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Citizens of Mexico City wear masks to prevent the spread of swine flu. (David de la paz / XinHua / Xinhua Press / Corbis)

Dreading the Worst When it Comes to Epidemics

A scientist by training, author Philip Alcabes studies the etymology of epidemiology and the cultural fears of worldwide disease

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In many ancient cultures, it was assumed what we now call epidemics were random acts of God or gods that couldn’t be explained. In fact, a kind of philosophical advance that the ancient Hebrews brought was that disaster happened because God got angry (with people). These were real attempts to explain what happened on the basis of people’s actions. The leading example is the ten plagues in Exodus. God smites the Egyptians with these plagues because they won’t let the Hebrews go. The idea was that when there are natural disasters it’s not a random eruption of the spirit world but a predictable response by an angry deity.

You say the Black Death was the archetypal epidemic.

We think of epidemics in the pattern of the Black Death. It comes suddenly, without warning, and causes great harm. And then it goes away. There are certain really terrible disease disasters that we don’t call epidemics. Worldwide there are about 1.8 million deaths per year from tuberculosis but we don’t say there’s a tuberculosis epidemic. We don’t talk about that as an epidemic because TB does the same thing year in and year out. There’s something about the sameness of that, the predictability of it, that makes us not consider it an epidemic.

How did medieval epidemics help strengthen communities?

The era of the plague starts in Europe in the mid-1300s and goes to about the year 1700. One of the things that’s remarkable is that at the same time as there were these florid and violent responses that I write about -- the burning of the Jews and hounding people out of their homes and exiling them from the land -- there were also very cogent and thoughtful communitarian responses, like quarantine. Communities decided to protect themselves by preventing goods from coming in or people from coming in, which in essence were the beginnings of public health intervention.

In the 20th century, how did epidemics impact the status of marginalized ethnic groups like Jews in Europe and Irish immigrants and blacks in America?

One of the themes that threads through the history of thinking about epidemics is this idea of fear or suspicion of foreigners or outsiders, fears about people who don’t seem to fit in. The Black Death example is the Christian townspeople in Western Europe who seized on Jews as the cause. Now they basically knew Jews weren’t the cause of the plague, but in many places nonetheless they either ran the Jews out of town or beat them or burned them to death. It was an expression of some unconscious, or not-so-unconscious, fear that I think was really about the stability of society. Fortunately we don’t see so much burning at the stake anymore when there are epidemics. But there’s still an impulse to fix on foreigners and outsiders as being suspect, as being somehow responsible. With cholera in the mid- 19th century, the suspects were Irish immigrants. There was an outbreak of plague in San Francisco in 1900 that started in Chinatown. The plans for what to do about the plague were tied up with anti-immigrant sentiments, which focused on Chinese-Americans but also included Japanese-Americans.

How did dread of epidemics influence women’s place in society?

There are scholarly papers in peer-reviewed medical journals that attribute tuberculosis (in the 1920s) to the new trend of young women’s independence. Instead of staying home and finding a husband, they were going out, getting jobs, and particularly wearing abbreviated clothing. They go out, catch a chill and one thing leads to another, the thinking went. Was there real science behind this? Yes and no. But it really reflected a set of prejudices about women. You see that set of prejudices more generally in the context of sexually transmitted diseases. There’s a general implication that sexual women are dangerous in the history of disease control in America.

What fears did the AIDS epidemic reveal?

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A frequent contributor to Smithsonian, Abigail Tucker is writing a book about the house cat.

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