For those of you who track these things, this past week is World Immunization Week, an annual awareness campaign for immunizations worldwide sponsored by the World Health Organization. As part of of their efforts to increase awareness of the need to vaccinate worldwide, they put together an online question and answer session last week in an attempt to debunk some of the myths surrounding vaccinations. In other words, some of the greatest minds in worldwide healthcare issues, including infectious diseases and vaccinations, answered and debunked some of the craziest myths about vaccines across the world.
The Centers for Disease Control and Prevention, commonly known as the CDC, this week published Progress in Global Measles Control, 2001-2010. In 1980, there were over 2.6 million deaths worldwide from the measles virus. Though measles is considered by many people as innocuous, it is, in fact, a relatively dangerous infection with a variable prognosis. For vast majority of sufferers, there are few complications, but for some, even healthy individuals, it can be debilitating or even fatal. Notwithstanding, I have always wondered why the anti-vaccination gang is willing to risk the possible death of their children by refusing to inoculate them, in light of very few risks or side effects of the vaccination itself. I digress.
The number of measles cases dropped to around 340,000 in 2010, a nearly 66% decline from 2001.
(more…) «Worldwide progress in measles control–vaccines…»
- Immunization prevents an estimated 2.5 million deaths every year. Immunization prevents deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles. It is one of the most successful and cost-effective public health interventions.
- More children than ever are being reached with immunization. In 2010, an estimated 109 million children under the age of one were vaccinated with three doses of diphtheria-tetanus-pertussis (DTP3) vaccine. These children are protected against infectious diseases that can have serious consequences like illness, disability or death.
- An estimated 19.3 million children under the age of one did not receive DTP3 vaccine. Seventy percent of these children live in ten countries, and more than half of them live in WHO’s Africa and South-East Asia regions.
- Over 1 million infants and young children die every year from pneumococcal disease and rotavirus diarrhea. A large number of these deaths can be prevented through vaccination.
- Public-private partnerships facilitate the development and introduction of vaccines. For example, a new vaccine which prevents the primary cause of epidemic meningitis in sub-Saharan Africa, meningococcal A, MenAfriVac, was introduced in Burkina Faso, Mali and Niger last year. At the end of 2011. Cameroon, Chad and Nigeria are vaccinating more than 22 million individuals with the vaccine which has the potential to eliminate the leading cause of meningitis epidemics in Africa.
- The supply of influenza vaccines has been significantly expanded. The expansion has been possible as a result of WHO supporting the efforts of vaccine manufacturers to produce and license influenza vaccines in 11 developing countries.
- Global measles mortality has declined by 78%. Global measles mortality has been reduced from an estimated 733 000 deaths in 2000 to 164 000 deaths in 2008, thanks to intensified vaccination campaigns.
- Polio incidence has been reduced by 99%. Since 1988, polio incidence has fallen by 99%, from more than 350 000 cases to 1410 cases in 2010. Only four countries remain endemic – Afghanistan, India, Nigeria and Pakistan – down from more than 125 countries in 1988.
- Annual deaths from neonatal tetanus have fallen. Neonatal tetanus deaths have declined to an estimated 59 000, down from 790 000 deaths in 1988.
- Immunization provides an opportunity to deliver other life-saving measures. Immunization not only protects children from vaccine-preventable diseases. It also serves as an opportunity to deliver other life-saving measures, such as vitamin A supplements to prevent malnutrition, insecticide-treated nets for protection against malaria and deworming medicine for intestinal worms. In addition, the benefits of immunization are increasingly being extended across the life course to include adolescents and adults, providing protection against life-threatening diseases such as influenza, meningitis, and cancers that occur in adulthood.
Has there been a more successful human medical effort in the history of man? No.
Along with HIV and malaria, tuberculosis (TB) is one of the most dangerous diseases in the world. According to the World Health Organization, there were 8.8 million new worldwide cases of TB, along with 1.4 million deaths in 2010. TB is difficult to treat, usually taking over six months with antibiotics that sometimes have difficult side effects.
Also, because of low patient compliance, misdiagnosis, and other issues, multi-drug resistant (MDR) and extensively drug-resistant (XDR) versions of TB can arise in a population. MDR is resistant to the first-choice drugs, requiring treatment with a larger cocktail of one or more of the nine different “second-line” antibiotics, which are less effective, have more adverse effects, and can take much longer to effect a cure, up to 2 years or more. XDR TB is resistant to the three first-line drugs and several of the nine antibiotics usually considered as second line choices.
As the article states:
The vast majority of these unfortunate patients seek care from private physicians in a desperate attempt to find a cure for their tuberculosis. This sector of private-sector physicians in India is among the largest in the world and these physicians are unregulated both in terms of prescribing practice and qualifications. A study that we conducted in Mumbai showed that only 5 of 106 private practitioners practicing in a crowded area called Dharavi could prescribe a correct prescription for a hypothetical patient with MDR tuberculosis. The majority of prescriptions were inappropriate and would only have served to further amplify resistance, converting MDR tuberculosis to XDR tuberculosis and TDR tuberculosis.
The spread of this disease could be quicker than some other infectious disease (like HIV), because of how easily it’s spread (one patient can infect up to 15 others before diagnosis and treatment), and, of course, the lack of viable antibiotics for XDR TB.
Right now, the infection seems to be in a small subgroup of TB patients in India (and Iran) in a border region that has poor medical care. However, given the lack of effective antibiotics means that we’re all in this together.
The interesting fact about the title of the article–the authors seem to have invented a new subset of TB, Totally Drug Resistant.