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The Greatest Killer: Smallpox in History

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... A large number of slaves transported along this route contributed to the spread of VARV strains between the continents. At the same time, extensive smallpox epidemics-especially in South America, where a significant part of the population died due to epidemics after contacts with Europeans [1,41]-contributed to the accelerated evolution of VARV and the emergence of minor alastrim strains. ...
... This is consistent with the absence of smallpox description in more ancient sources. At the same time, the first reliable description of smallpox referred to the Chinese manuscripts of the 4th century, in which India is named as the source of the disease [1,41]. Some researchers believe that the first descriptions of smallpox are given in the ancient Indian treatises Charaka Samhita and Sushruta Samhita, which were presumably created in the 1st-4th centuries AD [41]. ...
... At the same time, the first reliable description of smallpox referred to the Chinese manuscripts of the 4th century, in which India is named as the source of the disease [1,41]. Some researchers believe that the first descriptions of smallpox are given in the ancient Indian treatises Charaka Samhita and Sushruta Samhita, which were presumably created in the 1st-4th centuries AD [41]. Mühlemann et al. [2] showed that smallpox existed in the early 7th century AD in northern Europe (VARV VK388 from Norway). ...
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Although variola virus (VARV) has been eradicated through widespread vaccination, other orthopoxviruses pathogenic for humans circulate in nature. Recently, new orthopoxviruses, including some able to infect humans, have been found and their complete genomes have been sequenced. Questions about the orthopoxvirus mutation rate and the emergence of new threats to humankind as a result of the evolution of circulating orthopoxviruses remain open. Based on contemporary data on ancient VARV DNA and DNA of new orthopoxvirus species, an analysis of the molecular evolution of orthopoxviruses was carried out and the timescale of their emergence was estimated. It was calculated that the orthopoxviruses of the Old and New Worlds separated approximately 40,000 years ago; the recently discovered Akhmeta virus and Alaskapox virus separated from other orthopoxviruses approximately 10,000–20,000 years ago; the rest of modern orthopoxvirus species originated from 1700 to 6000 years ago, with the exception of VARV, which emerged in approximately 300 AD. Later, there was a separation of genetic variants of some orthopoxvirus species, so the monkeypox virus West African subtype originated approximately 600 years ago, and the VARV minor alastrim subtype emerged approximately 300 years ago.
... Smallpox was declared eradicated 40 years ago, in 1980 [1], after unparalleled devastation of human populations for many centuries [2,3]. Until the 19th century, smallpox is thought to have accounted for more deaths than any other single infectious disease, even plague and cholera [2][3][4][5][6][7]. ...
... Smallpox was declared eradicated 40 years ago, in 1980 [1], after unparalleled devastation of human populations for many centuries [2,3]. Until the 19th century, smallpox is thought to have accounted for more deaths than any other single infectious disease, even plague and cholera [2][3][4][5][6][7]. In the city of London, England alone, more than 320,000 people are recorded to have died from smallpox since 1664. ...
... Smallpox is an acute, highly contagious, and frequently fatal disease. The name "small-pox" was first used in England at the end of the 15th century to distinguish it from syphilis, which was known as "great-pox" ( [2], pp. [22][23][24][25][26][27][28][29]. ...
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Smallpox is unique among infectious diseases in the degree to which it devastated human populations, its long history of control interventions, and the fact that it has been successfully eradicated. Mortality from smallpox in London, England was carefully documented, weekly, for nearly 300 years, providing a rare and valuable source for the study of ecology and evolution of infectious disease. We describe and analyze smallpox mortality in London from 1664 to 1930. We digitized the weekly records published in the London Bills of Mortality (LBoM) and the Registrar General’s Weekly Returns (RGWRs). We annotated the resulting time series with a sequence of historical events that might have influenced smallpox dynamics in London. We present a spectral analysis that reveals how periodicities in reported smallpox mortality changed over decades and centuries; many of these changes in epidemic patterns are correlated with changes in control interventions and public health policies. We also examine how the seasonality of reported smallpox mortality changed from the 17th to 20th centuries in London.
... Rimoin et al. (2010) and Reynolds and Damon (2012) also discuss the use of smallpox vaccines to curtail the spread of other communicable Orthopoxvirus-associated illnesses such as monkeypox amid waning immunity against smallpox. The history of the fight against smallpox also illuminates how countermeasures led to distinctive styles of public health, to vaccination programs, (religious) anti vaccination campaigns, and increased state control (Hopkins 2002;Foege 2011;Williams 2011;Bennett 2020). Krylova and Earn (2020) as well as Davenport et al. (2018) provide evidence that changes in epidemiological patterns may be correlated with control interventions and public health policies in cities. Port cities in particular were forerunners in this regard (Mortimer 2008;Brabin 2020). ...
... Synthesising works on the history of smallpox have explained the large-scale impact of the 1870s outbreak by pointing to a combination of coincidences (Rutten 1997;Hopkins 2002). For instance, the virulence seems higher compared to earlier smallpox outbreaks. ...
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The complex relationship between the history of infectious diseases and social inequalities has recently attracted renewed attention. Smallpox has so far largely escaped this revived scholarly scrutiny, despite its century-long status as one of the deadliest and widespread of all infectious diseases. Literature has demonstrated important differences between rural and urban communities, and between cities, but has so far failed to address intra-urban disparities due to varying living conditions and disease environments. This article examines the last nationwide upsurge of smallpox in the Netherlands through the lens of Amsterdam’s 50 neighborhoods in the period 1870–72. We use a mixed methods approach combining qualitative spatial analysis and OLS regression to investigate which part of the population was affected most by this epidemic in terms of age and sex, geographic distribution across the city, and underlying sociodemographic neighborhood characteristics such as relative wealth, housing density, crude death rate, and birth rate. Our analyses reveal a significant spatial patterning of smallpox mortality that can largely be explained by the existing social environment. Lacking universal vaccination, the smallpox epidemic was not socially neutral, but laid bare some of the deep-seated social and health inequalities across the city.
... Smallpox epidemics were caused by variola virus (VARV), a human-specific member of the Orthopoxvirus (OPXV) genus of the Poxviridae, and resulted in high mortality and morbidity with survivors frequently disabled or disfigured [1][2][3]. Smallpox remains the only human infectious disease eradicated, a global accomplishment achieved through widespread coordinated vaccination [2,3]. Despite these profound public health benefits, the origins and diversity of the viruses used in the early vaccination programs remain uncertain. ...
... Smallpox epidemics were caused by variola virus (VARV), a human-specific member of the Orthopoxvirus (OPXV) genus of the Poxviridae, and resulted in high mortality and morbidity with survivors frequently disabled or disfigured [1][2][3]. Smallpox remains the only human infectious disease eradicated, a global accomplishment achieved through widespread coordinated vaccination [2,3]. Despite these profound public health benefits, the origins and diversity of the viruses used in the early vaccination programs remain uncertain. ...
