Control of Infectious Diseases: A Twentieth-Century Public Health Achievement

Abstract

The marked decline in infectious-disease-associated mortality that took place in the United States during the first half of the 20th century contributed to the sharp drop in infant and child mortality and the more than thirty-year average increase in life expectancy over the past 100 years. The 19th-century discovery that microorganisms are the cause of many diseases led to substantial improvements in sanitation and hygiene, formulations of vaccinations, development of diagnostic tests, and the introduction of antibiotics. Despite this overall progress, devastating pandemics of infectious diseases occurred during the 20th century including the influenza in 1918 and human immunodeficiency virus first recognized in 1981. This chapter reviews major 20th-century achievements in the control of infectious diseases in the United States and ends with a discussion of challenges for the 21st century.

Parasites, democratization, and the liberalization of values across contemporary countries

“…Ward & Warren (2007; also Bud, 2007; Levitt, Drotman & Ostroff, 2007) review the literature on the remarkable achievements in public health in the 20 th Century in the West. Sulfa drugs became available in the 1930s, but were used on a more limited basis than the newer antibiotics (e.g.…”

“…These later antibiotics had fewer negative side‐effects and killed more kinds of disease organisms. At about the same time, antibiotics that were useful against fungal diseases, viral diseases, and protozoan and nematode parasites became available (Levitt et al , 2007). At the end of World War II, penicillin, quickly followed by other antibiotics that provided an even wider spectrum of defence against bacterial diseases, were administered widely in the West—so widely that concern about the evolution of antibiotic resistance quickly arose.…”

“…In Britain in 1948, as evidence accumulated for antibiotic resistance, legislation was enacted to limit through prescription the public’s access to antibiotics (Bud, 2007). Additionally, in the West in the late 1940s, child vaccination programs were implemented; for example, a combined diphtheria–pertussis–tetanus vaccine was given widely to children (Levitt et a l., 2007). Moreover, by the late 1940s in the U.S.A., malaria was reduced to negligible levels through mosquito‐control programs of insecticide use combined with eliminating mosquito breeding areas (Levitt et al , 2007).…”

In their own words: nurses’ discourses of cleanliness from the Rehoboth Mission

“…Discourses of cleanliness at Rehoboth had a firm, but relatively new, basis in established sanitary practices of the day. Much of the dramatic increase in life expectancy, lowering of death rates, longer life expectancies and decreased infant mortality rates since the mid‐ to late nineteenth century can be attributed to changes in housing, public sanitation and personal hygiene (Tomes 1998; Greene 2001; Kudzma 2006; Levitt, Drotman and Ostroff 2007; Tauxe and Esteban 2007, Widerquist 1997). With increased knowledge about specific causes of infectious diseases, there was a shift in locus of responsibility in the late eighteenth century from public sanitation to personal hygiene 11 (Greene 2001, 204).…”

“…9 9 See Levitt, Drotman and Ostroff (2007 ) for further discussion of the importance of water treatments in reducing infectious disease in the early 1900s. …”