I am writing a book and in it, I mention the epidemiological triangle (sometimes called the public health or infectious disease triad). Where did the formulation come from? Who first described it? The references I have found are not informative but it is clearly a very old idea. I am aware that the idea as applied to animal health was formulated in 1974 by an eminent fisheries biologist, Stanislas F. Snieszko (1902 – 1984) to apply to fish diseases. However, I am sure that there must be earlier versions for human health. So far I have been unable to find them.
Hello Tee
This quotation cited in: Francl, L.J. 2001. The Disease Triangle: A plant pathological paradigm revisited.The Plant Health Instructor. DOI: 10.1094/PHI-T-2001-0517-01
http://www.apsnet.org/edcenter/instcomm/TeachingArticles/Pages/DiseaseTriangle.aspx
may assist:
"The disease triangle drawing most likely was first published by Stevens in 1960 (6), although earlier plant pathologists certainly recognized the interaction among plant, pathogen, and environment. For example, Duggar (4) wrote in 1909: ". . . the abundance of a very large number of fungous [sic] diseases is directly connected with or conditioned by climatological factors . . . factors may affect independently host and parasite, and they may affect the interrelations of these organisms."
References
(4) Duggar, B.M. 1909. Fungous Diseases of Plants. Ginn and Co., N.Y.
Book :AVAILABLE at UQueensland, SB601 .D8 1909, Engin & Sciences
(6) Stevens, R.B. 1960. Pages 357-429 in: Plant Pathology, an Advanced Treatise, Vol. 3. J.G. Horsfall and A.E. Dimond, eds. Academic Press, NY.
Roman Scheurer
Hi Tee - This always seems to be attributed to Virchow, but haven't ever seen or found it, or Max von Pettenkauffer (swallowing cholera bacilli to show the role of the environment separate from the host & agent) although again the attributions seem to be retrospective, i.e. the ideas are there but no one specifically draws a triangle or triad
Earliest that that I'm aware of comes from the first English epidemiology text in 1931 - Stallybrass: Principles of Epidemiology and the Process of Infection, where it's described as "the sower, the soil, and the seed." I suspect that it was a concept in the air or water (...sorry...) for some time previously, but never seems to make it into print until sometime later.
See Lillienfield's review http://aje.oxfordjournals.org/content/157/9/856.full?ijkey=ba508bb173f62f142616fd0eb79b85b67a2c4aee&keytype2=tf_ipsecsha
Go to Google Ngrams (https://books.google.com/ngrams) to search 5 million + books. Enter epidemiological triangle. Note first extensive use in late 1960s but sporadic use earlier in 1920s.
Thank you, all three! This has been very helpful. The earliest usage I could find for the triad on Google Ngrams was 1937, but haven't tracked down the actual cite. However, I now have as much as I need, thanks to you three and to ResearchGate!
Till now, I too have had challenges tracing the origin of Epidemiologic triangle theory.
Stevens, R.B. 1960. Pages 357-429 in: Plant Pathology, an Advanced Treatise, Vol. 3. J.G. Horsfall and A.E. Dimond, eds. Academic Press, NY.
Tee: In 1928, in the Cutter Lecture at Harvard, Wade Hampton Frost introduced the epidemic triad. The lecture was published in AJE in 1976.
In 1975, Dr. Jerry Morris, a prominent British epidemiologist, set out a list of seven uses of epidemiology. These uses are still widely accepted today. They demonstrate the wide-ranging application of epidemiology to a variety of sectors of the health system.
The uses of epidemiology, as determined by Dr. Morris (Morris, 1975), are as follows:
(Source: Adapted from Morris, 1975, and Maxcy-Rosenau-Last, 1998)
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