title: A Rose by any other name : historical epidemiology in late colonial and early modern Victoria (1853-c.1930)
title: Historical epidemiology during late Colonial and early modern Victoria (1851-1930)
titleType: AlternativeTitle
Creators: name: Roberts, Phillip
Publisher: name: The Australian National University
Year: 2013
Subjects: subject: Communicable diseases HistoryAustralia Victoria
subject: Communicable diseases Transmission HistoryAustralia Victoria
subject: Epidemiology History 20th century
subject: Epidemiology History 19th century
subject: Mortality History 19th centuryAustralia Victoria

description: This thesis contains an examination of infectious disease and its socio-economic relationship with the Victorian population during the colonial and early modern eras (1853 to c.1930) (the study period). This involved interpreting some now obsolete diagnoses, studying disease natural history and engaging in the debate surrounding the decline in mortality rates in the nineteenth century. The study period has proved to be an extremely good model in which to test the effects of various social and economic variables on health at a population level. The Gold Rush of the early 1850s and the resulting waves of boom and bust changed the population demography, economic development, and social diversification and stratification. This will be demonstrated to have had an effect on population health both at the state and local levels. Disease exposure and disease susceptibility were observed to vary substantially over the study period for typhoid and whooping cough: typhoid mortality shifts dramatically from children and older adults before 1870, to young adults after 1870, which is indicative of a change in disease exposure patterns with the urbanisation of the colony; whooping cough mortality patterns reduce in some groups compared to others, indicative of changing susceptibility to the disease. These examples highlight the heterogeneity of factors affecting disease causation for different infectious diseases and therefore the specificity of information that can be drawn from observations of changing disease patterns. It was shown that variation in the natural history of disease also occurred. For Group A streptococcal infections, a scarlet fever epidemic cycle was observed until 1876, from which point on mortality from post streptococcal nephritis increases dramatically. For diphtheria cases, however, the natural history of the disease remained very predictable until medical developments in the late nineteenth century. Like disease causation the factors associated with disease progression are also disease specific. To investigate variation in the natural history of diseases with a more complicated ecology, tuberculosis and syphilis mortality and morbidity were investigated. It was shown that for tuberculosis mortality from pulmonary and extra-pulmonary tuberculosis was negatively correlated for much of the study period. Mortality from congenital syphilis and venereal syphilis also trended in opposite directions, with mortality in children trending higher while syphilis mortality in adults trended lower. The principal findings of this work are how disease-specific the ecological interaction is between parasite and host and how responsive a particular disease is to a historical event (which can be interpreted as an ecological change in behaviour by the host in the parasite host relationship) whilst other diseases may not have any reaction or a completely different reactions to the same historical event. This thesis just scratches the surface of the potential of this data in furthering our understanding of the ecological interaction between parasite and host in the past.