Contagious! Visiting an Exhibition on Epidemic Diseases

What do objects from a bygone age tell us about epidemics today?

Since opening in June, the exhibition Contagious! reflects on the history of pandemics, including patients’ painful experiences, coping and containment strategies, and examples of ground-breaking medical research. Ruben Verwaal reports on his recent visit.

Visiting an exhibition on contagious diseases in times of COVID-19 is illuminating and disconcerting at the same time.

As I sit on the train to Leiden to visit the Contagious! exhibition, I realise that my visit had already begun. Earlier that week, I had purchased my admission ticket online. The website reminded me of the special COVID-19 rules to be observed while in the museum. On the train I’m wearing my face mask and sit in a designated seat – all part of the guidelines to help prevent the spread of the coronavirus. On entering the museum, I’m greeted by a hand-sanitiser station and a tall banner summarising the rules once more:

“Observe 1.5 metres social distancing

Follow the route specified

Wash your hands regularly

Sneeze or cough into your elbow

Use contactless payment only

Who would have thought that an exhibition on contagious diseases would coalesce with a pandemic? The Rijksmuseum Boerhaave, the national museum of the history of science and medicine in The Netherlands, certainly didn’t. In fact, the curators of Contagious! started preparing the exhibition over two years ago. They planned it to revolve around some future ‘Disease X’, asking what factors would be important in its outbreak. Little did they know how quickly Disease X would get a name.

Entering the dark exhibition space, I’m bombarded with recent news headlines. The alarming reports from hospitals, interviews with virologists and epidemiologists, and the speech by the Dutch prime minister announcing a national lockdown – they feel like ancient history, even though it has been only a few months. The walls are covered with newspaper reports from the previous century, covering the cholera, the 1918 influenza or “Spanish Flu”, measles, tuberculosis, and poliomyelitis. A sign as tall as the ceiling gives a chronological overview of all major outbreaks, running from the medieval Black Death until MERS, Ebola, and Zika. The overwhelming size of the numbers left me shocked and numb.

One object in particular epitomises the relationship between our current pandemic and epidemic diseases from the past. It’s a fascinating dress made from raw silk, inspired by 17th-century designs. Its maker, Anna Dumitriu, impregnated the embroidery with the DNA of the Yersinia pestis bacterium, commonly known as the plague. Painted with walnut husks and filled with lavender, the dress also incorporates the seeds and plants used in the treatment and prevention of the plague. This “Plague Dress” beautifully combines the science and fear of infectious diseases in a work that undercuts temporal distance.

Continuing my tour through the exhibition, I find myself in a temporary triage and test tent. The sides are transparent, creating a space that locks you up and simultaneously makes you aware of the world outside – I’m suddenly back in lockdown. Inside the decontamination tunnel, I learn about quarantine practices throughout history. Objects such as yellow signal flags for code Q and a model of the disinfection vessel Rat tell the story of how, since the Middle Ages, merchant ships were placed under quarantine (from the Italian quaranta, or 40 days) in times of outbreak. A number of black-and-white photographs from the twentieth century reveal a less well-known story of quarantine. On the island Onrust (‘Unrest’, Poelau Kapal) in the bay of modern-day Jakarta, pilgrims returning from Mecca were obliged to quarantine, even though they did not appear to spread any disease. Putting people in quarantine has been a measure of control as much as it has been an instrument of fear.

But fear of what exactly? The exhibition features impressive historical medical moulages, which visualise the devastating effect of contagious diseases. A girl suffering from measles is covered with a red rash. A man suffering from the plague has an enormous swelling in his neck. These wax moulages bring the harm and injury of contagious diseases frighteningly close. But above all it’s the invisibility of contagion that is the source of constant anxiety. The art installation “A Cluster of 17 cases” tells the gripping story of an unsuspecting woman who was infected in a hotel in Hong Kong – lights visualise the elusive spread in the rooms on the hotel’s 9th floor. She ends up in hospital where her parents try to comfort her by firmly holding her hands, unknowingly infecting themselves. The woman ends up losing both her parents to SARS, and is never able to look at her hands in the same way.

Besides fear, scapegoating is also an unfortunate part of any epidemic. Not much has changed, the exhibition tells me, between the casting out of lepers in the past and today’s prejudice against people with coronavirus or Ebola. The most heart-breaking object in this respect is the enormous memorial quilt with name flags of AIDS victims: Gunnar Paullisse with a flag made by his mother; Marcus Erich’s flag made by his sister-in-law and friend; Ad van der Donk; Domenico and Gert-Jan… Fear and stigma can seriously hamper the management of epidemics, let alone social cohesion.

Even so, there is a lot to be optimistic about. A large part of the exhibition deals with medical research in an attempt to tackle contagious diseases. Since the nineteenth century, for example, experts have wondered how diseases go from door to door. They draw up charts, create models, and use statistics to trace the spread of disease.

We don’t have a vaccine for COVID-19 yet, but a timeline shows what medicine has achieved throughout the centuries: from a Narwhale’s tooth and Johannis Pennis’ germander herb (thought to be effective against fever and the plague), to drops against cholera, and emtricitabine/tenofovir disoproxil medicine for PrEP, a pill that can prevent an HIV infection. Numerous treatments have been developed to combat infectious diseases. Vaccinations save many millions of lives worldwide. And as new diseases keep arising, it’s a line of research that is of continued importance. Optimistically, the curators of the exhibition have kept a display cabinet empty for a future vaccine or drug for COVID-19.

While potential medicines are being explored, communication is vital in the prevention of disease. The modern concept of public health has a rich history since the nineteenth century. The exhibition displays a number of skilfully designed posters informing the public with health advice.

Finally, a video at the very end of the exhibition visualises the newest research trajectories. Scientists of the twenty-first century now take into account globalisation, climate change, and the close interaction between humans and animals – all combined in the concept of One Health. Taking all these factors into account, scientists are trying to prepare us to deal more effectively with future outbreaks.