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The War on Dengue Fever
By THOMAS FULLER, The New York Times, November 4, 2008
BANGKOK — There was little that doctors could do for a 3-year-old boy brought to Bangkok’s main children’s hospital two weeks ago with dengue fever. Like thousands before him, he had reached the most dangerous phase of the disease, dengue shock syndrome, and he died of internal bleeding and organ failure three days after being admitted.
Directly across the street, in the United States Army’s largest overseas medical research laboratory, military scientists are offering hope for future generations: a vaccine. Developed after decades of trying, it is one of two experimental vaccines that experts believe may be commercially available by the middle of the next decade.
Dengue (pronounced DENG-ee), a mosquito-borne illness once known as breakbone fever for its intense joint and muscle pain and crushing headaches, has a relatively low death rate — about 2.5 percent of hospitalized patients, the World Health Organization reports.
But because patients can require constant, careful monitoring, it is one of the costliest diseases in tropical countries. Each year, it leads to about 500,000 hospitalizations around the world.
Dengue is seldom seen in the United States or Europe, though it is the second-most common cause (after malaria) of feverish symptoms for Western tourists returning from developing countries.
But it is important to the Army: American soldiers have contracted dengue as recently as the 1990s, on missions in Haiti and Somalia. So it is one of the tropical diseases that are the focus of research here at the Armed Forces Research Institute of Medical Sciences, which the Army has operated with the Royal Thai Army for five decades.
The research facility, which employs several hundred people, is housed in an unremarkable 1960s building alongside a greasy alley where food vendors hawk fried grasshoppers and freshly mashed papaya salad.
“There’s no dengue in Kansas,” said Col. James W. Boles, the commander at the laboratory. “No malaria, either. That’s why we are here.”
In wars past, disease has often proved a greater foe than opposing armies. During the Anglo-Boer War in South Africa in the late 19th century, more soldiers died of typhoid than in battle. Thousands of cases of hepatitis during the Vietnam war among soldiers spurred Army researchers to help develop two of the vaccines now in use to prevent hepatitis A and B.
“All we care about is that we get a vaccine that protects soldiers,” said Lt. Col. Stephen J. Thomas, a medical doctor who is director of dengue vaccine development in the Bangkok laboratory. “Fortunately a lot of our concerns are also global health concerns.”
For many years, the leading drugs used to treat malaria were developed by the Army. Today research on tropical diseases is spread across a broader constellation; in the hunt for a dengue vaccine, money and research have come from the Thai government, nonprofit organizations like the Bill and Melinda Gates Foundation, and drug companies like GlaxoSmithKline, which is working with the Army.
The other vaccine at an advanced stage of development is being jointly developed by the French drug company Sanofi-Aventis and a Thai university on the same Bangkok street as the Army lab.
“We’re further along with the dengue vaccine than we’ve ever been,” said Duane J. Gubler, director of the emerging infectious diseases department of the Duke-N.U.S. Graduate Medical School in Singapore. “There’s a good possibility that we’ll have a vaccine in five to seven years.”
The dengue virus is transmitted mainly by a mosquito called Aedes aegypti, which survives on human blood. Aedes rarely travels more than about 100 yards from its birthplace and thrives in populated areas.
The mosquito can breed in something as small as a soda bottle, but its ideal breeding conditions are large containers common in many parts of Southeast Asia to store drinking water. (Unlike other mosquitoes, Aedes aegypti prefers clean water, according to Thomas W. Scott, a professor at the University of California, Davis, who is a leading expert on the species.)
The mosquito cannot survive freezing weather, and though it is endemic to some parts of the United States, mainly the South, experts say good sanitation practices have kept it from spreading the dengue virus. It commonly lives inside people’s homes, lingering in closets or curtains.
The World Health Organization estimates that 50 million people are infected every year. But most of those infected, perhaps as many as 90 percent, experience only minor flulike symptoms or none at all.
In more serious cases, like that of the boy who died here last month, symptoms include severe headaches, rapid onset of a high fever, debilitating joint and muscle pain, nausea, vomiting and internal bleeding. Generally, though, dengue is considered treatable as long as patients are brought to the hospital on time and the disease is properly diagnosed.
Scientists believe the disease has existed for centuries — an outbreak appears to have occurred in Philadelphia in 1780 — but dengue has become more common and more virulent over the past half-century.
In 1970, only nine countries were known to have had epidemics of the most serious form of the disease, dengue hemorrhagic fever. By the mid-1990s that number had quadrupled, and experts say a quirk makes the disease particularly well adapted to an age of air travel and international trade.
There are four types of dengue virus. Patients who have been infected with one of them are believed to develop immunity to that type only — and, paradoxically, are more vulnerable to dengue hemorrhagic fever if they are exposed to a second type.
The four types have intermixed as people carried them on airplanes to far-flung places; outbreaks of the hemorrhagic fever have been traced to specific flight paths and trade routes.
“What we’ve done is provided the ideal mechanism for these viruses to move around the world,” said Dr. Gubler, who has researched dengue for nearly four decades.
It was probably soldiers who caused the original spread of dengue hemorrhagic fever around Southeast Asia, during World War II.
“You had a movement of soldiers from England, the U.S., Australia and Japan,” said Dr. Suchitra Nimmannitya, a pioneer in dengue research who developed a handbook on how to treat the disease. “Soldiers flew from city to city.”
A Japanese scientist first isolated the virus during the war, and a United States Army physician, Albert Sabin, made the discovery that there were distinct virus types. (Dr. Sabin went on to help develop the polio vaccine.)
“Dengue is very unique,” said Dr. Harold S. Margolis, formerly of the Centers for Disease Control and Prevention and now director of the Pediatric Dengue Vaccine Initiative, a nonprofit organization based in South Korea. “I’ve done a lot of infectious-disease work over the years, and dengue is probably one of the most complicated.”
The development of a vaccine is especially difficult because it will need to counter all four types of virus.
“If dengue was a single virus we would have had a vaccine already, for sure,” said Dr. Jean Lang, director of research and development at Sanofi’s emerging vaccine program.
Sanofi’s dengue vaccine, which will undergo trials in 4,000 children in Thailand in a few months, is one of the first vaccines to be produced using genetic engineering.
The Army’s vaccine, which is at a similar stage of development and has been tested on volunteers in the United States, Puerto Rico and Thailand, was produced using live attenuated viruses, a more traditional technique. The two or three doses, spaced months apart, are administered by injection.
Experts say the wide array of researchers involved — some with profit motives and others without — increases the chances of success and could help make the vaccine affordable to people in developing countries.
“We have always tried to broaden the R.&D. base,” said Joachim Hombach, who coordinates vaccine research at the World Health Organization in Geneva. “At the end of the day, what drives down the price of the product is competition.”
Findings: Obama and McCain Walk Into a Bar ...
