The Typhoid Toll

Johnson, George A.

doi:10.1002/j.1551-8833.1916.tb11900.x

Cited by 12 publications

(10 citation statements)

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“…Historically, typhoid fever cases peaked during late summer/early fall in the U.S. (6, 27). Yearly peaks of typhoid transmission coincide with warmer temperatures, similar to global trends (7, 28–30).…”

Section: Discussionmentioning

confidence: 99%

“…This pattern may be related to the enhanced growth of the bacteria at warmer temperatures, seasonal changes in diet (i.e. increased consumption of uncooked fruit and vegetables in summer and fall), or the increased abundance of flies that may serve as mechanical vectors of the bacteria (6, 7, 31, 32). Additional fluctuations in typhoid transmission seen in some cities might be explained by seasonal variation in rainfall, which typically peaks in spring and summer in the eastern U.S. and winter on the west coast, and can impact the water supply to a city (29, 30, 33).…”

Section: Discussionmentioning

confidence: 99%

“…Examining short- and long-term trends in typhoid incidence can provide insights into factors driving transmission (5). In many countries, typhoid fever follows a seasonal pattern, with peak incidence occurring around the same time every year (6). Seasonality in typhoid exhibits distinct patterns by region and latitude, and can be influenced by rainfall, temperature, and climate (7).…”

Section: Introductionmentioning

confidence: 99%

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Changes in historical typhoid transmission across 16 U.S. cities, 1889-1931: Quantifying the impact of investments in water and sewer infrastructures

Phillips¹,

Owers²,

Grenfell

et al. 2019

Preprint

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Background: Investments in water and sanitation systems are believed to have led to the decline in typhoid fever in developed countries, such that most cases now occur in regions lacking adequate clean water and sanitation. Exploring seasonal and long-term patterns in historical typhoid mortality in the United States can offer deeper understanding of disease drivers. Methods:We fit modified Time-series Susceptible-Infectious-Recovered models to city-level weekly mortality counts to estimate seasonal and long-term typhoid transmission. We examined seasonal transmission separately by city and aggregated by water source. We fit regression models to measure associations between long-term transmission and financial investments in water and sewer systems.Results: Typhoid transmission peaked in late summer/early fall. Seasonality varied by water source, with the greatest variation occurring in cities with reservoirs. Historical $1 per capita ($25.80 in 2017) investments in construction and operation of water and sewer systems were associated with 8-53% decreases in typhoid transmission, while $1 increases in total value or debt accrued to maintain them were associated with 4-7% decreases. Conclusion:Our findings aid in the understanding of typhoid transmission dynamics and potential impacts of water and sanitation improvements, and can inform cost-effectiveness analyses of interventions to reduce the typhoid burden. ABSTRACT WORD COUNT: 199geographically and historically depending on the water supply and treatment; and (2) to quantify the relationship between investments in water and sanitation infrastructures and long-term typhoid transmission rates. METHODS Study Design, Data, and VariablesWe extracted reported weekly typhoid mortality from 1889 to 1931 at the city level from the Project Tycho database (13, 14). Cities were chosen based on two criteria: (1) at least 1,000 typhoid deaths were reported during the study period, and (2) less than 25% of weekly data was missing. These exclusion criteria resulted in data for 16 U.S. cities ( Figure S1).Yearly population estimates were obtained from the U.S. Census Bureau (15-17). The population <1 year of age was used as a proxy for births, since birth rate data was not available and typhoid is rare in <1-year-olds (18). Cubic splines were used to extrapolate weekly population estimates. Financial data on water supply and sewer systems for each city were extracted from U.S. Census Bureau yearly reports (16); we obtained data on eight variables across five categories: "receipts," "expenses," "outlays," "total value," and "funded debt" (Table 1), divided by the yearly city population to generate per capita estimates. Data on water treatment and type for each city were extracted from a variety of sources (Table S1) (17).All cities had missing data on weekly typhoid mortality. In many cases, missing mortality counts were instances of zero cases, because cities frequently only reported during weeks when deaths occurred. To account for both true zero counts and missing data, mo...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes in historical typhoid transmission across 16 U.S. cities, 1889-1931: Quantifying the impact of investments in water and sewer infrastructures

