Professor has Historical Interest in Flu Epidemics

A: I find it fascinating that people are sitting up and taking a hard look at the flu again. Maybe it is because recent natural disasters have brought people’s attention in that direction. On the other hand, it is hardly something new. Epidemiologists have been saying for years that another pandemic is possible, just as the hydrologists and meteorologists were saying for years that New Orleans was a disaster waiting to happen.

Q: Should Americans be wary of the virus spreading to the U.S.?

A: People tend to get very nervous quickly, sometimes too quickly. We do need to watch it, as we watched SARS very closely. But I wouldn’t hit the panic button just yet.

Q: The World Health Organization has reported that more than 65 people have died in Asia from the bird flu.

A: Influenza viruses that infect birds, which are called “avian influenza viruses,” come in several varieties. The H5N1 strand of the influenza virus appeared in migratory birds in Vietnam and south China, and spread to domestic birds. It exists primarily in Vietnam, Thailand, Cambodia and Indonesia but has been spreading through migratory fowl. I think that the first human cases were seen in Hong Kong eight years ago. Humans catch the disease from infected birds, through aerial transmission or indirect contact.

Q: What would happen if the virus could be spread from human to human? Could it become a global outbreak?

A: It could become a pandemic, and potentially become very deadly. Look at the influenza pandemic of 1918-1919. During this pandemic, known as the “Spanish flu,” the disease spread across the world, killing more than 25 million people over six months. But these days, people are exposed much more frequently to various influenza viruses, which means that we have some immunity to a potential pandemic. So it is quite possible that a future pandemic could be much less dangerous.

Q: What are other notable pandemics of the past century?

A: They seem to be on a 30-year cycle. There was the Asian Flu pandemic in 1957 that started in China and spread to the United States. It caused about 1 million deaths. A flu vaccine was developed to stop the outbreak. The 1968 pandemic wasn’t as deadly. It started in Hong Kong and spread to America, killing about 750,000 people worldwide.

In 1976, an Army recruit caught the swine flu, and the government thought this could be a big outbreak. President Ford thought it might be a revival of the 1918 influenza, and wanted to immunize all 220 million Americans at the cost of $135 million. The flu never came, and hundreds of Americans who were inoculated filed suits against the government in cases where side effects of the vaccine proved fatal.

Q: According to the Centers for Disease Control and Prevention, in the absence of any vaccination or drugs, it has been estimated that in the United States a “medium–level” pandemic could cause 89,000 to 207,000 deaths, and another 20 to 47 million people to be sick. How should we go about containing diseases?

A: Controlling a disease like this is not a sexy thing. When disease control works, we see nothing, there is nothing to show other than the absence of disease, and that is hard to point to. On the other hand, when it fails, all hell breaks lose. That is a tension in public health. Do we mandate vaccinations and put the common good of all above individual rights? This tension is perennial in American society and will never be resolved.

Practically speaking, I would especially recommend that anybody whose immune system is in any compromised, such as in the case of older people, persons with HIV, and those prone to infection should definitely get a vaccine. It is also a good idea for people who come into contact with lots of individuals from disparate locations—which is to say most students and teachers.

Q: What is your personal interest in the history of disease?

A: I did my dissertation on the history of tuberculosis, and teach courses called Disease and Epidemics in a Historical Perspective and Introduction to the History of Disease and Medicine. I’m also the author of a book called “The Modern Epidemic: A History of Tuberculosis in Japan.”

Q: Is the history of disease somewhat esoteric?

A: It sounds esoteric. People leave that topic in the corner until they start getting sick. It’s a real common attitude to have about the history of disease.

Q: Students in what majors are attracted to this class?

A: I get a lot of history and pre-med majors. But there are other students in art and theater who magically seem to come out of the woodwork. They’re realizing all of a sudden that diseases play a huge role and they want to understand them better.

Q: Where are your degrees from?

A: My bachelor’s of art is from Elmira College, my master’s and Ph.D are from Harvard University.

Q: In addition to the history of disease, what are your other research interests and areas of expertise?

A: I’m interested in the history of syphilis in early modern Japan, warfare and state formation in 16th century Japan, the historiography of Amino Yoshihiko, an important historian of medieval Japan, the history of medicine in Japan and the history of sexuality in modern Japan. I’m also interested in photography in history, women’s issues and cultural change.

Q: What are some classes that you commonly teach?