While walking along the bustling streets of Beijing, Chengde, Shenyang, Wuhan, or other Chinese cities during the Qing dynasty (1644–1911), people would regularly brush past bats, cranes, pheasants, peacocks, egrets, or ducks; slow their step so a lion, leopard, tiger, rhinoceros, or bear could hurry past; or yield to allow passage to a dragon, unicorn, or qilin (a chimera with horns, a dragon’s head, fish scales, an oxen’s tail, horse’s hooves, and multicolored skin). Of course, it was not those actual animals jostling their way through the crowded causeways but rather myriad Chinese statesmen, civic officials, military officers, and members of the imperial court, as well as their wives, all of whom indicated their rank and status by wearing embroidered badges featuring images of those creatures on their outer coats. | | From the late 14th century until the early 20th century ce, these ornate rank badges (called buzi or Mandarin squares) featured fierce animals to denote military officials, various bird species to identify civic officials, and exotic and imaginary creatures to signify members of the imperial court. Art historian Mary Dusenbury writes, “Qing badges generally include an abbreviated cosmic diagram with an earth-mountain in the lower center, and a multitude of auspicious symbols filling up the surrounding space. In the center, the animal or bird looks up at a prominent red sun, symbol of the emperor.”

Volcanoes―active, dormant, and extinct―are found on every continent on Earth. Many lay submerged below the oceans, and others exist as islands. Volcanic explosions, upheavals, and lava flows, coupled with eons of weathering, have formed mountains and plateaus, created craters, and etched valleys. Approximately 80 percent of Earth’s surface was created by volcanic activity. The United States Geological Survey notes, “Gaseous emissions from volcanic vents over hundreds of millions of years formed the Earth’s earliest oceans and atmosphere, which supplied the ingredients vital to evolve and sustain life.” | | Ancient to modern eyewitness accounts document the devastation and spectacle associated with volcanic eruptions. For centuries, artists have depicted in their works both the sublime beauty and unthinkable destruction of volcanic eruptions. Among them is the Norwegian painter Johan Christian Claussen Dahl. Considered the first great Romantic painter in Norway and among the greatest European artists of all time, Dahl traveled to Italy during the fall of 1820. He visited Naples in late December of that year and observed firsthand Vesuvius erupting, an event he called an “interesting and horribly wondrous sight.” This month’s cover image, Eruption of the Volcano Vesuvius, 1821, is the first in a series of paintings he created after that experience.

In March 2020, the World Health Organization classified the COVID-19 outbreak as a pandemic. According to data from the WHO Coronavirus (COVID-19) Dashboard (April 12, 2021), ≈137,000,000 confirmed cases of COVID-19, including ≈2,930,000 confirmed deaths, have been documented in 223 countries. Actual numbers of cases and deaths are larger because of challenges with testing and determining causes of death. | | The UN Educational, Scientific and Cultural Organization (UNESCO) notes that the culture sector, which includes more than 30 million people globally, has been hit hard by the coronavirus pandemic. Nonetheless, artists everywhere have responded to the pandemic; many are not only depicting their experiences and circumstances but are also promoting public health practices that can aid in reducing the spread of COVID-19, such as washing hands and wearing masks.

Anthony Fauci, who retired as head of the National Institute of Allergy and Infectious Diseases, National Institutes of Health, at the end of 2022, wrote that “The emergence of new infections and the reemergence of old ones are largely the result of human interactions with and encroachment on nature. As human societies expand in a progressively interconnected world and the human–animal interface is perturbed, opportunities are created, often aided by climate changes, for unstable infectious agents to emerge, jump species, and in some cases adapt to spread among humans.” | | Factors that can lead to emergence of pathogens also include contaminated food and water, modern agricultural practices, human migration, use and misuse of antimicrobial agents, and lack of public health resources in some areas. In 2013, Morens and Fauci wrote, “The inevitable, but unpredictable, appearance of new infectious diseases has been recognized for millennia, well before the discovery of causative infectious agents. Today, however, despite extraordinary advances in development of countermeasures (diagnostics, therapeutics, and vaccines), the ease of world travel and increased global interdependence have added layers of complexity to containing these infectious diseases that affect not only the health but the economic stability of societies.”

