
Environmental Encyclopedia 3
Epidemiology
tionships might be important. Further investigation might
disclose that all of the infected persons had dined at one
time or at short intervals in a specific home, and that the
person who had prepared the meal had visited a rural area,
suffered a mild attack of the disease, and now was spreading
it to family and friends by unknowing contamination of food.
One very real epidemic of
cholera
in the West African
nation of Guinea-Bissau was tracked by CDC researchers us-
ing maps, interviews, and old-fashioned footwork door-to-
door through the country. An investigator eventually tracked
the source of the cholera outbreak to contaminated shellfish.
Epidemic diseases result from an ecological imbalance
of some kind. Ecological imbalance, and hence, epidemic
disease may be either naturally caused or induced by man.
A breakdown in
sanitation
in a city, for example, offers
conditions favorable for an increase in the rodent population,
with the possibility that diseases may be introduced into
and spread among the human population. In this case, an
epidemic would result as much from an alteration in the
environment as from the presence of a causative agent. For
example, an increase in the number of epidemics of viral
encephalitis, a brain disease, in man has resulted from the
ecological imbalance of mosquitoes and wild birds caused
by man’s exploitation of lowland for farming. Driven from
their natural
habitat
of reeds and rushes, the wild birds,
important natural hosts for the virus that causes the disease,
are forced to feed near farms; mosquitoes transmit the virus
from birds to cattle to man.
Lyme disease, which was tracked by epidemiologists
from man to deer to the ticks which infest deer, is directly
related to environmental changes. The lyme disease spiro-
chete probably has been infecting ticks for a long time;
museum specimens of ticks collected on Long Island in the
l940s were found to be infected. Since then, tick populations
in the Northeast have increased dramatically, triggering the
epidemic.
There are more ticks because many of the forests that
had been felled in the Northeast have returned to forestland.
Deer populations in those areas have exploded, close to
concentrated human populations, as have the numbers of
Ixodes dammini ticks which feed on deer. The deer do not
become ill, but when a tick bite infects a human host, the
result can be a devastating disease, including crippling arthri-
tis and memory loss.
Disease detectives, as epidemiologists are called, are
taking on new illnesses like heart disease and
cancer
, diseases
that develop over a lifetime. In 1948, epidemiologists en-
rolled 5,000 people in Framingham, Massachusetts, for a
study on heart disease. Every two years the subjects have
undergone physicals and answered survey questions. Epide-
miologists began to understand what factors put people at
521
risk, such as high blood pressure, elevated cholesterol levels,
smoking, and lack of exercise.
CDC epidemiologists are now tracking the pattern of
violence, traditionally a matter for police. If a pattern is
found, then young people who are at risk can be taught to
stop arguments before they escalate to violence, or public
health workers can recognize behaviors that lead to spouse
abuse, or the warning signs of teenage suicide, for example.
In the 1980s, classic epidemiology discovered that a
puzzling array of illnesses was linked, and it came to be
known as AIDS. Epidemiologists traced the disease to sexual
contact, then to contaminated blood supplies, then proved
the AIDS virus could cross the placental barrier, infecting
babies born to HIV-infected mothers.
The AIDS virus, called human immunodeficiency vi-
rus, may have existed for centuries in African monkeys and
apes. Perhaps 40 years ago, this virus crossed from monkey
to man, although researchers do not know how or why.
African
chimpanzees
can be infected with HIV, but they
don’t develop the disease, suggesting that chimps have devel-
oped protective immunity. Eventually AIDS, over centuries,
probably will develop into a less deadly disease in humans.
But before then, researchers fear that new, more deadly,
diseases will evolve.
As human communities change and create new ways
for diseases to spread, viruses and bacteria constantly evolve
as well. Rapidly increasing human populations prove a fertile
breeding ground for
microbes
, and as the planet becomes
more crowded, the distances that separate communities be-
come smaller.
Epidemiology has become one of the important sci-
ences in the study of nutritional and biotic diseases around
the world. The United Nations supports, in part, a World
Health Organization investigation of nutritional diseases.
Epidemiologists have also been called upon in times
of natural emergencies. When
Mount St. Helens
erupted
on May 18, 1980, CDC epidemiologists were asked to assist
in an epidemiologic evaluation. The agency funded and as-
sisted in a series of studies on the health effects of dust
exposure, occupational exposure, and mental health effects
of the volcanic eruption.
In 1990, CDC epidemiologists began research for the
Department of Energy to study people who have been ex-
posed to radiation. A major task of the study is to quantify
exposures based on historical reconstructions of emissions
from nuclear plant operations. Epidemiologists have under-
taken a major thyroid disease study for those people exposed
to radioactive iodine as a result of living near the
Hanford
Nuclear Reservation
in Richland, Washington, during the
l940s and l950s.
[Linda Rehkopf]