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Modern Era of Epidemiology and Public Health
As knowledge in the sciences began to grow, so did its credibility and public acceptance. A shift occurred away from theoretical or religious explanations for public health concerns, and it began to move towards scientific hypotheses of why diseases occurred, how they occurred, and how to prevent or manage them. This era saw the fastest growth in medicine as a whole, along with developing public health policies. (Health Promotion and Population Health, 2021) -
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Bacteriology Phase
This phase followed the Miasma Phase, which kickstarted the world into the modern era of epidemiology. It wasn't until this era that science began to become the source of understanding of diseases and the idea of "bacteria" was formed. Desire for social changes regarding public health ensued. An American lifespan change from 47 year to 70 years in 1900 became known as the "First Public Health Revolution." (Health Promotion and Population Health, 2021) -
U.S. Army Discovers the Cause of Yellow Fever
Walter Reed, Jesse Lazear, and Henry Carter discovered the first human virus. Sent to Cuba by the US Army, they set out to learn everything they could about the Yellow Fever that killed so many US troops during the Spanish-American War. Realizing there must be a live host transmitting the disease, they allowed mosquitos to feed on the infected, then feed on the non infected. When the non infected then became sick, they realized the mosquito was the vector. (All timelines overview, 2022). -
Biologics Control Act
The Biologics Control Act was the first attempt by Congress to control the quality of medications, drugs, and health related items. Its intent was to "Regulate the sale of viruses, serums, toxins, and analogous products." This act also created the Hygienic Laboratory, a division of the US Public Health Service which would eventually become the National Institutes of Health. (All timelines overview, 2022). -
"Typhoid Mary" Epidemic Begins
Considered one of the largest outbreaks of Typhoid ever, it all began with Mary Mallon. Serving as a cook at a hospital, she infected 122 New Yorkers with the bacteria. 5 of those original 122 infected died. It is believed an estimated 13,160 people died from the outbreak in 1906, and 12,670 died in 1907. In 1911, a vaccine was developed and the antibiotic treatment was released in 1948. Typhoid fever causes malaise along with a rash to form on the chest and abdomen.(Robinson, 2020). -
Pertussis Vaccine is Developed
Jules Bordet, a Belgian bacteriologist, and Octave Gengou, a French bacteriologist, are credited with the creation of the Pertussis vaccine. They did so by growing the Pertussis bacteria, then using heat to kill it, and adding formaldehyde. They also developed the Wassermann Test. (Encyclopedia, 2022). -
First Major Polio Outbreak
The initial outbreak of Polio in the United States was in 1916 in New York City, killing 2,000 people. It eventually spreads across the country, killing another 6,000. Polio is a viral disease that attacks and destroys the nervous system. Spreading through direct contact, those that it did not kill, it paralyzed. (Rotary and the Fight Against Polio, 2022). -
H1N1 "Spanish" Flu
While still in existence, in 1918 the H1N1 was first found in infected military personnel. 675,000 estimated died in the US from the outbreak. Roughly 500 million were infected worldwide. The highest mortality rates were in children under 5, elderly over 65, and 20-40 year olds which was unusual for that type of virus. There were no vaccines available at the time, leaving quarantine, isolation, and hygiene to be the sole treatment. (1918 pandemic (H1N1 virus), 2019). -
End of WWI
The US involvement in WWI was from July 28th, 1914 until the wars end. During this timeframe, Congress enacted the Selective Service and held 3 drafts initially for 21-31 year olds, with the final being 18-45. (World War I Draft Registration Cards, 2019). A post war review of the draft system revealed that 34% of draftees were disqualified for service due to disabilities. This began to draw attention to neglected areas of public health. (Health Promotion and Population Health 2021) -
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Health Resources Phase
This phase saw a public change in how the country viewed health disparities, and worked to improve access to care to the general public. Specialized clinics were created, along with mass immunization programs, and funding for health education. Hospital construction, health research, and healthcare manpower all saw a substantial increase. No change in lifespan is noted during this era despite these advancements. (Health Promotion and Population Health, 2021) -
