The Rich Flee and the Poor Take the Bus by Troy Tassier

Author:Troy Tassier
Language: eng
Format: epub
Publisher: Johns Hopkins University Press
Published: 2023-07-15T00:00:00+00:00

Chapter 8

ROGUE WAVES

“It is time to close the book on infectious diseases, and declare the war against pestilence won.” This quote, attributed to William H. Stewart, the US Surgeon General from 1965 to 1969, became a ubiquitous straw man used to argue the seriousness of the resurgence of infectious disease. The quote appeared in many places, including a PBS documentary, a Wall Street Journal article, and even Dr. Stewart’s obituary in the highly prestigious medical journal, the Lancet.1 The problem with using this quote as a setup for arguments extolling the dangers of infectious disease in our times is that it appears Dr. Stewart never uttered these words. It is a false legend with a tangled history and, like most folklore, no definitive origination.2

The myth of this quote came about in part because of great decreases in the incidence of infectious disease in the early twentieth century. These reductions occurred because of a multitude of factors. Great improvements occurred in urban sanitation and building ventilation beginning in the middle of the nineteenth century. Improved nutrition, at least for the average member of society, brought better levels of benchmark health. Perhaps most importantly, the germ theory of disease revolutionized how we identified and fought infectious disease. It ushered forth a remarkable string of treatments and illness preventions. Sir Alexander Fleming’s accidental discovery of penicillin in 1928 saved millions of soldiers during World War II.3 Streptomycin provided effective treatment for bubonic plague beginning in 1947.4 Other antibiotic treatments were found to treat a range of infections. Along with these advancements in treatment came the steady development of vaccines to prevent infection and illness. The Salk and Sabin vaccines eliminated polio as a major health concern in many parts of the world during the 1950s and 1960s. The measles vaccine, discovered and licensed in the 1960s by a team led by Dr. John Enders, drastically reduced the incidence of measles. Prior to this vaccine, 500,000 measles cases were diagnosed each year in the United States alone. By the mid-1970s, cases plummeted to less than 10 percent of those in the two decades prior.

Together these treatments and vaccines led to a false hope in the public consciousness that the end to infectious disease had indeed arrived. This thinking, coupled with comments made by Stewart emphasizing the need to place greater focus on chronic health crises, such as the link between smoking and cancer, likely fed the flames of the myth.5 Nowhere was the world’s public health success more evident than with smallpox.

Smallpox has existed for tens of thousands of years. It ravaged human hosts and killed billions over many centuries of human existence. In the twentieth century alone, over 300 million people died from smallpox and up to 500 million died in the last 100 years of its existence.6 However, it was defeated by vaccines, and the World Health Organization declared smallpox eradicated in 1980. It has not been seen, outside a lab, since.

Smallpox was not the only major infectious disease during these years.

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