Living through COVID-19: What can we learn from typhoid epidemics of the past?

by guest contributor Jacob Steere-Williams, PhD, Associate Professor of History, College of Charleston.

Join us for Steere-Williams’ talk on typhoid on September 23. 

For decades, thinking about and learning from past pandemics has largely been an academic exercise, one for historians and archivists who specialize in public health. Now, in the midst of a generation-defining pandemic, COVID-19, there has been an explosion of public interest in epidemics and epidemiology. Before 2020, few Americans outside of infectious disease specialists routinely spoke the words “contact tracing” and “case fatality,” or knew the difference between isolation and quarantine.

The recent surge in popular understandings of epidemics has centered on some familiar examples, such as the 1918–1919 influenza pandemic, the mistakenly called “Spanish Flu.”[1] As this was the most significant pandemic of the 20th century, the comparisons make sense, and the public health struggle between individual rights and community health is as apt now as it was then. Other historians, seeing the rise of xenophobia as a cultural response to COVID-19 in the West, have perceptively turned our attention to 19th-century pandemics of cholera and bubonic plague. Then, as now, a uniquely durable, yet startlingly western approach to framing pandemics has been to blame Asian people and Asian cultural practices.[2] 

At a time when the cultural mileage of past pandemics is perhaps at its height in modern history, we might fruitfully turn to the history of a relatively unexplored disease, typhoid fever, to think about our current moment.

Typhoid fever is a food- and water-borne infectious disease, the most virulent of the Salmonella family. The disease continues to wreak havoc on the Global South, killing about 200,000 people each year. In the western world typhoid was at its height in the 19th century, when it was a ubiquitous and insidious reality in North America and Western Europe. In Britain, for example, typhoid annually struck up to 150,000 people, taking the lives of 20,000 each year.

Thomas Godart, “Head and Neck of a Patient Suffering from Typhoid Fever.” Courtesy of the Wellcome Library.

Typhoid’s patterns of distribution were erratic; it might spare a community for months or even years, then erupt as a local outbreak. Epidemiologists today discuss COVID-19 as a cluster disease, exploding in localized events not unlike the way that typhoid did in the past.

Interestingly, typhoid outbreaks continued after the introduction of early sanitary improvements such as toilets, pumped water, and sanitation systems. In the second half of the 19th century no infectious disease was as central to the rise of public health than typhoid. Typhoid was a model disease because the burgeoning group of public health scientists, the first to call themselves epidemiologists, saw that stopping typhoid’s different pathways—through food, water, and healthy human carriers—could transform the nation through preventive public health.[3]

“Avoid the Grip of the Typhoid Hand,” in G.S. Franklin, “Sanitary Care of Privies” (1899), from “Health and Sanitation: Disease and the Working Poor,” https://www.wm.edu/sites/wmcar/research/danvilledig/millworker-life/health-sanitation/index.php.

The story of typhoid in the 19th century is one deeply tied to the emergence of modern epidemiology, which George Buchanan, Chief Medical Officer of Britain’s central public health office, called “the minute observations of particular outbreaks.”[4] Epidemiological practice does not operate in a vacuum, then or now with COVID-19; it is inherently a political exercise. Everyday people, business owners, and politicians have to be convinced about the science of disease communication, requiring complex rhetorical strategies that tell us a great deal about the inherent struggles of public health.

“Transmission of Typhoid Fever,” in George Whipple, Typhoid Fever; Its Causation, Transmission, and Prevention (New York: John Wiley and Sons, 1908).

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Notes

[1] See, for example, a recent blog post in Nursing Clio: Jessica Brabble, Ariel Ludwig, and Thomas Ewing, “‘All the World’s a Harem’: Perceptions of Masked Women During the 1918–19 Flu Pandemic,” Nursing Clio. https://nursingclio.org/2020/09/08/all-the-worlds-a-harem-perceptions-of-masked-women-during-the-1918-1919-flu-pandemic/.

[2] Catherine E. Shoichet, “What historians hear when Trump calls coronavirus ‘Chinese’ and ‘foreign,’” CNN. https://www.cnn.com/2020/03/12/us/disease-outbreaks-xenophobia-history/index.html.

[3] Graham Mooney, “How to Talk About Freedom During a Pandemic,” The Atlantic. https://www.theatlantic.com/ideas/archive/2020/05/freedom-pandemic-19th-century/611800/.