Article
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Vaccination has transformed public health, most notably including the eradication of smallpox. Despite its profound historical importance, little is known of the origins and diversity of the viruses used in smallpox vaccination. Prior to the twentieth century, the method, source and origin of smallpox vaccinations remained unstandardised and opaque. We reconstruct and analyse viral vaccine genomes associated with smallpox vaccination from historical artefacts. Significantly, we recover viral molecules through non-destructive sampling of historical materials lacking signs of biological residues. We use the authenticated ancient genomes to reveal the evolutionary relationships of smallpox vaccination viruses within the poxviruses as a whole.
... Historically, Pox-like scars were firstly found on the skin of the Egyptian king Ramesses V from 1100 to 1580 Before Christ (B.C.), and it is believed that he died at 35 years due to a smallpox infection. In addition, the smallpox virus infection was also reported in the Chinese texts in 4 th Century Anno Domini (A.D.) (Fenner et al., 1988;Hopkins, 2002;Schmidt, 2007). Most poxviruses infect multiple hosts, including mammals, birds, reptiles, insects, and marsupials. ...
Article
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Poxviruses as a group have variable levels of host ranges and virulence. For example, smallpox , which is caused by the variola virus, only infects humans with fatal outcomes, whereas related viruses, such as cowpox viruses can infect multiple hosts, but only cause mild disease in humans. Recently, the monkeypox virus (MPXV) re-emerged and infected over 780 human cases in over 20 countries worldwide at the time of writing this review. It has been shown before not only monkeys play a role in the transmission of MPXV to humans, but also rodents (Cricetomys gambianus, and Graphiurus murinus) and squirrels (Heliosciurus spp, Funisciurus spp). In addition, anthropogenic actions, such as deforestation, climatic changes, animal-human interfacing, globalization, and the cessation of smallpox vaccination, could contribute to the re-emergence of MPXV. Herein, we review the current nomenclature, epidemiology, genetic diversity of poxviruses, particularly MPXV, and the control regiments, including available antivirals and vaccines. We further highlight the genetic relatedness of the emergent MPXV viruses to know viral lineage using phylogenetic analysis.
... The notion that promoting mild infections could be an effective disease control strategy has a long history. In the eighteenth century, it was common to infect children with smallpox intentionally-a process known as variolationby administering a small inoculum of smallpox virus taken from an infected person [19][20][21][22][23][24]. While SARS-CoV-2 infections are never intentional, Gandhi & Rutherford [17] refer to SARS-CoV-2 transmission via small inocula that penetrate masks as variolation. ...
Article
Face masks do not completely prevent transmission of respiratory infections, but masked individuals are likely to inhale fewer infectious particles. If smaller infectious doses tend to yield milder infections, yet ultimately induce similar levels of immunity, then masking could reduce the prevalence of severe disease even if the total number of infections is unaffected. It has been suggested that this effect of masking is analogous to the pre-vaccination practice of variolation for smallpox, whereby susceptible individuals were intentionally infected with small doses of live virus (and often acquired immunity without severe disease). We present a simple epidemiological model in which mask-induced variolation causes milder infections, potentially with lower transmission rate and/or different duration. We derive relationships between the effectiveness of mask-induced variolation and important epidemiological metrics (the basic reproduction number and initial epidemic growth rate, and the peak prevalence, attack rate and equilibrium prevalence of severe infections). We illustrate our results using parameter estimates for the original SARS-CoV-2 wild-type virus, as well as the Alpha, Delta and Omicron variants. Our results suggest that if variolation is a genuine side-effect of masking, then the importance of face masks as a tool for reducing healthcare burdens from COVID-19 may be under-appreciated.
... Secolul XVI a cunoscut pandemia de variolă a "lumii noi". Documentele acelor vremuri atestă existența virusului variolic în urmă cu cel puțin 3000 de ani, conform OMS (2020), iar anumiți cercetători atribuie chiar moartea lui Ramses V infecției cu acest virus (Fenner, 1988) (Hopkins, 2002). ...
Article
Since ancient times, mankind has faced various pandemics that through a large number of diseases and deaths have completely disrupted daily activities, being considered true natural disasters. The weapons used for their eradication varied depending on the period in which they appeared, the laboratory methods used to identify the pathological agent involved, and last but not least the therapeutic and prophylactic possibilities used. The study of past pandemics can contribute to a better understanding of the current one, both in terms of the main epidemiological factors and the application of the best possible methods to limit it. Rezumat Încă din cele mai vechi timpuri, omenirea s-a confruntat cu diferite pandemii care prin numărul mare de îmbolnăviri și decese au perturbat în totalitate activitățile zilnice, fiind considerate adevărate calamități naturale. Armele folosite pentru eradicarea lor au variat în funcție de perioada în care au apărut, de metodele de laborator folosite pentru identificarea agentului patologic implicat și nu în ultimul rând de posibilitățile terapeutice și de profilaxie folosite. Studierea pandemiilor trecute poate contribui la o mai bună înțelegere a celei din prezent, atât din punct de vedere al factorilor epidemiologici principali cât și al aplicării unor metode cât mai bune de limitare a acesteia.
... For many centuries, smallpox, or as it was called in ancient times "Black pox", BIOCHEMISTRY (Moscow) Vol. 87 No. 3 2022 caused several large scale epidemics, in which the mor tality rate reached 70% [96]. So, in the XX century small pox killed more than 300 million people [97]. ...
Article
Paleogenomics is one of the urgent and promising areas of interdisciplinary research in the today's world science. New genomic methods of ancient DNA (aDNA) analysis, such as next generation sequencing (NGS) technologies, make it possible not only to obtain detailed genetic information about historical and prehistoric human populations, but also to study individual microbial and viral pathogens and microbiomes from different ancient and historical objects. Studies of aDNA of pathogens by reconstructing their genomes have so far yielded complete sequences of the ancient pathogens that played significant role in the history of the world: Yersinia pestis (plague), Variola virus (smallpox), Vibrio cholerae (cholera), HBV (hepatitis B virus), as well as the equally important endemic human infectious agents: Mycobacterium tuberculosis (tuberculosis), Mycobacterium leprae (leprosy), and Treponema pallidum (syphilis). Genomic data from these pathogens complemented the information previously obtained by paleopathologists and allowed not only to identify pathogens from the past pandemics, but also to recognize the pathogen lineages that are now extinct, to refine chronology of the pathogen appearance in human populations, and to reconstruct evolutionary history of the pathogens that are still relevant to public health today. In this review, we describe state-of-the-art genomic research of the origins and evolution of many ancient pathogens and viruses and examine mechanisms of the emergence and spread of the ancient infections in the mankind history.
