, called “buboes,” septic shock, organ failure, high blood pressure, coughing up blood, and welts. Three different types of plague infections exist(ed): bubonic, septicemic, and pneumonic. Bubonic involves swollen buboes; septicemic involves infection of blood streams; pneumonic, the most lethal and most contagious, involved infection of the lung(s).

The plague struck fear in history. The people thought of it as a punishment from God, and further began punishing themselves in hopes of protection against the disease. Many blames were thrown at different ideas and groups: Jews, Mongols, tainted people and prostitutes, and other religious ideologies that could have been viewed as “evil.”

These blames lead to social distancing amongst different groups, living and nonliving. The treatment of the dead became less respectful, as the highly contagious plague could be caught from a living or nonliving host. Mass burials became popular, and it was difficult to find people willing to deal with any form of close contact with the bodies. Certain groups of people, because of religion or “ungodly” practices, were thrown out of cities. The more nobles and individuals more well-off would flee cities, creating an even bigger barrier amongst classes, leaving the less fortunate to be killed by the plague. Some doctors began to stop seeing or treating patients in order to save themselves. The plague took out over half of Europe, turned people against each other, and instilled fear, ruining all social order and any economy Europe held.

The plague is still a problem today; Y. pestis has not changed its virulence (neither worse nor better). However, though the strain of bacteria is exactly the same with the same capabilities and transmission, because of modern medicine and technology, it is now identifiable enough in its early stages to be treatable. Y. pestis can be found in fleas that seek rodents as hosts. Interaction with these rodents or host other animals results in disease. When these hosts die, the fleas and bacterium find new hosts, sometimes found to be house animals, e.g. cats or dogs. This allows easy access to humans of the disease. Those with the disease are quickly hospitalized after early identification for the chance to survive. Once hospitalized, the patient is isolated and treated.

The plague in recent years has been a huge threat to Madagascar, reaching epidemic levels after 2009 due to the poor living conditions and poverty of the country. Children and elderly, along with men and women who do outdoor work, are the most susceptible to the disease because they are more likely to come into contact with the lethal bacterium. The poverty, filth, and lack of hygiene contribute to the re-emergence and the epidemic levels of the plagued reached in 2009 Madagascar.

Help received: power points, class handouts, class notes, class movie

As the world has evolved, so have those whom inhabit it. The environment directly affects living organisms and species’ way of life. Living organisms and species’ way of life and habits, in turn, also have a direct effect on the environment. In tandem, these factors, specifically the environment, the human race, and animals, can work wonders; however, if one oversteps their boundaries, negative consequences can potentially result for all three.

With time, humans have learned to try to adapt in ways that complement other factors. This being a learning experience, humans have not always known what specific risks they may or may not have been taking. With the growth of the human race on Earth also came the growth of microbial organisms and other disease-causing substances that have contributed greatly to the health and well-being of both humans and animals.

In man’s first years, we lived as hunter-gatherers, constantly on the move. Because of this, no real “plague” could form because people were spread out and always traveling from location to location. When people caught diseases, the diseases couldn’t spread too far outward because of isolation of populations, and thus died along with the individuals it took out.

The appearance of plagues can be attributed to peoples’ decision to settle down in towns, villages, and population. Some main factors that contributed to explosion of plagues include the denser, increase in population that was supported by settling down, domestication of animals, the making of tools, and agriculture. Crowd diseases or plagues such as TB, malaria, cholera, influenza, and small pox spread quickly throughout the newly-denser population, particularly from such close contact with animals. About 75% of emerging diseases are zoonotic (class notes). Clearing of forests, killing off keystone species, and killing off game species also have tremendous affects on environments, providing water pockets perfect for breeding of disease (e.g. mosquitoes in small water pockets). These problems are still prevalent today; however, because we are more advanced in technology for health and medicine and aware of causes and symptoms, the disease’s casualties are not nearly as significant as they have been throughout history.

Globalization served as a perfect breeding ground for microbes. As we move around, we also are carrying germs and diseases with us. By traveling from one side of the globe to the other via plane, these germs can cause world-wide risks in a matter of hours. Globalization lead to the spread of, as well as exposure to, many infectious diseases worldwide. Another risk factor to infectious diseases is climate change, by damaging ecosystems or affecting microbial organisms and bacteria. The dispersion of carriers or change of demographics of specific infectious diseases can have dramatic affects on populations not accustomed to exposure to certain organisms or germs.

Help received: PowerPoint “The Price of Being Sedentary,” class notes; globalization/climate change/ human health homework/ reference page