5 - Anthropological Contributions to the Study of Cholera

Summary

Those with power were expected to take action against cholera. Those without power were the likely victims. Each had a choice of action, quarantine, cleansing, medical provision, prayer or just doing nothing on the one hand, and flight, anger, alarm, obedience to regulations, or just doing nothing on the other. Values emerged in choices between life and property, between work and safety, between charitable action and government agencies.

(Morris 1976:18–19, on the 1832 cholera epidemic in Britain)

Outbreak investigations are a classic method in epidemiology; they have determined the causes of new epidemics such as Legionnaires' disease, Hanta virus, Ebola virus, SARS, and E. coli O157:H7. An outbreak investigation is designed primarily to identify the sources of unusual diseases or unusual numbers of cases of disease, as well as to prevent additional cases (Reingold 1998). The steps in an epidemiological outbreak investigation include finding cases, verifying diagnoses, and comparing rates with background expectations; interviewing both cases and controls about onset and exposure; establishing causes; and developing measures of control.

Disease outbreaks are almost always newsworthy and a topic of great public concern. The public reads many sensational tales of disease and heroism, real and imagined, with titles like The Coming Plague, The Hot Zone, Outbreak, The Demon in the Freezer, The Andromeda Strain, and Plague Time. But there are other, somewhat less thrilling, stories to be told about new pathogens.