By JOHN TIERNEY, The New York Times, November 4, 2008
While Americans choose their next president, let us consider a question more amenable to science: Which candidate’s supporters have a better sense of humor? In strict accordance with experimental protocol, we begin by asking you to rate, on a scale of 1 (not funny at all) to 9 (hilarious) the following three attempts at humor:
A) Jake is about to chip onto the green at his local golf course when a long funeral procession passes by. He stops in midswing, doffs his cap, closes his eyes and bows in prayer. His playing companion is deeply impressed. “That’s the most thoughtful and touching thing I’ve ever seen,” he says. Jake replies, “Yeah, well, we were married 35 years.”
B) I think there should be something in science called the “reindeer effect.” I don’t know what it would be, but I think it’d be good to hear someone say, “Gentlemen, what we have here is a terrifying example of the reindeer effect.”
C) If you saw two guys named Hambone and Flippy, which one would you think liked dolphins the most? I’d say Flippy, wouldn’t you? You’d be wrong, though. It’s Hambone.
Those were some of the jokes rated by nearly 300 people in Boston in a recent study. (You can rate some of the others at TierneyLab, nytimes.com/tierneylab.) The researchers picked out a variety of jokes — good, bad, conventional, absurdist — to look for differences in reactions between self-described liberals and conservatives.
They expected conservatives to like traditional jokes, like the one about the golfing widower, that reinforce racial and gender stereotypes. And because liberals had previously been reported to be more flexible and open to new ideas, the researchers expected them to get a bigger laugh out of unconventional humor, like Jack Handey’s “Deep Thoughts” about the reindeer effect and Hambone.
Indeed, the conservatives did rate the traditional golf and marriage jokes as significantly funnier than the liberals did. But they also gave higher ratings to the absurdist “Deep Thoughts.” In fact, they enjoyed all kinds of humor more.
“I was surprised,” said Dan Ariely, a psychologist at Duke University, who collaborated on the study with Elisabeth Malin, a student at Mount Holyoke College. “Conservatives are supposed to be more rigid and less sophisticated, but they liked even the more complex humor.”
Do conservatives have more fun? Should liberals start describing themselves as humor-challenged? To investigate these questions, we need to delve into the science of humor (not a funny enterprise), starting with two basic kinds of humor identified in the 1980s by Willibald Ruch, a psychologist who now teaches at the University of Zurich.
The first category is incongruity-resolution humor, or INC-RES in humor jargon. It covers traditional jokes and cartoons in which the incongruity of the punch line (the husband who misses his wife’s funeral) can be resolved by other information (he’s playing golf). You can clearly get the joke, and it often reinforces stereotypes (the golf-obsessed husband).
Dr. Ruch and other researchers reported that this humor, with its orderly structure and reinforcement of stereotypes, appealed most to conservatives who shunned ambiguity and complicated new ideas, and who were more repressed and conformist than liberals.
The second category, nonsense humor, covers many “Far Side” cartoons, Monty Python sketches and “Deep Thoughts.” The punch line’s incongruity isn’t neatly resolved — you’re left to enjoy the ambiguity and absurdity of the reindeer effect or Hambone’s affection for dolphins. This humor was reported to appeal to liberals because of their “openness to ideas” and their tendency to “seek new experiences.”
But then why didn’t the liberals in the Boston experiment like the nonsense humor of “Deep Thoughts” as much as the conservatives did? One possible explanation is that conservatives’ rigidity mattered less than another aspect of their personality. Rod Martin, the author of “The Psychology of Humor,” said the results of the Boston study might reflect another trait that has been shown to correlate with a taste for jokes: cheerfulness.
“Conservatives tend to be happier than liberals in general,” said Dr. Martin, a psychologist at the University of Western Ontario. “A conservative outlook rationalizes social inequality, accepting the world as it is, and making it less of a threat to one’s well-being, whereas a liberal outlook leads to dissatisfaction with the world as it is, and a sense that things need to change before one can be really happy.”
Another possible explanation is that conservatives, or at least the ones in Boston, really aren’t the stiffs they’re made out to be by social scientists. When these scientists analyze conservatives, they can sound like Victorians describing headhunters in Borneo. They try to be objective, but it’s an alien culture.
The studies hailing liberals’ nonconformity and “openness to ideas” have been done by social scientists working in a culture that’s remarkably homogenous politically. Democrats outnumber Republicans by at least seven to one on social science and humanities faculties, according to studies by Daniel Klein, an economist at George Mason University. If you’re a professor who truly “seeks new experiences,” try going into a faculty club today and passing out McCain-Palin buttons.
Could it be that the image of conservatives as humorless, dogmatic neurotics is based more on political bias than sound social science? Philip Tetlock, a psychologist at the University of California, Berkeley, who reviews the evidence of cognitive differences in his 2005 book, “Expert Political Judgment,” said that while there were valid differences, “liberals and conservatives are roughly equally closed-minded in dealing with dissonant real-world evidence.”
So perhaps conservatives don’t have a monopoly on humorless dogmatism. Maybe the stereotype of the dour, rigid conservative has more to do with social scientists’ groupthink and wariness of outsiders — which, come to think of it, resembles the herding behavior of certain hoofed animals. Ladies and gentlemen, what we have here is a terrifying example of the reindeer effect.
Mind: When Duty Calls: The Value of Voting, Beyond Politics
By BENEDICT CAREY, The New York Times, November 4, 2008
For those who love the civic cheer and lukewarm coffee of their local polling place, an absentee ballot has all the appeal of a tax form. The paperwork, the miniature type, the search (in some states) for a notary public: it’s a tedium bath, and Pam Fleischaker, a lifelong Democrat from Oklahoma City, had every reason to take a pass this year.
Ms. Fleischaker, 62, was in New York recovering from a heart transplant, for one. And in her home state, the Democratic candidate, Senator Barack Obama, was polling hopelessly behind his opponent, Senator John McCain. She mailed in her absentee packet anyway, and hounded her two children, also in New York, to do the same.
“That one vote isn’t going to be decisive makes no difference to me,” Ms. Fleischaker said in a telephone interview last week. “Your vote is your voice, and there’s more power in it than in most of the things we do. It’s a lost pleasure, the feeling of that power.”
In recent years psychologists and neuroscientists have tried to get a handle on how people make voting decisions. They have taken brain scans, to see how certain messages or images activate emotion centers. They have spun out theories of racial bias, based on people’s split-second reactions to white and black faces. They have dressed up partisan political stereotypes in scientific jargon, describing conservatives as “inordinately fearful and craving order,” and liberals as “open-minded and tolerant.”
None of which has helped predict people’s behavior in elections any more than a half-decent phone survey. The problem is not only sketchy science, some experts say; it’s that researchers don’t agree on the answer to a more fundamental question: Why do people vote at all?
“There’s a longstanding literature looking at why any rational person would vote, when the chances of actually influencing an election are about the same as getting hit by lightning,” said John Londregan, a professor of politics and international affairs at Princeton. “In most theoretical models, it’s hard to get a predicted turnout above one. That is, one voter.”
