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香港中文大學歷史系 HIST4312 F : 公眾歷史專題研究 現代社會中健康與醫療: 一個比較歷史學上的考察

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香港中文大學歷史系 HIST4312 F : 公眾歷史專題研究 現代社會中健康與醫療: 一個比較歷史學上的考察 - PowerPoint PPT Presentation


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香港中文大學歷史系 HIST4312 F : 公眾歷史專題研究 現代社會中健康與醫療: 一個比較歷史學上的考察. 第八週:個人與公共衛生 (Personal Hygiene, Public Health). 熊秉真教授 歷史系講座教授 人文學科研究所所長 2012/13 年度下學期 三月七日, 10:30~12:15 李兆基樓 306 室. 現代嚴重疫症. 中國東北鼠疫 (1910) 西班牙流感爆發 (Spanish flu, 1918) 愛滋病 (AIDS, 20 世紀至現在 ) 非典型肺炎或「沙士」 (SARS, 2003).

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hist4312 f

香港中文大學歷史系HIST4312F:公眾歷史專題研究現代社會中健康與醫療:一個比較歷史學上的考察香港中文大學歷史系HIST4312F:公眾歷史專題研究現代社會中健康與醫療:一個比較歷史學上的考察

第八週:個人與公共衛生

(Personal Hygiene, Public Health)

熊秉真教授

歷史系講座教授

人文學科研究所所長

2012/13年度下學期

三月七日,10:30~12:15

李兆基樓306室

slide2

現代嚴重疫症

  • 中國東北鼠疫 (1910)
  • 西班牙流感爆發(Spanish flu, 1918)
  • 愛滋病 (AIDS, 20世紀至現在)
  • 非典型肺炎或「沙士」 (SARS, 2003)
slide3

中國東北鼠疫 (1910)

  • 1910年10月25日爆發於滿洲里頭,即迅速擴散至華北地區。死者近六萬。
  • 1910年12月清政府派伍連德往哈爾濱防疫。
  • 伍醫生向清廷建議使用火化屍體的方法控制疫情。由於中國人有令死者「入土為安」的思想,伍醫生只得向清廷請求皇帝頒下聖旨。
  • 1911年春,疫情正式受到控制。

伍連德醫生

slide5

西班牙流感 (Spanish flu, 1918)

  • 1918年全球性流感爆發,至1920疫情受控為止,約5億人感染,當中可能有5千萬至1億因病死去。
  • 由於流感爆發於第一次世界大戰期間,故此歐洲諸各一直封鎖疫情,隱瞞數據,以免影響軍心,引致疫病數據有很大偏差。由於當時西班牙為中立國,主動公開病情,加上當時連國王阿方索十三世(Alfonso XIII)也感染,故此有「西班牙形流感(Spanish Flu)」之稱。

流感期間必須戴上口罩(美國西雅圖)

slide6

西班牙流感 (Spanish flu, 1918)

  • 由於流感爆發於第一次世界大戰之中,各參戰國隱瞞疫情,沒有立即進行防疫,引致流感難以收拾。
  • 而第一次大戰期間,軍營的惡劣衛生環境,以及流動人口增加(如軍隊移動和人民逃竄),也有助疫情擴散。
  • 1918年11月第一次大戰結束,流感才慢慢受到控制。

美國肯薩斯州軍營內病人

slide7

愛滋病 (AIDS, 20世紀至現在)

  • 愛滋病(AIDS)源於在黑非州(撒哈拉以南)生長的靈長類病毒HIV,約在19至20世紀之交傳至人類,成為人類傳染病。
  • 一般認為愛滋病爆發與19世紀末開始受新殖民主義影響的非洲殖民風潮(Scramble for Africa)有非常密切關係。由於歐洲人的開發,大量沿海地區開始發展城市,而大量男性勞動人口湧入。而當地非洲女性慢慢逃離原先傳統家庭社會,在欠缺安全性行為的情況下,令愛滋病傳播。
slide8

二十世紀後半,愛滋病漸漸傳到西方先進國家,加上早期欠缺安全性行為意識,以及輸血等,令HIV病毒散播。二十世紀後半,愛滋病漸漸傳到西方先進國家,加上早期欠缺安全性行為意識,以及輸血等,令HIV病毒散播。

  • 1996年,聯合國愛滋病規劃署(UNAIDS)成立。

資料來源:

UNAIDS 2009年報告

slide9

非典型肺炎或「沙士」(SARS, 2003)

