The Decline Of Infectious Diseases

Credit for the decrease of infectious diseases, epidemics, and a dramatic decrease of women dying in birth has to be given for the social reformers. Vocal social reform groups relentlessly campaigned for clean water, sewage and garbage disposal systems, improved housing, access to clean and healthy food sources, better-paying jobs for industrial workers, and education for all.

Brian Inglis, Medical Historian and a whole lot of other things...

"Incessant warfare at the frontier, political oppression within its boundaries, and civil disaffection in and around the seat of government, all lead to the kind of inefficiently run, disorganized and dissatisfied society of a kind which is custom made to encourage the spread of an infectious disease, when one is introduced'.

Plagues have always been associated with the poorer communities throughout human history. Poverty, poor living standards, and malnutrition were the vanguards, the handmaidens of the plagues and infectious diseases. Link
Philosophers and spiritual leaders have known that the health of the community were dependent on their environment and a virtuous leadership. Where there is corrupt leaders there is always poverty and disease. Link
Pliny a Roman Statesman during the 6th century wrote in one of his treatise that the Romans were healthy because of their continuous attention to hygiene. Proper hygiene included proper sanitation of human waste and clean water for everyone. Link

A detailed demographic history of London in the late sixteenth and early seventeenth centuries has largely been a mystery. In this article we analyzed a large sample of London parish records, allowing us to reconstruct the spatial and temporal properties of London mortality in the plague era, and to see how these responded to living standards. We found that mortality in the major plagues ran at around five to six times normal mortality, while the impact of plague on richer city parishes fell through time and its impact on suburban parishes rose. Looking at the spatial diffusion of plague, we find a consistent pattern of crisis mortality first emerging in the poor northern suburbs, although this sometimes coincided with its emergence in eastern parishes. Looking at the seasonality of mortality, we found that mortality before 1665 peaked in the autumn as we would expect with plague, but that this pattern persisted for several decades after the supposed disappearance of plague, especially in poorer suburbs of the city..

Fifty percent of the children living in London during 1800 died before the age of five years old. If you have read my “The History of Vaccines,” London was a cesspool. The living conditions are unimaginable to those who live in the West Today. People, multiple families were crammed into one room apartments without plumbing or running water, the air was feted without any means of circulation as well as dark with coal that ran their industry. Most were too poor to heat their poor homes. The water was taken from rivers were open sewers allowed to flow into the river. Edwin Chadwick lawyer who championed the poor published a report on the poor and impoverished of London stated:

"That the various forms of epidemic, endemic and other disease caused, or aggravated, or propagated chiefly among the laboring classes by atmospheric impurities produced by decomposing and vegetable substances, by damp and filth, and dose and overcrowded dwellings prevail among the population in every part of the Kingdom, whether dwelling in separate houses, in rural villages, in small towns, in the larger towns - as they have been found to prevail in the lowest districts of the metropolis.

”That such disease, wherever its attacks are frequent, is always found in connection with the physical circumstances above specified... and where the removal of the noxious agencies appeared to be complete, such disease almost entirety disappears.

Because of the Edwin Chadwick's speaking out for the poor galvanized the elite and middle class were inspired to the champion construction of a complete sanitation system for everyone. Many of the elite class fought the battle because of the cost. Chadwick didn't address poor wages and nutrition for the working class, and he would eventually step away from his leadership position because of his narrow views.

The sanitation campaign won their funding, new housing policies, improvement in living standards and working conditions introduced by the British government through policies like the “Public Health Act (1848) started creating a healthy environment for all citizens. As the cities cleaned up their act infectious diseases and deaths also started to decline, this was before the mandatory vaccine policies began being strictly enforced. During that time vaccines were given by rubbing a mix of cow teat pus, horse hoof pus, and other putrid materials onto open wounds….

When the Panama Canal was under construction Major William Gorgas, the United States Sanitary Officer reduced yellow fever by imposing hygiene and sanitation for the white construction workers. Sanitation and hygiene were not introduced to the Black laborers, and the deaths from yellow fever and other disease continued unabated.

Because of Pettenkofer’s efforts galvanized a major movement to clean up Munich fresh water was provided to all houses, which also included a working system of sewage disposal. Typhoid deaths declined dramatically, from 72 per 1,000,000 in 1880 to 14 per 1,000,000 population in 1898. The correlation between the decline of infectious diseases and cleaning up cities is hard to miss!

The Deadly River cholera:

"It is a disease that rapidly spreads whenever there is a serious breakdown in sanitary services .... During an epidemic in 1854, Snow was able to prove that areas of London supplied by water from the relatively dean upper Thames were much freer from incidences of cholera that those sections of the city supplied with water from the human sewage fouled lower Thames. By 1866, much of the main drainage scheme of the London metropolis was established and water companies were supplying much of the city with water from the uncontaminated upper Thames. With sanitary reform cholera was virtually eliminated from England'.

Herbert M Shelton who wrote, Hygienic Care of Children wrote:

"It is now everywhere admitted that the decline of typhoid fever, along with typhus, cholera, bubonic plague, yellow fever etc has been due to hygiene and sanitation. The serum is pushed for commercial reasons only.”

