The plague in Bologna in the year 1527

In the year 1527, following the invasion of Italy by Landsknechts, who were headed by Georg von Frundsberg, the bubonic plague appeared in the country. These soldiers were part of an army that Charles V sent to invade Italy in order to subjugate the Italian states which had adhered to the League of Cognac. In Bologna during the year 1527 believers held a procession from the Sanctuary of the Madonna del Soccorso, through the city, as far as the Church of San Rocco. The reason for this practice was linked with the plague epidemic. After some cases of plague observed in the Borgo di San Pietro district the miracle of the interruption of the epidemics, thanks to the intervention of Our Lady, was narrated by the faithfuls. Later, after several decades, it was reported by several authors from Bologna, who were not witnesses to the facts, that the epidemic had involved 12,000 out of a total population of around 60,000 inhabitants at that time. We re-evaluated this situation starting from the demographic data concerning the citizens in Bologna during the 15th, 16th and 17th centuries. Furthermore, we performed a search in the State Archives in the city of Bologna in order to find any public notices from the city authorities in the year 1527 aiming to counteract a plague epidemic. Our investigation found no elements to support the outbreak of this disease. Throughout the 16th century, until 1590, the population grew significantly, and no public notices were issued or specific laws enacted to deal with the plague until the year 1557. However, it remains possible that in the area in question, some episodes of plague occurred, but it was fortunately a micro-epidemic, which involved a very poor area of the city. Then this disease was self-limited. However, in our opinion, this episode proved very important, since in this district of Bologna, and around a wooden image of the Madonna del Soccorso, a confraternity took place, and its activities continued until the year 1798. This group of citizens also played a major role in many charitable activities to aid the inhabitants of Bologna, during a difficult historical period, namely the Protestant Reformation, and contributed to strengthen the faith of Catholic believers.

[Infectious Socialization-The History of Contagious Bodies]

This paper is part of Forum COVID-19: Perspectives in the Humanities and Social Sciences. Being a "trauma of mankind" epidemics have been a major subject of historical research for a long time and regarding every historical period. Recurring to the concept of Rudolf Schlögl ("Vergesellschaftung unter Anwesenden") my proposal is to research epidemics as a history of the communicating body and thus including the contagium as part of this communication.

[The "Plague Doctor's Mask" in the German Museum for the History of Medicine, Ingolstadt]

This paper is part of Forum COVID-19: Perspectives in the Humanities and Social Sciences. The figure of the plague doctor with the beak mask has become the symbol of the plague par excellence. It's little wonder that the plague mask in the collection of the German Museum of the History of Medicine in Ingolstadt (Bavaria) is one of the museum's most popular objects and motifs. This forum paper investigates the figure of the plague doctor on several levels: first, it analyses contemporary textual and image sources in regard to protective clothing used in times of plague and the respective role of the beak-like part of the mask. Then it takes a close look at the Ingolstadt specimen. By examining the mask's materiality and fabrication, questions of its authenticity and practicability are raised. Finally, the Ingolstadt mask is compared with the specimen at the German Historical Museum in Berlin.The conclusion: the beak mask is not mentioned before the mid-seventeenth century, and then only in Italy and Southern France. There is no proof at all of its use during plague outbreaks in Middle Europe. And the specimens in Ingolstadt and Berlin? Both masks present details which suggest that they were not used as protective clothing at all. We do not know, however, if they were produced as replicas for historic reasons or as fakes for the modern art market.

Entomological surveillance with viral tracking demonstrates a migrated viral strain caused dengue epidemic in July, 2017 in Sri Lanka

Dengue is the most important mosquito-borne viral infection disease in Sri Lanka triggering extensive economic and social burden in the country. Even after numerous source reduction programmes, more than 30,000 incidences are reporting in the country every year. The last and greatest dengue epidemic in the country was reported in July, 2017 with more than 300 dengue related deaths and the highest number of dengue incidences were reported from the District of Gampaha. There is no Dengue Virus (DENV) detection system in field specimens in the district yet and therefore the aim of the study is development of entomological surveillance approach through vector survey programmes together with molecular and phylogenetic methods to identify detection of DENV serotypes circulation in order to minimize adverse effects of imminent dengue outbreaks. Entomological surveys were conducted in five study areas in the district for 36 months and altogether, 10,616 potential breeding places were investigated and 423 were positive for immature stages of dengue vector mosquitoes. During adult collections, 2,718 dengue vector mosquitoes were collected and 4.6% (n = 124) were Aedes aegypti. While entomological indices demonstrate various correlations with meteorological variables and reported dengue incidences, the mosquito pools collected during the epidemic in 2017 were positive for DENV. The results of the phylogenetic analysis illustrated that Envelope (E) gene sequences derived from the isolated DENV belongs to the Clade Ib of Cosmopolitan genotype of the DENV serotype 2 which has been the dominant stain in South-East Asian evidencing that a recent migration of DENV strain to Sri Lanka.