Diphtheria Epidemic Begins
Diphtheria is a bacterial infection that usually affects children the worst. It causes swelling of the mucous membranes, and can obstruct breathing and swallowing. Worst at its onset, Diphtheria began with 206,000 case in 1921. By the middle of the decade, a vaccine was developed, which brought an end to the epidemic in 1925. The CDC estimated that over 80% of children today are vaccinated, and if they become infected, it's easily treated with antibiotics. (Robinson, 2020). -
Diphtheria Antitoxin is Created
Created by Emil von Behring, a German bacteriologist, the Diphtheria Antitoxin was the first developed treatment for the disease. Essentially a vaccine, it would go on to help end the epidemic all together. Behring received the Nobel Prize for Physiology or Medicine for his work. (Encyclopedia Britannica, 2021). -
Iron Lung is Invented
In 1927 Philip Drinker and Louis Shaw developed the Iron Lung at Harvard. Using positive and negative pressure, it could assist the patient inside with breathing. This was a breakthrough for aiding Polo patients who struggled to breath on their own. The Iron Lung could take over until the patient had recovered enough to adequately breath on their own again. Eventually a Polio vaccine would eradicate polio in the US and the Iron Lung was no longer needed. (Flashback: Iron Lung 2022). -
The Ransdell Act - Creation of the National Institute of Health (NIH)
The Hygienic Laboratory, a sub division of the Public Health Service, is re-structured into the NIH. Notable for quelling the Anthrax outbreak during WWI and extensive research in chemistry problems in healthcare, the laboratory sought private funding to form an institute of research. A lack of interest privately led to Louisiana Senator Joseph Ransdell backing the Ransdell Act, and gaining government funding for the creation of NIH. (National Institutes of Health, 2022). -
Tetanus Toxoid Created
Created by Emil von Behring, a German bacteriologist, the Tetanus Toxoid was the first developed treatment for the disease. It was not heavily used until it was a mandatory vaccination of all US troops in WWII. (Encyclopedia Britannica, 2021). -
Hill-Burton Act
Originally the Hospital Survey and Construction Act, the Hill-Burton Act was signed into law by President Harry Truman. One of the most instrumental healthcare acts of the 1900's, the act allowed communities in need of hospitals to apply for government funding to build them. This put hospitals in 40% of the counties that did not have them by 1945. By 1975, 1/3 of US hospitals had been built by the bill. By 2000, 6,800 hospitals in 4000 communities had ties to this bill. (Schumann, 2016) -
First DTP Vaccine Created
The first Diphtheria, Tetanus, Pertussis combination vaccine is created by Pearl Kendrick, Grace Eldering, and Loney Gordon. This combination vaccine was not only the first of its kind and paved the way for future vaccines to be developed the same way, but it also was highly effective against the 3 diseases. (Fanget, 2020) -
Second Major Polio Outbreak
Polio continued to infect and kill after 1916, but the second worst notable year was 1952. Killing 3,145 people and infecting 57,628, tens of thousands of people who survived were left in wheelchairs and with permanent disabilities. A vaccine was soon discovered in 1955, which would end the epidemic and work towards eradicating the disease. -
Polio Vaccine Created
Jonas Stalk, while working at the University of Pittsburgh School of Medicine, would invent the Polio vaccine. The National Foundation for Infantile Paralysis would provide the funding needed for the project. Upon release of the vaccine, polio cases in the US were roughly 45,000. In 1962, they had dropped to 910. Today, Polio is not considered a threat to the world. (About Jonas Salk, 2015). -
H2N2 Flu
Originally discovered in Singapore and Hong Kong, H2N2 eventually made it to the western coast of the United States in 1957. It killed an estimated 116,000 people in the US and 1.1 million worldwide. Being caught as early as it was, medicine was able to get a jump on the epidemic and prevented it from getting as bad as the "Spanish" flu epidemic. The prior development of an influenza vaccine in 1942 also aided in containing the epidemic. (Robinson, 2020). -
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Social Engineering Phase
Blame for little change in lifespan is placed on a continued lack of accessibility to healthcare by the poor, elderly, and remote populations. The system began identifying populations that are high risk to improve delivery of healthcare to them. Again, despite social engineering initiatives, no changes are noted to improvement in life span of Americans. A significant per capita cost of healthcare is noted in this timeframe. (Health Promotion and Population Health, 2021) -
