Temporal Trends in Disease Emergence and Re-emergence: World Regions, 1850–2006

Abstract

In Chapters 4–8, we have examined a series of processes that, often working in combination, have served to precipitate the emergence and re-emergence of infectious and parasitic disease agents in the human population. In this chapter, we conclude our survey with an analysis of temporal trends in disease emergence and re-emergence since 1850. The discussion is informed by long-term shifts in the underlying causes of mortality encapsulated in Omran’s model of epidemiological transition (Section 1.4.1), paying particular attention to the manner in which sample infectious and parasitic diseases have waxed and waned at a variety of geographical scales from the global to the local over the last ∼150 years. Our choice of examples strikes a balance between coverage of geographical regions and epidemiological environments, and coverage of important diseases that we have not so far examined in detail. Our consideration is structured by geographical scale: (1) At the global level, we discuss three major human diseases that have undergone phases of rapid global expansion since 1850—plague, cholera, and HIV/AIDS (Section 9.2). (2) At the regional level, we examine twentieth-century trends in general infectious disease mortality in the advanced economies of Europe, North America, and the South Pacific, 1901–75, before looking at time sequences for sample emerging (Ebola–Marburg) and cyclically re-emerging (meningococcal) diseases in sub-Saharan Africa (Section 9.3). (3) At the national level, we use Hall’s (1993) data to establish the main trends in morbidity due to infectious diseases in Australia, 1917–91 (Section 9.4). (4) At the local level, we extend our examination of long-term disease trends in London, described for the pre-1850 period in Section 2.4, into the late twentieth century (Section 9.5). The chapter is concluded in Section 9.6. In this section, we examine long-term trends in three major human infectious diseases that have undergone phases of global expansion in the last 150 years: plague (Section 9.2.1); cholera (Section 9.2.2); and HIV/AIDS (Section 9.2.3).