Responding to Infectious Disease

When yellow fever struck Philadelphia in 1793, a ninth of the city’s population died.  The entire federal government picked up and fled.   A hundred years later, the pendulum had swung sharply in the opposite direction.  Health workers took extreme measures to contain disease — imprisoning the sick, burning entire districts, and vaccinating resistant citizens at gunpoint.  We wondered: why the change?

In this episode, we’ll trace the shifting role of the state in preventing and coping with epidemics.  Where do we draw the line between promoting the public good and protecting individual rights?  How did people understand the causes and experience of disease in their own time?  And why did so many people resist public health measures, so fiercely, for so long?

Please help us shape this show!  Were you transfixed by “Contagion”?  Remember avoiding the swimming pool during polio scares?  Have an opinion on current vaccination requirements?  Share your stories, questions, and ideas below.


Comments (10)

{Discussion is closed
  1. Tom Ewing

    I am a historian at Virginia Tech, working with colleagues in Computer Science, English, and University Libraries on a project that explores the 1918 influenza pandemic using digitized American and Canadian newspapers as a large data set. Our project is being funded by the Digging into Data Challenge from the NEH Office of Digital Humanities. We would interested in contributing to this show, as our project is exploring many of the questions outlined on this page.

  2. MB Lewis

    You mention polio–have you viewed these interviews with polio survivors afiliated with the University of Michigan?
    More info at

    Also, we recently did a special section and video on HIV/AIDS at the 30-anniversary: See

    Let us know if you would like to speak with experts at the Michigan School of Public Health.
    MB Lewis, UM SPH web communications specialist

  3. Sean

    I do wonder how Native Americans dealt with disease. How did their own policies and attitudes change or evolve? What was their understanding of their history of dealing with diseases of European origin?

  4. Debra

    I am interested to know more about distrust of vaccinations and other medicine. I’m guessing that this did not begin with the vaccination-autism-scare of the ’90s?

  5. Dan McCauley

    Didn’t government have a direct responsibility for the spread of the flu in the 1917 pandemic due to the movement of troops during W.W. I?

  6. Dan McCauley

    Didn’t the government have a direct responsibility in the spread of the flu during the pandemic in 1917 due to the movement of troops during W.W. I?

  7. Yvonne

    This topic might be too racy for public radio, but I’d like to know more about the evolution of sexually transmitted diseases in America, and the politics of treatment/control programs by state and non-state actors. I’ve not come across a book of that sort dedicated specifically to 18th- to 20th-century America.

    I know that Clare Lyons’ Sex Among the Rabble: An Intimate History of Gender and Power in the Age of Revolution (2006) has a section on how misguided narratives of virtue and sin governed the (ineffective) treatment of syphilis among prostitutes who were treated in special asylums set up by anti-vice activists in Philadelphia in the 1810s.
    William Hitchcock’s Bitter Road to Freedom (2008) has a detailed section on the U.S. military’s controversial efforts during WWII to control VD among American occupation troops in Europe. By June 1945 infection rates reached 15%, and the government undertook aggressive, racially- and culturally-charged treatment and control programs that soon caused domestic and international friction (see p.95).

    Thanks for the new episodes. Keep up the great work!

  8. Robert Welch

    As part of a government program to combat tuberculosis and bovine tuberculosis, the state of Iowa implemented a testing program for cattle. When cattle tested positive, they were destroyed, with 1/3 reimbursement each from the state and Federal governments. In the height of the early Depression, farmers in Iowa not only faced the loss of 1/3 the value of their cow, but also the loss of their milk check, often the only financial lifeline that kept the wolf from the door.

    In 1931, the farmers of Cedar County, Iowa, resisted the veterinarians, and the police officers sent to protect them. They gathered at farms where the vets were coming by using code over the party-line phones, and acted to prevent testing. In June, after they assaulted two veterinarians and their guard, and kidnapped the head state veterinarian, the Governor called out the National Guard to protect and ensure testing continued. The episode came to be known as the Cow War.

  9. Ben Panko

    As a question, I wonder when did the government (federal, state, and/or local) begin to take an active role in public health? As you mentioned above, they fled Philadelphia during the yellow fever scare.

    I would also highly suggest devoting a section of the show to the rise of the anti-vaccination movement from the late 1980’s to today.

    For reference, a thorough book on the topic is “Deadly Choices: How the Anti-Vaccine Movement Threatens Us All” by Paul Offit, a pediatrician at the Children’s Hospital of Philadelphia. He would make a great interview on the topic too, I imagine.