Stella Lowry wrote in the British Medical Journal (1/20/1990):

"Sanitation has had, and continues to have more impact on health than any advance in medical science ... in 19th century Britain epidemics of cholera and typhoid were common until the introduction of clean drinking water and safe sewage disposal.

My favorite Professor Rene Dubos on tuberculosis:

"It must never be forgotten that tuberculosis is not an inevitable accompaniment of human life, as is shown by the fact that it has long remained practically non-existent in many primitive societies and that it is disappearing as an important medical problem from some limited sections of the most highly evolved modern communities. It is only through gross errors in social organization and mismanagement of individual life, that tuberculosis could reach to catastrophic levels that prevailed in Europe and North America during the nineteenth century, and that still prevails in Asia and much of South America today".

Dr. H.O. Lancaster (Medical Journal Australia 18/11/1967) writes about the decline of death rates from infectious diseases:

"Australian mortality rates have been relatively low over the last 100 years and have declined greatly at the lower ages. The declines have been due to many causes. The diminished rate of passage of infective organisms from one member of the population to another has been significant; important factors here have been the geographical, social and prophylactic isolation of cases, improved water supplies, and a general improvement in the standard of living. Surgery has played some part in the decline of mortality from violence. Medical therapy had few active drugs until the introduction of chemotherapeutic and antibiotic agents quite recently. Active immunization has played some part but passive immunization has been unimportant. Endocrine therapy has been unimportant. Nutrition has been at a high level. Public health measures against insects have been important. Social factors are difficult to separate but have been of great importance. Genetic measures have been quite unimportant.”

From the book “Health and Healing” by Dr. Andrew Weil:

"Scientific medicine has taken credit it does not deserve for some advances in health. Most people believe that victory over the major infectious diseases of the last century came with the invention of immunizations. In fact, cholera, typhoid fever, tetanus, diphtheria, whooping cough, and the others were in decline before vaccines for them became available - the result of better methods of sanitation, sewage disposal, and distribution of food and water."

There have been enough books and articles written correlating sanitation and hygiene to the reduction of infectious diseases, you could fill up my little town's library. Once I figured out I couldn’t find the data I needed to write my papers from online databases, I started searching online libraries and hit gold! Evidence linking infectious to disease to environment and living conditions comes from studies on the incidence of disease between different social classes. People who live in the lower classes have a higher incidence of respiratory and infectious disease when compared to people living in upper-income brackets.

Englands Labour Government in 1977 organized a working group chaired by Chief Scientist at the Department of Health and Social Security, Sir Douglas Black. He was tasked to investigate inequality and health. Sir Black said:

Further evidence linking the infectious disease to environment and living conditions comes from studies on the incidence of disease amongst the different social classes. It has been found that people living in the lower classes have a higher incidence of respiratory and infectious disease than people living in the upper classes. In England, 1977, the Labour Government established a working group chaired by the then Chief Scientist at the Department of Health and Social Security, Sir Douglas Black, to investigate the inequalities in health. At the time, the Secretary of State for Social Services said:

"Social class differences in mortality begin at birth. In 1971 neonatal death rates - deaths within the first month of life - were twice as high for children of fathers in social class V as they were in social class I. Death rates for the post-neonatal period - from one month up to one year - were nearly five times higher in social class V than in social class 1..

The study was finished in 1980, and the results proved the poverty of the working poor, their working conditions, poor living, and nutrition were the leading cause of poor health.

The whooping cough was higher in homes that were crowded and had poor ventilation. The families had little money or social standing. Professor Stewart stated, “a child’s social class is three times more important than vaccination in influencing whooping cough outbreaks:

"In the epidemic of 1974, notifications of whooping cough were significantly higher in crowded households!'.

The data shows the true reason for the decline in death rates from infectious diseases are correlated with better nutrition, living and working conditions, education in hygiene and sanitary practices along with education in health and living standards on a community level.

Lecture Part 1

Lecture Part 2Herbert M Shelton wrote from one of his articles, “Why We have Epidemics:”

“Scarlet fever was always every bit as fatal as diphtheria. That it declined in every way, both in incidence and in so-called virulence, as rapidly as did diphtheria, and all without a vaccine or an anti-toxin, should have vital meaning for every truth seeker. When a number of epidemic or so-called infectious diseases all decline together and immunizing agents are available for but one or two of these, it means that some common factor is responsible for the total decline, although credit for the decline in one or two diseases is given to the immunizing agent for commercial reasons. If cholera, bubonic plague, English sweat and typhus fever decline and, ultimately disappeared from Europe and America at the same time that smallpox declined and disappeared, while there was a vaccine for smallpox only, what had the cause of the decline of other diseases to do with the concomitant decline of smallpox?... if yellow fever disappeared from New Orleans after General Butler cleaned up the city and no vaccine was used, what has sanitation had to do with the disappearance of other epidemic diseases? Is vaccination a medical substitute for personal and community cleanliness?

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Are Germs The Cause Of Infectious Disease? - Part 3

The Decline Of Infectious Diseases