A History of Healing: Infectious Diseases and the Community Responses to Defeat Them

Battling and enduring infectious disease sparks scientific innovation and advancement, stronger public health systems, and compassionate community responses--all of which help improve the quality of our lives. Ripping through individuals, families, communities, and entire populations, infectious diseases can leave a wake of suffering, fear, and death.

However, medical professionals, scientists, and communities aggressively respond through the process of scientific discovery and advancement, adaptation, and community response. Understanding the changes infectious disease wrought in Champaign County and abroad is extremely important. So, too, are the community responses to those diseases.

Through this exhibit, you can build an appreciation and understanding of the historic influences infectious diseases had on people’s lives and communities--both in Champaign County and abroad--resulting in a better understanding of how disease affects us today and informing our responses to it. The exhibit specifically explores 9 infectious diseases including smallpox, 1918-1919 influenza, HIV/AIDS, tuberculosis, polio, malaria, cholera, typhoid, and COVID-19.

What are Infectious Diseases?

An infectious disease, also referred to as a communicable disease, is defined as an illness caused by a specific infectious agent resulting from the spread of that agent or its products from an infected person, animal, or reservoir to a susceptible host--either directly or indirectly. There are a variety of organisms that can cause infectious disease, like viruses, bacteria, fungi, or parasites.

Cowpox and Smallpox

Smallpox has been around for at least 3,000 years, as evidenced by the scarring and markings left behind on the bodies of Egyptian mummies. As early civilizations spread and more extensive trade networks developed, smallpox spread, too. Smallpox is characterized by a high fever, head and body aches, vomiting, scarring and scabbing, potential blindness, organ damage, and a decreased immune response, and a red rash beginning in the mouth that eventually develops into pustules susceptible to rupture.

Variolation, the first method of inoculation used to immunize against smallpox, was practiced in Africa and China for several centuries prior to its use in the West. The History of Healing exhibit features a milking stool (pictured below) that helps tell the story of the Western world’s venture into smallpox inoculation.

Edward Jenner, a British country doctor noticed that the milkmaids--women who sat on a stool much like the one featured in the exhibit--rarely had pock-marked faces. He reasoned that, through their work, these women were exposed to cowpox--a disease related to Smallpox. The milkmaids would contract a mild case of Cowpox, develop sores on their hands, and would recover quickly. Perhaps that was providing some immunity against the dreaded smallpox. 

To test his theory, Jenner inoculated a young boy with Cowpox and then Smallpox to see if he had indeed developed immunity. Such a shocking method to us, but this method worked and started a very effective campaign against Smallpox that eventually led to its eradication in 1979.

Because Smallpox is the one disease we often believe has been eradicated through human efforts, we tend to think of it as a disease of the distant past. However, in February of 1938 there was a Smallpox scare in Illinois. The University of Illinois campus was closed for 16 days, as isolation and vaccination were required. All but 7 University students were vaccinated and given a card verifying their participation. The University Health Services Station was open between 7:30 a.m. and 10:30 p.m. for 9 days to administer over 10,000 vaccinations. An additional 10,000 grade school and high school students were vaccinated. Only 20 cases were reported at that time.

1918-1919 Influenza

The first cases of this infectious disease in the United States were identified among military personnel in April of 1918 near the end of World War I. Because the news of the spread of influenza was freely reported in Spain, many believed that Spain was the origin of the outbreak which led to the impression that disease was a "Spanish Flu." However, the disease spread within the United States following the troops' deployment to, and return from, France--it was a global flu.

Influenza is characterized by fever and chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headache, fatigue, vomiting and diarrhea, and can potentially cause secondary infections like pneumonia. In 1918 and 1919, an influenza vaccine did not exist, and there were not any antibiotics to treat secondary infections. The main method used to combat this disease was prevention.

Those who contracted influenza were isolated and quarantined, quality hygiene measures were put in place, gatherings were limited, disinfectants were used, and preventative tactics were implemented. However, these tactics were not universally adopted and thus had marginal effectiveness. In the spring of 1918, many public spaces were closed to stop the spread of the disease, and in the winter of 1919 a major push from public health departments emerged warning of the dangers of influenza. One way in which Illinois addressed the 1918-1919 Influenza pandemic was through the passage of a law in February of 1919 that created the practical nurse position, which was intended to help address the nursing shortage the global influenza outbreak had caused.

HIV/AIDS

HIV, or Human Immunodeficiency Virus, is the infectious disease that leads to AIDS—Acquired Immunodeficiency Syndrome. The disease originated as SIV, Simian Immunodeficiency Virus, and was first discovered among a group of Central African chimpanzees. The disease continues to circulate among non-human primates today. By the 1800s, the disease jumped to humans, found a very successful host, and eventually became known as HIV. By the 1970s, HIV made its way to the United States.

