Stories of untreatable new diseases, from Aids to Ebola to Creutzfeldt-Jakob, fill the headlines. Might they foretell epidemics on the scale of the Black Death, and even the end of the human race? Or is modern medicine a match for such outbreaks? Christopher Wills, considers the evidenceby Christopher Wills / May 20, 1996 / Leave a comment
Throughout our history, diseases have come and gone. Leprosy, which was widespread in Europe during the middle ages, inexplicably disappeared-though it remained a terrible scourge in much of the rest of the world. Between the end of the 15th century and the middle of the 16th century a mysterious disease called the sweating sickness broke out repeatedly in England and Wales. In 1529 it spread to the continent and then, somehow, burnt itself out. We have no idea what it was-the best guess is a viral encephalitis carried by mosquitoes. In the 17th century, bubonic plague, which had broken out repeatedly since the Black Death 300 years earlier, disappeared from Europe. All these diseases vanished without the aid of antibiotics or anything much in the way of public health measures.
These were large events, for which we have some documentation. There is no doubt that other diseases, some known and many unknown, have appeared and disappeared in the long history of the crowded and filthy cities of Europe. I emphasise how little we know about that distant time, because the situation has now changed completely. Today, the global village responds to every report of a disease, real or imagined, and prophecies of doom are everywhere.
In spite of what appears to be a recent upsurge of disease, in the last few years there has been only one plague in the classic sense of appearing from nowhere and spreading swiftly. This was the outbreak of cholera in South America in 1991, which affected half a million people and caused 5,000 deaths before it gradually faded away. But during this same period there have been many outbreaks of other diseases, so numerous as to constitute a kind of rash of mini-plagues.
In general, the world community has reacted swiftly to these dangers. In Rwanda, cholera and typhus were swiftly controlled in the refugee camps, in spite of the dreadful conditions there. The outbreaks of Ebola haemorrhagic fever in Zaire and elsewhere over the last decade, which have caused only a few hundred deaths, were contained not by medicine, but by keeping family members away from victims, and protecting health workers from victims’ blood. This broke the cycle of infection.
Two apparent outbreaks of bubonic plague in India in 1994 were contained in part by airlifts of millions of tetracycline tablets into the affected regions. One of these outbreaks, which resulted in…