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"The Anatomy of the Epidemic": Contested Illness Outbreaks in US Medicine and Public Health, 1934-2020
"The Anatomy of the Epidemic": Contested Illness Outbreaks in US Medicine and Public Healt...
"The Anatomy of the Epidemic": Contested Illness Outbreaks in US Medicine and Public Health, 1934-2020

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자료유형  
 학위논문 서양
최종처리일시  
20260202103210
ISBN  
9798280712423
DDC  
900
저자명  
Broder, Emma Mendoza.
서명/저자  
The Anatomy of the Epidemic: Contested Illness Outbreaks in US Medicine and Public Health, 1934-2020
발행사항  
[Sl] : Harvard University, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
306 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-12, Section: B.
주기사항  
Advisor: Brandt, Allan M.;Jones, David S.
학위논문주기  
Thesis (Ph.D.)--Harvard University, 2025.
초록/해제  
요약A symptom complex marked by fatigue, muscle weakness, and brain fog has puzzled patients and clinicians for nearly a century, attracting several contested explanations from the psychosomatic to the post-viral. These contestations affect not just the perceived legitimacy of patient suffering, but the legitimacy of the illness and of biomedicine itself, which may be at risk of delegitimization when it cannot locate the cause of people's suffering. Throughout the twentieth century, these symptoms cropped up in the context of outbreaks of an infectious disease resembling poliomyelitis. The first set of outbreaks took place between 1934-1956 before public health interest waned. In the 1980s outbreaks reemerged and were connected to other viral threats like Epstein-Barr virus, but by then the condition had spread far beyond the local outbreak context and has persisted through to the present problem of long COVID. Although the condition has not been deadly, these episodes often led to long-term disability with a prolonged, relapsing course. With the rise of an epidemiological infrastructure shaped by the fight against polio, organizations like the Yale Poliomyelitis Study Unit, the U.S. Public Health Service, and the CDC's Epidemic Intelligence Service investigated these mysterious outbreaks from 1934 to 1956. Despite thorough investigation, no pathogen was identified. The illness, eventually named epidemic neuromyasthenia or myalgic encephalomyelitis, defied dominant germ-theory frameworks. Lacking microbial evidence, researchers increasingly attributed it to psychosomatic causes or mass hysteria-especially given the global rise of similar outbreaks amid stress, schooling pressures, and Cold War anxieties about crowd behavior and social contagion.As outbreaks waned by the 1970s, the mass hysteria narrative gained further traction. In the 1980s, attention returned to viral theories as doctors began to publish reports of chronic symptoms linked to Epstein-Barr virus. The "chronic Epstein-Barr virus disease" mirrored earlier syndromes, culminating in a high-profile CDC investigation in Lake Tahoe. The CDC ultimately labeled the condition "chronic fatigue syndrome" and dismissed a direct EBV link, initiating decades of controversy over its legitimacy. CFS became emblematic of "contested illnesses"-conditions with real suffering but unclear etiology. In the COVID-19 pandemic, many people developed persistent symptoms post-infection, now called "long COVID," again echoing past episodes. Long COVID has spurred more medical attention and scientific research on these kinds of conditions than ever before, with the potential to change how science and medicine can help patients.This thesis explores how the epidemiological context-shaped by scientific paradigms, public health institutions, and cultural narratives-has influenced the medical and social treatment of diseases with diffuse, disabling symptoms and uncertain viral origins. It also asks how these conditions went from novel public health threats to marginal, stigmatized, and illegitimate conditions, and back to novel public health threats once again with long COVID.
일반주제명  
History
일반주제명  
Science history
일반주제명  
Public health
일반주제명  
Medicine
일반주제명  
Epidemiology
키워드  
Contested illness
키워드  
Epidemic neuromyasthenia
키워드  
Poliomyelitis
키워드  
Long COVID
기타저자  
Harvard University History of Science
기본자료저록  
Dissertations Abstracts International. 86-12B.
전자적 위치 및 접속  
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MARC

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■1001  ▼aBroder,  Emma  Mendoza.▼0(orcid)0009-0002-9242-8903
■24510▼a"The  Anatomy  of  the  Epidemic":  Contested  Illness  Outbreaks  in  US  Medicine  and  Public  Health,  1934-2020
■260    ▼a[Sl]▼bHarvard  University▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a306  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-12,  Section:  B.
■500    ▼aAdvisor:  Brandt,  Allan  M.;Jones,  David  S.