Phillips¹,

Owers²,

Grenfell

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…In the early 1900s, before widespread use of chlorination, waterborne disease in the United States was a serious public health problem. In 78 American cities in 1902 the average death rate for typhoid fever caused by unsafe water and food and poor sanitation was 37 per 100,000 people (Johnson, 1916). To give a contemporary perspective to this figure, it was more than twice the current death rate due to traffic accidents.…”

Section: Literature Reviewmentioning

confidence: 99%

Hindsight Is 20/20: Using History to Avoid Waterborne Disease Outbreaks

Logsdon¹,

Schneider²,

Budd³

2004

Journal AWWA

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Despite strenuous efforts to prevent them, waterborne disease outbreaks continue to occur from time to time in countries that have the knowledge and capability to prevent them. This article presents the concept that multiple adverse events or changes can often be associated with waterborne disease outbreaks. The information in this article is designed to encourage water treatment plant operators, water quality supervisors, and plant managers to maintain vigilance at all times so circumstances that might lead to a treatment failure and a disease outbreak can be avoided. The authors discuss the importance of water treatment plant personnel being alert at all times and remaining watchful for changes in source water quality, changes in treated water quality, or both to help minimize the likelihood of future waterborne disease outbreaks.

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“…In the 80's and 90's, Johnson's "Typhoid Toll" shows, typhoid in many American cities caused from 50 to 100 and in some extreme cases in some years 150 to 180 deaths per 100,000. By 1915 the mortality had been greatly reduced (65). Since Johnson's figures were compiled the rates have declined greatly until in recent years it has not been uncommon for city after city to go one or more years without a single typhoid death.…”

Section: Goitre and Typhoid Controlmentioning

confidence: 99%

Sketch of the History of Water Treatment

Baker

1934

Journal AWWA

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Water treatment as a rule-of-thumb art is a century old. As a scientific concept it is scarcely half that age. As an applied art, working to known ends by known means-engineering, chemical and biological-it falls almost within the present century. Although it is true that unnumbered centuries ago various crude forms of water treatment were in household use, ages passed before cities attempted to improve the quality of their water supplies. It was not until comparatively recent times that the aim was other than reduction of turbidity. The means to this end most commonly employed was sedimentation and filtration, the latter often being "natural filtration" -really wells or galleries for the development of underground supplies. Sometimes the primary aim was storage for a reserve supply which incidentally gave a trilogy of benefits: clarification, color removal and bacterial reduction; the first early recognized, the second appreciated later on; the third and most important unknown until within the last century.Folk days and folk ways. It took no genius to see that after water from a turbid source had stood in a household jar for a time it became clarified by simple deposition of its suspended matter. Chance, more likely than design, showed that precipitation of mud would be hastened in time and increased in amount by dropping alum into the water jar.By the various means indicated clarification without, and then with, coagulation became established, first and perhaps for centuries for household or temple use only; then, for city use. If the water was colored as well as turbid, its color might also be reduced by coagulation. Filtration, on a small scale, may have come into use just as naturally; sometimes being taken over from a household or industrial art or perhaps being suggested by noting the clearness of water drawn from a well or gallery in the sand. Boiling was introduced in early Grecian times, but seems to have been confined mostly to water carried by armies on the march in waterless areas.

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The Typhoid Toll

Cited by 12 publications

References 0 publications

Changes in historical typhoid transmission across 16 U.S. cities, 1889-1931: Quantifying the impact of investments in water and sewer infrastructures

Changes in historical typhoid transmission across 16 U.S. cities, 1889-1931: Quantifying the impact of investments in water and sewer infrastructures

Hindsight Is 20/20: Using History to Avoid Waterborne Disease Outbreaks

Sketch of the History of Water Treatment

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