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It is important to honor the contributions of scientific leaders who have dedicated their lives to advancing knowledge and serving their country. One way is to document their experiences and personalities in a documentary format, which can serve as a historical record and an inspiration for future generations. Dr. Mostafa Pourtaghva Shahrestani, a renowned physician and specialist in infectious diseases and tropical medicine, has made significant contributions to public health in Iran. He has played a crucial role in controlling infectious diseases such as smallpox, tuberculosis, rabies, plague, and cholera. Throughout his career, he has held various executive positions, including the head of Pasteur Hospital and the director of the Pasteur Institute of Iran. Dr. Pourtaghva's life is a testament to his unwavering dedication to public health services, as evidenced by his continuous effort, love, and interest in honest work. His inspiring story can serve as a model for those who seek to follow in his footsteps., (© 2024 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

More than a decade ago Singer (2009) described Gibraltar's experience with cholera and smallpox in 1865 as a syndemic. In this study, we provide a reassessment of that event and, consequently, propose a methodology to identify a syndemic at the population level. We propose that the concept of the harvesting effect from demographic studies on crisis mortality provides a useful framework for evaluating the presence of a syndemic. Our research begins by establishing a normative baseline mortality (BM) through life table analysis, where changes in life expectancy (LE) around BM can be used to show a distinctive pattern of significant decline and increase. Such was the case with the presence of both cholera and smallpox in the fall of 1865, when LE fell significantly to 19.64 years from the background LE of 32.88 years. A year later, this decline was followed by a significant increase in LE to 41.34 years. Excessive mortality followed by a fallow (healthy) period represents a signature feature of a syndemic driven by a short-term infectious disease epidemic. The presence of both cholera and smallpox in 1860 did not produce similar results, evidence which suggests that the presence of two infectious epidemics in an impoverished population was not sufficient to produce a syndemic. The presence of a protracted state of quarantine, with its concomitant social and economic consequences, was a driving force responsible for amplifying the disease burden in 1865, and elevating to a syndemic status. Multivariate Poisson regression revealed patio level limiting factors (such as, presence of a cistern, a well, a live-in servant, and a Jewish co-resident), as well as risk factors (such as, a smallpox death in the building; the presence of a foreign-born individual). From the two-phase assessment of the syndemic in Gibraltar, we developed a conceptual framework for identifying, contributing, driving, and limiting factors., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

Between 1554 and 2021, the number of and mortality from epidemics in Amsterdam decreased sharply. The decrease in epidemic outbreaks, such as those of plague, smallpox and cholera, paralleled the decrease in chronic mortality from endemic ailments and diseases, such as tuberculosis, malaria and dysentery. There are several theories about the reason for these declines, which are not necessarily mutually exclusive: better nutrition, greater prosperity, increasing altruism, and a growing understanding of cause and effect with targeted medical and public health measures. In the powder keg of chronic poverty and poor public health, a social crisis, such as war, migration, and natural disaster, usually was the spark that led to epidemic outbreaks. The nature and extent of poverty and ill health have changed and improved over the centuries, but the threat of man-made crises is unfortunately unabated.

In the past two centuries, several fatal infectious outbreaks have arisen in Iran. Presented here is a brief historical account of four fatal epidemics including cholera, plague, Spanish influenza of 1918 and smallpox between1796 and 1979. The lessons from these outbreaks could be helpful for better combatting other deadly epidemics including the present-day disastrous COVID-19 pandemic., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)