Tag: eradicated diseases

Diphtheria in Canada

A lot of people were surprised by the news of a case of diphtheria in Canada this past week.

Some folks were quick to blame the anti-vaccine movement, assuming it was in an unvaccinated child.

News soon came that the child was vaccinated!

“I’ve always been on top of that, I’m a firm believer in immunizations.”

Mother of 10-year-old with diphtheria

What happened next?

Anti-vaccine folks began using the fact that he was vaccinated, but still developed diphtheria, as some kind of proof that vaccines don’t work.

The Case of Diphtheria in Canada

They are wrong.

The diphtheria vaccines have worked very well to control and eliminate diphtheria from Canada, just like it has in the United States.

Diphtheria has become rare since the pre-vaccine era.
Diphtheria has become rare since the pre-vaccine era.

So how did a vaccinated child in Canada get diphtheria?

It’s simple.

He has cutaneous diphtheria, not respiratory diphtheria.

What’s the difference?

“Extensive membrane production and organ damage are caused by local and systemic actions of a potent exotoxin produced by toxigenic strains of C. diphtheriae. A cutaneous form of diphtheria commonly occurs in warmer climates or tropical countries.”

Vaccines Seventh Edition

Cutaneous diphtheria occurs on your skin. It is usually caused by non-toxigenic strains of Corynebacterium diphtheriae.

On the other hand, respiratory diphtheria is usually caused by toxigenic strains of Corynebacterium diphtheriae.

Diphtheria strikes unprotected children.The diphtheria vaccine (the ‘D’ in DTaP and Tdap), a toxoid vaccine, covers toxigenic strains. More specifically, it covers the toxin that is produced by toxigenic strains of Corynebacterium diphtheriae. It is this toxin that produces the pseudomembrane that is characteristic of diphtheria.

It was the formation of this pseudomembrane in a child’s airway that gave diphtheria the nickname of the “strangling angel.”

So why the fuss over this case in Canada? They likely don’t yet know if it is a toxigenic strain. If it is, then it could be a source of respiratory diphtheria.

But remember, even if these kids developed an infection with the toxigenic strain of Corynebacterium diphtheriae, those that are fully vaccinated likely wouldn’t develop respiratory diphtheria. Again, it is the toxin that the bacteria produces that cause the symptoms of diphtheria. The vaccine protects against that toxin.

For example, when an intentionally unvaccinated 6-year-old in Spain was hospitalized with severe diphtheria symptoms a few years ago, although many of his friends also got infected, non of them actually developed symptoms because they were all vaccinated.

Diphtheria Is Still Around

Diphtheria is DeadlyTragically though, especially since diphtheria is still endemic in many countries, we are starting to see occasional lethal cases of diphtheria in many more countries where it was previously under control:

  • at least 7 diphtheria deaths in Venezuela this past year
  • a family that became infected in South Africa in which at least one child died (August 2017)
  • an unvaccinated 3-year-old who died in Belgium (2016)
  • a 22-year-old unvaccinated women who died in Australia (2011)

It is even more tragic that diphtheria is not under control in so many more countries.

In 2016, the WHO reported that there were just over 7,000 cases of diphtheria worldwide. While that is down from the 30,000 cases and 3,000 deaths in 2000, thanks to improved vaccination rates, there is still work to be done.

And as this recent case in Canada shows, diphtheria is still around in many more places than we would like to imagine.

Get educated. Vaccines are necessary.

What to Know About Diphtheria in Canada

The case of cutaneous diphtheria in Canada is a good reminder that vaccines are still necessary.

More on Diphtheria in Canada

What Are the Benefits of Vaccines?

Vaccines are safe, effective, and necessary.

They are neither 100% safe nor 100% effective.

That doesn’t make them any less necessary though.

It’s easy to see why when you look at all of the benefits that vaccines have given us.

Perceptions of Risks vs Benefits of Vaccines

One of the reasons that some parents become vaccine-hesitant is that they forget about the many benefits of vaccine.

That’s not surprising, as the better vaccines work, the less obvious their benefits are to everyone. After all, few people remember what it was like in the pre-vaccine era.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951, as this New York Times article reports.

That makes it easy to for some people to downplay the benefits of vaccines.

Unfortunately, at the same time, some parents might over-estimate the risks of vaccines. And that makes it even easier for them to justify a decision to skip or delay their child’s vaccines.

What Are the Benefits of Vaccines?