... Патогенный вирус VARV существует в двух разновидностях: Variola major, вызывающий бо лее тяжёлую клиническую форму болезни с ле тальностью 20-40%, а в некоторых эпидемияхдо 90%, и Variola minor, отличающийся низкой летальностью (1-3%) [95]. На протяжении мно гих столетий оспа, или как её называли в древ ности «Чёрная оспа», вызывала несколько круп номасштабных эпидемий, уровень смертности в которых доходил до 70% [96]. Так, уже в XX в. от оспы погибло свыше 300 млн человек [97]. ...
... The earliest substantive evidence of smallpox in Europe, the 'Plague of Antonius' epidemic, started in A.D 164 in Rome during the reign of Emperor Marcus Aurelius Antonius. It lasted for 15 years and claimed an estimated three to seven million lives [8]. Epidemics of smallpox continued to plague humankind intermittently, and in the last full century of the disease, the 20th century, an estimated 300 million people died of smallpox [9]. ...
... The viral diseases and the viruses in particular have been the centre of science, agriculture and medicine for time immemorial and some of our greatest challenges have involved the research on virus. Take the example of smallpox, it has been one of such kind of a disease that was humankind's greatest killer and has changed the course of history during the European times and it is also a kind of a disease which has been eradicated from the globe [18]. A number of minute viral infections have been prevented and controlled throughout the world with the use of vaccination and other public Health measures. ...
Article
Disasters related to infectious disease involve biological interference along with social and cultural involvement which results in a number of mortalities which can be called as an outbreak of an emerging disease that is termed as infectious. The 21st century had an unusual beginning which is experiencing severe acute respiratory syndrome pandemic and a rigorous measure of warrant and acylation that is being termed as social distancing bye professionals and practitioners. Biology history and culture combined defines humans future. An anthropologist in the present situation has a greater role to take up to understand the cultural and ecological constraints to control such pandemic. History is a treasure of evidences having hymns and clues to modify and treat various kinds of diseases which results in epidemic to Pandemic. The present paper is an initiative to understanding of history mythology spirituality social cultural and biological means to understand the present scenario the world is undergoing through related to the pandemic situation.
... Smallpox is one of the most devastating diseases known to mankind. Its deadly hold, 27 now vanished from the face of the earth thanks to a large-scale eradication campaign launched 28 by the World Health Organization (WHO) in 1967, has since become a subject of medical, 29 epidemiological and historical interest for the scientific community [1]. Ancient biological Table S1). ...
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Pluridisciplinary investigations were carried out to evaluate the prevalence of smallpox infection among the modern osteoarchaeological corpus of “La Capelette” (Marseille, France). Bone samples of a non-adult specimen yielded positive PCR results for short fragments of a degraded Variola virus genome, identical to those obtained from previous paleomicrobiological studies. https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(21)00535-8/fulltext
... I risultati comunque erano gli stessi di quelli ottenuti in Cina. Questa tecnica veniva chiamata variolazione o variolizzazione (24) . Qui comincia una storia di coraggio al femminile: Lady Mary Wortley di nobili origini sposò Eduard Montagu, che divenne prima membro del parlamento inglese e poi Ambasciatore presso l'Impero Ottomano a Istanbul. ...
Article
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In times of pandemics, it is inevitable for dissertations to revolve around epidemics and that cost efficient cure that can save most lives. Much has already been written about vaccines and much more will be published in the future. When tracing the history of vaccines, authors often begin with the Jenner’s revolutionary technique, and follow its evolution up to the present day. But one’s technique or discovery, however ingenious and innovative, does not originate from thin air. Since the dawn of days, the genus Homo had to deal with infectious and non-comunicable diseases, trying to tackle them with the cultural means that were available at any given time. “Producing the first vaccine was therefore a long and fascinating adventure of human ingenuity”. I want then to retrace this path with what archeology, molecular biology, literature and history have to offer, placing Edward Jenner’s work as the culmination of our journey KEY WORDS history of medicine; epidemics; vaccines.
... In Europe, infectious diseases were particularly common in the Middle Ages (1)(2)(3)(4)(5)(6), occasionally reaching immense proportions and wreaking havoc across the whole continent. For instance, the infamous Black Death and subsequent plague outbreaks left behind millions of dead who, due to the scale of the pandemic, were often inhumed in mass burials (7). ...
Article
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Outbreaks of infectious diseases repeatedly affected medieval Europe, leaving behind a large number of dead often inhumed in mass graves. Human remains interred in two burial pits from 14 th century CE Germany exhibited molecular evidence of Salmonella enterica Paratyphi C ( S. Paratyphi C) infection. The pathogen is responsible for paratyphoid fever, which was likely the cause of death for the buried individuals. This finding presented the unique opportunity to conduct a paratyphoid fever association study in a European population. We focused on HLA-DRB1*03:01 that is a known risk allele for enteric fever in present-day South Asians. We generated HLA profiles for 29 medieval S. Paratyphi C cases and 24 contemporaneous controls and compared these to a modern German population. The frequency of the risk allele was higher in the medieval cases (29.6%) compared to the contemporaneous controls (13%; p = 0.189 ), albeit not significantly so, possibly because of small sample sizes. Indeed, in comparison with the modern controls ( n = 39,689 ; 10.2%; p = 0.005 ) the frequency difference became statistically significant. This comparison also suggested a slight decrease in the allele’s prevalence between the medieval and modern controls. Up to now, this is the first study on the genetic predisposition to Salmonella infection in Europeans and the only association analysis on paratyphoid fever C. Functional investigation using computational binding prediction between HLA variants and S. Paratyphi and S. Typhi peptides supported a reduced recognition capacity of bacterial proteins by DRB1*03:01 relative to other common DRB1 variants. This pattern could potentially explain the disease association. Our results suggest a slightly reduced predisposition to paratyphoid fever in modern Europeans. The causative allele, however, is still common today, which can be explained by a trade-off, as DRB1*03:01 is protective against infectious respiratory diseases such as severe respiratory syndrome (SARS). It is thus possible that the allele also provided resistance to corona-like viruses in the past.
... Overall, one out of every four victims died. 6 In many ways, the perils of smallpox are similar to those we are currently experiencing with COVID-19. As previously documented, smallpox eradication achieved that kind of phenomenal success in a relatively short period of time and reasonable amount of resources. ...
Article
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There have been various infectious disease eradication programs implemented in various parts of the world with varying degrees of success since the early 1900s. Of all those programs, the one that achieved monumental success was the Smallpox Eradication Program (SEP). Most of the global health leaders and authorities that came up with the new idea of disease eradication in the 1980s tried to design and shape the new programs based on their experience in the SEP. The SEP had a very effective tool, vaccine, that did not require a cold chain system, and a relatively simple way of administration. The total cost of the eradication program was about US$300 million and the entire campaign took about 10 y. However, the Guinea worm and polio eradication programs that followed in the footsteps of SEP attained varying levels of success, consuming a huge amount of resources and taking a much longer time (>30 y each). This paper reviews the factors that played major roles in hindering the attainment of eradication goals and outlines possible recommendations for the way forward. Among other things, this paper strongly emphasizes that endemic countries should take the lead in all matters pertaining to making decisions for disease elimination and/or eradication initiatives and that ‘elimination as a public health problem’ is the preferred option rather than going for complete eradication at the expense of other health programs and thereby contributing to weakening of already fragile health systems, mainly in Africa.