Yet new models have done better, predicting elections with turnouts closer to the nation’s average of about 50 percent of eligible voters. They have also revealed some of the basic motives underlying both personal and group decisions about when to vote and why.
Casting a ballot clearly provides a value far higher than its political impact. The benefit may include side payments — say, the barbecues and camaraderie of a campaign, or the tiny possibility that a single vote may be decisive.
But recent research suggests that it has more to do with civic duty and the maintenance of moral self-image. In a series of experiments, researchers from Northwestern University and the University of California, Berkeley, have had study participants play a simple election game involving monetary rewards. A group of designated voters cast their vote for Choice A, an equal distribution of money among voters and nonvoters in the study; or B, a payout to be split only among the designated voters — a smaller group, so a higher amount. It cost money to vote, and participants could abstain at no cost.
The study authors, led by Sean Gailmard at Berkeley, called Choice A “ethical” and Choice B “selfish.” They found that ethical voting ran highest, at about 20 percent, when individual votes were least likely to affect the outcome. Selfish voting ran highest, also about 20 percent, when individuals’ choices were most likely to change the outcome.
This finding could explain why people might vote against a local tax increase but for a Congressional candidate who was likely to raise their income taxes: their vote carries far less value in a national race than in a local one.
This study and others also imply that there is a core of voters who not only turn out at the polls but also cast their ballot for the candidate or proposal they believe represents the larger good. This makes sense to those who study the evolution of group behavior. Small communities often have a scattering of people who stand up and do the right thing; their compensation is the private knowledge that they are willing to pay some cost to do what they believe is right, even if that price amounts to standing out in the cold for 15 minutes waiting to pull a lever.
“It may be a form of identity construction for individuals,” Dr. Gailmard wrote in an e-mail message. “Or it could be a duty to do the right thing, or a social norm.”
Ms. Fleischaker, the absentee Oklahoma voter, put it this way: “Who are we to ask others to do things for this country, small or very large, like fighting in a war, if we ourselves are not going to take the trouble to vote?”
The military analogy is not overdrawn, Dr. Londregan says. In a 2006 paper, “Voting as a Credible Threat,” he and Andrea Vindigni of Princeton argue from historical and sociological evidence that at times of deep division, elections function as an X-ray into the strength of the opposition, the number of people willing to bear a cost to have their way. In the extreme, election returns prompt factions on the brink of civil war to reassess their chances and negotiate — making communities, small and large, far more stable and adaptive.
“We started to see that elections function as a kind of SAT score to show what kind of guerrilla you’d be,” Dr. Londregan said. “They’re a way to see how many people would actually fight to oppose a policy — and how much is just bravado.”
Dutiful voters know all this, at some level, no matter how they define the larger good. They think more broadly about what others of their stripe will do, spending more effort if they feel their home team will be underrepresented, political scientists have found.
By taking into account such calculations, as well as ethical voting, the costs of casting a ballot and other parameters, Timothy Feddersen and Alvaro Sandroni of Northwestern University — Dr. Gailmard’s co-authors on the ethical voting research — have designed a model that accurately predicted turnout in several local Texas elections.
“The model predicts that in states where the election is close, turnout will be high among all groups,” Dr. Feddersen said, adding that in states where the election is unlikely to be close, “partisans are less likely to vote when they are in the majority and more likely to vote when they are in the minority,” or expect to lose.
In short, expect the race in states like New York and Oklahoma to be closer than polls show, not because of hidden racism or “inordinate fear” but because many people find it satisfying to stand up and be counted — even if they’re doing the counting for themselves.
This article has been revised to reflect the following correction:
Correction: November 5, 2008
Because of an editing error, the Mind column on Tuesday, about psychologists’ efforts to analyze voting behavior, paraphrased incorrectly from a comment by Timothy Feddersen of Northwestern University, who helped devise a model that accurately predicted turnout in several local Texas elections. Dr. Feddersen said that “partisans are less likely to vote when they are in the majority and more likely to vote when they are in the minority” in states where the election is unlikely to be close — not in “toss-up states.”
Images from Mars show deposits of minerals like opals in magenta and blue.
Minerals on Mars Point to More Recent Presence of Water
By KENNETH CHANG, The New York Times, November 4, 2008
Still puzzling over how warm and wet Mars may have once been, scientists are now seeing global mineralogical signs that the planet was at least occasionally wet for the first two billion years of its existence.
In an article in the November issue of the journal Geology, scientists working with data from NASA’s Mars Reconnaissance Orbiter report that they have spotted widespread deposits of opals and related minerals on the surface of Mars.
Opals belong to a class of minerals known as hydrated silicas, with water molecules wedged into silicon-based minerals like quartz. The formation of hydrated silicas requires liquid water.
Most interesting is that the opal deposits lie in areas that appear to have formed only about two billion years ago. Previously, spacecraft have detected other water-bearing minerals like clays in regions that date back more than 3.5 billion years. Mars, like the other planets in the solar system, is about 4.5 billion years old.
“The water was more widespread and extended to younger times,” said Scott L. Murchie, a staff scientist at Johns Hopkins’ Applied Physics Laboratory and the principal investigator for the orbiter’s spectrometer, which found the opal evidence.
In July, Dr. Murchie and other scientists reported that the orbiter had detected vast deposits of the claylike minerals on the older terrains. Images also showed ancient lakebeds with accumulations of the minerals, indicating standing water persisted for thousands of years.
The presence of water on Mars has been known for many years; its ice caps, easily visible from space, are largely made of frozen water. The unanswered question is how often the ice has melted. The Phoenix Mars Lander, now nearing the end of its six-month mission, is exploring whether the arctic ice has melted in recent millennia.
The most intriguing possibility is that Mars, when it was less than a billion years old, was warm enough for lakes and oceans of liquid water — and with that, the possibility of life. The planet’s landforms offer compelling evidence for flowing water: immense canyons and channels, dried-up river deltas.
“I think most people agree there was lots of water on the surface in the first few hundred million years,” said Maria Zuber, a professor of geophysics at the Massachusetts Institute of Technology. “It’s later on when I get confused, although I’m confused about the whole thing. That’s what makes it interesting.”
Some scientists have suggested that rare catastrophic floods carved the landforms, either in the aftermath of an impact by an asteroid or comet or by underground water — melted by residual volcanic warmth — bursting to the surface.
Those who believe that liquid water was more persistent were nonetheless perplexed when earlier spacecraft detected only small quantities of carbonates, minerals that should have formed in large amounts from reactions involving carbon dioxide and liquid water.
But data collected by the two Mars rovers, Spirit and Opportunity, show a highly acidic environment that prevented the formation of carbonates. “That part of the story is fairly well agreed upon,” Dr. Zuber said.
The two rovers have also found signs of past water. Opportunity found hydrated sulfates in the Meridiani Planum rocks; Spirit found opal-like minerals similar to those spotted by the Reconnaissance Orbiter from space.