HIV has historically been transmitted through blood transfusions, needle sharing, the exchange of bodily fluids through sexual contact, and perinatally. Within the first few weeks of infection, people may begin to experience fever, chills, rash, night sweats, muscle and body aches, sore throat, fatigue, swollen lymph nodes, mouth ulcers, and a decreased immune response. This decreased immune response can eventually lead to presence of opportunistic infections like tuberculosis, thrush, salmonella, or pneumonia.

In the beginning, health professionals had found that gay men were at higher risk for infection. Health professionals eventually found that AIDS does not only affect the gay community. Because many believed the disease was strictly associated with the gay community, AIDS became a stigmatized health issue. As such, in 1983, an individual from Bloomington-Normal came to Champaign County for treatment, so their local community would not be aware of their infection. Although the patient was not local to Champaign County, this infection became the first case of AIDS reported at one of our local hospitals. Currently, our community serves the needs of those affected by HIV and AIDS through the Greater Community AIDS Project, a program that provides assistance with housing and shelter, food and supplies, medical expenses, general utility expenses, education, and intensive support services.

Tuberculosis (Consumption)

Tuberculosis (TB), often referred to as Consumption in the past, is an infection disease that primarily affects the lungs and respiratory system. The disease was originally found in bison 17,000 years ago hence its scientific name, Mycobacterium bovis. Human Tuberculosis, or Mycobacterium tuberculosis as it was named in 1882, has been around for approximately 9,000 years. The first written accounts of this disease appeared in India about 3,300 years ago. The disease first appeared on the North American continent about 2000 years ago.

Tuberculosis is an airborne pathogen, meaning that the disease is spread from person to person through the inhalation of air particles carrying the disease. When an infected person spits, coughs, sneezes, vocalizes, the disease can be spread. Some individuals can become infected with Tuberculosis but show no signs or symptoms of the disease. This is referred to as a Latent TB Infection (LTBI), which can result in a positive skin test but will not result in infection of contagion. It is almost as if the bacteria are sleeping inside the body. However, Latent TB can become active within an individual, and the bacteria can overcome the immune system. The bacteria multiply, and the individual can then become symptomatic. Some of the symptoms include a bad cough lasting three weeks or longer, chest pain, hemoptysis (coughing up blood or bloody sputum), weakness and fatigue, weight loss, loss of appetite, chills, fever, and night sweats.

The disease has been, and can still be, very lethal. In response to this, a local social worker, Emily Bissel, began raising money for a sanatorium for Champaign County. She designed a holiday themed stamp and began selling them for a penny. Within the first year, Bissel raised $3,000. She started a tradition of selling “Christmas Seals” to raise money for TB sanatoriums. Currently, there are 30 deaths per year due to Tuberculosis in the state of Illinois. In Champaign County, approximately 1.43 cases emerge per 100,000 people. There are a variety of treatments available to those affected by TB.

Polio (Poliomyelitis)

Polio, or Poliomyelitis, is an infectious disease that has been around for thousands of years. The disease is caused by a virus called poliovirus, which lives in the throat and intestines of an infected person. Polio has also been known as Infantile Paralysis, which also affected adults. In the 1930s, 1940s, and 1950s, Polio became rampant around the world.

Polio is only found naturally in humans, and the disease can either be mild or very severe. Polio has historically been most prevalent within the summer months. The disease is spread through person-to-person contact via nasal and oral secretions, fecal contamination, and through contaminated food and water. An individual can contract three different types of polio, Type 1, Type 2, and Type 3, all which can present slightly different symptoms. Some of the symptoms that an infected person can experience are paralysis; throat and chest paralysis; nerve damage of the brain, spine, and lungs; ataxia, or loss of muscle control; muscle and joint pain; fatigue; atrophy; trouble swallowing or breathing; and more.

With the help of the Polio vaccine, the United States has been polio-free since 1979. According to a report from 2018, there have been only 33 cases of polio across two countries. To limit the spread and prevalence of polio, the local, national, and international community had to respond. During the 1940s, many parents were frightened to let their children go outside, especially in the summer months when the infection rate seemed to peak. The spread of polio during this time also caused travel restrictions and the emergence of public health-imposed quarantines. One of the large-scale responses to polio was the creation of the March of Dimes Organization by President Franklin Delano Roosevelt in 1938. This became the national foundation for infantile paralysis, which promoted polio research, vaccine development and funding, financial support for those affected by polio, and more.