... The impact of smallpox on the course of human history cannot be overstated. Smallpox has been called 'the most terrible of the ministers of death' by English historian Thomas Macaulay [1], and 'The Greatest Killer' by Donald R. Hopkins [2]. Smallpox may have emerged as early as 10,000 BCE [3], and some of the earliest historical descriptions of a disease consistent with smallpox appear between 1350 and 1122 BCE [3,4]. ...
Article
INTRODUCTION: Tecovirimat (TPOXX(R); ST-246) was approved for the treatment of symptomatic smallpox by the USFDA in July of 2018 and has been stockpiled by the US government for use in a smallpox outbreak. While there has not been a reported case of smallpox since 1978 it is still considered a serious bioterrorism threat. AREAS COVERED: A brief history of smallpox from its proposed origins as a human disease through its eradication in the late 20th century is presented. The current smallpox threat and the current public health response plans are described. The discovery, and development of tecovirimat through NDA submission and subsequent approval for treatment of smallpox are discussed. Google Scholar and PubMed were searched over all available dates for relevant publications. EXPERT OPINION: Approval of tecovirimat to treat smallpox represents an important milestone in biosecurity preparedness. Incorporating tecovirimat into the CDC smallpox response plan, development of pediatric liquid and intravenous formulations, and approval for post-exposure prophylaxis would provide additional health security benefit. Tecovirimat shows broad efficacy against orthopoxviruses in vitro and in vivo and could be developed for use against emerging orthopoxvirus diseases such as monkeypox, vaccination-associated adverse events, and side effects of vaccinia oncolytic virus therapy.
... Without question, the "holy grail" of managing diseases in aquaculture is being able to certify an operation, region, or country as free from one or more pathogens or diseases. While some have questioned if eradicating a disease is feasible or possible (Peeler & Otte, 2014), good examples of where this has been achieved can be taken from how rinderpest (a devastating disease in livestock), or small pox (that ravaged human populations prior to the 20th Century) were prevented, controlled, and finally eradicated around the world (e.g., Hopkins, 2002;Spinage, 2012;FAO & OIE, 2011;Thèves, Crubézy, & BiaginiIn, 2016;McVety, 2018). ...
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Growth of global aquaculture is affected by increasing number of infectious and contagious diseases, stressing the importance of biosecurity programs that effectively prevent, control, and eradicate infectious diseases. As aquaculture developed throughout the world in last decades, disease outbreaks have led to catastrophic impacts on aquaculture producers, industries, and countries. The thinking of what constitutes biosecurity, and what can be practically and efficiently implemented, has been slow to evolve. Leaning on principles developed and tested by the International Aquatic Veterinary Biosecurity Consortium (IAVBC), and summarized in this chapter, the recent decision of the World Organization for Animal Health (OIE) to address biosecurity in more detail is likely to provide practical and internationally acceptable procedures to allow aquaculture to grow without many impairments resulting from infectious diseases. It is hoped that these approaches will elevate and focus attention to disease prevention, control, and eradication activities, and allow farms and countries to be considered disease-free.
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The host is well defended against virus infections, for the immune system has several weapons at its disposal. The role of recovery from a first episode of an infectious disease in providing protection against another attack has been known for centuries. Characteristic traces of smallpox, pockmarks on the skin, were recognized as evidence of past infection and hallmarks of immunity to reinfection. During the Revolutionary War smallpox played a devastating role, leading General George Washington to order the inoculation of the regular troops. The studies of Metchnikoff on phagocytosis and Nuttall on humoral mechanisms demonstrated the two arms of host defense. In years to come, neutralization tests, with complement fixation assays, would become serological mainstays of diagnostic virology. By the 1940s, the technical advances made it possible to establish viral diagnostic laboratories. The U.S. Army established the first general diagnostic virology and rickett‐siology lab.
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From 1720 to 1722, the French region of Provence and surrounding areas experienced one of the last major epidemics of plague to strike Western Europe. The Plague of Provence was a major disaster that left in its wake as many as 126,000 deaths, as well as new understandings about the nature of contagion and the best ways to manage its threat. In this transnational study, Cindy Ermus focuses on the social, commercial, and diplomatic impact of the epidemic beyond French borders, examining reactions to this public health crisis from Italy to Great Britain to Spain and the overseas colonies. She reveals how a crisis in one part of the globe can transcend geographic boundaries and influence society, politics, and public health policy in regions far from the epicentre of disaster.
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Hastalıklar, dünya üzerinde ki yaşamın ortaya çıkışından bu yana insan hayatının önemli bir parçası haline gelmiştir. Geçmişte ve günümüzde yaşanan ve yaşanmaya devam eden salgın hastalıklar insan psikolojisini ve birçok sektörü etkilemiştir. Covid-19 pandemisi de bunlardan biridir. Turizm başta olmak üzere birçok sektörü etkisi altına alan pandemi, günümüz insan psikolojisinde de önemli etkiler bırakmıştır. Pandeminin kaynağı olarak görülen ve özellikle Uzakdoğu’da gıda ürünü olarak tüketilen yarasa ve pangolin, Türk kültürüne oldukça uzak ve helal olmayan gıdalardandır. Bu çalışmanın amacı, pandeminin kaynağı düşünüldüğünde Türkiye’de ki Müslüman bireylerin helal gıdalara yönelik motivasyon, helal turizme katılma ve satın alma niyetlerinde ne gibi değişimler yaşadığını ortaya çıkarmaktır. Özellikle pandeminin çıkış kaynağının Müslüman bireyler için problem teşkil etmektedir. İlgili problem hakkında derinlemesine bir literatür araştırması yapılmıştır. Bu çalışmada problem ile alakalı olarak Türkiye’de yaşayan Müslüman tüketicilerin pandemi sırasında helal gıda tüketimlerinde yaşanan değişimler araştırılmıştır. Çalışmada nicel yöntemlerden faydalanılmış ve anket toplama tekniği kullanılmıştır. Elde edilen verilere uygulanan analizler sonucunda, bireylerin pandemi sırasında helal gıdaları daha güvenilir bulduğu, pandemiden sonra helal ürünlere yönelik bakış açılarının değişmediği ancak pandemi sonrasında helal gıdaları satın almaya devam edecekleri görülmüştür. Buna ek olarak Covid-19 pandemisi sırasında helal gıda tüketiminin, satın alma niyeti ve helal turizme katılma niyeti üzerinde olumlu yönde etkisi olduğu saptanmıştır.
