INSTRUCTOR:       Pascal Gagneux Ph.D. (Professor, Departments of Pathology and Anthropology)



The course will explore the major epidemiological transitions from ape-like ancestors to foraging tribes, farmers and pastoralists, to the global metropolitan primate we now are. We will focus on how diseases have shaped humans and how humans have shaped disease over time.


FORMAT:            1 hour 20 minute  Lectures


READING:           Review article or book chapter,

                             posted on the course webpage in advance of each class

DAY:                   Tuesday and Thursday

TIME:                   11:00 to 12:30 AM

LOCATION:        Peterson Hall 103

EXAMS:              A) Midterm, multiple choice, 1 hour on TBD

                            B) Final: two hours, multiple choice & simple sentence replies to questions, TBD


GRADES:           Grades will be based on student participation throughout and Midterm and Final exam performances.

HONESTY:         This course does not tolerate academic dishonesty and follows UCSD policy on this matter. For more information       

                            see below.


April 2

Lecture 1:           What is disease and how sick are we?

                           Causes of sickness and mortality, unrealized potential, under and over-nourished, stunted, polluted, poisoned, mentally        

                           traumatized, culturally deprived etc. Obesity from status symbol to disease                             

                           Disease now: heart disease, cancer, respiratory disease (COPD), diabetes type 2, influenza/pneumonia, Alzheimers, traffic    

                           accidents, renal failure, septicemia, gun violence

                           READING:         Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 1: Evolutionary Thinking


April 4

Lecture 2:           From the inside or from the outside (Virchow vs Pasteur/Koch)

                           Theories on the origin of maladies. The germ theory vs Virchow’s inner balance/ cell driven disease. Humors, Qi, Bingdu, Krimi

                           and Miasmas…….Malaria, Plague and leprosy.

                           READING:         Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 2, part 1 p 28 to p57: What is a patient?



April 9                Immunity and immune system & the cost of an effective defense

Lecture 3:           Evolved defenses of longer-lived, multicellular hosts. Life-saving reactions and life threatening over-reactions. Harnessing

                           immunity for prevention and cure.


                           READING:           Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 2, part 2 p 58 to p857: What is a patient?


April 11              Host-pathogen co-evolution

Lecture 4:           Arms races and truces between hosts and their pathogens and parasites. Foes become symbionts and symbionts can become


                           READING:         Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 3: What is a disease?Lecture 5:     


April 16              (Hu)Man-made diseases & iatrogenic disease

Lecture 5            Ways of life and cultural practices can create disease. Humans can culturally define/invent diseases. Pellagra, HCV along Nile,

                           Puerperal fever, Toxic shock syndrome, Medication over- and misuse, drug abuse DES (diethylstilbestrol) daughters.

                           READING:           Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 5: Defenses  

                           READING:           Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 5: Pathogen Evolution


April 18              Eco-Health/ Emerging diseases

Lecture 6:           Human encroachment on and disruption of wild ecosystems generates novel diseases. The latest epidemiological Transition?

                           READING: The Puzzling Origins of AIDS. 2004. James J. Moore Sci. American



April 23              No Class

April 25              The emperor of all maladies (Cancer)

Lecture 7:            If you have more than one cell, you might get cancer. Cancer perfectly combines nature and nurture.

                           READING:           Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 6: Cancer                   



April 30               Uniquely human diseases

Lecture 8:           Humans seem to be susceptible to a number of diseases not or only rarely seen in any other primates. The role of evolutionary


                           READING:           Biomedical Differences Between Human and Nonhuman Hominids: Potential Roles for Uniquely Human          

                                                       Aspects of Sialic Acid Biology. 2011. Nissi Varki et al., Annual Reviews of Pathology


May 2               Reconstructing past disease, Major epidemiological transitions

Lecture 9:           Paleopathology: how much can we find out about diseases in the distant past?                         

                           READING:   The Changing Disease Scape in the Third Epidemiological Transition. 2010. Kristin Harper and George

                                                       Armelagos  Int. J. Environ. Res. Public Health



May 7                Uniquely human diseases & The three smokes

Lecture 10:         How exposure to environmental, indoor and tobacco smoke kills    


May 9                MIDTERM (one hour)



May 14

Lecture 11:         Disease as a weapon, unintentional and intentional

                           Humans have inadvertently and intentionally used disease as a powerful weapon.

                           READING:           History of biological warfare and bioterrorism. 2014. Barras and  Greub, Clinical Microbiology and Infection


May 16

Lecture 12:         Diseases of other primates & Domesticated disease? Endogenous retroviruses,           

                   transposons etc.

                           What diseases do our closer and more distant evolutionary relatives suffer from?

                           READING:           Primates and the Ecology of Their Infectious Diseases: How will Anthropogenic Change Affect Host-Parasite                                                              Interactions? 2005. Chapman et al. Evolutionary Anthropology.

May 21

Lecture 13:         Reproductive disease

                           Evolution acts mostly on differential reproduction. What are reproductive diseases?

                           READING:           Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 7: Reproductive Disease


May 23

Lecture 14:         Cultural attitudes to disease

                           Attempts to make sense of disease. From blaming the victim to patient-interest groups. How culture, technology and commerce

                           can become a viruses’ best friends.

                           READING:           The Anthropology of Infectious Disease. 1990. Inhorn and Brown. Ann. Rev. Anthropol.


May 28

Lecture 15:         Affluenza and SESitis?

                           Do modern humans suffer from microbe deficit disorder. How socio-economic status (SES), affluence or poverty can make you


                           READING:           Sick of Poverty/ 2005 Robert Sapolski. Scientific American.


May 30

Lecture 16:         The mind/brain, our most fail-prone organ?

                           No other organ has such a high failure rate as the human brain. How costly is our most unusual organ?

                           READING:           Evolutionary Medicine, 2016, Stearns and Medzhitov. Chapter 9, Mental disorders


June 4

Lecture 17:         Violence as an infectious disease.

                           Diseased behavior? Can societies have diseases? Epidemics of suicide?

                           READING:           The Transmission of Gun and Other Weapon-Involved Violence Within Social

                                                        Networks, 2016 Tracy et al. Epidemiologic Reviews


June 6

Lecture 18:        "Let them eat Cake!"

                           How we humans are eating ourselves sick

                           READING:          Sweets in Human Evolution. Gagneux P. in Oxford Companion to Sweets, 2015


June 11              Final exam




Statement on Academic Integrity: 

“Academic Integrity is expected of everyone at UC San Diego. This means that you must be honest, fair, responsible, respectful, and trustworthy in all of your actions. Lying, cheating or any other forms of dishonesty will not be tolerated because they undermine learning and the University’s ability to certify students’ knowledge and abilities. Thus, any attempt to get, or help another get, a grade by cheating, lying or dishonesty will be reported to the Academic Integrity Office and will result sanctions. Sanctions can include an F in this class and suspension or dismissal from the University. So, think carefully before you act. Before you act ask yourself the following questions: a) is my action honest, fair, respectful, responsible & trustworthy and, b) is my action authorized by the instructor? If you are unsure, don’t ask a friend—ask your instructor, instructional assistant, or the Academic Integrity Office. You can learn more about academic integrity at” (Source: Tricia Bertram Gallant, Ph.D., UCSD Academic Integrity Office, 2017)

© 2017 by P.Gagneux, Ph.D.       UC San Diego

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