West Coast History of Science Society Meeting
University of California, San Francisco
April 11th - April 14th, 2002
[Program]
Bioterroism, Surveillance, and American Public Health at Millennium's End
Nicholas King
Department of Anthropology, History, and Social Medicine
University of California, San Francisco150 years ago, the British physician John Snow determined the source of a cholera outbreak by mapping the locations of its victims on a London city map. During the same period, American government officials utilized quarantines and immigration restrictions to control outbreaks of numerous infectious diseases. Since then, epidemiologists and public health officials have recognized that these two activities lie at the center of the discipline of public health: the collection, manipulation, and management of information; and the monitoring and control of the movement of bodies through space. The advent of new communication and information technologies has fundamentally reconfigured these activities, changing both the nature of threats to health that urban populations face, and the institutional responses to these threats. This paper examines the impact of these new technologies on the theory and practice of urban public health through a close examination of two late 20th-century health threats: emerging diseases and biological terrorism.
During the past decade, American public health experts have become increasingly alarmed at the threat to urban health posed by infectious disease, in the form of natural outbreaks of new pathogens such as Ebola hemorrhagic fever or West Nile virus, and utilization of horrific agents such as anthrax and smallpox by individuals and terrorist organizations. The literature on these topics exhibits a deep-seated ambivalence to the perils and promise of new information technologies. On one hand, the proliferation of global informational networks is celebrated as an integral part of the new public health. Local, national, and international data-collection and surveillance are thus identified as fundamental prerequisites to the prevention of and response to disease outbreaks. On the other hand, the escalating democratization and uncontrolled global dispersal of scientific information is seen as a threat to American urban health and security. The availability of molecular biological information on the internet, and ability of terrorist organizations to operate outside of national police scrutiny in virtual space, intensifies the threat of bioterrorist attacks on American cities.
Echoing other recognitions of the Faustian bargain of modern technology, this literature sees the movement of information in electronic space as both the potential savior of, and a catastrophic threat to, the integrity of bodies in urban space. Public health -an essential part of the self-definition of virtual and material communities - is re-shaped around the collision of bodies and information. As a consequence, maintenance of the health of the city (both as a political-economic unit and a collection of individual citizens) requires the surveillance of the motion of bodies and information through space. This, in turn, justifies increasingly close collaborations between the institutions of medicine, public health, police, and national security