During mid-March 2020, the World Health Organization (WHO) declared that the spread of COVID-19, the respiratory illness caused by SARS-CoV-2, was a pandemic. This novel emerging infectious disease spread insidiously and swiftly around the globe, undeterred by geographic borders. Countries reacted to COVID-19 with attempts to control transmission, including isolation and quarantine orders, social distancing recommendations, and mask requirements. Responses at the local, national, regional, and international levels involved public health experts, field epidemiologists (disease detectives), clinicians, researchers, policy makers, political leaders, and civil authorities. | | Artists from across the globe also responded to the effects of COVID-19 in myriad ways, communicating a wide range of perspectives and experiences about the pandemic through imagery, music, dance, and writing. Efforts to collect and share some of this artistic output via online platforms helped connect artists and audiences to a greater degree than would otherwise have been possible during the pandemic. For example, in spring 2020 the Washington Post invited readers to submit artwork created during the early months of the COVID-19 outbreak. The paper featured 20 works, selected from more than 650 submissions, in the article “The Best Art Created by Washington Post Readers during the Pandemic.” Michael Cavna, a writer-artist-cartoonist who penned the story, explained, “The Post considered not only the quality and creativity of the art, but also the fascinating accompanying backstories. Enduring quarantines, some artists rendered what isolation and loneliness felt like, while others depicted longed-for social scenes from a pre-pandemic time.”

Microbes, including myriad pathogens, have demonstrated their tenacity and malleability to endure, even flourish, under extreme conditions thought to be inhospitable to life. These microbes evolve at a pace that proves hard to fathom: they can undergo as many as 500,000 generations during a single human generation. | | The proliferation and abundance of modern antibiotics have accelerated the pace of pathogens’ evolutionary adaptation through mutation and acquisition of genetic material conferring resistance from other species. The World Health Organization notes that new resistance mechanisms are emerging and spreading around the world and that without effective antimicrobials, treating infectious diseases is becoming increasingly challenging. | | Researchers Julian and Dorothy Davies offer this perspective: “What happened during the evolution of bacteria and other microbes and organisms over several billions of years cannot be compared to the phenomenon of antibiotic resistance development and transfer over the last century. Contemporary selection pressure of antibiotic use and disposal is much more intense; selection is largely for survival in hostile environments rather than for traits providing fitness in slowly evolving populations.”

Kitchen, a painting completed in 1580 by Italian artist Vincenzo Campi, celebrates the chaotic workspace that was devoted to keeping a noble family’s house supplied with food and drink. The kitchen workers are preparing an assortment and quantity of meats, pies and breads, sauces, and side dishes as a special meal for a celebration or holiday. | | Invisible to the viewer and unknown to Campi, his subjects, or his patrons, this kitchen would have been permeated by numerous unwelcome microorganisms that could cause zoonotic foodborne diseases. Such a setting would provide many opportunities for transmission of potentially pathogenic bacteria, viruses, and parasites in the raw meat and poultry, in the blood and viscera spattered on the workers’ skin and clothing, on floors and shared work surfaces, knives, and other utensils, and from domestic pets, rodents, and insects. | | Campi’s Kitchen is alive with activity. Near the top of the painting, demonstrating the artist’s mastery of the technique of perspective, the viewer sees a dining room containing a long table festooned with a white tablecloth and tended by a young girl. Half a dozen colorfully dressed women are busy preparing the food, seemingly using every available surface. An older woman is working on the floor and appears to react negatively to the taste or smell of whatever is covering the bottom of a large pestle. A small child is sitting on a colander, amusing himself by inflating an animal’s stomach. On the upper left periphery, a pair of men are butchering a deer carcass, while across the kitchen, a young man is carefully skewering raw, uncooked game birds on a spit. A cat and dog scrap for entrails plucked from the poultry carcass in the foreground, cooking pans dangle near rows of stacked plates in the upper right, and a small fire smolders in the fireplace near the center.

Water is the most precious and essential natural resource. If unadulterated and at room temperature, it is tasteless, odorless (to humans), and transparent. Water sustains life, reshapes topography, provides passage and conveyance, and delineates and destroys geopolitical boundaries. Water comprises ≈71% of Earth's surface, and the United States Geological Survey estimates that Earth is covered by more than 332,500,000 cubic miles (mi3) of water. Archaeology, history, and anthropology corroborate that most civilizations originated near water. American marine biologist Sylvia Earl offers this perspective: “No water, no life. No blue, no green.” | | Vivid blues and greens interspersed with layers of white splash across this month’s cover art, “Water Prayer I,” one of a series of water-related pieces from the portfolio of artist Patricia Goslee, who lives in Washington, DC, United States. Her abstract work points to the possibility of mutability and transformation in water. A hazy hatch work sweeps across the top of the painting and repeats in the lower right. Green and pale blue spheres of color float above the patterns. Dominating the image, a dense V-shaped amalgamation of speckled shapes—some uniform and others elongated—streaks diagonally across the center of the canvas while a column of undulating forms juts up along the left side.

