An Examination of Infectious Disease and Public Health Response in Argentina (1867-2013) Open Access

Ohringer, Alison (2015)

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Argentina's experience with infectious disease and public health intervention helps illuminate the country's history through the lens of politics, medicine, and social change. With epidemics of historic infectious diseases (such as smallpox, yellow fever, and cholera) as well as modern infectious diseases (including vaccine-preventable diseases, HIV/AIDS, and neglected tropical diseases), Argentina has seen both social and medical interventions in public health at the government, community, and individual levels. However, these interventions vary in nature with each different type of disease; a strategy that is successful for vector-borne diseases is not necessary applicable to vaccine-preventable diseases. Following the ratification of its Constitution in 1853, Argentina has experienced large waves of immigration and, simultaneously, epidemics of infectious disease. During the last decades of the 20th century, half of all deaths in Buenos Aires were attributable to epidemic disease. The question of provincial versus federal authority in implementing public health interventions was complicated, and is still an issue in the country today. Compulsory vaccination was introduced into Argentina in 1886 and, presently, vaccines are still free for all Argentines, as delineated on their Vaccination Calendar. In examining epidemics, data analysis was performed using total death rates for historic epidemic diseases and incidence per 100,000 for modern diseases. T-tests were performed for modern diseases to establish significance in evaluating the decrease of disease rates pre- and post-public health interventions. All death and incidence rates were graphed, all relevant references--including historical epidemiological data--were translated, and rates were averaged during and after epidemics. Argentina's response to historic infectious disease can assist in the development of additional policies to control epidemics of modern diseases. The interventions that have been broad in scope have lasted and those that are multi-faceted in nature have been the most successful in controlling epidemics of infectious disease.

Table of Contents

Chapter 1: Introduction 1

Chapter 2: Methods 6

Chapter 3: Historical infectious diseases 7

Smallpox 10

Background 10

Results 17

Discussion 18

Yellow Fever 19

Background 19

Results 23

Discussion 23

Cholera 26

Background 26

Results 29

Discussion 30

Polio 31

Background 31

Results 34

Discussion 34

Chapter 4: Modern infectious diseases 36

Vaccination Calendar: Preventing modern diseases like tuberculosis and diphtheria 38

Results: Tuberculosis 39

Results: Diphtheria 40

Discussion 40


Background 42

Results 45

Discussion 46

Neglected Tropical Diseases 48

Chagas disease 49

Background 49

Results 53

Discussion 53

Dengue 55

Background 55

Results 57

Discussion 58

Chapter 5: Conclusion 60

Appendix 64

Bibliography 87

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