But planetary scientists are still trying to explain the transition of Mars from lots of water to today’s cold and dry climate. In fact, they are still trying to explain how it ever had lots of liquid water. Even if young Mars were enshrouded in a thick atmosphere of carbon dioxide belched by giant volcanoes, climatologists have had trouble coaxing enough global warming in their computer simulations to push temperatures above the melting point of ice.
James F. Kasting, a professor of geosciences at Penn State, believes he may have figured out how to warm up Mars. In research that he will present in December at a meeting of the American Geophysical Union, the key may be nitrogen dioxide.
In his climate models, carbon dioxide did act as a greenhouse gas, trapping heat near the surface, but it also reflected shorter wavelengths of light back into space, limiting the amount of heating. His models peaked at about minus-40 degrees Fahrenheit. Nitrogen dioxide, which is also released by volcanic eruptions, reduces the reflectivity of Mars in the models. With more light absorbed, temperatures jumped 100 degrees. “That would be more than you need,” Dr. Kasting said.
He said he still needed to demonstrate that the nitrogen dioxide would mix throughout the atmosphere rather than remain in pockets around the volcanoes.
Even if scientists figure out the water question, they have another problem: what happened to the Martian air? The climate models suggest early Mars had an atmosphere denser than Earth’s. Now, it’s a faint wisp.
“Well, we don’t know,” Dr. Zuber said. “One day we’re going to nail that one. There’s a whole bunch of things on my list of things to do.”
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Grave Warnings of Disease, With the Adman’s Flair
By AMANDA SCHAFFER, The New York Times, November 4, 2008
The woman could be the girl next door, posing for a portrait or selling cereal or soap. Her hair is neatly parted. Her earnest eye and smile seem to telegraph innocence.
Beware.
“She may look clean,” the poster warns. But “pick-ups, ‘good-time girls,’ prostitutes spread syphilis and gonorrhea.”
The poster, one of many created by the Public Health Service during World War II to warn the troops about the dangers of casual sex, is on display as part of a retrospective of 20th-century health posters from the permanent collection of the National Library of Medicine.
Titled “An Iconography of Contagion,” the exhibition features work from numerous countries on an array of diseases, among them syphilis, malaria, tuberculosis and AIDS. The posters are on display at the National Academy of Sciences in Washington through Dec. 19.
Much of the exhibition suggests a mash-up of advertising and public health. The posters tried to convey the danger of disease and get people to change their behavior, said the curator, Michael Sappol, a historian at the library of medicine, part of the National Institutes of Health.
But “they’re also about the pleasure of the image,” he continued, adding, “There have been some very sexy, colorful, playful posters about some very serious diseases.”
The visual world underwent rapid changes in the late 19th and early 20th centuries. Newspapers featured larger headlines and more drawings and photographs. The advertising industry integrated text and images, and it turned to behavioral science to sharpen its pitches.
At the same time, public health groups like the National Tuberculosis Association, founded in 1904, took some cues from advertising and began to rely on mass communication, with pamphlets, posters and, later, films and radio spots. For diseases like tuberculosis that lacked effective treatments, efforts to promote screening and change people’s behavior were especially important. “Media campaigns were themselves seen as magic bullets,” Dr. Sappol said.
In an iconic poster from around 1940, a mother and two children gather around an armchair, smiling, as the father reads a newspaper. An urban throng, in monochromatic red, appears in the background. “Tuberculosis Undiscovered Endangers You: Discover the Unknown Spreaders!” reads the caption.
“At the time, many people who had TB, including some who were contagious, were unaware that they were infected,” said Dr. Mary E. Wilson, an associate professor of global health and population at the Harvard School of Public Health. A large number of them were identified through mass screening using X-rays. (Many were exposed to large doses of radiation that would be unacceptable today, she added.)
Another poster, created in China in 1935, was intended to discourage spitting, which could spread TB. The image shows a man in traditional dress walking past a group of playing children. A line extends from the man’s mouth to a clump of spittle on the ground; from there, an arrow points to a pool of pink bacteria magnified under a microscope.
The caption reads, in part: “TB is rampant in our country because of the error of spitting anywhere. This is unforgivable!” It continues: “Spit into a handkerchief and boil it, or spit into paper and burn it. This not only ensures virtue but is a gift to mankind.”
The poster includes a symbol that resembles that of the National Tuberculosis Association in the United States — a vertical line with two horizontal crosses. In the Chinese version, the edges of the cross are curved upward, resembling a pagoda.
A similar message was promoted in many countries. In a Danish poster from 1947, the emphasis is on screening. A couple, shown as a shadowy form with green and red highlights, strolls arm in arm, wearing hats that could be merry or devilish. “Tuberculosis examination — a citizen’s duty,” reads the text.
The poster has “a beautiful, creamy texture” and was “part of the Danish enchantment with modernity, both in health infrastructure and in aesthetics,” Dr. Sappol said. “It seduces you into paying attention.”
In the 1960s, the enchantment with health posters declined, at least in the United States. “There was a general feeling among the public that we’ve got the polio vaccine, penicillin, DDT and other magic bullets, and that’s going to conquer disease,” Dr. Sappol said.
But that confidence plummeted in the 1980s and 1990s with H.I.V./AIDS, which brought about a renaissance of public health posters, said John Parascandola, a former historian for the Public Health Service. Activist groups like Act Up and Gran Fury in the United States and the Terrence Higgins Trust in Britain campaigned to raise awareness about the disease.
One poster from the mid-1980s shows a muscular man leaning down to perform oral sex on a partner of ambiguous gender. A tattooed tiger bulges on his shoulder. The poster, which reads “Discover safer sex,” is from the Terrence Higgins Trust’s “Love Sexy, Love Safe” campaign. The text notes that safer sex can also prevent unwanted pregnancy, suggesting that the campaign hoped to draw in heterosexuals.
AIDS posters tended to be less moralistic than many earlier ones, said Dr. Wilson, who noted that the World War II campaigns against syphilis and gonorrhea often treated the woman “as the villain, the temptress, and men almost as innocent bystanders.”
By contrast, she said, while AIDS patients were often stigmatized in the broader society, the major public health campaigns “tried very hard to work against that stigma.”
Ultimately, the posters tried to sell ideas to specific audiences, Dr. Parascandola said. They were a compelling form of advertising — and perhaps they still are.
By THOMAS FULLER, The New York Times, November 4, 2008
BANGKOK — There was little that doctors could do for a 3-year-old boy brought to Bangkok’s main children’s hospital two weeks ago with dengue fever. Like thousands before him, he had reached the most dangerous phase of the disease, dengue shock syndrome, and he died of internal bleeding and organ failure three days after being admitted.
Directly across the street, in the United States Army’s largest overseas medical research laboratory, military scientists are offering hope for future generations: a vaccine. Developed after decades of trying, it is one of two experimental vaccines that experts believe may be commercially available by the middle of the next decade.
Dengue (pronounced DENG-ee), a mosquito-borne illness once known as breakbone fever for its intense joint and muscle pain and crushing headaches, has a relatively low death rate — about 2.5 percent of hospitalized patients, the World Health Organization reports.
