Poughkeepsie Journal (Hudson River Valley, NY), 1797 (from the microfilm collection at Adriance Library, Poughkeepsie, NY).
Yellow Fever invades Philadelphia.
This small item published in the Poughkeepsie Journal is the tale of what happened in Philadelphia, when the yellow fever struck it in 1797. 40,000 people fled the city in just days. Once more ships infected with yellow fever struck New York, just as many fled the streets of its greatest city, finding refuse upstream and in the more rural settings of the Hudson River Valley in New York. According to the weekly reports that appeared in the papers about either of these disease outbreaks, deaths climbed from the hundreds to the thousands in a very short time.
Much the same is happening right now or readying to take place for Ebola. The article this image links to details how to deal with a global epidemic catastrophe ‘in just five steps.’
To understand human behavior during an epidemic, we need only turn to American history. When yellow fever came to Philadelphia in 1797, deaths were in the thousands per week by the time the outbreak peaked within the urban proper. Many of these deaths occurred at home or in the Almshouses. Much of this news was published by the weekly newspaper of the Hudson River Valley, the Poughkeepsie Journal, the major newspaper for lower New York State along the Hudson River Valley.
According to this brief report, in just a few days to weeks, the City of Philadelphia experienced 40,000 departures as the residents left surviving escaped from the core of the city, creating congestion along the way as they relied upon local merchant ships and wagoneers to make their way to safe haven.
At times, these passengers unknowingly brought the disease with them, or at least the means for infecting the next mosquito vector that consumed their blood before making its way to the next victim(s). In this way, the yellow fever managed to spread from one town to the next, one city to the next, one poor neighborhood to the next, whether it be from hamlet to city, shipping port to shipping port, port city to countryside.
The late 1790s yellow fever epidemic and the one or two that recurred later were all it took for doctors at medical schools in New York, and Philadelphia to implement and succeed in producing the first effective quarantine practice. In New York City, they relied on the islands just outside New York City, in the harbor and adjacent riverways.
These quarantine practices were put to the test over the next decade or two. In the 1830s, they were no longer that effective when the next major epidemic made its way to the United States. The famous Asiatic cholera, originating from large ports in India, made a brief stay in the U.S. in 1832. In winter of 1848/1849, it began are more aggressive importation in February from India to the Mississippi River delta, just before the Gold Rush in lower California began.
Since the Gold Rush pioneers were mostly boys and men, they did not bring the cholera with them westward as much as the later pioneers would do. Re-emerging in Spring of 1850, and again in 1852, between April 15th and May 30th for each of these years, the experiences of the large numbers of deaths due to cholera were penned in Oregon trail diaries.
Just west of Fort Kearney, these Oregon Trail pioneers wrote about the deaths that ensued following their brief stay at Fort Kearney, where thousands of people moved about on a busy day. Departing Fort Kearney, they penned their experiences and observations and they witnessed dozens of people taken ill by the disease, many dying, except for young men and young boys.
The reason for these "hot spots" west of the Fort were several. Climate, distance travelled, close contact and population density were perfect for making this outbreak happen. With each death, the remains left behind found new victims passing through. It ended up, the environment was perfect for maintaining a steady culture of Vibrio cholerae within the alkaline waters filling freshly dug drinking wells. "Dig your own well" was the saying for the time.
This outbreak was more deadly than any other diarrhea like contagious disease for the time, including the most likely dysentery to strike the people in Nebraska at this time. Until vibrio came upon to the plains, a Salmonella intermedia (and perhaps Listeria) growing upon the rotting flesh of bisons was known to cause severe diarrhea. For the pioneers, those who made it past Fort Kearney and a similar outbreak next to Fort Laramie, Wyoming, were often put at risk by the decaying carcasses of oxen and cattle that died while trying to ascend the eastern face of the Rockies. (See my thesis page on this research, for more detail, at http://oregontrailcholera.wordpress.com/ .)
