By Theodore H. Tulchinsky
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Additional info for The New Public Health. An Introduction for the 21st Century
The isolation and identification of new disease-causing organisms proceeded rapidly in the last decades of the nineteenth century. The diphtheria organism was discovered in 1884 by Edwin Klebs and Friedrich Loeffler (students of Koch), and a vaccine for it in 1912, leading to the control of this disease in many parts of the world. Between 1876 and 1898, many pathogenic organisms were identified, providing a basis for many advances in vaccine development. During the last quarter of the nineteenth century, it was clear that inoculation of attenuated microorganisms could produce protection through active immunization of a host by generating antibodies to that organism, which would protect the individual when exposed to the virulent (wild) organism.
Budd then concluded that water was the vehicle of transmission of the disease. He investigated other outbreaks and summarized his reports in Typhoid Fever: Its Nature, Mode of Transmission and Prevention, published in 1873, which is a classic work on waterborne transmission of enteric disease. These investigations contributed to the movement to disinfect public water systems on a preventive basis. The brilliant epidemiologic studies of Snow and Budd set a new direction in epidemiotogy and public health practice, not only with waterborne disease.
Following the Great Depression of the 1930s and hopes raised by the victory in World War II, important social and health legislation was enacted to provide health care to the populations of Britain, Canada, and the United States. In Britain, the welfare state, including the National Health Service (NHS), was developed by the Labour Government. In Canada, a more gradual development of improved social legislation took place in the period 1940-1970, including the establishment of national pensions and a national health insurance program.