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2.
Infez Med ; 28(4): 621-633, 2020 Dec 01.
Article in English | MEDLINE | ID: covidwho-950505

ABSTRACT

The plague caused by the bacterium Yersinia pestis, provides one of the best historical examples of pandemic infection. It can therefore be considered the first "globalized" disease, thanks also to the crowds that favoured the rebalancing of infectious agents between Europe and the Middle East. In this paper we analyse all the official documents of the time, highlighting the most effective prevention measures implemented in the city of Ferrara during the Italian plague. Historical mortality data for the 1630 Italian plague in northern Italy are first analysed. In contrast to the high rates recorded throughout the area from Milan to Florence, the mortality rate in Ferrara remained normal over the period. From the city's documents it emerged that the authorities, from the 16th century onwards, had already understood that the spread of the contagion could also occur through domestic animals, although rats are never mentioned. The strength of Ferrara's response to the "plague emergency" stems from an efficient and emergency-ready health control system, financed and supported by the "permanent surveillance team of the city and the Pontifical Legation of Ferrara - Azienda Sanitaria Pubblica" even in times of great economic difficulty for the State. Among the various measures that the city of Ferrara adopted to deal with the plague the following should be mentioned: guards at the city gates, lazarettos, safety of doctors, self-isolation and treatment of every suspicious case as if it were a real case of plague, measures to support the poorer classes of the population, veterinary and hygiene standards for the city and for housing, management of Catholic religious functions and the precepts of the Legation of Ferrara, which was under papal control, closure of churches to avoid mass gatherings, and limitations of all kinds of social and economic relations within and outside the population. The broad regimen, laid down in the 16th century, contains extremely modern health rules which are very much in line with those recommended by the WHO and the health authorities of each individual state in the current COVID-19 pandemic, even starting with hand-washing. The fight against epidemics of the past, especially the history of the plague in the 17th century, anticipates very important and valid concepts, and represents a wake-up call for the recent epidemics of emerging pathogens.


Subject(s)
Pandemics/history , Plague/history , Yersinia pestis , Animals , /prevention & control , Disease Vectors , History, 17th Century , History, Medieval , Humans , Italy/epidemiology , Paintings/history , Plague/epidemiology , Plague/prevention & control , Plague/transmission
3.
Proc Natl Acad Sci U S A ; 117(44): 27703-27711, 2020 11 03.
Article in English | MEDLINE | ID: covidwho-880729

ABSTRACT

Historical records reveal the temporal patterns of a sequence of plague epidemics in London, United Kingdom, from the 14th to 17th centuries. Analysis of these records shows that later epidemics spread significantly faster ("accelerated"). Between the Black Death of 1348 and the later epidemics that culminated with the Great Plague of 1665, we estimate that the epidemic growth rate increased fourfold. Currently available data do not provide enough information to infer the mode of plague transmission in any given epidemic; nevertheless, order-of-magnitude estimates of epidemic parameters suggest that the observed slow growth rates in the 14th century are inconsistent with direct (pneumonic) transmission. We discuss the potential roles of demographic and ecological factors, such as climate change or human or rat population density, in driving the observed acceleration.


Subject(s)
Pandemics/history , Plague/epidemiology , Plague/history , Animals , History, 15th Century , History, 16th Century , History, 17th Century , History, Medieval , Humans , London , Plague/transmission , Population Density , Rats
4.
PLoS Negl Trop Dis ; 14(8): e0008251, 2020 08.
Article in English | MEDLINE | ID: covidwho-788854

ABSTRACT

Yersinia pestis, the bacterial causative agent of plague, remains an important threat to human health. Plague is a rodent-borne disease that has historically shown an outstanding ability to colonize and persist across different species, habitats, and environments while provoking sporadic cases, outbreaks, and deadly global epidemics among humans. Between September and November 2017, an outbreak of urban pneumonic plague was declared in Madagascar, which refocused the attention of the scientific community on this ancient human scourge. Given recent trends and plague's resilience to control in the wild, its high fatality rate in humans without early treatment, and its capacity to disrupt social and healthcare systems, human plague should be considered as a neglected threat. A workshop was held in Paris in July 2018 to review current knowledge about plague and to identify the scientific research priorities to eradicate plague as a human threat. It was concluded that an urgent commitment is needed to develop and fund a strong research agenda aiming to fill the current knowledge gaps structured around 4 main axes: (i) an improved understanding of the ecological interactions among the reservoir, vector, pathogen, and environment; (ii) human and societal responses; (iii) improved diagnostic tools and case management; and (iv) vaccine development. These axes should be cross-cutting, translational, and focused on delivering context-specific strategies. Results of this research should feed a global control and prevention strategy within a "One Health" approach.