When an outbreak happens. human behavior becomes difficult to manage, almost impossible to control or predict. If the Ebola outbreak were to reach the U.S., and if its severity were to reach the level that cholera reached during the 1850s, what we should expect to see is a disease that spreads like "wildfire" (taken from the Andromeda Strain). The diffusion would be from neighborhood to neighborhood, one population setting to another, in a heterogenous, mixed radial-hierarchical diffusion process (using Gordon Pyle’s sense of the words, see http://brianaltonenmph.com/gis/historical-disease-maps/john-c-peters-and-the-asiatic-cholera/1960-pyles-cholera-diffusion-and-migration-patterns/  ;).
By keeping a close watch on this outbreak–were it to happen (I am trying to be rational about this)–spatial epidemiologists would no doubt have a very unique opportunity to map one of the most aggressive epidemics to take hold of its victims in fairly short time. Due to its incubation time, this Ebola would always be a little ahead of them, by two or three weeks.
My proposal is that this disease (see my July 7th ScoopIt!, personalblog, and map image: https://wordpress.com/post/7215587/41081  ;), is that it will follow a dual path mathematically (nature’s common practical joke on us). It will be opportunistic and appear very deterministic in its earliest habits, but demonstrate the more complex migration patterns (Pyle’s mixed models) as time passes for each setting; transportation helps to define these stochastic (chaos theory) behavior of the disease, and will ultimately define whenever and where ever the Ebola decides to travel to next. All of this makes prediction modeling a much tougher process. The most likely routes, based on natural ecology, not human ecological impacts, are noted on this map.
It is important to note here that Ebola is a viral disease, not be spread by airborn vectors like the mosquito born yellow fever or more recent west nile (that is for not, it is not airborn). Still, Ebola is more deadly than the west nile and yellow fever. In terms of appearances, it may be as bad as or worse than the looks of the yellow fever and cholera victims during their dying hours.
But more importantly, Ebola is different from Yellow Fever and Cholera because it has a more distinctly landborn element as part of its natural ecology.
Vibrio cholerae remain alive in deltaic brackish saline water, are dependent upon copepods, and from there enter into the higher animal portions of the food chain or web. West Nile survives the winter due to its hibernation in surviving female mosquito bodies not destroyed by the coldness of winter, able to arise and infect their first animal or human victim of the year.
The spatial limits for each of these are the chemistry and zooecology of the aquatic environment, and the need for the right climate and water.
Ebola lacks these restrictions to aquatic and shoreline settings. Yet it still bears some other features of its own, that may even be foretelling.
Ebolavirus can remain alive on land where certain mammals reside. Its ability to survive within a supporting ecosystem, without incidence of human involvement, is very much possible. Even in distant places, Ebola can reside for a considerable length of time, undetectable and unpredictable by contemporary surveillance programs. Regions that are poorly managed, poorly funded, and otherwise forced to live with underfunded health surveillance programs are going to be the most impacted by this disease. They also bear the population most at risk due to sanitation problems, their social disconnect, and their problematic lifestyles. Regions that are rich in domestic and wild animal populations but lacking adequate disease surveillance programs for zoonotic diseases, are where this disease could most likely have its greatest impact on local public health.
So can we really afford to prevent a disease like Ebola? much less stop it in its tracks should it become an ecological phenomenon.
Due to the mobility of its hosts and carriers (mammals, esp. frugivorous bats), Ebola is capable of migrating where ever it needs to, given enough time and new victims. It may not even be an immediate human threat, until its finds the right human ecological setting to establish its new domain. According to the research of its hosts, carriers, vectors, zoonosis ecology, there are specific regions that exist, each with its own outbreak and nidus development potentials. The way to define these regions and what the Russian geographer call their ‘metaxenotic potential’ and combined host-human spatial region, is defined by the works of Voronov and Pavlovsky. ( http://brianaltonenmph.com/gis/historical-disease-maps/zoonoses/   ;)
See on Scoop.it – Medical GIS Guide