But because patients can require constant, careful monitoring, it is one of the costliest diseases in tropical countries. Each year, it leads to about 500,000 hospitalizations around the world.
Dengue is seldom seen in the United States or Europe, though it is the second-most common cause (after malaria) of feverish symptoms for Western tourists returning from developing countries.
But it is important to the Army: American soldiers have contracted dengue as recently as the 1990s, on missions in Haiti and Somalia. So it is one of the tropical diseases that are the focus of research here at the Armed Forces Research Institute of Medical Sciences, which the Army has operated with the Royal Thai Army for five decades.
The research facility, which employs several hundred people, is housed in an unremarkable 1960s building alongside a greasy alley where food vendors hawk fried grasshoppers and freshly mashed papaya salad.
“There’s no dengue in Kansas,” said Col. James W. Boles, the commander at the laboratory. “No malaria, either. That’s why we are here.”
In wars past, disease has often proved a greater foe than opposing armies. During the Anglo-Boer War in South Africa in the late 19th century, more soldiers died of typhoid than in battle. Thousands of cases of hepatitis during the Vietnam war among soldiers spurred Army researchers to help develop two of the vaccines now in use to prevent hepatitis A and B.
“All we care about is that we get a vaccine that protects soldiers,” said Lt. Col. Stephen J. Thomas, a medical doctor who is director of dengue vaccine development in the Bangkok laboratory. “Fortunately a lot of our concerns are also global health concerns.”
For many years, the leading drugs used to treat malaria were developed by the Army. Today research on tropical diseases is spread across a broader constellation; in the hunt for a dengue vaccine, money and research have come from the Thai government, nonprofit organizations like the Bill and Melinda Gates Foundation, and drug companies like GlaxoSmithKline, which is working with the Army.
The other vaccine at an advanced stage of development is being jointly developed by the French drug company Sanofi-Aventis and a Thai university on the same Bangkok street as the Army lab.
“We’re further along with the dengue vaccine than we’ve ever been,” said Duane J. Gubler, director of the emerging infectious diseases department of the Duke-N.U.S. Graduate Medical School in Singapore. “There’s a good possibility that we’ll have a vaccine in five to seven years.”
The dengue virus is transmitted mainly by a mosquito called Aedes aegypti, which survives on human blood. Aedes rarely travels more than about 100 yards from its birthplace and thrives in populated areas.
The mosquito can breed in something as small as a soda bottle, but its ideal breeding conditions are large containers common in many parts of Southeast Asia to store drinking water. (Unlike other mosquitoes, Aedes aegypti prefers clean water, according to Thomas W. Scott, a professor at the University of California, Davis, who is a leading expert on the species.)
The mosquito cannot survive freezing weather, and though it is endemic to some parts of the United States, mainly the South, experts say good sanitation practices have kept it from spreading the dengue virus. It commonly lives inside people’s homes, lingering in closets or curtains.
The World Health Organization estimates that 50 million people are infected every year. But most of those infected, perhaps as many as 90 percent, experience only minor flulike symptoms or none at all.
In more serious cases, like that of the boy who died here last month, symptoms include severe headaches, rapid onset of a high fever, debilitating joint and muscle pain, nausea, vomiting and internal bleeding. Generally, though, dengue is considered treatable as long as patients are brought to the hospital on time and the disease is properly diagnosed.
Scientists believe the disease has existed for centuries — an outbreak appears to have occurred in Philadelphia in 1780 — but dengue has become more common and more virulent over the past half-century.
In 1970, only nine countries were known to have had epidemics of the most serious form of the disease, dengue hemorrhagic fever. By the mid-1990s that number had quadrupled, and experts say a quirk makes the disease particularly well adapted to an age of air travel and international trade.
There are four types of dengue virus. Patients who have been infected with one of them are believed to develop immunity to that type only — and, paradoxically, are more vulnerable to dengue hemorrhagic fever if they are exposed to a second type.
The four types have intermixed as people carried them on airplanes to far-flung places; outbreaks of the hemorrhagic fever have been traced to specific flight paths and trade routes.
“What we’ve done is provided the ideal mechanism for these viruses to move around the world,” said Dr. Gubler, who has researched dengue for nearly four decades.
It was probably soldiers who caused the original spread of dengue hemorrhagic fever around Southeast Asia, during World War II.
“You had a movement of soldiers from England, the U.S., Australia and Japan,” said Dr. Suchitra Nimmannitya, a pioneer in dengue research who developed a handbook on how to treat the disease. “Soldiers flew from city to city.”
A Japanese scientist first isolated the virus during the war, and a United States Army physician, Albert Sabin, made the discovery that there were distinct virus types. (Dr. Sabin went on to help develop the polio vaccine.)
“Dengue is very unique,” said Dr. Harold S. Margolis, formerly of the Centers for Disease Control and Prevention and now director of the Pediatric Dengue Vaccine Initiative, a nonprofit organization based in South Korea. “I’ve done a lot of infectious-disease work over the years, and dengue is probably one of the most complicated.”
The development of a vaccine is especially difficult because it will need to counter all four types of virus.
“If dengue was a single virus we would have had a vaccine already, for sure,” said Dr. Jean Lang, director of research and development at Sanofi’s emerging vaccine program.
Sanofi’s dengue vaccine, which will undergo trials in 4,000 children in Thailand in a few months, is one of the first vaccines to be produced using genetic engineering.
The Army’s vaccine, which is at a similar stage of development and has been tested on volunteers in the United States, Puerto Rico and Thailand, was produced using live attenuated viruses, a more traditional technique. The two or three doses, spaced months apart, are administered by injection.
Experts say the wide array of researchers involved — some with profit motives and others without — increases the chances of success and could help make the vaccine affordable to people in developing countries.
“We have always tried to broaden the R.&D. base,” said Joachim Hombach, who coordinates vaccine research at the World Health Organization in Geneva. “At the end of the day, what drives down the price of the product is competition.”
Findings: Obama and McCain Walk Into a Bar ...
By JOHN TIERNEY, The New York Times, November 4, 2008
While Americans choose their next president, let us consider a question more amenable to science: Which candidate’s supporters have a better sense of humor? In strict accordance with experimental protocol, we begin by asking you to rate, on a scale of 1 (not funny at all) to 9 (hilarious) the following three attempts at humor:
A) Jake is about to chip onto the green at his local golf course when a long funeral procession passes by. He stops in midswing, doffs his cap, closes his eyes and bows in prayer. His playing companion is deeply impressed. “That’s the most thoughtful and touching thing I’ve ever seen,” he says. Jake replies, “Yeah, well, we were married 35 years.”
B) I think there should be something in science called the “reindeer effect.” I don’t know what it would be, but I think it’d be good to hear someone say, “Gentlemen, what we have here is a terrifying example of the reindeer effect.”
