An Epidemiological Odyssey: The Evolution of Communicable Disease Control PDF
Preview An Epidemiological Odyssey: The Evolution of Communicable Disease Control
An Epidemiological Odyssey Dr. George Pollock An Epidemiological Odyssey The Evolution of Communicable Disease Control Dr. George Pollock Honorary Senior Research Fellow Department of Public Health and Epidemiology University of Birmingham Edgbaston Birmingham B15 2TT United Kingdom ISBN 978-94-007-3997-0 ISBN 978-94-007-3998-7 (eBook) DOI 10.1007/978-94-007-3998-7 Springer Dordrecht Heidelberg New York London Library of Congress Control Number: 2012935873 © Springer Science+Business Media B.V. 2012 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) “To Edie Kate Pollock, whose odyssey is just beginning.” Foreword Epidemics of communicable diseases are a natural occurrence co-existing with life itself. They have been reported in literature from the Bible onwards including refer- ences with comment in the plays of William Shakespeare. In early times they were generally referred to as plagues. The invention of the microscope led to their cause being identifi ed in transmission of micro-organisms by humans or other animals. Protection from disease by quarantine of infected persons was followed by vaccina- tion. With the introduction of antibiotic therapy there became a belief in the mid- twentieth century that communicable disease could be eliminated from the planet. This proved to be true for smallpox and possibly for poliomyelitis by programmes of vaccination, but otherwise this soon became apparent as a politician’s dream. Resistance to antibiotics by organisms, emergence of new micro-organisms, par- ticularly the human immunodefi ciency virus (HIV) and increased of travel soon put an end to such beliefs. It therefore becomes essential that people at large understand how such beliefs came about and how epidemics can occur in order that they may be avoided in the future. That is the purpose of this treatise by Dr. George Pollock. A critical analysis of the history of epidemics, is followed by reports of personal experiences. These are related as sufferer, observer, National Health Service consul- tant and now historian. There are few who can have had the opportunity to describe at fi rst hand how the risks and actual occurrence of epidemics affect both the indi- vidual patient and the community. He experienced the initial appearance of poten- tial epidemics, and relates the measures taken to combat their spread. The reaction of those advising government is reported, giving a lively insight to the processes of management under stress as well as the reactions of the populace and its handling by the media in a number of specifi c instances are described for posterity. The past successes and failures to combat communicable diseases are set down as personal experiences for posterity. The misjudgement of politicians in 1974 of dismantling the organisations for control of communicable diseases that had been developed over the previous half century is emphasised. The measures taken to reintroduce systems of control of infection particularly surveillance at local, district, national and European level are detailed The importance of considering the effects of an vii viii Foreword epidemic on social, mystical and religious thought must be appreciated. This book is both an autobiography and an historical report including fi nally a perspective from today with hopes for the future. The book is therefore essential reading for those who wish to prevent overwhelming epidemics in any part of the world especially if they intend to propose changes in health care structure. Professor Keith Shinton Emeritus Professor of Postgraduate Medical Education University of Warwick United Kingdom Preface This book had its origin in a “valedictory” presentation which I gave at Birmingham University in December 2008 to mark the end of my honorary senior lectureship. The fact that the earlier part of the book constitutes a reworking of familiar h istorical narrative represents a kind of paradox for me as I grew up in a house- hold where Henry Ford’s dictum that “History is bunk” was the received wisdom, the result of my father’s having worked at the Ford Motor Company in Detroit in the late 1920s. My conversion came much later as the result of taking my young son to see the fi lm Richard III, in which the combination of Shakespeare’s dialogue, Olivier’s acting and Walton’s music had the power to present historical events as a gripping drama. By a curious coincidence, at about the same time, I came across an account of the disease known as the “English sweat” and refl ected that, had Henry’s victori- ous troops known what was about to assail them shortly after Bosworth Field, they would perhaps been less triumphalist. I have not attempted to create a continuous narrative in the fi rst three chapters, rather a series of epidemiological snapshots of England at times of signifi cance, such as the rapid assembly of a network of local public health authorities when cholera breached the supposedly protective wall of maritime quarantine. From Chap. 4 onwards I have tried to present the account from a personal point of view, as an individual sometimes on the periphery of events, frequently affected by organ- isational change but only rarely in a position to infl uence it. In doing so, I hope to have been able to re-create the atmosphere of a number of situations: the chattering teeth of a line-up of shivering 10-year olds nervously awaiting their fi rst inocula- tion; the surreal absurdity of an emergency 1-day promotion to ensure that both Army Regulations and WHO requirements were met; the horror of learning, many years afterwards, that my determination to prevent a smallpox outbreak had led to my unwittingly breaking, probably, several laws. Understandably, I hope, my adopted home town of Coventry receives many mentions, as I have spent the greater part of my professional life in that vibrant city. ix
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