For most of us, the greatest benefit of any vaccine is that it keeps us from worrying that our kids will get a vaccine-preventable disease. If they do get sick, we don’t worry that every fever is measles or that every cough is pertussis either.

“It is also much cheaper to prevent a disease than to treat it. In a 2005 study on the economic impact of routine childhood immunization in the United States, researchers estimated that for every dollar spent, the vaccination program saved more than $5 in direct costs and approximately $11 in additional costs to society.”

NIH: National Institute of Allergy and Infectious Diseases

Among the other benefits of available vaccines are that:

The benefits of vaccines become more obvious when folks stop vaccinating.

immunization-program-stages
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

What happens?

Invariably, we start to see outbreaks.

Then they quickly remember why vaccines are necessary, vaccines rates go up, and the outbreaks get under control.

And everyone understands that all of great benefits of vaccines far outweigh any of their small risks. They also begin to hopefully understand that not everyone can attempt to hide in the herd or follow an alternative immunization schedule. That too can simply lead to more outbreaks, as the number of unvaccinated folks increases, at least temporarily.

What to Know About the Benefits of Vaccines

The great benefits of vaccines, which include that they have saved millions of lives, far outweigh any small risks.

More About the Benefits of Vaccines

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The Leicester Method and Smallpox Eradication

Did you know that the Leicester Method helps prove that the small pox vaccine didn’t really help eradicate small pox?

It’s true – well, at least it’s true among “mythical history of vaccination” types.

A Brief History of Smallpox

First developed in the 1870s in Leicester, England to help control smallpox, many people don’t have a good understanding of how it worked, or they wouldn’t use it as an anti-vaccine talking point.

“There is very good reason why the “Leicester Method” is so often quoted by those who are opposed to compulsory vaccinated; for the essential characteristic of the “Method” – that which indeed constitutes its most distinctive feature – is that it professes to suffice for the control of small-pox without resort to universal vaccination, the one measure which is regarded as all-important in most places.”

C. Killick Millard, MD – Medical Officer of Health for Leicester 1904

To understand the Leicester Method, it is important to understand the history of smallpox and smallpox eradication:

  • 2nd millenium BC – earliest evidence of smallpox infections
  • 10th-18th Century – use of variolation
  • 1746 – London Small-Pox and Inoculation Hospital established
  • 1796 – Edward Jenner‘s smallpox vaccine (using cowpox virus)
  • 1840 – 1871 – Vaccination Acts in Great Britain made smallpox vaccination increasingly compulsory
  • 1898 – Vaccination Act of 1898 in Great Britain adds a conscientious objector clause
  • 1967 – Intensified Eradication Program
  • 1977 – last case of wild smallpox
  • 1980 – smallpox declared eradicated

On the way to eradication, some folks fought first inoculation and then smallpox vaccination – the birth of the anti-vaccine movement.

Although the Anti-Vaccination League and Anti-Cumpulsory Vaccination League had been protesting vaccination for years, Leicester had become “a stronghold of anti-vaccination.”

Those anti-vaccine feelings were evident in the Leicester Demonstration March of 1885, which has been described as “one of the most notorious anti-vaccination demonstrations. There, 80,000-100,000 anti-vaccinators led an elaborate march, complete with banners, a child’s coffin, and an effigy of Jenner.”

The Leicester Method and Smallpox

So does the Leicester Demonstration March help prove that folks in Leicester refused to have the vaccine any more?

The Leicester Method never attempted to do entirely without smallpox vaccination.
The Leicester Method never attempted to do entirely without smallpox vaccination. Adapted from Wellcome Library

Did the people in Leicester simply rely on good sanitation and a system of quarantine?

Not exactly.

Originally formulated in 1877, The Leicester Method was modified by Dr. C. Killick Millard, the Medical Officer of Health for Leicester, who tells us that the patients were quarantined in the Leicester Small-pox Hospital, where all of the staff were vaccinated so that they wouldn’t get smallpox!

And most people in Leicester were already vaccinated. That changed in 1883, when it went changed a “well-vaccinated town” to a “Mecca of the anti-vaccinationists” after a new Board of Guardians was elected on an “anti-vaccination ticket.” So even though vaccination dropped after that point, most people in town were already vaccinated and protected against smallpox.

Another thing that people don’t discuss about the Leicester Method? The fatality rate in Leicester in the late 19th century and early 20th century was 1 to 2% for those who were vaccinated. What was it for folks who were unvaccinated? It was 8 to 12%!

