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August 2, 1941


JAMA. 1941;117(5):368. doi:10.1001/jama.1941.02820310040012

Again the four horsemen of the apocalypse are riding. Once more war, hunger, disease and death destroy mankind. The horsemen of today travel with the increased speed of mechanized transportation. Today the possibilities for sudden and widespread outbreaks of disease arising far from their endemic foci are more likely than ever previously.

Among the endemic diseases which are kept from epidemic proportions only by the most stringent public health activities are malaria, yellow fever, typhus and plague. News dispatches from Europe indicate already that typhus is being held in check only with the greatest difficulty. Indeed, with the fragmentary information available it has probably reached serious epidemic proportions already in certain areas, especially Poland and the Balkans.

No doubt plague, as far as this country is concerned, is a problem of greater potentiality. Epidemiologic data give definite information on the comparative permanence of endemic foci of plague infections in localities