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Pre-existing medical conditions and co-infections are common to all human populations, although the natures of the pre-existing conditions and the types of co-infections vary. For these reasons, among others, the arrival of a highly infectious pathogenic agent may differentially affect the disease burden in different sub-populations, as a function of varying combinations of endemic disease, chronic disease, genetic or epigenetic vulnerabilities, compromised immunological status, and socially determined risk exposure. The disease burden may also vary considerably by age cohort and socio-economic status. The social consequences of infection, the medical sequelae, and the paths of recovery from infection may also vary, according to these variables. As a result, different sub-populations may have different experiences of a disease process, including when and how an epidemic comes to an end. This essay suggests that historians' engagement with path-breaking biological and medical anthropological research will allow new approaches to understanding disease processes that will enrich the study of epidemics and their endings. It is organized in three sections. The first discusses some general approaches to and assumptions about epidemics that are used by many historians. The second introduces new perspectives on the study of historical epidemics opened up by the medical anthropological concept of syndemic disease interactions and by an engagement with biological scientific perspectives. It briefly discusses two rural epidemics-one of anemia caused by the syndemic interaction of hookworm and malaria co-infections in early 20th-century British Malaya, and the other of rebound infections caused by the loss of acquired immunity to falciparum malaria in mid-20th-century Liberia-that illustrate, respectively, the utility of the concept of syndemic disease interactions and the centrality of immunological status in understanding epidemic outbreaks in these discrete populations. The third section addresses some of the research considerations involved in moving beyond the single pathogen model of epidemic disease.
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Warnings about new pandemics have been issued for decades. Every 8 months, a new infectious disease emerges. The cautionary discourse of emerging infections focuses on preparedness. Already in 2005, the WHO urged countries to make national bio-preparedness plans. The Covid-19 pandemic, nonetheless, overwhelmed countries; policies are late and incoherent, basic materials such as tests, face masks and protective equipment are scarce. Another consequence of the emerging diseases discourse which is often not articulated by policy-makers is prevention. Once the pandemic is expanding, attention concentrates on treatment and care, as well as the search for vaccines and drugs. Efforts will be directed at mitigating the effects of the new disease rather than exploring its origins. As discussed in this chapter, human beings and the natural world are fundamentally interdependent. Humans are enveloped in a virosphere. Viruses are indispensable for the evolution and continuation of life. When the current pandemic has waned, humanity will inevitably be affected by new infectious diseases. What is necessary is more awareness of the ecological perspective on health and disease. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
Article
In January 1900, John E. Cox filed a lawsuit in Third District Court, Salt Lake County, against the Salt Lake City Board of Education and the principal of Hamilton school, Samuel B. Doxey. Cox asserted that Doxey had violated the law on January 23 when he forbade his ten-year-old daughter, Florence Cox, to enter school on account of her failure to provide satisfactory proof of smallpox vaccination from a licensed medical doctor, a condition of school attendance. This condition existed due to the highly contagious nature of smallpox and the close social interaction that schools promoted. According to health authorities, a smallpox epidemic appeared to be imminent, with several cases of the disease in the Salt Lake Valley and two hundred more in the state. Yet Florence possessed “sound health” and no obvious signs of illness and, therefore, had been “wrongly excluded.” Cox’s attorney asserted: “Neither boards of health nor boards of education have a right to exclude unvaccinated children from schools, unless express authority is given by the Legislature or ordinance to that effect.” In the case at bar, “the health board is passing rules which in effect are legislative enactments.”1
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Astrovirology is the study of beneficial vs harmful viruses that originated from comets, meteors, solar winds, and ejecta from other planets, or which mutated when lofted by winds into the upper atmosphere. That these upper atmospheric and putative extraterrestrial viruses have contributed to the evolution of the biosphere and life on Earth, and caused disease and plague, is discussed, and the role of astro-viruses and endogenous retroviruses in the evolution of life and biosphere is reviewed. Evolution leading to the Cambrian Explosion and continuing to humans is characterized by repeated viral invasions and insertion of retroviral genes into host species' genomes. "Evolution" parallels the genetic-biological engineering of the environment (e.g. oxygen production), which activates inherited retroviral genes. Viral plagues are associated with comets, and have caused extinctions that served to promote evolution and eradicate those not "fit." Given evidence of life on Mars and association of plague with comets, extraterrestrial viruses may be commonplace. Extraterrestrial viruses may have acquired genes via interplanetary horizontal gene transfer which in turn have been transferred to the genomes of eukaryotes on Earth. "Evolution" may be the metamorphosis and replication of life and biospheres that evolved on other planets.
Conference Paper
This thesis examines the architectural history of University College London (UCL) from its foundation to 1939. UCL traces its beginnings to 1825, when a group of radical thinkers set about establishing a secular, non-residential metropolitan university. Its first architectural expression was the grand neoclassical building constructed in 1827–9 to designs by William Wilkins. Only the central block, portico and dome of Wilkins’s scheme were completed, yet successive wing extensions gradually formed a neoclassical quadrangle in Gower Street. A hospital was built in 1833–4, securing space for clinical teaching. UCL was initially denied a charter and precluded from awarding degrees, a complication that was resolved by the creation of the University of London as a separate examining body in 1836. Over the next century, UCL and its hospital expanded in a gradual and piecemeal manner in line with advances in education, technology and healthcare. UCL’s estate became increasingly complex, with a mixture of purpose-built blocks and the adaptation of buildings in the vicinity. A wealth of archival records, along with documentary sources and field investigation, has been used to examine the historic core of UCL’s estate in Bloomsbury. Institutional identity and aspirations are analysed in concert with practical influences on building projects, such as finances and functionality. The matter of identity also arises in the attribution of buildings to specific architects, which points to a tradition of enlisting professors such as Thomas Leverton Donaldson, Thomas Hayter Lewis, Thomas Roger Smith, Frederick Moore Simpson and Albert Richardson. In practice, their work was informed by multiple voices such as committee members, academic staff, external consultants and benefactors. This research addresses significant gaps in knowledge of the buildings, planning and development of UCL, while considering issues of identity, attribution and methodology pertinent to the study of architectural history.
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This article sketches a short history of the Covid-19 passport by examining its earlier iterations, including the “sanitary passport” (passeport sanitaire), an epidemiological tool officially introduced on the global stage by the French delegation during the 1893 International Sanitary Conference in Dresden. The sanitary passport shares with the Covid-19 passport two features. First, a similar aim, that of controlling the movement of potentially infected individuals across borders. Second, a similar condition of possibility, that of being the product of a pandemic crisis. The article identifies key characteristics as well as departures with the reinvention of the Covid-19 vaccine or immunity passport. The paper also situates the birth of the sanitary passport within a security context of increasing use of national passports as a means for the continuous surveillance of criminals and vagabonds as well as a scientific context marked by a key mutation: the birth of the immunized self.
