ANTC67 – W3
Top hat monocle
- Questions the prof will be asking during class will be kept as a battery of
questions. This means that you will have access to all the questions we raised
in class which could be a study guide
- 2 planes arriving from Cuba. There was an outbreak of a disease (nausea,
vomiting, diarrhea, etc.) there are only a few washrooms in the plane.
- Publication that was stopped because people were concerned with H1N1 –
there was mutation. Article was discussing the worldwide opportunity to use
them as biological form of warfare. These events that are in the news speak
why you as a student of epidemiology should be aware of what is going on
around you. It is ongoing.
Starting from Slide 20
- John Snow: a man that changed tremendously about what we think about
disease. He shifted paradigm of epidemiology.
- In 1831, he was around our age – why is prof mentioning his age and that he
was an apprentice? That is how he became a doctor. Today we have MCAT,
GPA, etc. but in the old days you just find a doctor you serve apprenticeship
for. At the age of 14 you don’t know anything. This happened in the second
pandemic of cholera – when we don’t know anything about the transmission.
(even though the slide says SECOND, the first spread of cholera never
reached the shores of England)
- John Snow was trying to shift the way of thinking (contagionist/non-
contagionist) to novel ways of approaching the subject.
Miasmatic theory of spread of disease
- Most doctors believed that cholera was miasmatic – it came from sewers and
Opposition to current paradigm
- Snow thought “wait, cholera also occurred when there was no organic
substances going bad. There was no swamps or anything”. So he thought how
can an origin of particular disease among minors exposed to this miasmatic
kind of origin? Wave of controlling the absence of the cause of cholera. When
there was no gas/swamp you were creating unusual experiment. If they get
cholera then there is something else in play.
- Few years later another cholera strikes in 1848 in London. He is much older
by then, so he will track the origin of this disease over space and time. This is
rather novel way of approaching the subject (not armchair epidemiology) – it
was a very different thing – he was going to go out and really going to collect
real data. - He thought that maybe it was spread by germs (general vague terms back in
- It just took a few drops of this substance of this germ to pollute water supply.
You could then start onset of epidemic. This was novel way of looking at
He began research by
- He discussed this theory with colleagues.
- Then went thru medical journals – connection between water/sewers and
cholera. He suspected that this was water-bourn disease.
- Then he wrote queries – made questionnaires about water conditions to
places that experienced high mortality due to cholera.
- His actions were something modern epidemiologists would take today
- August of 1849, Snow felt obligated to share his findings and published “On
the Mode of Communication of Cholera”.
o Midterm: The work called “OMCC” is written by… A. B. C. D. Snow ***
- When it was published, no one really cared. “London Medical Journal”
actually asked for proof. Snow reached the scientific community but he didn’t