The Outbreak Narrative: What has changed this time around?

EDITOR’S NOTE: Points is delighted to welcome past guest contributor, Jessica Diller Kovler (check out her previous post here). Kovler is part of the History of Science program at Harvard University and currently teaches at John Jay College of Criminal Justice, the City University of New York. Her work has appeared in The New York Times, Forbes, and Discover magazines. 

Unless you’ve had your head buried in the sand for the past month, you’ve undoubtedly thought of the recent Ebola outbreak. Even if you have a background in public health, you would probably avoid the New York bowling alley visited by Dr. Craig Spencer (even though the City shut it down the day the news of his illness hit the papers). You’re probably using extra Purell, even though we’re relatively knowledgeable about the pathogen’s mode of transmission.

News reporters have scrambled to assemble our patient zero. Even our most liberal friends are arguing for shutting down the borders. We are blaming and looking for answers.

Bloomberg Buisnessweek, September 24, 2014
Bloomberg Buisnessweek, September 24, 2014

As my grandfather would ask at our Passover Seder: “Manishtana?” (What has changed?) As a social historian, I wonder what makes the societal response to Ebola any different than our collective response to the Black Death, typhoid, polio, and HIV? In the past few weeks, people have compared the response to Ebola to the first cholera pandemic of the early-19th century, the 1918 Spanish Flu epidemic, the polio epidemic of the first half of the 20th century, and AIDS in the early 1980s. Perhaps, as some have argued, there is a formulaic narrative in how we respond to outbreak of disease. But does this narrative also apply to epidemics involving alcohol abuse (or, in the case of the disease I’m about to describe, suspected alcohol abuse)?

From 1915 to 1927, a mysterious illness befell millions worldwide. Its symptoms were wide-ranging—no two patients presented exactly the same—and the illness left many of its survivors in a catatonic, semi-conscious state. Those who “awakened” were left with Parkinsonism, psychiatric sequelae, and severe behavior disturbance. Almost as quickly as Encephalitis Lethargica appeared in 1915, it seemingly vanished 12 years later. Thousands around the world, however, lived long past 1927, imprisoned—some for decades—in their own bodies. The lack of attention to this disorder beyond its peak, has, in recent years, earned the disease the moniker “The Forgotten Epidemic.” (Perhaps you’ve heard of the disease thanks to the 1990 Oscar-nominated film, Awakenings, starring Robin Williams and Robert DeNiro, based on the work of Oliver Sacks.)

Yet the history of Encephalitis Lethargica is more than the tale of a forgotten epidemic. It is an illness narrative evoking shifting socio-medical paradigms in the second half of the 20th century that is uniquely tied to the sociomedical response to alcoholism.

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