■5021  ▼aThesis  (Ph.D.)--Harvard  University,  2025.
■520    ▼aA  symptom  complex  marked  by  fatigue,  muscle  weakness,  and  brain  fog  has  puzzled  patients  and  clinicians  for  nearly  a  century,  attracting  several  contested  explanations  from  the  psychosomatic  to  the  post-viral.  These  contestations  affect  not  just  the  perceived  legitimacy  of  patient  suffering,  but  the  legitimacy  of  the  illness  and  of  biomedicine  itself,  which  may  be  at  risk  of  delegitimization  when  it  cannot  locate  the  cause  of  people's  suffering.  Throughout  the  twentieth  century,  these  symptoms  cropped  up  in  the  context  of  outbreaks  of  an  infectious  disease  resembling  poliomyelitis.  The  first  set  of  outbreaks  took  place  between  1934-1956  before  public  health  interest  waned.  In  the  1980s  outbreaks  reemerged  and  were  connected  to  other  viral  threats  like  Epstein-Barr  virus,  but  by  then  the  condition  had  spread  far  beyond  the  local  outbreak  context  and  has  persisted  through  to  the  present  problem  of  long  COVID.  Although  the  condition  has  not  been  deadly,  these  episodes  often  led  to  long-term  disability  with  a  prolonged,  relapsing  course.  With  the  rise  of  an  epidemiological  infrastructure  shaped  by  the  fight  against  polio,  organizations  like  the  Yale  Poliomyelitis  Study  Unit,  the  U.S.  Public  Health  Service,  and  the  CDC's  Epidemic  Intelligence  Service  investigated  these  mysterious  outbreaks  from  1934  to  1956.  Despite  thorough  investigation,  no  pathogen  was  identified.  The  illness,  eventually  named  epidemic  neuromyasthenia  or  myalgic  encephalomyelitis,  defied  dominant  germ-theory  frameworks.  Lacking  microbial  evidence,  researchers  increasingly  attributed  it  to  psychosomatic  causes  or  mass  hysteria-especially  given  the  global  rise  of  similar  outbreaks  amid  stress,  schooling  pressures,  and  Cold  War  anxieties  about  crowd  behavior  and  social  contagion.As  outbreaks  waned  by  the  1970s,  the  mass  hysteria  narrative  gained  further  traction.  In  the  1980s,  attention  returned  to  viral  theories  as  doctors  began  to  publish  reports  of  chronic  symptoms  linked  to  Epstein-Barr  virus.  The  "chronic  Epstein-Barr  virus  disease"  mirrored  earlier  syndromes,  culminating  in  a  high-profile  CDC  investigation  in  Lake  Tahoe.  The  CDC  ultimately  labeled  the  condition  "chronic  fatigue  syndrome"  and  dismissed  a  direct  EBV  link,  initiating  decades  of  controversy  over  its  legitimacy.  CFS  became  emblematic  of  "contested  illnesses"-conditions  with  real  suffering  but  unclear  etiology.  In  the  COVID-19  pandemic,  many  people  developed  persistent  symptoms  post-infection,  now  called  "long  COVID,"  again  echoing  past  episodes.  Long  COVID  has  spurred  more  medical  attention  and  scientific  research  on  these  kinds  of  conditions  than  ever  before,  with  the  potential  to  change  how  science  and  medicine  can  help  patients.This  thesis  explores  how  the  epidemiological  context-shaped  by  scientific  paradigms,  public  health  institutions,  and  cultural  narratives-has  influenced  the  medical  and  social  treatment  of  diseases  with  diffuse,  disabling  symptoms  and  uncertain  viral  origins.  It  also  asks  how  these  conditions  went  from  novel  public  health  threats  to  marginal,  stigmatized,  and  illegitimate  conditions,  and  back  to  novel  public  health  threats  once  again  with  long  COVID.
■590    ▼aSchool  code:  0084.
■650  4▼aHistory
■650  4▼aScience  history
■650  4▼aPublic  health
■650  4▼aMedicine
■650  4▼aEpidemiology
■653    ▼aContested  illness
■653    ▼aEpidemic  neuromyasthenia
■653    ▼aPoliomyelitis
■653    ▼aLong  COVID
■690    ▼a0578
■690    ▼a0585
■690    ▼a0564
■690    ▼a0766
■690    ▼a0573
■71020▼aHarvard  University▼bHistory  of  Science.
■7730  ▼tDissertations  Abstracts  International▼g86-12B.
■790    ▼a0084
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357340▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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