Bollet A J
Yale University School of Medicine, New Haven, Connecticut.
Yale J Biol Med. 1992 May-Jun;65(3):211-21.
The epidemic of pellagra in the first half of this century at its peak produced at least 250,000 cases and caused 7,000 deaths a year for several decades in 15 southern states. It also filled hospital wards in other states, which had a similar incidence but refused to report their cases. Political influences interfered, not only with surveillance of the disease, but also in its study, recognition of its cause, and the institution of preventive measures when they became known. Politicians and the general public felt that it was more acceptable for pellagra to be infectious than for it to be a form of malnutrition, a result of poverty and thus an embarrassing social problem. Retrospectively, a change in the method of milling cornmeal, degermination, which began shortly after 1900, probably accounted for the appearance of the epidemic; such a process was suggested at the time, but the suggestion was ignored.
本世纪上半叶，糙皮病疫情达到高峰，在15个南方州持续数十年，每年至少产生25万病例，导致7000人死亡。其他州的医院病房也人满为患，这些州发病率相似，但拒绝报告病例。政治影响不仅干扰了疾病监测，还影响了对疾病的研究、病因的确认以及预防措施的实施（当这些措施为人所知时）。政治家和公众认为，糙皮病具有传染性比它是营养不良的一种形式更容易接受，而营养不良是贫困的结果，因此是一个令人尴尬的社会问题。回顾过去，1900年后不久开始的玉米粉研磨方法的改变，即脱胚，可能是疫情出现的原因；当时有人提出了这样的过程，但该建议被忽视了。
