W OR L D At l a s of E P I D E M I C D I S E A S E S This page intentionally left blank W OR L D At l a s of E P I D E M I C D I S E A S E S A N D R E W C L I F F , P E T E R H A G G E T T M A T T H E W S M A L L M A N - R A Y N O R Distributed in the United States of America by Oxford University Press Inc., New York www.arnoldpublishers.com First published in Great Britain in 2004 by Arnold, a member of the Hodder Headline Group, 338 Euston Road, London NW1 3BH http://www.arnoldpublishers.com Distributed in the United States of America by Oxford University Press Inc. 198 Madison Avenue, New York, NY10016 © 2004 Andrew Cliff, Peter Haggett and Matthew Smallman-Raynor All rights reserved. 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Please send your comments to [email protected] CONTENTS Preface ix 2.3 Leprosy 32 Nature of leprosy (cid:122) CHAPTER 1 (cid:122) Past patterns of leprosy Current geography of leprosy (cid:122) INTRODUCTION 1 Further Reading 35 Introduction 2 CHAPTER 3 1.1 The Global Burden of Disease 2 The nature of diseases (cid:122) THE CLASSIC PLAGUES, II 36 The global disease burden (cid:122) Disease burdens at the national level (cid:122) Introduction 37 1.2 The Nature of Epidemics 7 3.1 Smallpox 37 Defining epidemics (cid:122) Nature of smallpox (cid:122) Epidemics in world history (cid:122) Origins and early Old World spread (cid:122) Epidemics as a branching process (cid:122) Subsequent spread and intensification (cid:122) Vaccination and nineteenth-century smallpox 1.3 Mapping Epidemic Diseases 11 (cid:122) Continuing twentieth-century problems The nineteenth century (cid:122) (cid:122) Twentieth-century mapping (cid:122) 3.2 Measles 41 New developments in disease mapping (cid:122) Nature of measles (cid:122) Old World origins of measles 1.4 Organization of the Atlas 16 (cid:122) New World extensions: the Americas Choosing diseases (cid:122) (cid:122) New World invasions: the Pacific Choosing structures (cid:122) (cid:122) Changes in measles waves in the twentieth century (cid:122) Further Reading 19 (cid:122) The declining mortality from measles 3.3 Rabies 51 CHAPTER 2 Nature of rabies (cid:122) Past patterns of rabies (cid:122) THE CLASSIC PLAGUES, I 20 Current geography of rabies (cid:122) Introduction 21 Further Reading 54 2.1 Plague 21 CHAPTER 4 Nature of plague (cid:122) Past patterns: the ‘Black Death’ (cid:122) (cid:122) Past patterns: later plague cycles PERSISTENT SCOURGES 55 Past patterns: plague in the ‘early modern’ period (cid:122) Current geography of plague (cid:122) Introduction 56 2.2 Cholera 25 4.1 Tuberculosis 56 Nature of cholera (cid:122) Nature of tuberculosis (cid:122) The great nineteenth-century pandemics (cid:122) Past patterns of tuberculosis (cid:122) Cholera waves in North America (cid:122) Current geography of tuberculosis (cid:122) Cholera in nineteenth-century London (cid:122) Cholera in the Philippines, 1902–4 4.2 Syphilis 61 (cid:122) (cid:122) Current geography of cholera (cid:122) Nature of syphilis v CONTENTS WORLD ATLAS OF EPIDEMIC DISEASES Past patterns of syphilis 6.2 Influenza II: The 1918–19 Pandemic 88 (cid:122) (cid:122) Current geography of syphilis (cid:122) Influenza waves in the northern hemisphere (cid:122) Yaws: a related spirochaetal disease (cid:122) Impact on the southern hemisphere: Australia 4.3 Typhus 63 6.3 Influenza III: Later Pandemics 90 (cid:122) Nature of typhus (cid:122) Identifying the causes of influenza (cid:122) Past patterns of typhus (cid:122) The 1957 ‘Asian flu’ pandemic (cid:122) Current geography of typhus (cid:122) Current geography of influenza 4.4 Relapsing Fever 66 6.4 Nature of Seasonal Epidemics 94 (cid:122) Nature of relapsing fever (cid:122) Seasonality in influenza (cid:122) Past patterns of relapsing fever (cid:122) The common cold Current geography of relapsing fever (cid:122) Further Reading 97 Further Reading 68 CHAPTER 7 CHAPTER 5 TROPICAL DISEASES, I 98 CHILDREN’S DISEASES 69 Introduction 99 Introduction 70 7.1 Malaria 99 Nature of malaria 5.1 Typhoid 70 (cid:122) Past patterns of malaria Nature of typhoid (cid:122) (cid:122) Current geography of malaria Past patterns of typhoid (cid:122) (cid:122) Burkitt’s lymphoma Current geography of typhoid (cid:122) (cid:122) 7.2 Yellow Fever 105 5.2 Diphtheria 