American Journal of Epidemiology Advance Access originally published online on October 12, 2007
American Journal of Epidemiology 2007 166(11):1239-1241; doi:10.1093/aje/kwm284
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Invited Commentary: The Context and Challenge of von Pettenkofer's Contributions to Epidemiology
1 Brooklyn College, City University of New York, Brooklyn, NY
2 Mailman School of Public Health, Columbia University, New York, NY
3 New York State Psychiatric Institute, New York, NY
Correspondence to Dr. Ezra Susser, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032 (e-mail: ess8{at}columbia.edu).
Received for publication July 11, 2007. Accepted for publication July 26, 2007.
Max von Pettenkofer is largely remembered for swallowing cholera vibrio, trying thereby to falsify the claim of his rival, the contagionist Robert Koch, that the bacillus he had isolated was cholera's sufficient cause. In this issue of the American Journal of Epidemiology, Alfredo Morabia reminds us that von Pettenkofer was more than this futile gesture. He was a 19th century public health leader whose multifactorial theory of cholera etiology deeply influenced the dominant anticontagionist school of disease transmission. His authority was undercut by the massive 1892 cholera epidemic in Hamburg, Germany. As it took off, the German government sent in Koch, who successfully contained the epidemic through interventions that von Pettenkofer regularly repudiated—quarantine, disinfection, and the boiling of water. The authors situate the antagonism between these two individuals within a broader scientific and political context that includes the evolution of miasma theory and debates over the role of governments confronted by epidemic disease. They also note that Koch's approach, which focused narrowly on the agent and its eradication, was missing key elements required for applying germ theory to public health. As scientists later incorporated biologic, host, and environmental factors into the germ theory paradigm, they reintroduced some of the complexity that had previously characterized the miasma model.
cholera; disease outbreaks; epidemiologic methods; Germany; history, 19th century; history of medicine; public health; sanitation
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Related articles in Am. J. Epidemiol.:
- Epidemiologic Interactions, Complexity, and the Lonesome Death of Max von Pettenkofer
- Alfredo Morabia
Am. J. Epidemiol. 2007 166: 1233-1238.[Abstract] [FREE Full Text]
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  A. Morabia THE AUTHOR REPLIES Am. J. Epidemiol., July 1, 2008; 168(1): 120 - 121. [Full Text] [PDF]
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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]
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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]
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