Malaria (Ague)

Malaria, also historically referred to as Ague, Roman Fever, or Swamp Fever, has had a very long history. The parasites that causes the disease belong to the genus Plasmodium (Plasmodium falciparum, Plasmodium malariae, Pladmodium vivax, Plasmodium ovale, and Plasmodium knowlesi). These parasites are estimated to have existed for millions of years. In 1880, a French doctor by the name of Charles Louis Alphonse was the first to identify the malaria causing parasites in red blood cells. By 1894, a Scottish doctor by the name of Sir Ronald Ross discovered that the disease was transmitted through, and carried by, mosquitos.

Unlike many diseases, malaria is not a contagious disease. Infection can only occur through blood transfusions, organ transplants, needle sharing, bites from an infective female Anopheles mosquito, or perinatally. The parasites infect the liver and red blood cells, and eventually destroys the red blood cells. An individual can experience either uncomplicated or sever malaria. An infected person may experience symptoms roughly 10-14 days after contact with the parasite which are fever and flu-like. These symptoms include fever, shaking and chills, headache, muscle aches, fatigue, nausea, vomiting, diarrhea, anemia, jaundice, kidney failure, seizures, confusion, and coma.

Malaria was eradicated in the United States by 1951. However, today nearly half of the world's population live in high-risk areas of malaria transmission, which includes 87 countries and territories. In order to combat this disease, many personal protective and mosquito control measure have been put in place. The World Health Organization (WHO) has recommended widespread use of the malaria vaccine in high-risk areas and preventative antimalarial medications are more available. Insecticide-treated nets, insect repellents, and larval control have also been implemented to combat malaria.

Cholera

The first European description of cholera emerged in 1642. It is still unclear as to how long cholera has been affecting humans. Cholera was extremely prevalent in the United States, and even around the world, during the 1800s. Between 1826 and 1837, there had been pandemics in both Europe and the United States. Over the last 200 years, there have been a total of 7 global pandemics of cholera. The first reportable disease was located in the United States, and by 1854 it had been discovered that cholera was linked to contaminated water sources.

Cholera is caused by a bacteria, called Vibrio cholerae, that originates in brackish marine environments. Its origin is believed to be on the Indian subcontinent. Cholera is transmitted fecal-orally, meaning through food and water that becomes contaminated with feces containing the bacteria. Inadequate water treatment, poor sanitation, and inadequate hygiene can exacerbate the spread of the disease. And infected individual may experience watery diarrhea, vomiting, leg cramps, dehydration, shock, kidney failure, and even death within hours if left untreated. Cholera is typically treated through IV fluid replacement and sometimes antibiotics.

Some responses to prevent and limit the spread of cholera have been the implementation of sanitation programs and hygiene awareness, targeted efforts for access to clean water, and the use of vaccines. The vaccines are not widely used in the United States and have not been 100 percent successful. Currently, the FDA has embarked upon a National Shellfish Sanitation Program (NSSP) that aids in the monitoring of shellfish for Vibrio cholerae.

Typhoid (Paratyphoid Fever)

Typhoid, also historically referred to as Nervous Fever, Slow Fever, Enteric Fever, or Infantile Remittent Fever, has been around since as early as 430 BCE. Typhoid has been linked to the Plague of Athens during the Peloponnesian War. By 1924, a typhoid outbreak had emerged in the United States in Portland, Oregon.

Typhoid is caused by two bacterias: Salmonella typhi and Salmonella paratyphi. The disease is transmitted through contaminated water and poor sanitation or through sewage contamination of food and water. An infected individual can experience sustained high fever, weakness, stomach pain, headache, diarrhea or constipation, cough, appetite loss, rash, general malaise, cough, delirium, or agitation. In its most advanced stages, typhoid can cause intestinal hemorrhage or perforation, encephalitis, pneumonia or bronchitis, metastatic abscesses, cholecystitis, endocarditis, osteitis, dehydration, delirium, and low platelet count. Typhoid is often treated with antibiotics, but antibiotic resistance in recent years has been a growing problem.

One of the primary ways in which the community has responded to Typhoid is through vaccination, either orally or intramuscularly. The vaccine was first developed by a British man named Almroth Edward Wright in 1896. By 1909, a United States Army Physician, Frederick Russell, adopted a typhoid vaccination program and made typhoid vaccines mandatory. In 1934, Arthur Felix and Miss S. R. Margaret Pitt discovered the Vi capsular antigen, which allowed for the development of the safer Vi Antigen vaccine that is widely in use today. A slogan was also developed which stated, "Boil it, cook it, peel it, or forget it," as a way to to encourage safe eating for travelers.