C) If you saw two guys named Hambone and Flippy, which one would you think liked dolphins the most? I’d say Flippy, wouldn’t you? You’d be wrong, though. It’s Hambone.
Those were some of the jokes rated by nearly 300 people in Boston in a recent study. (You can rate some of the others at TierneyLab, nytimes.com/tierneylab.) The researchers picked out a variety of jokes — good, bad, conventional, absurdist — to look for differences in reactions between self-described liberals and conservatives.
They expected conservatives to like traditional jokes, like the one about the golfing widower, that reinforce racial and gender stereotypes. And because liberals had previously been reported to be more flexible and open to new ideas, the researchers expected them to get a bigger laugh out of unconventional humor, like Jack Handey’s “Deep Thoughts” about the reindeer effect and Hambone.
Indeed, the conservatives did rate the traditional golf and marriage jokes as significantly funnier than the liberals did. But they also gave higher ratings to the absurdist “Deep Thoughts.” In fact, they enjoyed all kinds of humor more.
“I was surprised,” said Dan Ariely, a psychologist at Duke University, who collaborated on the study with Elisabeth Malin, a student at Mount Holyoke College. “Conservatives are supposed to be more rigid and less sophisticated, but they liked even the more complex humor.”
Do conservatives have more fun? Should liberals start describing themselves as humor-challenged? To investigate these questions, we need to delve into the science of humor (not a funny enterprise), starting with two basic kinds of humor identified in the 1980s by Willibald Ruch, a psychologist who now teaches at the University of Zurich.
The first category is incongruity-resolution humor, or INC-RES in humor jargon. It covers traditional jokes and cartoons in which the incongruity of the punch line (the husband who misses his wife’s funeral) can be resolved by other information (he’s playing golf). You can clearly get the joke, and it often reinforces stereotypes (the golf-obsessed husband).
Dr. Ruch and other researchers reported that this humor, with its orderly structure and reinforcement of stereotypes, appealed most to conservatives who shunned ambiguity and complicated new ideas, and who were more repressed and conformist than liberals.
The second category, nonsense humor, covers many “Far Side” cartoons, Monty Python sketches and “Deep Thoughts.” The punch line’s incongruity isn’t neatly resolved — you’re left to enjoy the ambiguity and absurdity of the reindeer effect or Hambone’s affection for dolphins. This humor was reported to appeal to liberals because of their “openness to ideas” and their tendency to “seek new experiences.”
But then why didn’t the liberals in the Boston experiment like the nonsense humor of “Deep Thoughts” as much as the conservatives did? One possible explanation is that conservatives’ rigidity mattered less than another aspect of their personality. Rod Martin, the author of “The Psychology of Humor,” said the results of the Boston study might reflect another trait that has been shown to correlate with a taste for jokes: cheerfulness.
“Conservatives tend to be happier than liberals in general,” said Dr. Martin, a psychologist at the University of Western Ontario. “A conservative outlook rationalizes social inequality, accepting the world as it is, and making it less of a threat to one’s well-being, whereas a liberal outlook leads to dissatisfaction with the world as it is, and a sense that things need to change before one can be really happy.”
Another possible explanation is that conservatives, or at least the ones in Boston, really aren’t the stiffs they’re made out to be by social scientists. When these scientists analyze conservatives, they can sound like Victorians describing headhunters in Borneo. They try to be objective, but it’s an alien culture.
The studies hailing liberals’ nonconformity and “openness to ideas” have been done by social scientists working in a culture that’s remarkably homogenous politically. Democrats outnumber Republicans by at least seven to one on social science and humanities faculties, according to studies by Daniel Klein, an economist at George Mason University. If you’re a professor who truly “seeks new experiences,” try going into a faculty club today and passing out McCain-Palin buttons.
Could it be that the image of conservatives as humorless, dogmatic neurotics is based more on political bias than sound social science? Philip Tetlock, a psychologist at the University of California, Berkeley, who reviews the evidence of cognitive differences in his 2005 book, “Expert Political Judgment,” said that while there were valid differences, “liberals and conservatives are roughly equally closed-minded in dealing with dissonant real-world evidence.”
So perhaps conservatives don’t have a monopoly on humorless dogmatism. Maybe the stereotype of the dour, rigid conservative has more to do with social scientists’ groupthink and wariness of outsiders — which, come to think of it, resembles the herding behavior of certain hoofed animals. Ladies and gentlemen, what we have here is a terrifying example of the reindeer effect.
Mind: When Duty Calls: The Value of Voting, Beyond Politics
By BENEDICT CAREY, The New York Times, November 4, 2008
For those who love the civic cheer and lukewarm coffee of their local polling place, an absentee ballot has all the appeal of a tax form. The paperwork, the miniature type, the search (in some states) for a notary public: it’s a tedium bath, and Pam Fleischaker, a lifelong Democrat from Oklahoma City, had every reason to take a pass this year.
Ms. Fleischaker, 62, was in New York recovering from a heart transplant, for one. And in her home state, the Democratic candidate, Senator Barack Obama, was polling hopelessly behind his opponent, Senator John McCain. She mailed in her absentee packet anyway, and hounded her two children, also in New York, to do the same.
“That one vote isn’t going to be decisive makes no difference to me,” Ms. Fleischaker said in a telephone interview last week. “Your vote is your voice, and there’s more power in it than in most of the things we do. It’s a lost pleasure, the feeling of that power.”
In recent years psychologists and neuroscientists have tried to get a handle on how people make voting decisions. They have taken brain scans, to see how certain messages or images activate emotion centers. They have spun out theories of racial bias, based on people’s split-second reactions to white and black faces. They have dressed up partisan political stereotypes in scientific jargon, describing conservatives as “inordinately fearful and craving order,” and liberals as “open-minded and tolerant.”
None of which has helped predict people’s behavior in elections any more than a half-decent phone survey. The problem is not only sketchy science, some experts say; it’s that researchers don’t agree on the answer to a more fundamental question: Why do people vote at all?
“There’s a longstanding literature looking at why any rational person would vote, when the chances of actually influencing an election are about the same as getting hit by lightning,” said John Londregan, a professor of politics and international affairs at Princeton. “In most theoretical models, it’s hard to get a predicted turnout above one. That is, one voter.”
Yet new models have done better, predicting elections with turnouts closer to the nation’s average of about 50 percent of eligible voters. They have also revealed some of the basic motives underlying both personal and group decisions about when to vote and why.
Casting a ballot clearly provides a value far higher than its political impact. The benefit may include side payments — say, the barbecues and camaraderie of a campaign, or the tiny possibility that a single vote may be decisive.
But recent research suggests that it has more to do with civic duty and the maintenance of moral self-image. In a series of experiments, researchers from Northwestern University and the University of California, Berkeley, have had study participants play a simple election game involving monetary rewards. A group of designated voters cast their vote for Choice A, an equal distribution of money among voters and nonvoters in the study; or B, a payout to be split only among the designated voters — a smaller group, so a higher amount. It cost money to vote, and participants could abstain at no cost.
