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The 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS) was an abrupt reminder that infectious diseases pose a continuing threat to human health. In 1967, U.S. Surgeon General William H. Stewart declared “it was time to close the book on infectious diseases” (Garrett, 1994, citing W.H. Stewart, “A Mandate for State Action,” presented at the Association of State and Territorial Health Officers, Washington, DC, December 4, 1967). In the latter half of the twentieth century, many shared this bold view that medical science had vanquished infectious disease. As a result, public health struggled to remain relevant in the face of advances in pharmaceuticals, surgery, genetics and other areas that were becoming increasingly dominant in the quest to extend and enhance human life. SARS forced many to rethink the significance of public health and the crisis, though relatively short-lived, (for commentary on the disparities between the responses to HIV and SARS, see e.g. Altman (2003)) underscored the need to rebuild public health capacity that had been allowed to slip down the health system priority list.

Tourism activity is a global industry and, as such, it is subject to global risks. International travel has developed exponentially over the last few decades. At the same time, diseases have increased their geographical spread influenced by ecologic, genetic and human factors. Currently, the increasing virus, epidemic and pandemic outbreaks represent some of the most negative consequences of globalization, causing deaths and significant economic losses due to the negative impacts they have on the tourism industry, one of the sectors that have been the most affected by health crises.

This work presents insights on the epidemics, pandemics and virus outbreaks that have occurred throughout the twenty-first century and how those occurrences have affected the tourism industry and the global economy. A brief literature review on health risks in tourism is presented, followed by a clinical perspective to help people understand the differences between endemics, outbreaks, epidemics and pandemics. Then, the study offers a presentation of the most significant pandemics in recent human history and a deep analysis of the COVID-19 disease. Finally, the effects that the different pandemics, epidemics and outbreaks that occurred in the present century had on tourism are explained, and the challenges tourism has to face are presented and discussed.

Purpose – Purpose of the research is to make a comprehensive study to elucidate the existing landscape of scientific production of disease outbreaks, pandemics and tourism research. In doing so, authors analyzed scientific production of pandemics and tourism-related studies such as year-wise publications, productive authors, institutes, funding sponsors, thematic areas of research and citation analysis.

Design/methodology/approach – Authors analyzed the research papers indexed in the online Scopus database over 50 years of time starting from 1971 to 2020 by using bibliometrics, and the data are visualized by using data visualization tools like VOSviewer and the Tableau.

Findings – The understanding of disease outbreaks and pandemics in tourism has increased over the years in terms of number of papers, citation, networks and collaborative themes of research.

Research limitations/implications – Data for the study were generated from Scopus online database and limited to English-written journal articles that were produced with search strategy of specific keywords associated with tourism, virus, pandemics and disease outbreak.

Practical implications – Findings of the research provide insights into academia and practitioners on the understanding of disease outbreaks, pandemics and tourism research, coherent development of the concept and understanding the research gap and focussed area of research.

Originality/value – As per authors' understanding, this paper would be one of the first attempts to provide greater understanding of disease outbreaks, pandemics and tourism as a research topic by examining the growth and evolution in an academic context through bibliometric analysis.

Paper type – Review paper.

The years following the 9/11/2001 terrorists attacks saw a marked increase in community and hospital emergency preparedness, from communications across community networks, development of policies and procedures, to attainment and training in the use of biological warfare resources. Regular drills ensured emergency and health care personnel were trained and prepared to address the next large-scale crisis, especially from terrorist and bioterrorist attacks. This chapter looks at some of the more familiar global health issues over the past two decades and the lessons learned from hospital responses to inform hospital management in preparation for future incidents.

This study is a narrative review of the literature related to lessons learned from four major events in the time period from 2002 to 2023 – SARS, MERS, Ebola, and COVID-19.

The initial search yielded 25,913 articles; 57 articles were selected for inclusion in the study.

Comparison of key issues and lessons learned among the four major events described in this article – SARS, MERS, Ebola, and COVID-19 – highlight that several lessons are “relearned” with each event. Other key issues, such as supply shortages, staffing availability, and hospital capacity to simultaneously provide care to noninfectious patients came to the forefront during the COVID-19 pandemic. A primary, ongoing concern for hospitals is how to maintain their preparedness given competing priorities, resources, and staff time. This concern remains post-COVID-19.