Why are both so low? That is because, at the time, it was “the mild type of of small-pox which has prevailed and still prevails in Leicester.” Historically, smallpox had a fatality rate of 30% or higher. But that was for variola major, not variola minor – the mild type of smallpox.

What else do folks leave out about the Leicester Method? That in addition to relying on good sanitation and a system of quarantine, they also “induced” contacts to get vaccinated!

The Vaccination of Contacts part of the Leicester Method is usually left out by anti-vaccination folks.
The Vaccination of Contacts part of the Leicester Method is usually left out by anti-vaccination folks.

The Leicester Method is starting to sound more familiar.

It sounds an awful lot like the ring vaccination method that was ultimately used by the Intensified Smallpox Eradication Program to eradicate smallpox.

Other Myths About Smallpox

Have you heard any of these other myths about smallpox?

  • Getting Edward Jenner’s smallpox vaccine would turn you into a cow.
  • Edward Jenner’s eldest son did not die after his father vaccinated him with his smallpox vaccine – he died of tuberculosis.
  • Smallpox vaccination campaigns caused smallpox outbreaks. They didn’t. The smallpox vaccine doesn’t even contain the smallpox virus – it is made with the vaccinia virus.
  • Smallpox was a mild disease. It wasn’t. As late as 1900, 894 people died of smallpox in the United States. Globally, at least 300 million people died of smallpox during the 20th century.
  • Vaccine experts wanted to reintroduce the smallpox vaccine in 2002 in response to bio-terrorism threats after 9-11. While some did, others, like Dr. Thomas Mack and Dr. Paul Offit, didn’t.
  • Dr. Thomas Mack didn’t think the smallpox vaccine helped eliminate smallpox. He did, stating that “Prophylactic vaccination of contacts is an important containment strategy,” and just didn’t think we needed mass vaccination campaigns.

And of course, there is the myth that the smallpox vaccine didn’t work to eradicate smallpox, which is ridiculous. Vaccines work.

What To Know About the Leicester Method and Smallpox

The Leicester Method of dealing with smallpox does not support the idea that smallpox was eradicated solely with good sanitation and quarantine folks with smallpox. They used vaccines too.

More Information on the Leicester Method and Smallpox

Vaccine Timeline and History of Vaccines

Most people are aware of the big historic dates and events related to vaccines.

For example, they might now when Edward Jenner first tested his smallpox vaccine (1798), when the first polio vaccine was licensed by Jonas Salk (1955), or that we just got a Meningococcal B vaccine (2014).

Smallpox was officially declared to have been eradicated in December 1979.
Smallpox was officially declared to have been eradicated worldwide in December 1979.

But few likely now that we have had rabies vaccines since 1885, a flu vaccine since 1945, or that the last case of wild polio in the United States was in 1979.

“It is hard to fully appreciate how vaccines have revolutionized modern medicine. The long schedule of vaccines may seem like a hassle, and rumors about harmful effects unnerve parents. But, the fact is, vaccines have helped save millions and millions of lives. Just a few generations ago, people lived under the constant threat of deadly infectious diseases, like smallpox, polio, and hepatitis.

Let’s look at the greatest infectious scourges of the past 1,000 years and how vaccines have mitigated or even eradicated the danger.”

Public Health Understanding Vaccines

From historical safety concerns, like the Cutter Incident in 1955 or the withdrawal of the first rotavirus vaccine in 1999, to improvements in vaccine safety and the control, elimination, and eradication of vaccine-preventable diseases, understanding the history of vaccines can help you get educated and understand that vaccines work and that they are safe and necessary.

Early History of Vaccination

In the early history of vaccination we had the the smallpox vaccine and the beginning of the pre-vaccine era – the first vaccines.

  • Lady Mary Wortley Montagu brings variolation to England to prevent smallpox
  • George Washington mandated that every soldier in the Continental Army had to be inoculated against smallpox
  • Edward Jenner conducts experiments in 1796 that led to the creation of the first smallpox vaccine a few years later and replaces variolation as a preventative for smallpox
  • *Dr. Luigi Sacco becomes the Jenner of Italy
  • James Madison, one of the Founding Fathers, signed the Vaccine Act of 1813 – An Act to encourage Vaccination.
  • a vaccine for rabies is developed by Louis Pasteur in 1885
  • vaccines for cholera and typhoid were developed in 1896 and a plague vaccine in 1887
  • the first diphtheria vaccine is developed in about 1913 through the work of Emil Adolf Behring, William Hallock Park, and others
  • the first whole-cell pertussis vaccines is developed in 1914, although it will take several decades before they are more widely used
  • a tetanus vaccine is developed in 1927
  • 12 children die when a multi-use bottle of diphtheria vaccine that didn’t contain a preservative became contaminated with bacteria in the Queensland Disaster in 1928
  • Max Theiler develops the first yellow fever vaccine in 1936
  • the AAP formally approves the use of a pertussis vaccine created by Pearl Kendrick and Grace Eldering in 1943
  • the first flu vaccine is licensed for use in the US in 1945

End of the Pre-Vaccine Era

In the mid-20th century, we started to get vaccines to control diseases that many of us have never seen, like polio, measles, and rubella.

