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In a finding that could inform the world's response to the coronavirus pandemic, researchers say they determined how public health measures beat an outbreak of typhus in the Warsaw Ghetto during World War II.
Using mathematical modeling and historical documents, the study showed how community health programs and social distancing beat back the epidemic.
In 1941, the Nazis confined more than 450,000 Jews to the Warsaw Ghetto in Poland.
"With poor conditions, rampant starvation and a population density five to 10 times higher than any city in the world today, the Warsaw Ghetto presented the perfect breeding ground for bacteria to spread typhus, and it ripped through the mainly Jewish population there like a wildfire," said researcher Lewi Stone, from RMIT University in Melbourne, Australia.
As many as 120,000 people were infected with typhus, and up to 30,000 died from it. Many more died from starvation or a combination of both.
Typhus is an uncommon disease caused by a bacteria spread through contact with infected body lice. Symptoms include fever, headache, rapid breathing, body aches, rash, cough, nausea, vomiting and confusion.
"Then, in October 1941, as a harsh winter was beginning and just as typhus rates would be expected to skyrocket, the epidemic curve suddenly and unexpectedly nose-dived to extinction," Stone explained in a university news release. "It was inexplicable at the time, and many thought it was a miracle or irrational."
Stopping disease transmission was likely due to behavioral changes, Stone said.
"Fortunately, many of the anti-epidemic activities and interventions are documented, and it turns out that Warsaw Ghetto had many experienced doctors and specialists," he said.
Stone found there were training courses about public hygiene and infectious diseases, hundreds of lectures on the fight against typhus and a medical university for young people.
Hygiene and cleanliness were urged, and sometimes enforced. Social distancing was considered common sense, as was quarantining.
"In the end, it appears that the prolonged determined efforts of the ghetto doctors and anti-epidemic efforts of community workers paid off," Stone said. "There is no other way we can find to explain the data."
The report was published July 24 in the journal Science Advances.
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