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better know an epidemiologist

History of Epidemiology: Patient Zero and Typhoid Mary

ResearchBlogging.orgBetter Know An Epidemiologist/History of Epidemiology is an ongoing feature where Mr Epidemiology pays tribute to people and studies that have set the stage for his generation of epidemiologists. All of the articles are listed here.

Gaetan Dugas, Air Canada flight attendant and one of the first diagnosed cases of HIV

EDIT 10/01/12: I had indicated (incorrectly) that Typhoid Fever was a viral disease. It is in fact due to a bacterium instead. Thanks to Mike the Mad Biologist for pointing that out!

EDIT 10/01/12: As Brett Keller points out in the comments, Gaetan Dugas was not Patient Zero for HIV. While he contributed to the spread of the virus, he wasn’t the first known case of it, and so the label of Patient Zero is unfairly applied to him.

Patient Zero is a common infectious disease epidemiology term. It refers to the first known case of the disease of interest, and is useful when tracking disease outbreaks. Knowing where the disease starts allows us to track not only the spread of the disease, but also how it spreads – through water, air, person-to-person contact etc.

I heard an absolutely phenomenal podcast through WNYC’s RadioLab podcast about Patient Zero, and that formed the inspiration for this post. I highly recommend listening to it when you have a chance – either through iTunes, on their website. They cover several different “Patient Zero’s,” including Typhoid Mary and Gaetan Dugas (pictured above).

Today, I’ll be talking about Typhoid Mary. To listen exclusively to the Typhoid Mary segment of the RadioLab podcast, click here.

Click the image to go to the RadioLab podcast about Patient Zero.

Continue reading “History of Epidemiology: Patient Zero and Typhoid Mary”

Interview with Jonathan Smith, Director of “They Go To Die” Part 3: Storytelling and Research

Over the past week, I have the pleasure of interviewing Jonathan Smith, a recent graduate of the Yale School of Public Health, and a current lecturer there, to the Blog. Jonathan has been working on a documentary about his research entitled “They Go To Die.” The interview is split into three parts: Part 1 was a broad background to the area, Part 2 covered the filming experience, and finally Part 3 will talk about the role of storytelling in research. Jonathan has mounted a campaign on Kickstarter to help fund the editing and final steps in making this movie a reality, and if you would like to support him, please click here.

What do you see as the role of filmmaking and storytelling in Epidemiology and research in general?

It seems like there is a history of pitting personal stories against data and research. You are either a believer in one or the other. I have no idea why, they work so harmoniously together. I think a few activist films have skewed this perception of how they can work together.

But honestly, this surly perception we have in accepting stories as valid isn’t uncalled for. They have much more room for bias. I said once that if I were to tell you the story of Godzilla backwards, it would be about a moonwalking dinosaur that rebuilds Japan. That may be a silly way of explaining it, but stories are often dismissed as academically rigorous because it depends on how and who is telling the story. Data on the other hand is undeniable (that is, if it is actually done correctly, a whole other debate…).

So we become comforted in data and rely on it to sway our positions. We have become oblivious to what this data means. Are policy arguments are now over a gain and loss of numbers. But mortality doesn’t simply mean that someone dies – it means that a person is removed from an ever-changing, organic infrastructure of family and community. A beam is removed from the foundation, and it weakens everything. It devastates people, families, and communities. But more importantly, it changes how those infrastructures operate. That cant be summed up in data. We have to find a way to show that, justly – because just like our data, we can’t present their stories in a biased way.

Continue reading “Interview with Jonathan Smith, Director of “They Go To Die” Part 3: Storytelling and Research”

Interview with Jonathan Smith, Director of “They Go To Die” Part 2: The Filming Process

Over the next week, I have the pleasure of welcoming Jonathan Smith, a recent graduate of the Yale School of Public Health, and a current lecturer there, to the Blog. Jonathan has been working on a documentary about his research entitled “They Go To Die” a story describing the plight of miners in South Africa. I’ll have the opportunity to talk to Jonathan about his experiences making this movie both as a film maker and an epidemiologist . The interview is split into three parts: Part 1 was a broad background to the area, Part 2 covers the filming experience, and finally Part 3 will talk about the role of storytelling in research. Jonathan has mounted a campaign on Kickstarter to help fund the editing and final steps in making this movie a reality, and if you would like to support him, please click here.

So how did you start the filming process? Did you have contacts? Did you encounter any resistance making this movie? How did the miners react when you told them?

Well, funny you should ask. My first question was, “how can I find these men?” I mean, think about the logistics of actually finding these men, who ‘disappear’ once they leave the mine, then try to get them to agree to let some white guy live with them… and film it? I literally had to start from scratch. I had no connections. It was a tough time.

