This document contains contact information for Stephen Hansell, a professor in the Department of Sociology at Rutgers University who studies health research. It lists his academic credentials, department affiliation, website, email address, and phone number.

1. Stephen Hansell, Ph.D.
Department of Sociology
Institute for Health Research
http://sakai.rutgers.edu
shansell@rci.rutgers.edu
609-203-2830

2. 210 Class 4 – History of Epidemic

3. D. Organ transplants
• have waiting lists but organs are highly perishable so
the closest appropriate candidate gets them
• but who gets them youngest people? most life to live
• oldest people? who paid their dues?
• sickest people? healthier people and ensure the organ
works?
• religion?
E. Fertilization technology (surrogate mothers, sperm
donors)
E. who has a right to the child?
F. cloning will likely to happen in france because they
are more easier with the rules
E. what rights will the clones have?
F. Cloning (sheep, humans?)

4. XXI.Health politics
A. Extraordinarily complex!
B. Major players
1. Patients
– improve the health (no one but patients care about the
health)
2. Doctors and other health care providers
– want to increase the amount of care
3. Health care institutions (hospitals, etc.)
– need to fill beds
4. Private insurance
– want to pay for nothing
5. Public insurance (Medicare, Medicaid, Social
Security)

5. I. History of disease - the Black Death
Black Death: Natural and Human Disaster in Medieval Europe. Robert
S. Gottfried. New York: Free Press. 1983.
– the black death was not the biggest killer, the flu epidemic in Spain was,
but the Black death killed higher percentage of population,
about 50%
A. Overview
1. Caused by bacillus Yersinia pestis
2. A disease of rats spread to humans by fleas
3. humans cant transmit black plague to each other

6. 3. 3 "pandemics" wiped out large proportions of
populations
– a pandemic is a world wide epidemic
a. 400-500 AD Rome
b. 1347-1665 Europe – killed 33%-50% of
population
» just a lil less than the spanish epidemic
» in Scandinavia the black plague morphed
and the could be spread from ppl to people
which killed everyone
c. 1896-1933 Asia

7. Great Plague of London, May-December 1665

8. B. Bubonic plague in medieval Europe
• the rats lived in houses cz they were made of mud so the people
lived with rats and fleas who lived in rats
• the land was more imp than people
• high infant and child mortality 75% of children died before 10 years
and 1/10 mothers died in child birth
1. Symptoms
– pain and swelling in the lymph glands
– chills, fever, vomiting, headache
– after third day, black spots on the skin
– lymph nodes continue to expand and explode
2. Medieval treatment totally ineffective
– physicians who were all priests belived diseases were caused
my body fluid imbalance
– they just tried to balance the fluids by bleeding them, giving
them diarrhea, burning them, burning incense
3. Modern treatment is streptomycin - cuts mortality to 5%

9. C. Transmission of bubonic plague
1. Rats carry fleas, which carry the bacteria
– fleas primary host for bacteria and the rats are secondary
ones
2. Rats usually have partial immunity to the plague
3. But when the fleas carry the bacteria to a new rat
population without immunity, the rats die off, the
fleas jump to humans, and a human epidemic
breaks out

10. 4. Surviving rats develop immunity and the human
epidemic ends
– fleas prefer rats cz they have good fur
5. This cycle is repeated about every 20 years, so
human epidemics recur once a generation
– humans cant develop immunity to the black plague like
the rats do

11. D. Effects of plague in Europe
1. Depopulation leads to breakdown of community
– society did not work anymore
– people abandoned everything
– no more cops so criminals were out loose
– skilled craftsmen became scarce
2. Becchini
– people who collected dead bodies in the plague
3. Failure of quarantine
– victims of plague were quarantine but that did not work...
people actually built walls around the house of sick
people but the healthy people died out of hunger

12. 4. Violent anti-Semitism
– people believed other religions to be the cause
5. Flagellism
– cult that went from village to village and beat each other with
sticks and stuff so they would bleed. The people believe that if
they lost blood, the chances of the town to get disease would
decrease
6. Clergy lost power
– religious leaders used to rule everything but they could not do
anything to stop plague so people lost faith and clergy lost
power
7. Feudal system broke down
– before the land was more valuable so now the labor for the first
time became more valuable than land and the rich land owners
became poor and the laborers who survived underwent the
golden age of labor and they lived an awesome life

13. E. Plague disappeared by itself - nobody knows why
1. Subtle mutation of the bacteria?
2. Subtle change in the ecology of rats and fleas?
– black rats were replaced by the more aggressive brown
rats
3. Shift from black rat to brown rat in cities?
– places in the south still get the plague from dogs

14. III. Unintentional Germ Warfare
Guns, Germs, and Steel by Jared Diamond, published by Norton,
1999
A. European's conquest and depopulation of the New World
1. Aztecs in Mexico
– spaniards brought small pox to the aztecs and killed them
– they lost 19 million people out of 20 million
2. Incas of Peru
3. American Indians in Mississippi Valley
4. small pox, measles (worse for adults than kids) influenza
and typhus .. went from europeans to natives
5. Syphilis went from native americans to europeans

15. IV. Intentional Germ Warfare
– never been successful but it could be
A. Plague associated with war
B. Civil War - use of yellow fever
• yellow fever weaken the walls of ur capillaries and
blood oozes out of every opening
• you throw up black stuff thats blood
• virus of the yellow fever is only spread by a
mosquito
C. Aum Shinrikyo cult in Japan

16. V. Anthrax
A. US mail system was attacked
B. What is anthrax?
C. Effects on mail system

17. D. Bio-weapons difficult to produce and handle
E. The threat from bio-warfare is real, but relatively low
F. The public health system is poorly prepared to deal
with bio-warfare

18. Stephen Hansell, Ph.D.
Department of Sociology
Institute for Health Research
http://sakai.rutgers.edu
shansell@rci.rutgers.edu
609-203-2830