73 Nature of yellow fever Nature of diphtheria (cid:122) (cid:122) Past patterns of yellow fever Past patterns of diphtheria (cid:122) (cid:122) Current geography of yellow fever Current geography of diphtheria (cid:122) (cid:122) 7.3 Dengue 107 5.3 Other Bacterial Diseases 75 Nature of dengue Scarlet fever (cid:122) (cid:122) Past patterns of dengue Whooping cough (cid:122) (cid:122) Current geography of dengue (cid:122) 5.4 Viral Diseases of Childhood 79 7.4 Meningococcal Disease 110 Rubella (German measles) (cid:122) Nature of meningococcal disease Mumps (cid:122) (cid:122) Meningococcal disease and the African ‘meningitis belt’ Chickenpox (cid:122) (cid:122) Current geography of meningococcal disease (cid:122) Further Reading 83 Further Reading 112 CHAPTER 6 CHAPTER 8 WINTER AND SEASONAL AILMENTS 84 TROPICAL DISEASES, II 113 Introduction 85 Introduction 114 6.1 Influenza I: Nature and Early Records 85 8.1 Sleeping Sickness 114 (cid:122) Nature of influenza (cid:122) Nature of sleeping sickness (cid:122) Measurement of influenza (cid:122) Past patterns of sleeping sickness (cid:122) Early influenza epidemics (cid:122) Current geography of sleeping sickness vi CONTENTS 8.2 Chagas’ Disease 116 CHAPTER 10 Nature of Chagas’ disease (cid:122) Past patterns of Chagas’ disease (cid:122) NEWLY-EMERGENT DISEASES, I 152 Current geography of Chagas’ disease (cid:122) 8.3 Leishmaniasis 118 Introduction 153 Nature of Leishmaniasis (cid:122) Past patterns of Leishmaniasis 10.1 Emergence of New Diseases 153 (cid:122) (cid:122) Current geography of Leishmaniasis (cid:122) The geographical question of disease origins Mechanisms of disease emergence (cid:122) 8.4 Schistosomiasis 120 Nature of schistosomiasis 10.2 AIDS I: Nature and Origins 155 (cid:122) (cid:122) Past patterns of schistosomiasis (cid:122) Nature of AIDS (cid:122) Current geography of schistosomiasis (cid:122) Origin of AIDS 8.5 River Blindness 123 10.3 AIDS II: Global Patterns 157 (cid:122) Nature of river blindness (cid:122) The global magnitude of AIDS (cid:122) Past patterns of river blindness (cid:122) Regional transmission patterns Current geography of river blindness (cid:122) 10.4 AIDS III: Regional Variations 158 8.6 Other Helminthic Diseases 125 (cid:122) Pattern I: AIDS in the United States (cid:122) Filariasis (cid:122) Pattern II: AIDS in Central Africa (cid:122) Guinea worm (cid:122) Transition I/II: AIDS in the Caribbean Hookworm (cid:122) 10.5 AIDS and Related Diseases 163 Further Reading 132 AIDS and other infectious diseases (cid:122) Gonorrhoea (cid:122) CHAPTER 9 Hepatitis B (cid:122) Further Reading 166 VACCINE-PREVENTABLE DISEASES 133 CHAPTER 11 Introduction 134 9.1 Concepts of Disease Eradication 134 NEWLY-EMERGENT DISEASES, II 167 Spatial control strategies (cid:122) Local elimination and natural breaks in infection (cid:122) Introduction 168 Impact of vaccination on epidemic cycles (cid:122) 11.1 Legionnaires’ Disease 168 9.2 Global Eradication of Smallpox 136 Nature of legionnaires’ disease (cid:122) The WHO smallpox control programme (cid:122) Past patterns of legionnaires’ disease (cid:122) Progress on eradication (cid:122) Current geography of legionnaires’ disease (cid:122) Post-eradication issues (cid:122) 11.2 Lyme Disease 170 9.3 Measles Elimination 143 Nature of Lyme disease (cid:122) The US campaigns (cid:122) Past patterns of Lyme disease (cid:122) Elimination campaigns in the rest of the world (cid:122) Current geography of Lyme disease (cid:122) Current geography of measles (cid:122) Other tick-borne fevers in North America (cid:122) 9.4 Poliomyelitis Elimination 146 11.3 Tropical Haemorrhaghic Fevers 172 Nature of poliomyelitis (cid:122) Nature of Ebola-Marburg fever (cid:122) Past patterns of poliomyelitis (cid:122) Past patterns of Ebola-Marburg fever (cid:122) Vaccination in the Americas (cid:122) Current geography of Ebola-Marburg fever (cid:122) Progress in the rest of the world (cid:122) Other tropical haemorrhagic fevers (cid:122) Further Reading 151 vii CONTENTS WORLD ATLAS OF EPIDEMIC DISEASES 11.4 Other Newly-Emergent Diseases 176 12.3 Conflicts and Disease Change 188 Neurological disorders: kuru and CJD Conventional wars: tsutsugamushi and the Pacific campaigns (cid:122) (cid:122) Hantavirus fevers Anthrax and