At first I tried just walking through the settlements asking around for people. Terrifying. Obviously, I’m an idiot. It wasn’t the correct approach and once was literally chased out of the settlement by men with butcher knives. Amazing how fast you can run when you need to!

Later, when I went to the exact same settlement to stay with Mr. Sagati, I approached it through ‘community leaders’ – informally appointed leader of the settlement. Once my intentions were actually explained and by someone they trusted, they were more than happy about letting me into the community. That experience also gave Mr. Sagati’s family in particular (who lived in the settlement) a pretty good laugh and some ammunition to make fun of me after I told them…

Continue reading “Interview with Jonathan Smith, Director of “They Go To Die” Part 2: The Filming Process”

Interview with Jonathan Smith, Director of “They Go To Die” Part 1: Background

Over the next week, I have the pleasure of welcoming Jonathan Smith, a recent graduate of the Yale School of Public Health, and a current lecturer in Global Health, to the Blog. Jonathan has been working on a documentary about his research entitled “They Go To Die“, and over the next week, I’ll have the opportunity to talk to Jonathan about his experiences making this movie.

The interview is split into three parts: Part 1 will be a broad background to the area, Part 2 covers the filming experience, and finally Part 3 will talk about the role of storytelling in research. If you have any questions for Jonathan, please do not hesitate to let me know. I’m really excited to be doing this – I believe that academia needs to branch out into other avenues to help convey our message, and this is just one route we can take.

Jonathan has mounted a campaign on Kickstarter to help fund the editing and final steps in making this movie a reality, and if you would like to support him, please click here to donate.

Hi Jonathan! Thanks for joining us (well, me) at Mr Epidemiology. Why don’t we start by introducing you to the audience …

My name is Jonathan Smith and I research TB and HIV in the context of migrant populations, specifically goldmine workers in South Africa, at Yale University’s School of Public Health (YSPH). I am currently a lecturer in the departments of Epidemiology of Microbial Diseases and Global Health at Yale, and an affiliate of Yale’s Global Health Leadership Institute.

As a graduate student at YSPH, the more I researched mining and TB, the more I realized that another traditional research project would do little to actually solve anything. We can get to the specifics as to why in a moment, but in short I posed the question, “What is the point of public health research if there is no public health benefit?” That’s when I decided to take on the role as filmmaker and create the documentary, They Go to Die. And that’s also when my whole perception of global health changed…

Continue reading “Interview with Jonathan Smith, Director of “They Go To Die” Part 1: Background”

History of Epidemiology: Jonas Salk and The Eradication of Polio

Better Know An Epidemiologist/History of Epidemiology is an ongoing feature where Mr Epidemiology pays tribute to people and studies who have set the stage for his generation of epidemiologists. All of the articles are listed here.

Poliomyelitis is an infectious viral disease. It enters through the mouth and is usually spread by contaminated drinking water or food. The virus passes through the stomach and then replicates in the lining of the intestines. Most healthy people infected with virus experience little more than mild fever or diarrhea. However, some people develop paralysis, and some die as a result.

Franklin Delano Roosevelt, 32nd President of the United States of America, suffered from Polio

In 1952, approximately 58,000 new cases of Poliomyelitis occurred in the United States. In 1953, approximately 35,000 new cases were reported. This was up from an annual average of 20,000 cases. The 1952 infections left 3,145 people dead and 21,269 with mild to disabling paralysis.

Even before the 1952 and 1953 outbreaks, labs had been worked diligently to find a cure for Polio. Relief finally came when Jonas Salk developed a vaccine.

More after the jump.

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Better Know An Epidemiologist: Alexander Langmuir

Better Know An Epidemiologist/History of Epidemiology is an ongoing feature where Mr Epidemiology pays tribute to people and studies who have set the stage for his generation of epidemiologists. All of the articles are listed here.

Epidemiology is a relatively new field. While John Snow made his breakthrough in the 1850s, even as recently as World War 2, there was no central epidemiology agency. However, with the start of the Korean War, the threat of biological warfare loomed. As a result, the government recognized the need for an organization who would track and monitor disease outbreaks.

Enter Alexander Langmuir.

Alexander Langmuir, founder of the Epidemic Intelligence Service

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Better Know An Epidemiologist: John Snow

Better Know An Epidemiologist/History of Epidemiology is an ongoing feature where Mr Epidemiology pays tribute to people and studies who have set the stage for his generation of epidemiologists. All of the articles are listed here.

Edit 11/02/11: I added in a link to a Google Map of the cholera outbreak

There have been many breakthroughs made off the blood and sweat of Epidemiologists. They have been at the forefront of eradicating polio, smallpox, reducing deaths from cholera and even detecting thalidomide as a teratogen.

But we will start at the beginning with the first Epidemiologist, John Snow.

More after the jump.

Continue reading “Better Know An Epidemiologist: John Snow”

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