The generation that endured through what was perhaps the most devastating epidemic ever—the great influenza pandemic of 1918—is now gone. The influenza strain of that pandemic infected about 500 million people, one third of the world’s population, with extraordinarily high pathogenicity and virulence. The result was staggering mortality: an estimated 20 to 100 million lives were lost worldwide. The estimate of deaths of Americans attributable to influenza in that pandemic is 675,000, the majority of which were among those from ages 20 through 40 years. During World War I, the “Great War,” influenza-associated mortality waves occurred in northern Europe, beginning in early summer of 1918 and extending over the course of year; influenza accounted for more fatalities than military engagement. The highest point of combined influenza and pneumonia mortality occurred in October 1918. At the time, the pandemic strain became known as “the Spanish flu,” so called because neutral Spain lacked war censors and was the first country to report on the pandemic publicly; however, the geographic origin of the causative organism remains an enigma.

In 1885, Russian Emperor Alexander III commissioned the first Imperial Easter egg from the House of Fabergé as a gift for his wife, Maria Feodorovna. Upon Alexander’s death in 1894, his son, Emperor Nikolai II, continued this Imperial family tradition, annually requesting one egg for his mother and another for his wife. The skilled artisans who created these treasures worked under the auspices of master craftsman Peter Carl Fabergé, head of the firm that still bears his family name. | | Fabergé operated with creative freedom, and his craftsmen had a treasure chest of riches at their disposal. Diamonds, pearls, sapphires, rubies, gold, guilloché enamel, aquamarine, lapis lazuli, ivory, mother of pearl, and platinum were commonly used embellishments. Each of these unique 50 objets d’art created during 1885–1916 shared a single feature: a concealed surprise. These sequestered miniature wonders include a rotating globe, a replica of Gatchina Palace, a four-leaf clover, a gold watch, Peter the Great’s monument on the Neva River, miniature portraits, a mechanical swan, an 18th century carriage that took 14 months to complete, and a jeweled elephant automaton (rediscovered in 2015 and reunited with its egg in 2017).

In 1577, Peter Paul Rubens was born in Siegen, Germany, to Belgian parents from Antwerp. He lived there until he was 10 years old, when his father died and his mother moved the family back to Antwerp. By age 13, Rubens knew he wanted to be an artist. In 1600, he traveled to Italy where he studied firsthand Renaissance and classical works by masters such as Michelangelo, Bassano, Titian, and Veronese and established his reputation as an artist. He furthered his studies during trips to Spain before returning to Antwerp in 1609. | Those influences, and his penchant for creating large-scale works, are evident in “Hippopotamus and Crocodile Hunt,” this month’s cover art, one of four paintings that Maximilian I, Elector of Bavaria, commissioned Rubens to create for display in the Schleissheim Palace, a summer residence for nobility. This work, as well as its companions that depicted lion, wolf, and boar hunts, was plundered from the palace during the Napoleonic Wars. Although this painting was recovered, the others are believed to have been destroyed.

This month’s cover image,1 Plate 99 from Birds of America (printed in stages during 1827−1838) by American ornithologist, naturalist, and painter John James Audubon (1785–1851), shows a pair of oft-vilified brown-headed cowbirds. This painting appears in the book as one of 435 life-sized watercolors that were reproduced from Audubon’s hand-engraved plates. In this painting, he portrays the birds frozen in act of foraging, a technique he honed from observing birds where they lived. Audubon’s own words best describe the work: “Male with the head and neck sooty-brown, the body black, glossed with green, the fore part of the back with blue. Female considerably smaller, greyish-brown, the lower parts lighter.” | | The genus of this bird, Molothrus ater—as well as the bronze-headed variant Molothrus aeneus—comes from Molothrus, the Greek work meaning vagabond or parasite. Although there are other bird species that prey on the parental skills of their feathered neighbors by laying eggs in their nests, only birds of those two species practice obligate parasitism in North America, placing them among approximately one percent of avian species worldwide.

We investigated an outbreak initially attributed to norovirus; however, Clostridium perfringens toxicoinfection was subsequently confirmed. C. perfringens is an underrecognized but frequently observed cause of foodborne disease outbreaks. This investigation illustrates the importance of considering epidemiologic and laboratory data together when evaluating potential etiologies that might require unique control measures.

During December 2009, over 200 individuals reported gastrointestinal symptoms after dining at a North Carolina restaurant. An outbreak investigation included a case-control study of restaurant patrons, a secondary household transmission study, environmental assessment of the restaurant facilities and operations, and laboratory analysis of stool and food samples. Illness was primarily associated with consumption of steamed oysters (odds ratio 12, 95% confidence interval 4.8-28) and 20% (8/41 households) reported secondary cases, with a secondary attack rate of 14% among the 70 susceptible household contacts. Norovirus RNA was detected in 3/5 stool specimens from ill patrons; sequencing of RT-PCR products from two of these specimens identified identical genogroup II genotype 12 sequences. Final cooked temperatures of the steamed oysters were generally inadequate to inactivate norovirus, ranging from 21 degrees C to 74 degrees C. Undercooked contaminated oysters pose a similar risk for norovirus illness as raw oysters and household contacts are at risk for secondary infection.