Miasma and mass graves

I mentioned in class that the fear of disease spreading from unburied corpses is largely unfounded and probably dates back to our fear of miasma. The worst miasma was that created from decaying corpses.

I wanted to chase up a citation for this since this comment was something I originally came upon in a historical paper on miasma. I found this press release, Mass burials do more harm than good, from UCLA Center for Public Health and Disasters that not only substantiates this comment but raises several points I hadn't considered about why the very hasty burial of bodies, in mass graves following large natural disasters for example, may be problematic.

(H)ealth workers said it was a myth that dead bodies constituted an acute health risk after earthquakes.
"As far as public health professionals have been able to determine, this concern has never been substantiated," Steven Rottman, director of the UCLA Center for Public Health and Disasters, told AlertNet.
Rottman said no scientific evidence existed that bodies of disaster victims increased the risk of epidemics, adding that cadavers in fact posed less risk of contagion than living people. 

Indiscriminate burial demoralises the survivors and can lead them to be deprived of transferable pension benefits through failure to provide death certificates for pension holders.
In some countries it is difficult for survivors -- especially women -- to prove their ownership of inherited property without proper documentation.
Alexander pointed out that spraying was a waste of disinfectant and manpower. 

The World Health Organisation has long challenged the often-cited need to conduct quick mass burials after earthquakes to prevent the spread of disease.
"The most pressing issue is preserving the identity of those who have lost their lives," its U.S. arm, the Pan American Health Organisation, said in a report in October. "Under no circumstances are burials in common graves or cremations justified or warranted."

The Sewer King

I haven't watched it yet but I just discovered that Episode 4 of a BBC series entitled Seven Wonders of the Industrial Age is all about Joseph Bazalgette and the construction of London's sewer system.

Set in London during the 1850s, this episode focusses on the construction of the London sewerage system, built to replace the antiquated medieval system that was overworked and inadequate for the needs of the-then largest metropolis in the world, causing epidemics of disease and a permanent foul stench to fill the air. The episode follows the efforts and work of Joseph Bazalgette, the brilliant engineer who designed the influential and modern sewer system that would purify the city, transform the streets above and would result in the end of the epidemics of cholera and typhoid that had ravaged the population - although, ironically not for the reasons that he initially thought.

I found it on YouTube but only with subtitles I'm afraid. Looks good if you like your history reenacted.

First case of Cholera in Haiti

Man collecting water in Port-au-Prince, Haiti.

Earlier this week a Boston aid group reported that it had tracked down the first person to be infected by Cholera in Haiti's epidemic. Cholera had been eliminated from Haiti for many decades prior to the recent earthquake

A mentally ill man who bathed in and drank from a contaminated river most likely was the first person to be infected in the Caribbean country's deadly cholera outbreak. Althoug the man's family had access to clean drinking water he bathed in and drank frequently from a river into which the Meye River fed. The Meye has been identified as the likely source of the epidemic. Studies suggest the cholera was likely brought to Haiti by a United Nations peacekeeping battalion from Nepal, where the disease is endemic.

"It's a striking example of how mental health, infectious disease and community health affects overall well-being." Dr David Waltern, a co-author of the study.

Given the conditions in Haiti it is perhaps inevitable that cholera might break out but this interaction with mental health is especially interesting, and tragic.

Great stink

In the sweltering summer of 1858 the stink of sewage from the polluted Thames was so offensive that it drove Members of Parliament from the chamber of the House of Commons. Sewage generated by a population of over two million Londoners was pouring into the river and was being carried to and fro by the tides. The Times called the crisis "The Great Stink". Parliament had to act - drastic measures were required to clean the Thames and to improve London's primitive system of sanitation.

I was going to post a link to some more information about the book I mentioned, The Great Stink of London, in case anyone was curious about this, the smelliest period in history, when I discovered that someone has written a novel about it with a very similar title set in the same era.

It takes a world of confidence to name your debut novel The Great Stink, and to set it in a sewer. Not even a modern sewer--charmless though that may be--but the crumbling, cholera-laden, rat-infested, fungus-rich sewers of London in the mid-Victorian period, from which pockets of deadly gas frequently burbled to the surface. Clare Clark's unsavory but completely absorbing first novel is a Dantean tour of this reeking underworld and its denizens: both the scavengers--human and animal--and the reformers, who brave the tunnels in the service of public hygiene and social progress after the 1858 Act of Parliament that called for the rebuilding of the sewer system. The Great Stink juxtaposes two darknesses, both embodied in the filthy tunnels: the lawless desperation of the very poor, and the despair of madness.

#cholera

Thanks to Julio for the tip on this article today in Nature reporting on a study that showed social media data, including Twitter posts, accurately tracked Haiti's cholera outbreak and provided this data up to two weeks before official reports.

Such data could allow health workers to "gain early insight into an evolving epidemic" — and help plan a response sooner.

Just an appendix...

Cholera cases by region. The size of a region shows the proportion of all cholera cases found in that region

We barely had time to get started with Cholera today but there was an interesting article on the Scientific American blog last week about how the appendix may not be as useless as we previously thought.

The essence of the argument is that in the presence of serious diarrheal diseases like Cholera the appendix forms a refuge for beneficial gut bacteria that are being purged from your intestines (hopefully along with the Cholera bacteria).

(T)he appendix serves as a nature reserve for beneficial bacteria in our guts. When we get a severe gut infection such as cholera (which happened often during much of our history and happens often in many regions even today), the beneficial bacteria in our gut are depleted. The appendix allows them to be restored.  In essence, Parker sees the appendix as a sanctuary for our tiny mutualist friends, a place where there is always room at the inn. If he is right, the appendix nurtures beneficial bacteria even as our conscious brains and cultures tell us to kill, kill, kill them with wipes and pills.

Welcome

Welcome to the blog for EEMB40 - the Ecology of Disease - for Winter 2012. It will also serve as a class website and you will find links to lectures etc. in a box at the top right imaginatively called 'links'. Lecture slides will be available shortly after each lecture. They are put there for your convenience (you don't need to scribble down details of a graph because you know it will be available later) but please note that they are not designed to be lecture notes. In fact in most cases my slides would make very poor notes. In order to help you take notes I have made a glossary for the class - also linked on the right. All the terminology you will be required to know is listed in the glossary.

You are all welcome, and encouraged to post here. To do that all you need to do is to send me an e-mail saying just that. I will then add your address and Google will send you an invitation to be an author. Just follow the simple instructions and away you go.

Postings to the blog should be relevant to the class but the blog is specifically designed to be a place where you don't need to worry about how relevant your post is. (I give you 'Basket full of puppies' as an example). I will be posting lots of things that I read in the news or that I take out of lecture (for time purposes) but that some of you may find interesting. By putting it here you can look at it at your leisure and you know it won't be on the exam.

I try to post every day when the class is running and, where possible, the postings are relevant to the current topics we are covering in class. You can access older postings (there are nearly 800 of them from the previous times I have taught this class) by using the 'Labels' (scroll down and they'll be on the right hand side) to pull up posts on particular topics.