Hardy Anne
Centre for History in Public Health, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
J Hist Med Allied Sci. 2014 Jan;69(1):3-37. doi: 10.1093/jhmas/jrs005. Epub 2012 Apr 5.
In the early twentieth century, death rates from typhoid in European cities reached an all time low. By contrast, death rates in America were six times as high, and the American public health community began a crusade against the disease in 1912. In the 1920s, hopes for greater control of the disease focused not just on sewers and drinking water supplies, but on the newly established scientific means of immunization, the supervision of food-related pathways of infection, and the management of healthy carriers. The management of carriers, which lay at the core of any typhoid control program, proved an intractable problem, and typhoid remained a public health concern. America and England both struggled with control of the disease during the interwar period. Coming from different starting points, however, their approaches to the problem differed. This paper compares and contrasts these different public health strategies, considers the variable quality of support provided by bacteriological laboratories, and demonstrates that "accidental" typhoid outbreaks continued to happen up to the outbreak of World War II.
在20世纪初，欧洲城市伤寒死亡率降至历史最低点。相比之下，美国的死亡率则高达其六倍，于是美国公共卫生界于1912年发起了一场抗击该疾病的运动。在20世纪20年代，对该疾病进行更有效控制的希望不仅集中在下水道和饮用水供应上，还集中在新建立的免疫科学方法、对与食物相关的感染途径的监管以及对健康带菌者的管理上。带菌者的管理是任何伤寒控制计划的核心，但这却是个棘手的问题，伤寒仍然是一个公共卫生问题。在两次世界大战之间的时期，美国和英国都在努力控制这种疾病。然而，由于起点不同，它们解决这个问题的方法也有所不同。本文比较并对比了这些不同的公共卫生策略，考虑了细菌学实验室提供的支持质量差异，并表明直到第二次世界大战爆发，“偶发性”伤寒疫情仍时有发生。