Subject(s)
Neglected Diseases/prevention & control , Plague/prevention & control , Yersinia pestis , Animals , Disease Outbreaks/prevention & control , Disease Reservoirs/microbiology , Humans , Insect Vectors , Madagascar/epidemiology , Neglected Diseases/epidemiology , Plague/epidemiology , Plague/transmission , Rodentia , Siphonaptera
5.
Postgrad Med J ; 96(1140): 633-638, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-751465

ABSTRACT

After the dramatic coronavirus outbreak at the end of 2019 in Wuhan, Hubei province, China, on 11 March 2020, a pandemic was declared by the WHO. Most countries worldwide imposed a quarantine or lockdown to their citizens, in an attempt to prevent uncontrolled infection from spreading. Historically, quarantine is the 40-day period of forced isolation to prevent the spread of an infectious disease. In this educational paper, a historical overview from the sacred temples of ancient Greece-the cradle of medicine-to modern hospitals, along with the conceive of healthcare systems, is provided. A few foods for thought as to the conflict between ethics in medicine and shortage of personnel and financial resources in the coronavirus disease 2019 era are offered as well.


Subject(s)
Coronavirus Infections/epidemiology , Ethics, Medical/history , Health Care Rationing/ethics , Hospitals/history , Pandemics/history , Pneumonia, Viral/epidemiology , Quarantine/history , Betacoronavirus , Cholera/epidemiology , Cholera/history , Health Workforce , Hippocratic Oath , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , History, Ancient , History, Medieval , Humans , Leprosy/epidemiology , Leprosy/history , Plague/epidemiology , Plague/history , Resource Allocation , United States/epidemiology
6.
Arch Iran Med ; 23(8): 578-581, 2020 08 01.
Article in English | MEDLINE | ID: covidwho-749392

ABSTRACT

In the past two centuries, several fatal infectious outbreaks have arisen in Iran. Presented here is a brief historical account of four fatal epidemics including cholera, plague, Spanish influenza of 1918 and smallpox between1796 and 1979. The lessons from these outbreaks could be helpful for better combatting other deadly epidemics including the present-day disastrous COVID-19 pandemic.


Subject(s)
Cholera/history , Communicable Disease Control/history , Epidemics/history , Influenza Pandemic, 1918-1919/history , Plague/history , Smallpox/history , Cholera/epidemiology , Cholera/prevention & control , Epidemics/prevention & control , History, 19th Century , History, 20th Century , Humans , Iran/epidemiology , Plague/epidemiology , Plague/prevention & control , Smallpox/epidemiology , Smallpox/prevention & control
9.
J Clin Epidemiol ; 125: 164-169, 2020 09.
Article in English | MEDLINE | ID: covidwho-597209

ABSTRACT

The crisis spurred by the pandemic of COVID-19 has revealed weaknesses in our epidemiologic methodologic corpus, which scientists are struggling to compensate. This article explores whether this phenomenon is characteristic of pandemics or not. Since the emergence of population-based sciences in the 17th century, we can observe close temporal correlations between the plague and the discovery of population thinking, cholera and population-based group comparisons, tuberculosis and the formalization of cohort studies, the 1918 Great Influenza and the creation of an academic epidemiologic counterpart to the public health service, the HIV/AIDS epidemic, and the formalization of causal inference concepts. The COVID-19 pandemic seems to have promoted the widespread understanding of population thinking both with respect to ways of flattening an epidemic curve and the societal bases of health inequities. If the latter proves true, it will support my hypothesis that pandemics did accelerate profound changes in epidemiologic methods and concepts.


