Deciphering Global Epidemics: Analytical Approaches to the Disease Records of World Cities, 1888-1912 (review)

Deciphering Global Epidemics: Analytical Approaches to the Disease Records of World Cities, 1888-1912. By Andrew Cliff, Peter Haggett, and Matthew Smallman-Raynor (New York, Cambridge University Press, 1998) 469 pp. $74.95 cloth $29.95 paper.

The passage of the U.S. National Quarantine Act in 1878 was the result of an increasing concern about diseases reaching the United States from abroad. It authorized an international disease-surveillance system, and in the year the act was passed, the United States Public Health Service began the occasional publication of morbidity and mortality data that evolved into the familiar Morbidity and Mortality Weekly Report (mmwr) now published by the U.S. Centers for Disease Control and Prevention.

In 1887, the bulletins began appearing on a regular basis as the Weekly Abstract of Sanitary Reports. The present work rests on the data that they provided for the quarter-century from 1888 to 1912. The morbidity and mortality data were derived from U.S. cities and gathered by the U.S. consular system for some 200 foreign cities. Of these U.S. and foreign cities, the authors selected 100 (from Aix [Aachen] to Zurich) with the most complete records. Although these cities are predominantly located in Europe and North America, the sample represents all corners of the world, throughout which the authors track the twenty-five-year courses of six infectious diseases: diphtheria, enteric fever, measles, scarlet fever, tuberculosis, and whooping cough.

Clearly, this effort alone represents a massive undertaking, but the authors also provide histories of practically every topic that they discuss, encompassing the century before, and nearly a century after, their twenty-five-year window. Thus, they follow the careers of all of the diseases under scrutiny by etiology, epidemiology, immunology, and history, as well as the morbidity and mortality that they generated. Also treated are U.S. immigration, the history of the United States consular service, shipping traffic reaching U.S. ports, and myriad other topics, including the aids epidemic.

In addition to textual material, information collated from a variety of analytical techniques is presented in 129 figures, 43 tables, and 11 plates. Moreover, four appendixes provide information on demographic and epidemiological data sources around the globe, as well as a listing of national and international epidemiological agencies. From the preface through chapter seven--the last chapter of the book--the authors keep readers carefully posted on conclusions reached, and in the concluding chapter, they examine the reasons for the decline in mortality produced by all of the diseases.

This work, which folds together the fields of geography, history, demography, economics, epidemiology, and public health (among others), is interdisciplinary history at its best. It provides the further service of showcasing the research possibilities inherent in the data presented by the mmwr and its antecedents for historical investigators. Many of these data were generated and published considerably before the League of Nations disease surveys that came after World War I and long before the reporting of the World Health Organization after World War II.

Kenneth F. Kiple
Bowling Green State University

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