Medicare & Medicaid Signed Into Law
President Lyndon Johnson signs the amendment to the Social Security Act of 1935, creating Medicare and Medicaid. This occured in Independence, MO at the Truman Library, with former President Harry Truman present as he began the fight for the amendment 20 years prior. This act provided government sponsored health insurance to the elderly over age 65, as well to certain members of the low-income populations. 19 million initially enrolled. (President Johnson Signs Medicare into law, 2009). -
Medicare Is Amended
The US government realized that they needed to aid in funding of healthcare for those with disabilities. Medicare eligibility is widened to Americans who have certain disabilities but are under the age of 65. People with permanent kidney disease and who require dialysis or a kidney transplant are also added for coverage under Medicare. (President Johnson Signs Medicare into law, 2009). -
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Health Promotion Phase
This phase saw the beginning of the "Second Public Health Revolution" and the priority of extending the life span of Americans past age 75. A realization is made that increasing expenditures does not correlate with an improvement in public health. Instead, the focus is shifted to aiding Americans in changing their lifestyle choices that attribute to increased health and disease risks. (Health Promotion and Population Health, 2021) -
First "Healthy People" Report is Released
Titled "Healthy People: The Surgeon Generals Report on Health Promotion and Disease Prevention", the report was the governments attempt to start the second public health revolution. Under the direction of President Jimmy Carter, Surgeon General Julius Richmond formed a committee to identify 5 healthcare goals for America to work towards. While many of the goals fell short, it began to the shift towards understanding determinants in public health concerns. (History of Healthy People, 2022). -
Measles Outbreak
Measles causes a rash that covers the body, sore throat, cough, red eyes, runny nose, and a fever. It's transmitted through the air making it extremely contagious. It was normal for children to catch the disease and acquire natural immunity before a vaccine was created. From 1981 to 1991 the US saw a large outbreak of Measles, and that has since re-began with roughly 1,000 cases a year. It is now recommended that everyone receive a second vaccine, if not the initial. (Robinson, 2020). -
HIV/AIDS Epidemic Begins
HIV is a lung infection that may eventually develop into AIDS. AIDS damages the immune system and renders is ineffective at fending out the most basic of infections. Commonly transmitted through sexual contact or sharing of needles, it can also be carried on from mother to baby. Many myths surrounded transmission of AIDS when it was first discovered. Today the most effective fight against it is education and use of safety techniques until a vaccine can be developed. (Robinson, 2020) -
Milwaukee Water Contamination
Milwaukee has 2 water treatment plants, one of which became infected with Cryptosporidium in 1993. This parasite causes dehydration, fever, stomach cramps, and diarrhea. Although the CDC claims that cases increased by 13 precent yearly between 2009 and 2017, in 1993 over 403,000 people were infected in this outbreak. 69 people died, most of which were immunocompromised. (Robinson, 2020). -
H1N1 "Swine" Flu
The outbreak of the "Swine" variant of H1N1 caused 60.8 million cases in the United States. 12,469 people eventually died from the infection. On a global scale, it was estimated that approximately 80% of the deaths were aged younger than 65. A vaccine ultimately ended the epidemic at the end of 2009, but H1N1 does still occasionally infect people every year. Yearly mutations of the disease continuously make the vaccination from the prior year ineffective. (Robinson, 2020). -
COVID-19
COVID-19, actually SARS-CoV-2 virus, was first detected in Wuhan, China in 2019. It quickly spread across the world, and in 2020, was detected in the US. COVID-19 has proven to be extremely hard to contain as its easily transmitted and sustains itself in communities well. With how recent is has occurred, it is still extremely misunderstood and an ongoing epidemic today. (Robinson, 2020) -
COVID-19 Vaccine Developed
In December of 2020, Pfizers version of the COVID 19 vaccine became the first to receive FDA approval. This received much skepticism due to it being accomplished in less than a year, which is the fastest developed vaccine to date. The fastest before the COVID vaccine was the mumps vaccine, taking 4 years to develop. Lower than anticipated vaccination rates spurred political turmoil as many are choosing to not become vaccinated. (Covid-19 vaccine: How was it developed so fast?, 2022).