[4] George Buchanan, “On the Dry Earth System of Dealing with Excrement,” Annual Report of the Medical Officer of the Privy Council for 1870. Parliamentary Papers. London: Eyre and Spottiswoode, 1871, 97.

Reflections on Past Pandemics: A Bibliography of Historical Articles

By Hannah Johnston, Library volunteer

Danzig_1709 0001

The plague in Danzig (in what is now Poland) in 1709, giving the death tolls from within the city (24,533), the outskirts (8,066), and the total of the two (32,599). From “Abbildung von der groszen Pest in Dantzig, 1709

From July 2019 until March 2020, with few exceptions, I spent one day out of every week in the Drs. Barry and Bobbi Coller Rare Book Reading Room of the NYAM Library. As a volunteer, I wrote for this blog, Books, Health, and History, on various topics that utilized sources from the Library’s collections; I wrote about monsters, famous female physicians, and even libraries themselves. In March, as the threat of COVID-19 became clearer, the reading room closed, and I (among many others) could no longer consult the physical collections at the NYAM Library. After discussing with Library staff, I decided that my next project would use the digital resources and collections I am lucky to have access to as a student. I compiled a bibliography of historical literature on the topic du jour—pandemics. 

Awareness that one is living through a historical moment is relatively rare; this awareness has led many to look to the past for hints as to how the current COVID-19 pandemic might impact the world going forward. In compiling this bibliography, I hoped to curate a resource that historians and history enthusiasts alike could use for research on epidemic history, personal interest, or simply to try to place our present moment in a larger historical context. I searched through several databases, including JSTOR, Project MUSE, and the History of Science, Technology, and Medicine database, looking specifically for journal articles from the last two decades which used a historical perspective to discuss pandemic or epidemic diseases. 

 

Fasciculus Plague 1509

A plague visitation scene from a 1509 edition of Fasciculus Medicinae, one of the earliest illustrated medical books to be printed. Image from the NYAM Digital Collections.

I limited my search to only those articles which are available in full digitally. This choice was made in part out of necessity—during a pandemic, a person may not be able to visit a library to find and read the journal they are looking for. Since I was “volunteering from home,” I could only read through and write descriptions for articles to which I had full digital access. Of course, this is not a perfect solution. Many articles were omitted from this bibliography because they are not available online, and they would surely have been useful.  The digital articles are still for the most part only available to readers with either individual or institutional subscriptions to the relevant databases or journals.

 

My own experience compiling this bibliography taught me quite a bit about the long and ever-changing relationship between humanity and disease throughout history. Some diseases and disease events, such as the influenza pandemic of 1918, can provide an example (or a warning) of how different public health responses can affect long-term outcomes. Others, such as the Black Death, HIV/AIDS, and countless others, show us how disease has changed art, politics, the environment, and even the minutiae of human behavior. We have already seen many of the ways COVID-19 has changed our daily lives. While it is important not to underplay the devastation wrought by epidemic disease, reading about the impacts of other, similar disease outbreaks makes it clear that this pandemic will bring with it (and perhaps already has) significant cultural, social, and economic change, and perhaps offers us some guidance in navigating the “new normal.”

 

1918 flu pandemic

Red Cross volunteers wearing and making gauze masks at Camp Devens near Boston in 1918. From the Centers for Disease Control 1918 Pandemic Historical Image Gallery.

 

Compiling the bibliography was certainly a survey for me in the history of disease, but also highlighted several obstacles brought on or exacerbated by the modern-day pandemic. The biggest of these, at least in relation to this bibliography, is access—for all the work I did to collect and curate these digital articles, and despite the fact that many databases, journals, and other resources have made some or all of their articles free to read, many of them are still accessible only to a select few. The debate over who has or should have access to academic works is one that predates the pandemic, and is perhaps beyond the scope of a blog post. The COVID-19 crisis, however, impacts everyone, and the articles in this bibliography would almost certainly be of value to any reader. When the day finally comes that the coronavirus is no longer the threat it is today, it will still be important to read and write about it—work which everyone should have the resources to do.

I hope this bibliography can be a useful and informative resource for anyone who wishes to better understand how the coronavirus pandemic fits into a much larger historical context. The history of epidemic disease can inform how we interpret our experiences and plan our next steps in the current crisis. No less important, we can consider how our modern-day experience with a pandemic informs the ways we interpret the past.

Check out Pandemics in Historical Perspective: A Bibliography for Evaluating the Impacts of Diseases Past and Present .