Thesis
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German anti-vaccinationism from around the years 1720, 1820, 1920 and 2020. A comparison of selected sources by means of discourse analysis. Selected German anti-vaccination sources around the years 1720, 1820, 1920 and 2020 (differentiating between before (bC) and after (aC) Covid-19) are analysed for arguments. In a second step the time spans are compared. The main findings are: Around 1720 and 1820 the anti-vaccination debate took place foremost in the scientific community, while around 1920 and 2020 bC it took place in the broader public and did not influence the scientific community’s doctrines. Around 2020 aC, the Covid-vaccines were debated critically both in public and in the scientific community. The danger of the practise was debated most prominently by anti-vaccinationist sources in all times – with the possible exception of around 2020 bC, where ineffectiveness might have been debated most. The claim of the ineffectiveness of the smallpox vaccination was upheld by some anti-vaccinationists throughout all the time spans, but since around 1920 when even many of them did accept some effect, it was not any more debated in the scientific community. Around 2020 bC the question of the vaccines’ significance in repressing infectious diseases was debated also in the scientific community. The notion that there was a lack of knowledge and therefore the need to refrain from using vaccines was present all times but only around 1720 and 2020 aC this notion was debated in the scientific communities. Anti-vaccination arguments around 2020 aC came also from general vaccination advocates. Anti-vaccinationists around 1820 and 1920 went primarily against compulsory vaccination and bad practise. Religious reasons to be anti-vaccination played a lesser role in all four time spans, but the topic was neglected in this thesis; conceptual objections (due to humoral pathology or Naturheilkunde) were present all times, but were only debated in the scientific communities around 1720 and 1820. Notions vaccines are used for illegitimate financial gain can be found around 1920 and 2020; that they could be weaponized could be found rarely around 1820 and frequently around 2020 aC. Counterintuitively, anti-vaccinationism advanced Science and made vaccination safer. The role of emotions and the underlying psychological reasons for being antivaccination are debated and an evolutionary explanation is offered.
Thesis
At the heart of this dissertation sits a question: why have access to infrastructures and services emerged as key metrics by which people evaluate and debate the meaning of social and political belonging in contemporary Kenya? Part of the answer, I argue, lies in the long and entangled history of marketization and state-formation in this corner of Eastern Africa. The tensions between the public and the private, the state and the corporation, were the basis of early infrastructural projects undertaken by the Imperial British East Africa Company (IBEA) under the dual mandate of “commerce and civilisation.” This marriage, I argue, formed the durable foundations of the austere state. Indeed, the tension between private capital and the commonweal did not end with the formalization of colonial rule, but critically shaped the infrastructural landscape of both the Kenya colony and later the postcolonial state. In understanding these dynamics, this dissertation addresses three infrastructures ‘in the making’—roads in the interwar period, radio broadcasting in the postwar period, and services offered by Safaricom, Kenya’s wildly successful communications company, in the present. Beginning in the nineteenth century, I explore how the state and Kenya’s various communities have negotiated the technopolitics of infrastructures enacted under durable conditions of austerity. As I argue, public austerity over the longer term has repeatedly undermined infrastructures’ purported status as public goods to which all should have access. Specifically, conditions of austerity not only guided the distribution of infrastructures and services, but critically shaped the conditions of infrastructural work. Considering infrastructures as multiply authored cultural and material objects, this dissertation pursues two lines of inquiry. First, I explore the ways in which designers and administrators imagined how infrastructures could materialize new economic, political, and social orders. Second, I trace the unforeseen ways that Kenya’s multiple publics, including ordinary and extraordinary experts, reshaped infrastructural networks in staking out the domain of the political.
Chapter
In 1796, Edward Jenner scraped pus from the blisters of a milkmaid infected with cowpox, which he inoculated into the arms of his gardener’s son to protect him from smallpox. Almost a century later, Louis Pasteur developed vaccinations against diseases such as anthrax and rabies using weakened pathogens. Shortly afterwards, Emil von Behring, Kitasato Shibasaburō, and Paul Ehrlich demonstrated that antitoxins in the serum of horses vaccinated with diphtheria toxin could cure diphtheria patients. The complementary lock and key binding of the antitoxin (antibody) with the toxin (antigen) postulated by Paul Ehrlich was confirmed 40 years later by Linus Pauling. As a direct result of the work of these early pioneers, successful vaccination campaigns have been carried out against various pathogens in the past 50 years. More recently, advances in the isolation and genetic engineering of antibodies against tumor-associated antigens have opened up new possibilities for treating cancer.
Article
Artykuł proponuje równoległą, porównawczą lekturę dwu tekstów: polskiego reportażu Zaraza (1965), autorstwa Jerzego Ambroziewicza oraz angielskiego eseju The Last Days of Smallpox: Tragedy in Birmingham (2018), autorstwa Marka Pallena. Teksty te poświęcone są, odpowiednio, epidemii czarnej ospy we Wrocławiu (1963) oraz zalążkowi epidemii tej samej choroby w Birmingham (1978). Przedmiotem porównania są podobieństwa i różnice w zakresie sposobu przedstawiania świata, technik narracyjnych, poetyki i retoryki. W zakończeniu postawione zostaje pytanie o sposób czytania obu „ospowych opowieści” w okresie pandemii COVID-19. On Two Smallpox Stories (Read in the COVID World) Abstract: The article proposes a parallel, comparative reading of two texts: the Polish nonfiction story Zaraza (1965) by Jerzy Ambroziewicz and the English essay The Last Days of Smallpox: Tragedy in Birmingham (2018) by Mark Pallen. The texts discuss, respectively, a smallpox epidemic which took place in Wrocław (1963) and an outbreak of the same disease in Birmingham (1978). The present paper studies the similarities and discrepancies in the methods of describing the represented world, narrative techniques, poetics, and rhetoric. The final part of the paper poses the question of how both of these “smallpox stories” may be interpreted in the era of the COVID-19 pandemic.