Epidemic of Chronic Kidney Disease of Nontraditional Etiology in El Salvador: Integrated Health Sector Action and South-South Cooperation

In El Salvador, chronic kidney disease had reached epidemic propor-tions towards the end of this century's first decade. In 2011-2012, the Ministry of Health reported it was the leading cause of hospital deaths in men, the fifth in women, and the third overall in adult hospital fa-talities. Farming was the most common occupation among men in dialysis (50.7%). By 2017, chronic kidney disease admissions had overwhelmed hospital capacity.In 2009, El Salvador's Ministry of Health, Cuba's Ministry of Public Health and PAHO launched a cooperative effort to comprehensively tackle the epidemic. The joint investigations revealed a total prevalence of chronic kidney disease in the adult population of farming communities higher than that reported internationally (18% vs.11%-14.8%), higher in men than in women (23.9% vs 13.9%) and higher in men who were farmers/farmworkers than in men who were not (31.3% vs. 14.8%). The disease was also detected in children. An association was found between chronic kidney disease and exposure to agrochemicals (OR 1.4-2.5). In 51.9% of all chronic kidney disease cases, traditional causes (diabetes, hyperten-sion, glomerulopathies, obstructive nephropathies and cystic diseases) were ruled out and the existence of a particular form of chronic kidney disease of nontraditional etiology was confirmed (whose initial cases were reported as early as 2002). In the patients studied, functional altera-tions and histopathologic diagnosis confirmed a chronic tubulointerstitial nephritis; most presented with neurosensory hearing loss, altered tendon refiexes and tibial artery damage. The main results of this cooperation were the epidemiologic, physio-pathologic, clinical and histopathologic characterization of chronic kid-ney disease of nontraditional etiology. This characterization facilitated case definition for the epidemic and led to the hypothesis of systemic toxicity from agrochemicals (e.g., paraquat, glyphosate), which par-ticularly affect the kidneys and to which farmers/farmworkers (who may also become dehydrated in the fields) are most exposed. The research thus also laid the foundations for design of comprehensive intersectoral government actions to reduce cases and put an end to the epidemic. KEYWORDS Chronic kidney disease; chronic renal failure; tubuloint-erstitial nephritis; epidemiology; histopathology; international coopera-tion; agrochemicals; environmental pollutants, noxae, and pesticides; occupational health; PAHO; El Salvador; Cuba.

Cholera epidemic and quarantine of open ports in Joseon in 1886

In 1886, cholera was prevalent nationwide in Joseon. This year was not yet the time when the Joseon government officially overhauled quarantine rules to go into effect. Thus, quarantine efforts to prevent cholera varied depending on each of the three opening ports in the Joseon Dynasty. In Wonsan, officials of the three countries(Joseon, Japan and Qing) discussed ways to deal with cholera, and quarantine activities were carried out smoothly. On the other hand, Busan underwent friction and conflict between the parties over the implementation of quarantine rules within the region. When the Japanese consulate said that it would establish quarantine rules first and implement them, officials from various countries, including the Joseon Dynasty, strongly protested against the movement, saying that they did not reach prior consent. On top of that, economic interests were also affecting circumstances of port trade. In Incheon, there were differences between the home country and the local consulate over the urgent issue to be dealt with locally and the legal principles of applying the treaty. Since consular officials were not authorized to establish quarantine rules, the situation was settled into cancellation of the rules already issued there. The Japanese consul working at each port in the Joseon Dynasty suggested specific rules to develop quarantine activities. At this point, we can read Japan's intention to preempt the standard of future quarantine inspections. The enforcement of quarantine rules, however, was a matter that required consent from the Joseon official Gamri, the Acting Commissioner of the Joseon Maritime Customs and diplomats from each country. Furthermore, they had to go through the process of obtaining review and approval from their home countries if there were any problems in the operation of the treaty. The establishment and implementation of quarantine rules were complicated by interests of various players in each country concerning protection of their own citizens. Even though it was timely and the purpose of implementation was good, it could not follow through the quarantine rules as proposed by the Japanese consul at the opening port. The accumulation of quarantine experience and information at each port of Joseon in 1886 provided the foundation for the Joseon government to move toward to establish quarantine rules and implement them with the consent of each country in the following year.

Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs

OBJECTIVE

Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed ancient classics and human studies.

METHODS

Historical records on prevention and treatment of infections in CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February, 2020. Research evidence included data from clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases.

RESULTS

The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36, 95% confidence interval 0.24-0.52; n=4). For prevention of COVID-19, 23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao).

CONCLUSIONS

Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.

An Analysis of the United States and United Kingdom Smallpox Epidemics (1901-5) - The Special Relationship that Tested Public Health Strategies for Disease Control

At the end of the nineteenth century, the northern port of Liverpool had become the second largest in the United Kingdom. Fast transatlantic steamers to Boston and other American ports exploited this route, increasing the risk of maritime disease epidemics. The 1901-3 epidemic in Liverpool was the last serious smallpox outbreak in Liverpool and was probably seeded from these maritime contacts, which introduced a milder form of the disease that was more difficult to trace because of its long incubation period and occurrence of undiagnosed cases. The characteristics of these epidemics in Boston and Liverpool are described and compared with outbreaks in New York, Glasgow and London between 1900 and 1903. Public health control strategies, notably medical inspection, quarantine and vaccination, differed between the two countries and in both settings were inconsistently applied, often for commercial reasons or due to public unpopularity. As a result, smaller smallpox epidemics spread out from Liverpool until 1905. This paper analyses factors that contributed to this last serious epidemic using the historical epidemiological data available at that time. Though imperfect, these early public health strategies paved the way for better prevention of imported maritime diseases.

Looking Sideways: Locating Epidemics and Erasures in South Asia

While focused on the United States, Rosenberg's work on epidemics offers a nuanced framing that defines the stages and unfolding trajectories of epidemics. His writing is a good starting point to analyze the scope and challenges of epidemic historiography in South Asia. To redress its gaps, I have suggested an approach focused on writing histories of epidemics "sideways" and examined plague and influenza epidemics to situate the fluid politics of lived risks and marginality, moving away from dominant interpretations that have tried to characterize epidemics as finite and episodic.

Reconsidering the Dramaturgy

This essay reconsiders epidemic narratives through the lens of polio to examine temporal shifts and overlapping and conflicting temporalities and assess some of the stakes in how we conceptualize the epidemic dramaturgy. I argue that while the dramaturgy of epidemics serves as a thread around which people, state actors, and institutions organize experiences, responses, and expectations, consideration of the multiplicity of epidemic temporalities is crucial in understanding how medical practice and knowledge are shaped and transferred, particularly with attention to actors that might be rendered invisible by the conventional narrative arc.

The Dramaturgy of Epidemics

My essay focuses on Charles Rosenberg's provocative and enduring ideal type of epidemic drama in three acts, which he assembled from a vast knowledge of disease history that stretched from the end of the seventeenth century to his then-present pandemic, HIV/AIDS of the 1980s. Reaching back to the Plague of Athens, my essay elaborates on Rosenberg's dramaturgy by questioning whether blame, division, and collective violence were so universal or even the dominant "acts" of epidemics not only before the nineteenth century but to the present. Instead, with certain pandemics such as yellow fever in the Deep South or the Great Influenza of 1918-20, unity, mass volunteerism, and self-abnegation played leading roles. Finally, not all epidemics ended "with a whimper" as attested by the long early modern history of plague. These often concluded literally with a bang: lavish planning of festivals of thanksgiving, choreographed with processions, innumerable banners, commissions of paintings, ex-voto churches, trumpets, tambourines, artillery fire, and fireworks.

Epidemics Have Lost the Plot

This article draws on Charles Rosenberg's classic essay "What Is an Epidemic?" (1989) to reflect on the complex narrative structures and temporalities of epidemics as they are experienced and storied. We begin with an analysis of Rosenberg's use of Albert Camus's The Plague and a discussion of how epidemics have been modeled in literature and in epidemiology concomitantly. Then, we argue that Charles Rosenberg's characterization of epidemics as events bounded in time that display narrative and epidemiological purity fails to account for the reinvention of life within health crises. Adopting the ecological, archaeological, and anthropological perspectives developed within African studies enriches the range of available plots, roles, and temporal sequences and ultimately transforms our way of depicting epidemics. Instead of events oriented toward their own closure, epidemics might be approached as unsettling, seemingly endless periods during which life has to be recomposed.

