Outbreak: Epidemics in a Connected World

A common frustration among historians of medicine is the way in which the media tends to treat each new epidemic as an alarming anomaly, divorced from the context of outbreaks past. It was therefore refreshing to visit the Smithsonian National Museum of Natural History's latest temporary exhibit, "Outbreak: Epidemics in a Connected World," where the public can explore this history firsthand.

The exhibit centers on the concept it calls "One Health." Akin to the World Health Organization's "planetary health," One Health considers human health to be inextricable from the health of animals and the environment. The argument the panels and displays put forth was that anthropogenic changes to the environment have caused humans, animals, and their viruses to interact in new ways. This transfer of zoonotic diseases has led to a series of new disease outbreaks, from the Hanta virus and pandemic influenza to HIV, Zika, and Ebola. The threat and opportunity of our interconnected world are common themes—while diseases like SARS and MERS were able to travel rapidly between countries due to globalized air travel, international collaborations represent our best hope for outbreak detection, response, and containment.

Outbreak asks its audience to become "disease detectives." Interactive displays showcase the various ways humans have altered the environment—including increased demand for meat, which led to factory farming and animals kept in too-close captivity enabling disease spread and mutation, to deforestation and climate change, bringing wild animals into close contact with humans—and invite the public to look for "clues" as to how these changes contribute to disease outbreaks. What risk factors do they see in this scenario? How would they diagnose patients lining up with a mysterious disease? Another interactive game drives home the message of collaboration, wherein up to three people can role-play, video game-style, a disease outbreak response, each with different talents and skills.

Current and recent outbreaks—of Zika and Ebola, for example—are well-situated within the longer history of epidemics. A timeline near one entrance documents human changes to the environment back to 9000 BCE with the rise of animal domestication and agriculture. Urbanization, trade, colonialism, and the world wars are highlighted as having contributed to specific pandemics, if somewhat simplistically given space constraints. Patient voices are given significant space, however. Portraits and quotes from survivors of the 1918 influenza pandemic, HIV/AIDS, and recent Ebola outbreak in West Africa were featured prominently, and a wall display was dedicated to the history of HIV/AIDS activism.

A small sign near the main entrance warns that "this exhibition contains human remains, images, and content about disease symptoms, transmission, fatalities, and prevention that may not be suitable for all audiences." Indeed, though situated in a museum known to be extremely child-friendly, this exhibit may be somewhat disturbing (as Ilearned firsthand) to even the most intrepid seven-year-old. Germophobes and hypochondriacs may also want to steer clear. Some images and displays of confined, sick, and dead animals may also warrant caution to animal-lovers, though—as my son pointed out—it is housed in a museum otherwise full of dead animals. Apart from one moment at the end of a video newsreel, which proclaimed that an "outbreak anywhere is a threat everywhere," the exhibit did a nice job of veering away from the alarmist rhetoric so often associated with epidemics.

"Outbreak" is certainly worth a visit for those in or stopping by Washington, D.C. It presents a historically informed take on the current state of disease in the Anthropocene, and will, I hope, inspire many to reconsider their relationship to the environment and our animal neighbors.