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脊灰炎、公共卫生记忆与全球北方再现传染病的时间不和谐

Polio, public health memories and temporal dissonance of re-emerging infectious diseases in the global north.

机构信息

Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom; The Vaccine Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom.

National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.

出版信息

Soc Sci Med. 2024 Sep;357:117196. doi: 10.1016/j.socscimed.2024.117196. Epub 2024 Aug 10.

Abstract

Social science research on polio has been centred in the global south, where countries that remain endemic or vulnerable to outbreaks are located. However, closely-related strains of poliovirus were detected in the sewage systems of several New York State counties and London boroughs in 2022. These detections constituted the first encounters with polio in the United States and United Kingdom for a generation - for both public health agencies and publics alike. This paper takes the transnational spread of poliovirus in 2022 as an opportunity to critique how public health memories of twentieth-century polio epidemics were mobilised to encourage vaccine uptake among groups considered vulnerable to transmission, notably Orthodox Jewish families. The study integrates data collected in London and New York as part of academic engagement with health protection responses to the spread of polio. Methods in both settings involved ethnographic research, and a total of 59 in-depth semi-structured interviews with public health professionals, healthcare providers, and Orthodox Jewish community partners and residents. Analysis of results demonstrate that narratives of epidemiological progress were deployed in public health responses in London and New York, often through references to sugar cubes, iron lungs, and timelines that narrate the impact of routine childhood immunisations. While memories of polio were deployed in both settings to provoke an urgency to vaccinate, vulnerable publics instead considered the more recent legacy of the COVID-19 pandemic when deciding whether to trust recommendations and responses. Critical attention to memory places analysis on the divergences between institutional (public health agencies) and peopled (publics) responses to disease events. Responses to re-emerging infectious disease outbreaks engender a temporal dissonance when historical narratives are evoked in ways that contrast with the contemporary dilemmas of people and parents.

摘要

社会科学对脊髓灰质炎的研究集中在全球南方,即那些仍然存在脊髓灰质炎流行或易受爆发影响的国家。然而,2022 年在几个纽约州和县和伦敦自治市的污水系统中检测到了与脊髓灰质炎病毒密切相关的菌株。这些检测结果构成了美国和英国一代人以来首次发现脊髓灰质炎——无论是公共卫生机构还是公众。本文以 2022 年脊髓灰质炎病毒的跨国传播为契机,批评了如何利用公共卫生对 20 世纪脊髓灰质炎流行的记忆,鼓励被认为易传播的群体(尤其是东正教犹太家庭)接种疫苗。该研究整合了在伦敦和纽约收集的数据,作为对健康保护应对脊髓灰质炎传播的学术参与的一部分。两种方法都涉及民族志研究,共对 59 名公共卫生专业人员、医疗保健提供者以及东正教犹太社区合作伙伴和居民进行了深入的半结构化访谈。结果分析表明,流行病学进展的叙述在伦敦和纽约的公共卫生应对中得到了应用,通常通过引用方糖、铁肺和时间线来叙述常规儿童免疫接种的影响。虽然脊髓灰质炎的记忆在这两个环境中都被用来引发接种疫苗的紧迫性,但弱势公众在决定是否信任建议和应对措施时,更多地考虑了最近的 COVID-19 大流行的遗留问题。对记忆的批判性关注将分析置于机构(公共卫生机构)和人民(公众)对疾病事件的反应之间的差异之上。当以与当代人们和父母的困境形成鲜明对比的方式唤起历史叙述时,对新出现的传染病爆发的反应会产生时间上的不和谐。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed56/11863350/1a9e36e883be/nihms-2058907-f0001.jpg

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