Panum and Measles in the Faroe Islands, 1846 – The Beginnings of Epidemiology

The field of epidemiology, our understanding of the true causes of disease, emerged before the effects of bacteria and other microorganisms were understood. Epidemiology studies factors affecting population health. For example, in The Canon of Medicine (around AD 1025), Avicenna discussed the contagious nature of sexually transmitted diseases and tuberculosis, and the usefulness of quarantine in limiting the spread of certain diseases. 

Among the best-known epidemiologists of the 1800s were Danish physiologist Peter Panum (measles transmission), John Snow (cholera transmission) and English physician William Budd (typhus fever transmission).

Panum’s work made important contributions to modern epidemiology. In 1846, the Danish government sent the 26-year-old Panum to investigate the spread of measles in the Faroe Islands, situated in the mists of the North Atlantic Ocean. 

In Panum’s time, however, measles could often be fatal. In 1846, it had caused no deaths in the Faroe Islands for 65 years, but suddenly more than 6000 of the 7782 inhabitants developed measles. Coastal valleys separated the islands’ populations, so disease progression in each small settlement could be studied in isolation. By examining different villages, Panum established that measles had an incubation period of about two weeks. He also gathered information on lasting immunity by interviewing older people infected in earlier years and found that none developed measles in 1846. He became convinced that infectious agents spread measles through contaminated objects or close human contact.

When Panum studied measles, viruses were not known to cause disease, making his work and vision particularly impressive and forward-looking. Viruses were discovered much later, at the end of the 19th century. The first identified virus, tobacco mosaic virus, was discovered in 1892 by Russian scientist Dmitri Ivanovsky. Thus, viruses had not yet been discovered when Panum investigated measles, and he did not know it was viral. Nevertheless, he observed its contagious nature and person-to-person transmission during the outbreak and documented these observations. This was an important step in understanding measles.

Panum’s important place in medical history rests on his meticulous fieldwork, “Observations Made During the Epidemic of Measles on the Faroe,” in 1846, which planted an early seed in the developing field of epidemiology.

Article image caption: The image on the left shows Dr Peter Paum; the image on the right locates the Faroe Islands in the North Atlantic on a map.

Historical figures mentioned: Abu ‘Ali al-Husayn ibn ‘Abd-Allah Ibn Sina (Avicenna) (980–1037), William Budd (1811–1880), John Snow (1813–1858), Peter Ludvig Panum (1820–1885)

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