bio-terrorism (cid:122) (cid:122) Cryptosporidiosis Conflict and disease eradication (cid:122) (cid:122) Buruli ulcer (cid:122) 12.4 Future Surveillance and Control 192 Further Reading 181 Further Reading 195 CHAPTER 12 APPENDIX A EPIDEMIC DISEASES ON THE CHANGING PATTERNS OF DISEASE 182 WORLD-WIDE WEB 197 Introduction 183 APPENDIX B GLOSSARY OF TERMS 198 12.1 Changes in Disease Environments 183 REFERENCES 200 Economic development and disease (cid:122) Population shift and disease (cid:122) Land use change and disease INDEX 207 (cid:122) Global warming and disease (cid:122) 12.2 Spatial Contraction and Disease 187 The collapse of geographical space (cid:122) Disease implications of global shrinkage (cid:122) viii PREFACE As we write this Preface, the world is recovering from least in some seasons of the year (for example, the placedatourdisposalandwerecordwithgratitudethe the shock of a new global epidemic. Since November common cold). For some, eradication is possible (e.g. work of skilled staff there. We wish particularly to 2002, the World Health Organization (WHO) has poliomyelitis) and in one case, it has been achieved acknowledge our debt to Dr John Clements, then of been anxiously monitoring outbreaks of a severe form (smallpox); for others (malaria and tuberculosis) one the WHO Expanded Programme on Immunization of respiratory infection first reported in the step forward seems to be matched by half a step back- (later the Global Vaccines Initiative). In earlier years, Guangdong province of Southern China. Labelled wards as drug resistance builds up. wemadesimilaruseofthelibraryandarchivesofthe Severe Acute Respiratory Syndrome (SARS), signs of Foreachofthe50diseasestreated,wehavetriedto Centers for Disease Control and Prevention in the disease include initial flu-like symptoms (rapid assemblerepresentativemapsattheworldlevelandto Atlanta, Georgia, and we are grateful to Stephen onset of high fever, followed by muscle aches, supplementthesewithregionalandlocalmapsasand ThackerandDonnaStroupatCDCfortheirencour- headaches and sore throat), and low platelet and white whereappropriate.Theseareaccompaniedbymicro- agementforourworkovermanydecades. blood cell counts. This is followed in many cases by graphs of the biological agents (from prions, through Our research would not have been possible without bilateral pneumonia, sometimes with acute respiratory virusesandbacteria,tomajorparasites)whichcausethe the generous support of the Leverhulme Trust. One of distress requiring assisted breathing on a respirator. disease being mapped. Other illustrations show the us (PH) was fortunate in retirement in being awarded SARS spread rapidly to Hong Kong and major environments in which they occur, the impacts they a Leverhulme Trust Emeritus Fellowship which made Chinese cities and, by mid-March 2003, was being have,orthepioneerswhounravelledtheircomplexlife the Geneva work possible, and a Senior Research reported from neighbouring countries in southeast and death cycles. The text which accompanies the Fellowship at the University of Bristol which provided Asia (notably Vietnam and Singapore). By May 2003 mapsandillustrationssummarizesthreeaspectsofeach office space at the Royal Fort House. The Leverhulme it had reached 30 countries around the world, ranging disease:(a)itsbasicnatureandimpacts;(b)itshistori- Trust also made available long-term help for both from Oceania, through Western Europe to the calorigins(whereknown)andthepastepidemicsithas ADC and MS-R via a programme grant on war and Americas. At the apparent close of the epidemic in caused; and (c) its current status and world distri- disease and a Leverhulme Prize Fellowship for MS-R. July, reported cases (and there is clear evidence of bution,includingtheprobabilityoffuturecontrol. In Cambridge, Philip Stickler, Head of the under-reporting from China in the first two months) It is equally important to define what we have not Cartographic Unit in the University’s Department of had mounted to over 8,000, one in ten of whom had attempted. In the Atlaswe have not tried to be inclu- Geography undertook the mammoth task of produc- died. WHO subsequently confirmed that a new sive and to cover all the many hundreds of infectious ing the original maps and diagrams. At Edward