Skip Navigation


American Journal of Epidemiology Advance Access originally published online on October 12, 2007
American Journal of Epidemiology 2007 166(11):1233-1238; doi:10.1093/aje/kwm279
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Figure 1
Right arrow All Versions of this Article:
166/11/1233    most recent
kwm279v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in Am. J. Epidemiol.
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (2)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Morabia, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Morabia, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Epidemiologic Interactions, Complexity, and the Lonesome Death of Max von Pettenkofer

Alfredo Morabia

From the Center for the Biology of Natural Systems, Queens College, City University of New York, Flushing, NY

Correspondence to Dr. Alfredo Morabia, Center for the Biology of Natural Systems, Queens College, City University of New York, Flushing, NY 11365 (e-mail: alfredo.morabia{at}qc.cuny.edu).

Received for publication January 24, 2007. Accepted for publication May 22, 2007.

In the mid-19th century, the German hygienist Max von Pettenkofer viewed cholera as resulting from the interaction between a postulated cholera germ and the characteristics of soils. In order to cause cholera, the cholera germ had to become a cholera miasma, but this transformation required prolonged contact of the germ with dry and porous soils when groundwater levels were low. This hypothetical germ-environment interaction explained more observations than did contagion alone. Despite its attraction, von Pettenkofer's postulate also implied that cholera-patient quarantine or water filtration was useless to prevent and/or control cholera epidemics. The disastrous consequences of the lack of water filtration during the massive outbreak of cholera in the German town of Hamburg in 1892 tarnished von Pettenkofer's reputation and marked thereafter the course of his life. von Pettenkofer's complex mode of thinking sank into oblivion even though, in hindsight, germ-environment interactions are more appropriate than is bacteriology alone for explaining the occurrence of cholera epidemics in populations. Revisiting the fate of von Pettenkofer's theory with modern lenses can benefit today's quest for deciphering the causes of complex associations.

cholera; disease outbreaks; ecology; epidemiologic methods; epistasis, genetic; Germany; history, 19th century

Abbreviations: G6PD, glucose-6-phosphate dehydrogenase

Editor's note: An invited commentary on this article appears on page 1239, and the author's response is published on page 1242.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?

Related articles in Am. J. Epidemiol.:

Invited Commentary: The Context and Challenge of von Pettenkofer's Contributions to Epidemiology
Gerald M. Oppenheimer and Ezra Susser
Am. J. Epidemiol. 2007 166: 1239-1241. [Abstract] [FREE Full Text]  

Morabia Responds to "The Context and Challenge of von Pettenkofer's Contributions to Epidemiology"
Alfredo Morabia
Am. J. Epidemiol. 2007 166: 1242-1243. [Extract] [FREE Full Text]  



This article has been cited by other articles:


Home page
 Am J EpidemiolHome page
A. Morabia
THE AUTHOR REPLIES
Am. J. Epidemiol., July 1, 2008; 168(1): 120 - 121.
[Full Text] [PDF]

Home page
 Am J EpidemiolHome page
M. Wildner and A. Hofman
RE: "EPIDEMIOLOGIC INTERACTIONS, COMPLEXITY, AND THE LONESOME DEATH OF MAX VON PETTENKOFER"
Am. J. Epidemiol., July 1, 2008; 168(1): 119 - 120.
[Full Text] [PDF]

Home page
 Am J EpidemiolHome page
G. M. Oppenheimer and E. Susser
Invited Commentary: The Context and Challenge of von Pettenkofer's Contributions to Epidemiology
Am. J. Epidemiol., December 1, 2007; 166(11): 1239 - 1241.
[Abstract] [Full Text] [PDF]

Home page
 Am J EpidemiolHome page
A. Morabia
Morabia Responds to "The Context and Challenge of von Pettenkofer's Contributions to Epidemiology"
Am. J. Epidemiol., December 1, 2007; 166(11): 1242 - 1243.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.