The study authors, led by Sean Gailmard at Berkeley, called Choice A “ethical” and Choice B “selfish.” They found that ethical voting ran highest, at about 20 percent, when individual votes were least likely to affect the outcome. Selfish voting ran highest, also about 20 percent, when individuals’ choices were most likely to change the outcome.
This finding could explain why people might vote against a local tax increase but for a Congressional candidate who was likely to raise their income taxes: their vote carries far less value in a national race than in a local one.
This study and others also imply that there is a core of voters who not only turn out at the polls but also cast their ballot for the candidate or proposal they believe represents the larger good. This makes sense to those who study the evolution of group behavior. Small communities often have a scattering of people who stand up and do the right thing; their compensation is the private knowledge that they are willing to pay some cost to do what they believe is right, even if that price amounts to standing out in the cold for 15 minutes waiting to pull a lever.
“It may be a form of identity construction for individuals,” Dr. Gailmard wrote in an e-mail message. “Or it could be a duty to do the right thing, or a social norm.”
Ms. Fleischaker, the absentee Oklahoma voter, put it this way: “Who are we to ask others to do things for this country, small or very large, like fighting in a war, if we ourselves are not going to take the trouble to vote?”
The military analogy is not overdrawn, Dr. Londregan says. In a 2006 paper, “Voting as a Credible Threat,” he and Andrea Vindigni of Princeton argue from historical and sociological evidence that at times of deep division, elections function as an X-ray into the strength of the opposition, the number of people willing to bear a cost to have their way. In the extreme, election returns prompt factions on the brink of civil war to reassess their chances and negotiate — making communities, small and large, far more stable and adaptive.
“We started to see that elections function as a kind of SAT score to show what kind of guerrilla you’d be,” Dr. Londregan said. “They’re a way to see how many people would actually fight to oppose a policy — and how much is just bravado.”
Dutiful voters know all this, at some level, no matter how they define the larger good. They think more broadly about what others of their stripe will do, spending more effort if they feel their home team will be underrepresented, political scientists have found.
By taking into account such calculations, as well as ethical voting, the costs of casting a ballot and other parameters, Timothy Feddersen and Alvaro Sandroni of Northwestern University — Dr. Gailmard’s co-authors on the ethical voting research — have designed a model that accurately predicted turnout in several local Texas elections.
“The model predicts that in states where the election is close, turnout will be high among all groups,” Dr. Feddersen said, adding that in states where the election is unlikely to be close, “partisans are less likely to vote when they are in the majority and more likely to vote when they are in the minority,” or expect to lose.
In short, expect the race in states like New York and Oklahoma to be closer than polls show, not because of hidden racism or “inordinate fear” but because many people find it satisfying to stand up and be counted — even if they’re doing the counting for themselves.
This article has been revised to reflect the following correction:
Correction: November 5, 2008
Because of an editing error, the Mind column on Tuesday, about psychologists’ efforts to analyze voting behavior, paraphrased incorrectly from a comment by Timothy Feddersen of Northwestern University, who helped devise a model that accurately predicted turnout in several local Texas elections. Dr. Feddersen said that “partisans are less likely to vote when they are in the majority and more likely to vote when they are in the minority” in states where the election is unlikely to be close — not in “toss-up states.”
Images from Mars show deposits of minerals like opals in magenta and blue.
Minerals on Mars Point to More Recent Presence of Water
By KENNETH CHANG, The New York Times, November 4, 2008
Still puzzling over how warm and wet Mars may have once been, scientists are now seeing global mineralogical signs that the planet was at least occasionally wet for the first two billion years of its existence.
In an article in the November issue of the journal Geology, scientists working with data from NASA’s Mars Reconnaissance Orbiter report that they have spotted widespread deposits of opals and related minerals on the surface of Mars.
Opals belong to a class of minerals known as hydrated silicas, with water molecules wedged into silicon-based minerals like quartz. The formation of hydrated silicas requires liquid water.
Most interesting is that the opal deposits lie in areas that appear to have formed only about two billion years ago. Previously, spacecraft have detected other water-bearing minerals like clays in regions that date back more than 3.5 billion years. Mars, like the other planets in the solar system, is about 4.5 billion years old.
“The water was more widespread and extended to younger times,” said Scott L. Murchie, a staff scientist at Johns Hopkins’ Applied Physics Laboratory and the principal investigator for the orbiter’s spectrometer, which found the opal evidence.
In July, Dr. Murchie and other scientists reported that the orbiter had detected vast deposits of the claylike minerals on the older terrains. Images also showed ancient lakebeds with accumulations of the minerals, indicating standing water persisted for thousands of years.
The presence of water on Mars has been known for many years; its ice caps, easily visible from space, are largely made of frozen water. The unanswered question is how often the ice has melted. The Phoenix Mars Lander, now nearing the end of its six-month mission, is exploring whether the arctic ice has melted in recent millennia.
The most intriguing possibility is that Mars, when it was less than a billion years old, was warm enough for lakes and oceans of liquid water — and with that, the possibility of life. The planet’s landforms offer compelling evidence for flowing water: immense canyons and channels, dried-up river deltas.
“I think most people agree there was lots of water on the surface in the first few hundred million years,” said Maria Zuber, a professor of geophysics at the Massachusetts Institute of Technology. “It’s later on when I get confused, although I’m confused about the whole thing. That’s what makes it interesting.”
Some scientists have suggested that rare catastrophic floods carved the landforms, either in the aftermath of an impact by an asteroid or comet or by underground water — melted by residual volcanic warmth — bursting to the surface.
Those who believe that liquid water was more persistent were nonetheless perplexed when earlier spacecraft detected only small quantities of carbonates, minerals that should have formed in large amounts from reactions involving carbon dioxide and liquid water.
But data collected by the two Mars rovers, Spirit and Opportunity, show a highly acidic environment that prevented the formation of carbonates. “That part of the story is fairly well agreed upon,” Dr. Zuber said.
The two rovers have also found signs of past water. Opportunity found hydrated sulfates in the Meridiani Planum rocks; Spirit found opal-like minerals similar to those spotted by the Reconnaissance Orbiter from space.
But planetary scientists are still trying to explain the transition of Mars from lots of water to today’s cold and dry climate. In fact, they are still trying to explain how it ever had lots of liquid water. Even if young Mars were enshrouded in a thick atmosphere of carbon dioxide belched by giant volcanoes, climatologists have had trouble coaxing enough global warming in their computer simulations to push temperatures above the melting point of ice.
James F. Kasting, a professor of geosciences at Penn State, believes he may have figured out how to warm up Mars. In research that he will present in December at a meeting of the American Geophysical Union, the key may be nitrogen dioxide.
In his climate models, carbon dioxide did act as a greenhouse gas, trapping heat near the surface, but it also reflected shorter wavelengths of light back into space, limiting the amount of heating. His models peaked at about minus-40 degrees Fahrenheit. Nitrogen dioxide, which is also released by volcanic eruptions, reduces the reflectivity of Mars in the models. With more light absorbed, temperatures jumped 100 degrees. “That would be more than you need,” Dr. Kasting said.