Subject(s)
Epidemiologic Methods , Pandemics/history , Acquired Immunodeficiency Syndrome/epidemiology , Cholera/epidemiology , Coronavirus Infections/epidemiology , HIV Infections/epidemiology , History, 17th Century , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Influenza, Human/epidemiology , Plague/epidemiology , Pneumonia, Viral/epidemiology , Tuberculosis/epidemiology
10.
Hastings Cent Rep ; 50(3): 50-53, 2020 May.
Article in English | MEDLINE | ID: covidwho-619245

ABSTRACT

When confronted by the novel ethical challenges posed by a pandemic, it is helpful to turn to history for guidance and direction. In this essay, the author revisits Thucydides's description of the Plague of Athens from The Peloponnesian War as he considers the New York State Task Force on Life and the Law's 2015 guidelines on ventilator allocation. Confronted by the exigencies of the Covid-19 surge that struck New York, he questions the task force's decision not to give any degree of preference to health care workers who might become ill. He posits that they are due a compensatory ethic and some deference given the risks they have assumed, often with inadequate protective gear. Reflecting on his ambivalence, he asks if his change of heart reflects the impact of experiential learning or the erosion of nomos-or governing norms-described by Thucydides when the plague struck Athens.


Subject(s)
Bioethical Issues , Clinical Protocols/standards , Coronavirus Infections/epidemiology , Health Personnel , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/epidemiology , Betacoronavirus , Greece/epidemiology , Humans , New York City/epidemiology , Pandemics , Plague/epidemiology
11.
Acta Biomed ; 91(2): 226-229, 2020 05 11.
Article in English | MEDLINE | ID: covidwho-314164

ABSTRACT

The ongoing 2020 coronavirus disease (COVID-19) pandemic is an enormous challenge for the health systems and the entire societies of the countries involved. Since at present the outbreak continues to evolve (April 2020), the World Health Organization (WHO) has declared it a public health emergency of international concern, specifying that public health interventions aimed at the prevention of the further spread of this disease include quarantine. Quarantine, that may be defined as a restraint on the activities of people or on the traffic of goods, targeted to the prevention of the diffusion of communicable pathologies, is a health concept profoundly rooted in the history of mankind. The lessons of the past are always pertinent for the present and for the future, in particular from a public health standpoint. One of the most relevant of them is connected with previous influenza pandemics, similar to the current COVID-19 2019/2020 pandemic, and it indicates that it is practically impossible, even in recent times, to contain the infection in the geographic area where it has risen and to prevent its trans-national disseminated spread. With specific reference to the COVID-19 pandemic, therefore, health authorities still adopt "classical" preventive interventions, namely workplace social distancing measures and quarantine, to reduce the transmission of the disease. Only the future will testify the precise overall effectiveness of preventive public health measures in containing the impact of the present coronavirus pandemic. However, what in this epidemiological scenario is already known, is that the multi-century international health value of quarantine remains essential and unavoidable.


Subject(s)
Coronavirus Infections , Pandemics , Plague , Pneumonia, Viral , Quarantine , Betacoronavirus , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Humans , Plague/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology
12.
Acta Biomed ; 91(2): 234-235, 2020 May 11.
Article in English | MEDLINE | ID: covidwho-295716

ABSTRACT

In western democracies, individual behaviour will be crucial to control the spread of COVID-19, as well as government actions [1] that unfortunately, except China, South Korea and Italy, followed by others,  seems to be generally unconvinced and, speculatively, late. Indeed human history has been marked by epidemics/pandemics which have affected, more or less, large geographical areas [2]. Italy, as well as the rest of Europe, has often been affected by these phenomena and, Lombardy, due to his position, was, as today by COVID-19, severely stroked in Italy that is, after China, the second most affected country [3]. This is also linked to the position of Lombardy and its capital, Milan, but this is beyond this brief comment. There are several differences between the past plagues and the actual COVID-19 pandemic and these must be sought in the increased ability to transmit diseases at-distance through the mobility of humans and goods [4], and in the catastrophic consequences of the breakdown of ecosystems, as told, a few years ago, by David Quammen in the book Spillover [5].


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Plague/history , Pneumonia, Viral/epidemiology , History, 17th Century , Italy/epidemiology , Pandemics , Plague/epidemiology
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