Preface

By presenting articles on a wide variety of subjects and from a broad range of authors, this volume will provide a general understanding of the history of epidemic outbreaks and the means by which we as a civilization can combat them collectively. As the World Health Organization, the United Nations, and various national institutes of medicine have noted, it is only through international efforts that epidemic outbreaks can be contained and lives saved.

The term “epidemic,” which is derived from the Greek epi, meaning “upon,” and demos, meaning “people,” is defined here as an outbreak of infectious disease that spreads through a human population at a faster rate than what has been recorded in recent incidences. Though “epidemic” is often used metaphorically to discuss a host of societal issues, from the spread of illegal drug use to the cell-phone craze, this volume will focus exclusively on the medical definition of the term. Endemic disease, or maladies that occur at steady if debilitating rates in certain areas, such as malaria in tropical climates, will not be discussed to any great degree. Because it would be impossible to cover every epidemic that has occurred throughout history in a volume of this size, several infamous and illustrative examples, both historic and current, will be highlighted in order to give the reader a sense of an outbreak’s magnitude and power.

Epidemics have existed throughout recorded human history. Though defining what constitutes an actual outbreak has proven somewhat subjective, the impact of an epidemic on humanity has not: AIDS, smallpox, the Black Death, and other diseases have exacted incalculable tolls from mankind, threatening entire societies and destroying ways of life. While poorer countries and regions tend to be more susceptible to epidemics, no nation, no matter how wealthy, is invulnerable. Though it may initially be contained in a certain locale, such as a city or town, an epidemic has the potential to develop into a larger outbreak impacting not only nations, but entire continents, and indeed the whole world. When a disease spreads across the planet, it is known as a pandemic. One of the more notable examples of such a phenomenon in recent history is the Great Influenza Pandemic of 1918–19, also known as the “Spanish Flu,” which first emerged in the trenches of World War I before spreading across the globe. Within 12 months it killed at least 50 million people—and did so in an era before modern transportation could disseminate the disease more effectively. Consequently, if such an outbreak were to occur today, in an age when people (and the germs they carry) can travel across the planet in a matter of hours, the toll could be even greater. Given the common interest in forestalling such an eventuality, crafting an effective international response, one that emphasizes both prevention and containment, is of vital concern to the global medical community.

This book is divided into five sections, the first of which, “Notable Epidemics in Human History,” features articles discussing the origin and evolution of the term “epidemic” and exploring several of the more historically devastating outbreaks, among them the bubonic plague, smallpox, cholera, the Spanish Flu, polio, and AIDS. Pieces in the second section, “Preventing, Controlling, and Eradicating Epidemic Outbreaks,” examine the various methods employed to combat epidemics in a globalized world and offer critiques of current strategies to contain the spread of such contagions as AIDS and tuberculosis. “Is Avian Flu the Next Epidemic?” the book’s third chapter, includes entries analyzing whether or not the “bird flu,” which has spread from poultry to humans in recent years, will emerge as the next pandemic and, if so, whether the international medical community is up to the task of containing and counteracting it. Setting the medical challenges aside, the fourth chapter, “The Psychological and Economic Impact of Epidemics,” presents articles debating the potential impact a widespread outbreak would have on the global economy and community. Pieces in the final section, “Bioterrorism,” discuss the threat posed by terrorists seeking to use biological agents to spark an epidemic outbreak and whether such fears are warranted.

In closing, I would like to thank Joseph Miller and Lynn Messina for the opportunity to edit this book, as well as Richard Stein and Paul McCaffrey for their invaluable contributions to its production. A special thank you goes to my wife, Ana Maria Estela, whose love, support, insight, and knowledge helped guide this volume from its conception to its final form.

Christopher Mari
April 2007