(Roughly) Daily

In the fall of 1713, measles struck the city of Boston, where Cotton Mather, a Puritan theologian and pastor, lived with his pregnant wife and numerous children. Within a month, his wife, their twin newborn babies, another child, and their maidservant had all died. On November 12, Mather wrote in his journal, “The epidemical Malady began upon this Town, is like to pass thro’ the Countrey. . . . it [might] be a service unto the public, to insert in the News-paper, a brief Direction for the managing of the sick. I will advise with a Physician or two.” On November 21, he wrote, “Lord I am oppressed; undertake for me!” On November 23, he wrote, “My poor Family is now left without any Infant in it, or any under seven Years of Age.”

Eight years later, when an explosive smallpox epidemic threatened Boston’s population of eleven thousand, Mather became an outspoken advocate for a new prophylactic against the virus: inoculation. Dr. William Douglass, one of the few doctors in town with a medical degree, rallied others to oppose Mather, claiming that the method was untested (which was true, at least in the new colony) and that it jeopardized the lives of all those who received it. In young Boston, the fight over inoculation tore at epidemic-addled nerves. In November 1721, a bomb was thrown through Mather’s window. A letter attached to it read, “Cotton Mather, you dog, dam you! I’ll inoculate you with this; with a pox to you.”

Douglass won out, quashing Mather’s plans for a systematic inoculation of the town’s population. Eight hundred and forty-four people died of the virus, accounting for 75 percent of all deaths in Boston that year. The unexploded bomb on Mather’s floorboards disabuses those of us living in 2019 of the impression—generated over the past two years by endless news stories about the current global measles outbreak—that inoculation controversies are a novel feature of our present hyper-mediated, hyper-politicized time.

Measles was considered to be eliminated in the United States in 2000. Still, the virus has regained extraordinary ground—and claimed an increasing number of lives—in recent years. Seven hundred and four cases were reported in the United States in the first four months of 2019, according to the Centers for Disease Control and Prevention. The count reached 1,077 by mid-June, occurring in twenty-eight states. More than six hundred cases have occurred in New York City alone since September of 2018.

In June, the CDC issued a warning to travelers planning to leave the country, by which point outbreaks were occurring in all the places you’d expect, countries beset by depressed economies, poor public health management, war, or extreme poverty, including Ethiopia, Madagascar, Kyrgyzstan, the Democratic Republic of Congo, the Philippines, Sudan, and Georgia (not the U.S. state, although cases have been reported there as well). But also, cases were appearing in countries where entrenched vaccination systems existed and where measles had been thought largely a disease of the past: Belgium, France, Germany, and Italy.

The grand cause for these infections—and for the 300 percent growth of reported measles cases around the world in the first quarter of the year over the same quarter the previous year—is precisely the absence of what Cotton Mather proposed for 1721-era Boston: systematic vaccination of the population. The more interesting question, beyond simple international vaccination logistics, is: What ideological and historical shifts have allowed the reemergence of a disease once believed to be under controlled decline?…

A history of the debates over vaccination that asks, can the social contract be protected from a measles outbreak?: “Herd Immunity.”

* Thomas Aquinas

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As we pull up our sleeves, we might send healing birthday greetings to Giovanni Maria Lancisi; he was born on this date in 1654.  A doctor (he was personal physician to three popes), epidemiologist (he made the correlation between mosquitoes and malaria), and anatomist (his study of the heart resulted in the eponymous Lancisi’s sign), he is considered the first modern hygienist.

He carried out extensive anatomical and physiological studies, also epidemiology studies on malaria, influenza and cattle plague.  Contrary to the then-traditional conception of “mal’ aria ” – literally, “bad air” – Lancisi observed that the lethal fever, malaria, disappeared when the swamps near to the city were cleared.  He concluded that injurious substances transmitted from flies and mosquitoes were the origin of the disease.

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