An analysis of deaths in Tuliszków parish caused by a cholera epidemic in 1831

BACKGROUND

Information is presented about cholera as an infectious disease and an epidemic in Polish lands and in Europe in 1831 based on old and modern sources.

OBJECTIVE

To analyze the difference in the percentages of deaths from cholera depending on age, in the Tuliszków parish during the cholera epidemic in 1831.

MATERIAL AND METHODS

A query was carried out in the archives. Information on deaths between 1829 and 1839 was obtained from the parish registry files. The following factors were taken into account: the cause of death, the age of the deceased and the place of residence. For individual age groups, the numbers of people who died of cholera in 1831 and those who died from other causes in the control year 1835 were compared by the Fisher test. The GBL and PubMed database was searched using the keywords: cholera, cholera epidemic, deaths, Tuliszków, the year 1831, Holy Spirit Hospital, Konin.

RESULTS

An outbreak of cholera in Tuliszków parish in 1831 began around the 8th of August and lasted until about the 10th of October. 81 people died of cholera: 74 people in Tuliszków and 7 people in Sarbicko. The number of deaths in infants and children up to 5 years of age was in fact significantly lower than in other age groups (p = 0.0052). The percentage of deaths from cholera compared to deaths from other causes among infants and children under 5 years of age decreased from 52.46% to 28.4%. In the age group of 20 to 40 years old it increased from 13.11% to 23.46% and in the age group over 55 years from 9.84% to 19.75%.

CONCLUSIONS

In Tuliszków parish in 1831, the number of deaths of infants and children under 5 years of age caused by cholera was indeed significantly lower than in other age groups (p = 0.0052).

Epidemics from the Perspective of Professional Nursing: Beyond Germs, Public Health, and Pot Banging

In his classic article, Charles Rosenberg brilliantly sets up epidemics as social phenomena of three interrelated stages-progressive revelation, develop ment of an explanatory framework to manage randomness, and negotiation of public response. This framework, although written almost thirty years ago, still resonates. Even as we have experienced different kinds of infectious epidemics over the last century (Ebola, AIDS), his stages still help us understand how society constructs the meaning of epidemics and manages policies, structures, and postepidemic explanations. Whether Rosenberg's three stages actually help frame the meaning of an epidemic for individual patients and professional care providers, for whom the epidemic is local and personal, is the subject of this essay, with an emphasis on the following question: What is the meaning of an epidemic from a nursing perspective?

Epidemics And Disability

This essay argues that considering disability and disability history needs to be part of any history of epidemics. Recent scholarship has shown the many intersections of disability history and history of medicine. This essay argues that disability plays many roles in an epidemic from establishing pre-existing conditions, to affecting the acute phase of the disease, to creating lingering disabilities in the long aftermath. Histories of epidemics that ignore the many ways in which disability affects the experience of an epidemic are incomplete.

Introduction: Reimagining Epidemics

Over the past year, historians of medicine have found our discipline invested with a new sense of relevance. In trying to make sense of epidemics past and present, many of us have been substantially influenced by Charles Rosenberg's 1989 Daedalus essay, "What Is an Epidemic? AIDS in Historical Perspective." Writing in the middle of another unfolding global pandemic, Rosenberg suggested that all epidemics possessed similar forms of social choreography, and that applying a narrative framework could help to understand their sequence, structure, and social impact. This issue of the Bulletin offers contributions from thirteen scholars working in various geographic, chronological, and thematic areas that engage with Rosenberg's fundamental historical question about what defines an epidemic, although the question takes on different forms, and different forms of urgency, in each of their works.

Spectacles of Difference: The Racial Scripting of Epidemic Disparities

This essay explores how epidemics in the past and present give rise to distinctive, recurring racial scripts about bodies and identities, with sweeping racial effects beyond the Black experience. Using examples from cholera, influenza, tuberculosis, AIDS, and COVID-19, the essay provides a dramaturgical analysis of race and epidemics in four acts, moving from Act I, racial revelation; to Act II, the staging of bodies and places; to Act III, where race and disease is made into spectacle; and finally, Act IV, in which racial boundaries are fixed, repaired, or made anew in the response to the racial dynamics revealed by epidemics. Focusing primarily on North America but touching on global racial narratives, the essay concludes with reflections on the writers and producers of these racialized dramas, and a discussion of why these racialized repertoires have endured.