He said he still needed to demonstrate that the nitrogen dioxide would mix throughout the atmosphere rather than remain in pockets around the volcanoes.
Even if scientists figure out the water question, they have another problem: what happened to the Martian air? The climate models suggest early Mars had an atmosphere denser than Earth’s. Now, it’s a faint wisp.
“Well, we don’t know,” Dr. Zuber said. “One day we’re going to nail that one. There’s a whole bunch of things on my list of things to do.”
More Here
Grave Warnings of Disease, With the Adman’s Flair
By AMANDA SCHAFFER, The New York Times, November 4, 2008
The woman could be the girl next door, posing for a portrait or selling cereal or soap. Her hair is neatly parted. Her earnest eye and smile seem to telegraph innocence.
Beware.
“She may look clean,” the poster warns. But “pick-ups, ‘good-time girls,’ prostitutes spread syphilis and gonorrhea.”
The poster, one of many created by the Public Health Service during World War II to warn the troops about the dangers of casual sex, is on display as part of a retrospective of 20th-century health posters from the permanent collection of the National Library of Medicine.
Titled “An Iconography of Contagion,” the exhibition features work from numerous countries on an array of diseases, among them syphilis, malaria, tuberculosis and AIDS. The posters are on display at the National Academy of Sciences in Washington through Dec. 19.
Much of the exhibition suggests a mash-up of advertising and public health. The posters tried to convey the danger of disease and get people to change their behavior, said the curator, Michael Sappol, a historian at the library of medicine, part of the National Institutes of Health.
But “they’re also about the pleasure of the image,” he continued, adding, “There have been some very sexy, colorful, playful posters about some very serious diseases.”
The visual world underwent rapid changes in the late 19th and early 20th centuries. Newspapers featured larger headlines and more drawings and photographs. The advertising industry integrated text and images, and it turned to behavioral science to sharpen its pitches.
At the same time, public health groups like the National Tuberculosis Association, founded in 1904, took some cues from advertising and began to rely on mass communication, with pamphlets, posters and, later, films and radio spots. For diseases like tuberculosis that lacked effective treatments, efforts to promote screening and change people’s behavior were especially important. “Media campaigns were themselves seen as magic bullets,” Dr. Sappol said.
In an iconic poster from around 1940, a mother and two children gather around an armchair, smiling, as the father reads a newspaper. An urban throng, in monochromatic red, appears in the background. “Tuberculosis Undiscovered Endangers You: Discover the Unknown Spreaders!” reads the caption.
“At the time, many people who had TB, including some who were contagious, were unaware that they were infected,” said Dr. Mary E. Wilson, an associate professor of global health and population at the Harvard School of Public Health. A large number of them were identified through mass screening using X-rays. (Many were exposed to large doses of radiation that would be unacceptable today, she added.)
Another poster, created in China in 1935, was intended to discourage spitting, which could spread TB. The image shows a man in traditional dress walking past a group of playing children. A line extends from the man’s mouth to a clump of spittle on the ground; from there, an arrow points to a pool of pink bacteria magnified under a microscope.
The caption reads, in part: “TB is rampant in our country because of the error of spitting anywhere. This is unforgivable!” It continues: “Spit into a handkerchief and boil it, or spit into paper and burn it. This not only ensures virtue but is a gift to mankind.”
The poster includes a symbol that resembles that of the National Tuberculosis Association in the United States — a vertical line with two horizontal crosses. In the Chinese version, the edges of the cross are curved upward, resembling a pagoda.
A similar message was promoted in many countries. In a Danish poster from 1947, the emphasis is on screening. A couple, shown as a shadowy form with green and red highlights, strolls arm in arm, wearing hats that could be merry or devilish. “Tuberculosis examination — a citizen’s duty,” reads the text.
The poster has “a beautiful, creamy texture” and was “part of the Danish enchantment with modernity, both in health infrastructure and in aesthetics,” Dr. Sappol said. “It seduces you into paying attention.”
In the 1960s, the enchantment with health posters declined, at least in the United States. “There was a general feeling among the public that we’ve got the polio vaccine, penicillin, DDT and other magic bullets, and that’s going to conquer disease,” Dr. Sappol said.
But that confidence plummeted in the 1980s and 1990s with H.I.V./AIDS, which brought about a renaissance of public health posters, said John Parascandola, a former historian for the Public Health Service. Activist groups like Act Up and Gran Fury in the United States and the Terrence Higgins Trust in Britain campaigned to raise awareness about the disease.
One poster from the mid-1980s shows a muscular man leaning down to perform oral sex on a partner of ambiguous gender. A tattooed tiger bulges on his shoulder. The poster, which reads “Discover safer sex,” is from the Terrence Higgins Trust’s “Love Sexy, Love Safe” campaign. The text notes that safer sex can also prevent unwanted pregnancy, suggesting that the campaign hoped to draw in heterosexuals.
AIDS posters tended to be less moralistic than many earlier ones, said Dr. Wilson, who noted that the World War II campaigns against syphilis and gonorrhea often treated the woman “as the villain, the temptress, and men almost as innocent bystanders.”
By contrast, she said, while AIDS patients were often stigmatized in the broader society, the major public health campaigns “tried very hard to work against that stigma.”
Ultimately, the posters tried to sell ideas to specific audiences, Dr. Parascandola said. They were a compelling form of advertising — and perhaps they still are.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
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Date: 2008-11-05 09:30 pm (UTC)no subject
Date: 2008-11-05 09:39 pm (UTC)That is why you don't drink rain water out of coconuts.
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Date: 2008-11-05 09:42 pm (UTC)no subject
Date: 2008-11-05 09:43 pm (UTC)no subject
Date: 2008-11-05 10:25 pm (UTC)There is a poster from the 80's in the NLM's online collection of an African American baby sitting in a cute little dress with words that read "She has her father's eyes and her mothers AIDS." Tell me that is not stigmatizing against black women!
Also: Dengue fever is one of my new areas of interest so I'm glad that it's getting more media attention. Though I am surprised that this article didn't mention this year's predictions that we will be seeing an increased incidence of Dengue in the Southern United States in the coming years (*cough*globalwarming*cough*).
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Date: 2008-11-05 11:52 pm (UTC)no subject
Date: 2008-11-05 10:56 pm (UTC)no subject
Date: 2008-11-06 09:37 am (UTC)This. And it pisses me off (thereby pulling me in line with the depressed liberal theory). In the last two elections I've followed, ours and the USA's, I've seen so many conservatives respond to issues like the Iraq war, or gay marriage, or poverty, with a fairly flippant "oh, it's not that bad, I don't think anything we do can make a difference anyway". Not the frothing-at-the-mouth right-wing nutbars, just the moderates who aren't actively involved with politics. If they're not personally inconvenienced by the issue, they assume that no-one else is either.