The history of responses to epidemic disease in the United States since the 18th century.

History offers some guidance for understanding social and policy responses to the AIDS epidemic. Pertinent themes in the history of responses to epidemic disease in the United States in the past two hundred years include an initial underestimation of the severity of the epidemic; the prevalence of fear and anxiety; flight, denial, and scape-goating as a result of fear; efforts to quarantine and isolate carriers and the sick; the assertion of rational policies by coalitions of business, government, and medical leaders; the recruitment of a special cadre of physicians to treat the sick; the similarity of responses to both epidemic and endemic infectious diseases; and the high cost of epidemics, which is shared by government, philanthropy, and private individuals. However, until more is known about the natural history of AIDS, generalizations about past epidemics must be cautiously applied to our present circumstances.