With the recent outbreak of Severe Acute Respiratory Syndrome (SARS) and on-going concerns about influenza and the use of pathogenic organisms as weapons, the management of outbreaks of contagious diseases has recently taken on a new urgency (Barbera et al., 2001). However, the public health law concerning disease outbreaks is still based on the perspectives, and often the words, of the early twentieth century, when most public officials saw little option but to take a very authoritarian approach to the protection of the public's health. Over the past 40 years, the jurisprudence of involuntary non-criminal incarceration, for example for the treatment of tuberculosis or as a result of mental disease, has changed dramatically, as basic concepts of due process have been incorporated into the process of civil commitment (Gostin, Burris, & Lazzarini, 1999). There is, therefore, a pressing need to rethink the approaches traditionally taken to the control of infectious disease outbreaks to address this gap between the old assumptions of plenary power to act in the public's interests and the rights of individuals threatened with state actions (Davis & Kumar, 2003). It is a canard sometimes used to justify authoritarian actions that the public responds to emergencies by losing control and panicking; indeed it is the consensus of social scientists that people in emergency situations tend to be more cooperative and more generous toward others than they may normally be (Smith, 2001; Clarke, 2002). If anything, it is my reading of such experiences as the bomb attacks on London during World War II (Harrisson, 1989) that it is the poorly prepared and under-supported public officials who are most likely to act in unproductive and socially divisive ways during public emergencies.

The Epidemiologic Transition can help us understand a fundamental puzzle about aging. The puzzle stems from two seemingly contradictory facts. The first fact is that death rates from noninfectious degenerative maladies – the so-called diseases of aging – increase as people age. It seems to be at odds with the historical fact that for nearly a century in which people were aging more than ever before, the aggregate rates of such diseases have been decreasing. In what sense can both be true? Crucial to resolving the puzzle are the age-profiles of such diseases in cohorts that grew up in the different regimes of the Transition. For each cohort, noninfectious diseases had increased with age, resulting in an upward-sloping age profile, which affirms the first fact. As the regimes were transitioning from the Malthusian to the modern one, however, the profiles of successive cohorts had been shifting downward: death rates from noninfectious diseases were shrinking at each age, signifying the newer cohorts’ greater aging potentials. The shifting profiles had been renewing the cohort mix of the population, shaping the century-long descent of such diseases in aggregate, giving rise to the historical fact. The profiles had shifted early in the cohorts’ adult years, associating closely with the newer epidemiologic conditions in childhood. Those conditions appear to be a circumstance under which aging potentials of cohorts could be misgauged, including in one troubling episode in the first half of the nineteenth century when the potentials had reversed.

Over the last decades, there has been an increasing interest among scientists on the linkage between population health and climate and environmental factors, as well as health impacts of climate change and climate variability. Numerous studies have been done and substantial results achieved, but mostly in the developed countries, and not much quantitative evidence or assessment of the impacts at national and local levels has been provided for developing countries.

The purpose of this chapter is to offer reflections on conventional theories concerning causes and determinants of diseases. It also intends to examine both theoretical and empirical bases for adopting an Integrated Social-Ecological Systems (ISES) lens as a tool for understanding complexities related to drivers, determinants and causes of diseases.

We assessed the theoretical underpinnings of a range of historical and contemporary lenses for viewing infectious disease drivers and the implications of their use when used to explain both personal (i.e. individual) and population health. We examined these issues within the empirical context of the City of Dhaka (Bangladesh) by adopting an ISES lens. Within this study an emphasis has been placed on illustrating how feedback loops and non-linearity functions in systems have a direct bearing upon various aspects of infectious disease occurrences.

A brief triumph over microbes during the last century stemmed in part from our improved understanding of disease causation which was built using disciplinary-specific, monocausal approaches to the study of disease emergence. Subsequently, empirical inquiries into the multi-factorial aetiology and the ‘web of causation’ of disease emergence have extended frameworks beyond simplistic, individualistic descriptions of disease causation. Nonetheless, much work is yet to be done to understand the roles of complex, intertwined, multi-level, social-ecological factors in affecting disease occurrence. We argue, a transdisciplinary-oriented, ISES lens is needed to explain the complexities of disease occurrence at various and interacting levels. More theoretical and empirical formulations, with evidence derived from various parts of the world, is also required to further the debate.

Our study advances the theoretical as well as empirical basis for considering an integrated human-nature systems approach to explaining disease occurrence at all levels so that factors at the individual, household/neighbourhood, local, regional and global levels are not treated in isolation.

In the late autumn of 2002 Severe Acute Respiratory Syndrome (SARS) broke out in Foshan city in the People's Republic of China, and over the next few months it rapidly spread to every continent and 29 countries. Although plagues may be global events, they are ultimately fought at the local level. In discussing the SARS epidemic, I present two theses. (1) In the wake of a plague, politics tends to shape a community's response in protecting the system, evaluating performances and allocating blame, punishments, and rewards, and restructuring organizations. (2) Because of their potential for demographic and institutional destruction, systemic responses to plague tend to become entwined in politics at all levels – the local, national, and international.