  • the individual diphtheria, tetanus, and pertussis vaccines become combined in a single DTP vaccine in 1948
  • the last smallpox outbreak in the United States kills one person, Lillian Barber, in the Rio Grande Valley of South Texas in 1949
  • the Salk inactivated polio vaccine (IPV) is introduced in 1955
  • President Dwight D Eisenhower signed the Polio Vaccination Assistance Act in 1955, which gave $30 million in federal grants to states to cover the costs of planning and conducting polio vaccination programs, including purchasing polio vaccine
  • about 200 children develop polio in 1955 from contaminated polio vaccines in what becomes known as the Cutter Incident
  • the live, oral Sabin polio vaccine (OPV) replaces the Salk polio vaccine in 1962
  • President John F Kennedy signed the Vaccination Assistance Act in 1962 (Section 317 of the Public Health Service Act), which started as a three year program to help get kids vaccinated against polio, diphtheria, tetanus, and pertussis, but it has been continuously reauthorized ever since
  • the first live measles vaccine was licensed in 1963 but was replaced with a further attenuated measles virus that caused fewer side effects in 1968
  • President Lyndon B Johnson established a legacy of US leadership in global immunization by funding the CDC Smallpox Eradication program in 1965
  • the MMR vaccine becomes available in 1971, combined the vaccines for measles, mumps (licensed in 1967), and rubella (1969), and was routinely given when toddlers were about 15 months old
  • routine vaccination with smallpox vaccines end in the US in 1972

The Vaccination Era

The end of the 20th century brought more vaccines and protection against even more now vaccine preventable diseases.