  • 2002年11月在廣東順德爆發,估計由動物傳至人類。爆發初期,中國政府為免民眾恐慌,壓抑疫情報導。
  • 2003年2月始中國政府才通知世界衛生組織有關疫情爆發。但病毒已經附近香港散播至越南以至全世界。而另一方面,國內春運也令病毒蔓延。
  • 2003年3月31日,香港淘大花園E座集體感染。
  • 2003年4月15日香港被世衛列為疫區,至6月23日始除名。
slide10
David R. Phillips, The Epidemiological Transition in Hong Kong: Changes in Health and Disease since the Nineteenth Century, Hong Kong: University of Hong Kong, 1988, p.31.
slide11
David R. Phillips, The Epidemiological Transition in Hong Kong: Changes in Health and Disease since the Nineteenth Century, Hong Kong: University of Hong Kong, 1988, p.38.
slide12
David R. Phillips, The Epidemiological Transition in Hong Kong: Changes in Health and Disease since the Nineteenth Century, Hong Kong: University of Hong Kong, 1988, p.37.
slide13
Notification rate of major infections diseases 1961-1985
  • David R. Phillips, The Epidemiological Transition in Hong Kong: Changes in Health and Disease since the Nineteenth Century, Hong Kong: University of Hong Kong, 1988, p.33.
slide14
The epidemiological transition in Hong Kong: proportions of mortality from different causes, 1912-1985.
  • David R. Phillips, The Epidemiological Transition in Hong Kong: Changes in Health and Disease since the Nineteenth Century, Hong Kong: University of Hong Kong, 1988, p.19.
slide15
David R. Phillips, The Epidemiological Transition in Hong Kong: Changes in Health and Disease since the Nineteenth Century, Hong Kong: University of Hong Kong, 1988, p.44.
slide16
David R. Phillips, The Epidemiological Transition in Hong Kong: Changes in Health and Disease since the Nineteenth Century, Hong Kong: University of Hong Kong, 1988, p.58.
slide17
Tuberculosis notification rate by sex and age 1975-1985
  • David R. Phillips, The Epidemiological Transition in Hong Kong: Changes in Health and Disease since the Nineteenth Century, Hong Kong: University of Hong Kong, 1988, p.59.
slide18
Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.36.
slide19
Thin section electron micrograph of infected Vero E6 cell, showing coronavirus particles within cytoplasmic membrane-bound vacules and the cisternae of the rough endoplasmic reticulum.
  • (Source: Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, Atlanta, USA)
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.34.
slide20
Global Outbreak: Aided by air travel, the disease spread rapidly on a global scale.
  • Key: Country: Number of infections / Number of deaths
  • (Figures correct as of 9 Apr 2003)
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.19.
slide21
Hong Kong’s Industrial Production, 1993-2003 *Denotes latest data available at time of writing.
  • Source: Hong Kong SAR Government Census and statistics Department, Hong Kong Monthly Digest of Statistics.
  • Hong Kong’s index of industrial production registered a decline of nearly 9% in the first quarter of 2003 compared to the same period last year. Due to SARS, the industrial production index further fell by 13% in the second quarter.
  • John Wong & Zheng Yongnian, ed., The SARS Epidemic Challenges to China’s Crisis Management, Singapore: World Scientific Publishing Co. Pte. Ltd., 2004, p.43.
slide22
Officially Confirmed SARS Patients in Hong Kong as of June 2003
  • Source: “SARS updated charts and figures in Hong Kong”, Hong Kong University of Science & Technology, at http://ihome.ust.hk/~bo_cckae/kivin/sars.html.
  • John Wong & Zheng Yongnian, ed., The SARS Epidemic Challenges to China’s Crisis Management, Singapore: World Scientific Publishing Co. Pte. Ltd., 2004, p.206.
slide23
Number of Buildings with Confirmed SARS Patients by Region and Date of Posting onto the Hong Kong Department of Health Website as of June 2003
  • Source: Hong Kong Department of Health, at http://www.info.gov.hk/dh/diseases/ap/eng/bldgcht.htm. Information was first posted at this site on 12 Apr 2003.
  • John Wong & Zheng Yongnian, ed., The SARS Epidemic Challenges to China’s Crisis Management, Singapore: World Scientific Publishing Co. Pte. Ltd., 2004, p.208.
slide24
Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.45.
slide25
Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.48.
slide26
Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.51.
slide27
Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.53.
slide28
Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.54.
slide29
Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.56.
slide30
Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.57.
slide31
Visits between PRC and Taiwan, 1988-2003
  • Source: http://www.chinabiz.org.tw/chang/Eco/136-2003-12/136-20.xls
  • Migration into Taiwan from China was not trivial, but it was the relocation of approximately half a million Taiwanese business investors and their families to China, in addition to seasonal tourists, that made Taiwan uniquely vulnerable to China’s initial disregard of public health measures. The dramatic rise and fall in the number of annual visists, however, also attest to the fragility of current interdependence.
  • Deborah Davis & Helen Siu, ed., SARS: Reception and Interpretations in Three Chinese Cities, London: Routledge, 2007, p.13.
slide32
Visits between Hong Kong and PRC, 1994-2004
  • Source: Hong Kong Tourism Board
  • In the context of the SARS outbreak the fissures of international politics and the everyday interdependence of trade, investment, and family ties therefore defined the reception and interpretation of the disease in Taiwan far more than it did in Hong Kong.
  • Deborah Davis & Helen Siu, ed., SARS: Reception and Interpretations in Three Chinese Cities, London: Routledge, 2007, p.9.
slide33
Masked! Face masks quickly became sold out as more and more people take personal preventive measure.
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.22.
slide34
Hong Kong residents combating the SARS outbreak
  • (Source: Strategic Business World Monthly)
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.44.
slide35
Protected: Air crew operating in affected countries wear face masks to protect themselves.
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.71.
slide36
Amoy Gardens Block E: An alarming number of residents in this apartment contracted the disease, prompting the authorities to quarantine the entire building.
  • (Source: Mingpao, Hong Kong)
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.132.
slide37
Increased Hygiene
  • The management of many workplaces as well as government ministries have stepped up their level of hygiene. Here, a janitor is shown disinfecting and cleaning the entrance of an office building. Lifts should be cleaned regularly and thoroughly, with special attention being paid to the panel buttons.
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.67, 98, 99.
slide38
Stepping Up Cleanliness: Singapore and Hong Kong have stepped up on the level of hygiene at public places. Here, a cleaner is shown cleaning a subway station.
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.71.
slide39
Traditional Remedy: Many people turn to Chinese herbs to strengthen their immune system. Demand for certain herbs surged dramatically, resulting in some herbs being sold out in many places.
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.103.
slide40
Developing diagnostic kits to ascertain that patients have SARS is pertinent.
  • (Source: Straits Times)
  • Leung Ping Chung & Ooi Eng Eong, ed., SARS War: Combating the Disease, Singapore: World Scientific Publishing Co. Pte. Ltd., 2003, p.127.