Thesis
Background In sub-Saharan Africa (SSA), health system resilience and preparedness for shocks such as wars are an urgent concern if the region is to meet the Sustainable Development Goals (SDGs), which includes a reduction in maternal deaths by fewer than 70 maternal deaths per 100,000 live births by 2030. There has been very little research on how health systems should achieve SD 3 if they are impacted by war. Aims This thesis examines the interrelationships between war, health systems, female empowerment and the utilisation of maternal health services in war-affected SSA countries (1990–2015). This study includes examining the factors that enabled some war-affected SSA countries to achieve a significant maternal mortality reduction during this period based on their health systems’ resilience and preparedness for shocks such as wars. Methods This study used diverse research methods: (1) quantitative analyses of maternal mortality in 49 SSA countries divided into two groups (countries with and without war (major armed conflict) during 1990–2015 (article to be submitted); (2) literature review and policy analysis to identify standard best health system practices in five SSA countries with war (1990–2015) and achieved a maternal mortality reduction (≥50%) in the same period (article published in Global Health Action); (3) qualitative research in Eritrea, a war-affected SSA country during 1990–2015 (article published in BMC Pregnancy and Childbirth); (4) quantitative analyses to assess the prevalence of female empowerment in 31 SSA countries using four female empowerment indicators in Demographic and Health Surveys (DHS) collected during 2010–2015 (article to be submitted); (5) quantitative analyses of DHS data to assess associations between female empowerment and the utilisation of maternal health services––antenatal care visits (≥4 ANC) and delivery by skilled birth attendants (SBAs)––in 31 SSA countries using the four DHS female empowerment indicators (article published in BMJ Open), and (6) quantitative analyses to compare female empowerment in countries with and without war (1990–2015), and examining whether there are no differences between female empowerment and the utilisation of maternal health services in countries with and without war in the same period (article to be submitted). 17 Results For the qualitative analyses of 49 SSA countries divided into two groups according to their war history (1990–2015). Countries with war (n=13) had a higher median maternal mortality ratio (MMR) (693 [IQR (477-732)]) than those without war (n=36) (380 [(247-570)]) (p<0.01). Adjusted regression models among all 49 countries showed an association between low maternal mortality and high density of nurses-midwives (p = 0.05) as well as a low level of corruption (p = 0.03). For countries with war, there was evidence of an association between low maternal mortality and high density of nurses-midwives (p = 0.05) besides the high density of hospitals (p = 0.02). For countries without war, only a low level of corruption was significantly associated with low maternal mortality (p = 0.03). The literature review and policy analysis study identified three general health system reforms across all five countries that could explain the observed maternal mortality reduction in these countries. These health system reforms were health systems decentralisation, innovation related to the health workforce (such as training of community healthcare workers), and government financing reforms. Qualitative research in Eritrea revealed two perceived facilitators of the women’s utilisation of and access to maternal health services: health education and improvement in gender equality and female empowerment, driven by the role women played as combatants during the War of Independence (1961–1991). The one perceived barrier was the inadequate quality of care. The importance of female empowerment in Eritrea led to a broader investigation of female empowerment in SSA using DHS data. The prevalence of female empowerment in 31 SSA countries ranged from 69% for opposing sexual violence to 42% for decisions on the spending of the household income. The prevalence of opposing sexual violence was highest in Southern Africa (85%), and lowest in Western Africa (64%); opposing domestic violence was highest in Southern Africa (64%) and lowest in Central Africa (36%); women’s involvement in decisions on the spending of the household income was highest in Southern Africa (72%) and lowest in Western Africa (27%); and women’s participation in decisions on the major household purchases was highest in Southern Africa (85%) and lowest in Western Africa (41%). Pooled results for all 31 countries (194,883 women) combined showed weak statistically significant associations between all four female empowerment indicators and 18 the utilisation of maternal healthcare services (aORs ranged from 1.07 to 1.15). The strongest associations were in the Southern African region. For example, the aOR for women who made decisions on the household income solely or jointly with husbands concerning the utilisation of SBAs in the Southern African region was 1.44 (95% CI 1.21 to 1.70). Paradoxically, there were three countries where women with higher autonomy on some measures were less likely to use maternal healthcare services. For example, the aOR in Senegal for women who made decisions on the major household purchases solely or jointly with husbands about the utilisation of SBAs was 0.74 (95% CI 0.59 to 0.94). The pooled prevalence of female empowerment was 42% for rejection of domestic violence in SSA countries with war and 50% in those without war; 60% for decisions on the spending of the household income made by the women solely or jointly with husbands in countries with war and 37% in those without war; 63% for decisions on the major household purchases in countries with war and 49% in those without war, and 67% for opposing sexual violence in countries with war and 70% in those without war. There was no difference between countries with and without war regarding the relationship between female empowerment and the utilisation of maternal health services. Conclusions Health system resilience and preparedness for shocks is an urgent concern in war-affected SSA countries. The results of this study suggest that reforms related to healthcare workers, leadership and governance (to tackle corruption) could be the keys to strengthening the health system and therefore reduce maternal mortality. This research also shows that empowering SSA women (SDG 5 aims to achieve gender equality and the empowerment of women and girls by 2030) is essential if the region is to meet the SDG 3.1 target of fewer than 70 MMR per 100,000 live births by 2030. As only a small number of studies have been published about the utilisation of maternal health services in war-affected SSA countries, findings of this study provide a basis for further research in countries recovering from the effect of war. Some of the results presented here should be interpreted with caution. In particular, female empowerment is a complicated issue that cannot be fully understood using only quantitative research methods.
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Isorokkoa on pidetty 1700-luvun Euroopalle leimallisena tautina ja rokonistutusta puolestaan aikakauden lääketieteen suurimpana saavutuksena. Uudesta menetelmästä toivottiin apua lohduttomaan tilanteeseen, jossa tautiin menehtyi jatkuvasti valtava määrä ihmisiä, lähinnä pikkulapsia. Erilaisilla tavoilla siirtää rokkotartunta ihmisestä toiseen immuniteetin saavuttamiseksi mahdollisimman suotuisissa olosuhteissa oli eri puolilla maailmaa pitkät perinteet. Länsimaisen lääketieteen kiinnostuttua menetelmästä 1710- ja 1720-lukujen vaihteessa sitä pyrittiin jatkuvasti kehittämään turvallisemmaksi. Rokonistutus pysyi kautta vuosisadan kiistakysymyksenä, josta käytiin kiihkeitä väittelyitä. Kaikki ristiriidat eivät kuitenkaan tulleet kirjatuiksi pamfletteihin, saarnoihin tai lääkäreiden kirjoittamiin yleistajuisiin kirjoihin. Rokonistutus oli vaikea kysymys myös lääkäreille, jotka joutuivat punnitsemaan vastuitaan ja valintojaan virkaveljien, hallinnon ja potilaiden vaatimusten ja pelkojen ristiaallokossa. Ruotsissa rokonistutus eli inokulaatio kytkeytyi tiiviisti hyötyvalistukseen ja rationaalisen, empiirisen tieteen ideaaleihin. Potentiaalisesti tappavan taudin tahallinen tartuttaminen potilaaseen saattoi kuitenkin sotia lääkärin omaa arvomaailmaa, ammattietiikkaa ja vakaumusta vastaan. Tässä kirjoituksessa avaan katsauksenomaisesti rokonistutukseen liittyneitä huolia ja pelkoja ja toisaalta toiveita ja odotuksia aikakauden lääkäreiden kannalta Ruotsissa. Teksti pohjautuu Porthan-seuran syysseminaarissa 8.11.2019 pitämääni esitelmään.
