The historical epidemiology of global disease challenges

In response to the spread of Ebola virus disease in west Africa, global public health agencies have scrambled to organise teams to staunch the spiral of infections and have urged researchers in medical anthropology, disaster management, ethics, and other social science fields to formulate ideas for intervention as quickly as possible. The epidemic is by far the worst of the Ebola outbreaks on record that date back to 1976. Yet, it is only one of several deadly viral pathogens—such as yellow fever, dengue, and influenza—that have repeatedly scourged populations in west Africa. How do the past and present Ebola outbreaks compare with other viral epidemics? What efforts were made to contain previous outbreaks and how did these efforts fare? How did local populations respond to and interpret these interventions? How did they understand the causes of the outbreaks?

We do not have robust answers to all these questions. In part, this is because the subject area of historical epidemiology—on the cusp of the fields of the history of medicine and epidemiology—has been claimed by neither of these disciplines. Historians of medicine and public health have mostly paid scant attention to the historical study of viral disease control efforts and their epidemiological consequences. Most medical historians tend to focus their research efforts on the social history of disease in developed nations. Epidemiologists are deeply involved in the analysis of viral outbreaks, focusing principally on dynamic modelling. The twain rarely meet. One consequence is that physicians and public health specialists do not usually draw lessons from the historical record of disease control efforts. This can sometimes result in poor policy decisions.