| Abstract |
The study of hygiene has an important place in the history of epidemiology. One of the first ever statistical investigations of death and disease was carried out on rates of death in childbirth in the Vienna General Hospital around 1847. Ignaz Semmelweis noticed that
patients attended by student doctors who had recently carried out autopsies died at a much higher rate than those attended by midwives. He correctly surmised that something was being transferred on the hands of the doctors. He solved the problem by instituting a handwashing regime in the hospital. Just a few years later John Snow conducted his famous investigation into the causes of cholera in London. His investigations incriminated not just contaminated water supplies but the poor hygiene practices of the people living around the Broad Street pump. Today modern living conditions including sewerage, piped water supplies and, above all, the
widespread adoption of commercially promoted soap have gone a long way towards eliminating infectious disease in rich countries, helping to reduce mortality rates from infection to 5% of all deaths. However, in Africa a full 65% of deaths are due to infections, while the figure is 35% in Asia (WHO, 2002). Today new generations of epidemiological studies help us to understand these disparities, and continue to point to the importance of good hygiene in preventing infectious disease. [authors abstract]
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