pathogen, a member of the coronavirus family never diseases. Information for mapping does not exist for Arnold, Liz Gooster as commissioning editor oversaw previously seen in humans, was the cause of SARS. many of them and, apart from any other consider- the complex task of integrating illustrations with the As this Atlas goes to press it is not clear whether ation, space would not permit. Rather, we have text. The team must have been close to tears on many SARS will prove to be one of the really great pan- selected diseases which act as cameos to illustrate occasions. demics of infectious diseases which from time to time broad principles. While working at WHO our usual venue at have swept from continent to continent around the Such a work is, for the three authors, part of a much ‘Chambre Quinze’ in La Truite in Divonne-les-Bains inhabited world, or whether it will be a footnote in larger canvas on which they have been working for was again littered with documents and computer epidemic history. If the former, then the pages which more than three decades. It has already seen the pub- cables (to the despair of dear Marie-France) while, for follow will show SARS to be in good (or should it be, lication of a series of epidemic disease monographs one of us, the Hotel Montana in Geneva opposite the bad?) company. Plague in the fourteenth century, which focus both on specific infectious diseases Rue de Berne became Hôtel du Lac. The comings and cholera in the nineteenth century, influenza in (notably measles and influenza, with poliomyelitis to goings provided light relief in the final stages of manu- 1918–19 and HIV/AIDS from the late 1970s all come), on specific epidemiological sources (the US script preparation. We recall with pleasure a rare day shared the ability to move quickly through the human consular records of disease), and on specific themes off to pay homage at the Pasteur Museum at Arbois. population, creating a bow-wave of anxiety and appre- (such as island epidemiology and the role of conflict in In the prefaces to our earlier volumes we have tried to hension in advance of the illnesses and deaths which epidemic generation). Especially relevant precursors say thank you to those closest to us who have cheer- followed. With each pandemic, the population reeled to this atlas were an Atlas of Disease Distributions(Cliff fully borne the brunt of our obsession with research. but (so far) eventually bounced back from the new and Haggett, 1988) and an Atlas of AIDS(Smallman- But perhaps we have now run out of adequate words microbiological onslaught. Raynoret al., 1992). of appreciation, and we will simply let these pages and In this Atlas we have tried to bring together maps Anatlaslikethiswouldnothavebeenpossiblebut maps stand as a token of our deep thanks and affec- that show the distribution of 50 of the great infectious fortheworkandsupportofmanyothers.Likeallsci- tion. There are instances where we have been unable epidemic-causing diseases which have assaulted the entists,we‘standontheshoulders’ofthosewhohave to trace or contact the copyright holder. If notified the human population over the last five thousand years of workedonsimilarthemesbeforeus.Weacknowledge publisher will be pleased to rectify any errors or its occupation of this planet. They include both very aparticulardebttotheGermanauthorsoftheSeuchen omissions at the earliest opportunity. old diseases (such as measles and smallpox) and very Atlas (1942–5, 1952–61) and of the American new ones (such as Lyme and legionnaires’ disease). Geographical Society’s Atlas of the Distribution of ANDREW CLIFF Some are limited to a very small geographical area (for Diseases (1950–4) for pioneering the world atlas area PETER HAGGETT example, kuru, confined to the New Guinea high- half a century ago. We have been particularly blessed MATTHEW SMALLMAN-RAYNOR lands), others, like syphilis, are near universal where bytheresourcesmadeavailabletousattwogreatcen- human sexual contact obtains. Some are deadly killers tresofepidemiologicalresearch.InGeneva,thelibrary Arbois (such as rabies), others are an accepted fact of life at and archives of the World Health Organization were Day of Julian the Hospitaler, 2003 ix
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