Article
Analyzes philologically and historically all testimony in the works of Gregory of Tours about various epidemics that struck Gaul, Iberia, and Italy in the sixth century; in particular, those of the most serious disease, “inguinal epidemic,” that is, bubonic plague (Yersinia pestis), as well as an illness that may have been smallpox (Variola major). Establishes that Gregory’s testimony, inspired by his personal and pastoral-theological concerns, is reliable and informative; delineates the motivations and sources for reporting the recurring epidemics of plague as they emerge from his writings; shows that Gregory’s information is robust but geographically constrained: of the twenty-two places and regions where he knows unambiguously about plague, only four are further than 400 km from his familial Clermont (Fig. 1). Gregory’s twenty-two mentions of plague also refer to six epidemics between c. 543–47 and c. 591–94, of which he treats four in greater detail; his silences are confirmed to be significant only rarely. Two epidemics are newly dated to springtime, and the initial outbreak is shown as likely to have reached Gaul from a western port. Contagion mirrors communications infrastructures and affected the countryside as well as towns, which populations tended to flee. Symptoms, epidemiology, and heavy mortality align with the ancient DNA proof that the pathogen was Yersinia pestis; pneumonic plague is suggested in two cases. Gregory’s historical testimony is confirmed by and integrated into the new biomolecular archaeological discoveries of early medieval plague victims in western Europe.Fig. 1. Plague outbreaks reported by Gregory of Tours, victims with robust aDNA of Y. pestis, and mass burials.View Large ImageDownload PowerPoint
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Smallpox, caused by the variola virus (VARV), was a highly virulent disease with high mortality rates causing a major threat for global human health until its successful eradication in 1980. Despite previously published historic and modern VARV genomes, its past dissemination and diversity remain debated. To understand the evolutionary history of VARV with respect to historic and modern VARV genetic variation in Europe, we sequenced a VARV genome from a well-described eighteenth-century case from England (specimen P328). In our phylogenetic analysis, the new genome falls between the modern strains and another historic strain from Lithuania, supporting previous claims of larger diversity in early modern Europe compared to the twentieth century. Our analyses also resolve a previous controversy regarding the common ancestor between modern and historic strains by confirming a later date around the seventeenth century. Overall, our results point to the benefit of historic genomes for better resolution of past VARV diversity and highlight the value of such historic genomes from around the world to further understand the evolutionary history of smallpox as well as related diseases. This article is part of the theme issue ‘Insights into health and disease from ancient biomolecules’.
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This volume investigates the multifaceted SHAPES (socio-historic, artistic, political, and ecological significance) of global disease. It challenges conventional views of infection and transmission by associating epidemics with ideologies and their accompanying institutions. It argues that the physical threat of epidemics is irrevocably linked to culture, economic resources, social class, and power. Epidemics involve both the infected and non-infected, affect the local and global, and they expose control and neglect. This book provides a radical collaborative approach, drawing contributors from closely related and vastly distant fields in the search for innovative ways to address human suffering, and to find real solutions that may determine whether people live or die. Such an approach is needed within an increasingly interconnected world where both pathological diseases and health behaviors are infectious. Experts from fifteen diverse disciplines in the natural sciences, social sciences, and arts and humanities present case studies from across the world and time, demonstrating the uniqueness of each disease and epidemic in its place, but also the shared experiences that span human life and death. In order to identify, measure and control epidemics, we must understand epidemics more as long biosocial processes than abrupt events in nature or culture. Such methodology examines the meaning we attach to epidemics, as well as their material reality, and provides a more complete understanding of how epidemics shape and are shaped.
Chapter
Not only did the Japanese navy and army become the largest organisational forms in Japan in the transition from the Tokugawa period to the Meiji period, but they also acted as a stimulus for the development of new systems mostly associated with a centralised tax system and a system of universal primary education. Education in the Meiji period was centrally controlled by the Ministry of Education, especially in the 1880s. This central control of the educational system was necessary because in Meiji Japan it was seen that only a uniform educational system would allow for state formation. And in contrast to the nation building objectives of the Meiji government, the Tokugawa Shogunate ruled over a politically decentralised country which was held loosely together and would not be a ‘nation’ in the modern context.
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Resumen La medicina china y su cultura ancestral parecen tener los antecedentes más remotos de los intentos por prevenir o curar el azote epidemiológico de esa época: la viruela. Estos conocimientos empíricos llegaron al Asia Central y Europa, y algunos granjeros hicieron observaciones de la utilidad de la inoculación o variolización sin llegar a documentar sus ensayos en la comunidad científica. El mérito de Edward Jenner reconocido como el descubridor de la vacuna antivariólica, radica en haber demostrado con evidencia práctica la protección conferida frente a la enfermedad por la administración en un niño sano de un material proveniente de una persona con lesiones causadas por el cowpox, virus de la viruela vacuna. Desde Europa en el siglo XVIII y comienzos del siglo XIX, la inoculación primero y luego la vacunación llegan a Hispanoamérica por vías informales o por determinación de la corona como un servicio a las colonias. La vacunación antivariólica tuvo el valor agregado de motivar y convencer a las autoridades gubernamentales sobre la necesidad de implementar políticas de salud pública para responder a las necesidades sanitarias de la población. En Chile, Fray Pedro Manuel Chaparro fue el pionero en la aplicación y difusión de la vacuna, realizó la primera campaña nacional y se cuenta entre los padres de la salud pública nacional.
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Después de una epidemia de viruela en Alemania a principios de la década de 1870 a raíz de la guerra francoalemana, la vacuna antivariólica se hizo obligatoria por Ley Imperial en 1874. La ley se debatió acaloradamente en el parlamento y en pú­blico, y la resistencia ya existente contra la vacunación se convirtió en un movimiento político antivacunas. Por ello, el gobierno alemán adoptó una serie de medidas de seguridad. El artículo actual describe, en primer lugar, las prácticas, regulaciones y políti­cas de vacunación en los estados alemanes hasta la década de 1870, y los desarrollos biopolíticos que llevaron a la Ley Imperial sobre la vacunación antivariólica obligatoria en 1874. En segundo lugar, se esbozan el debate público y la crítica sobre la vacunación, preguntando por qué la vacunación obligatoria tuvo éxito en Alemania. Se describen las medidas aplicadas por el gobierno alemán para promover la vacunación obligatoria y la aceptación de la Ley Imperial: inicialmente, las vacunas contra la viruela se fabricaban por centros de producción estatales supervisados por las autoridades locales. Se recopilaban estadísticas de todo el imperio que documentaban el éxito de la vacunación, así como los efectos secundarios relacionados. Desde la perspectiva del gobierno, estas precauciones podrían interpretarse como una tecnología de confianza.
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