  • Pneumovax, the first pneumococcal vaccine that protects kids and adults from certain types of Streptococcus pneumoniae bacteria is approved in 1971 and is given to high-risk kids
  • President Jimmy Carter’s  National Childhood Immunization Initiative in 1977 reached its goal of immunizing 90% of children
  • the Thirty-Third World Health Assembly declares that smallpox is eradicated in 1979
  • Menomune, the first meningococcal vaccine is licensed in 1981 and is recommended for high-risk kids until it is later replaced by Menactra
  • a plasma-derived hepatitis B vaccine is licensed in 1981
  • Vaccine Roulette, a controversial news segment, airs in 1982 and attempts to associate the DPT vaccine with permanent brain damage, downplays the risks of pertussis disease and helps start much of the modern American anti-vaccine movement
  • a Haemophilus b capsular polysaccharide vaccine is licensed in 1985, but unfortunately does not provide good protection in kids younger than 18 to 24 months, who are most at risk for Haemophilus influenzae Type b disease
  • a recombinant hepatitis B vaccine (Recombivax HB) is approved in 1986 but is only recommended to be used in those at high risk for infection
  • another hepatitis B vaccine, Engerix-B, is approved in 1989
  • the first Haemophilus b conjugate vaccine (PRP-D) is approved in 1988 to provide protection against Haemophilus influenzae type b disease in all kids at least 18 months old, but in 1990, they are replaced with two improved Hib conjugate vaccines (PRP-HbOC and PRP-OMP) that can be given to infants as young as two months old
  • a booster dose of MMR is first recommended in 1989, but only for kids who live in counties that have at least 5 cases of measles. The routine 2 dose MMR schedule wasn’t put into use for all kids until 1994.
  • the Vaccine Adverse Events Reporting System (VAERS) is established in 1990
  • the hepatitis B and Hib vaccines are recommended for all infants in 1991
  • after year’s of neglect under President Reagan, President George HW Bush’s immunization action plan in 1991 once again raised immunization rates following three years of measles outbreaks
  • the DTaP vaccine, which is supposed to have fewer side effects than DTP is licensed, and by 1997 replaces DTP for all required doses, although DTP is never actually shown to have caused seizures or brain damage, as was once claimed in Vaccine Roulette
  • President Bill Clinton’s Childhood Immunization Initiative in 1993 includes signing the Vaccines for Children (VFC) Act, providing free vaccines to many children
  • the WHO declares that polio has been eliminated from the Western Hemisphere in 1994
  • a vaccine to protect kids against chicken pox (Varivax) is licensed in 1995
  • VAQTA, the first hepatitis A vaccine is approved by the FDA in 1996 for kids who are at least two years old, but is mainly given to kids at high risk to get hepatitis A
  • the Salk inactivated polio vaccine (IPV) is once again recommended for kids and replaces the oral polio vaccine (OPV) in 1996 because of a small risk of vaccine-associated paralytic poliomyelitis (VAPP), beginning with a sequential IPV-OPV vaccine schedule and then going to an all IPV schedule in 2000
  • RotaShield, the first rotavirus vaccine is licensed in 1998 but is soon withdrawn from the market in 1999 after it is associated with an increased risk of intussusception, a form of bowel obstruction
  • LYMErix, a Lyme disease vaccine, is licensed in 1998
  • Dr. Andrew Wakefield publishes a report in the journal Lancet and attempts to link the MMR vaccine to autism
  • thimerosal is removed from the vast majority of vaccines in the childhood immunization schedule in 1999 and 2000
  • endemic measles is declared eliminated in the United States in 2000
  • Prevnar, a newer pneumococcal vaccine is licensed in 2000 and is added to the immunization schedule the next year
  • LYMErix goes off the market because of insufficient sales in 2002
  • Flumist, a live, intranasal flu vaccine, is approved in 2004
  • endemic rubella is declared eliminated in the United States in 2004
  • a flu shot for all healthy children between 6 and 23 months became a formal recommendation for the 2004-05 flu season.
  • beginning in the 2004-05 flu season, a flu shot is recommended for women who will be pregnant during flu season, in any trimester, which is different than previous recommendations for a flu vaccine if a women was going to be beyond the first trimester of pregnancy during flu season. Unfortunately, even though they are in a high-risk category, only about only 13% of pregnant women received a flu vaccine in 2003.
  • Havrix, another hepatitis A vaccine, is approved in 2005 and the age indication for both hepatitis A vaccines is lowered to 12 months.
  • Menactra, a vaccine to protect against certain types of meningococcal disease is licensed in 2005 and is added to the immunization schedule in 2006, being recommended for all at 11 to 12 years of age or when they enter high school
  • the Tdap vaccine (Boostrix or Adacel) is recommended for teens and adults to protect them from pertussis in 2006 and replaces the previous Td vaccine that only worked against tetanus and diphtheria
  • RotaTeq, another rotavirus vaccine, is licensed in 2006, and is added to the immunization schedule in 2007
  • the hepatitis A vaccine is added to the routine childhood immunization schedule in 2006
  • Gardasil, the first HPV vaccine, is approved in 2006
  • a shingles vaccine, Zostavax, is approved for adults in 2006
  • a 2nd booster dose of the chicken pox vaccine is added to the immunization schedule in 2007 to help prevent breakthrough infections

The Post Vaccination Era

Why call it the post-vaccination era?

It has been some time since a vaccine for a new disease has been added to the routine vaccination schedule, but we are also starting to see more and more outbreaks of old diseases, especially pertussis, mumps, and measles.

  • another rotavirus vaccine, RotaRix, is approved in 2008
  • another HPV vaccine, Cervarix, is approved in 2009
  • another meningococcal vaccine, Menveo, is approved in 2010
  • a newer version of Prevnar, which can provide coverage against 13 strains of the pneumococcal bacteria, is approved and replaces the older version (Prevnar 7) in 2010
  • Fluzone Intradermal and Fluzone High-Dose are two new flu vaccine options that became available in 2011
  • a combination vaccine that protects against both Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y was approved by the FDA in 2013. MenHibrix is recommended for infants at high risk for meningococcal disease.
  • Quadrivalent flu vaccines, which protect against four strains of flu, become available for the 2013-14 flu season
  • Trumenba, the first vaccine to protect against serogroup B Meningococcal disease is approved by the FDA (October 2014). Previously, Bexsero, a MenB vaccine that is approved in some other countries, was given to some college students during outbreaks under the FDA’s expanded access program for investigational products. Both are now recommended by the ACIP for those at increased risk for meningococcal serogroup B infections.
  • Gardasil 9 is approved by the FDA (December 2014) to provide protection against five additional types of HPV.
  • Cervarix is discontinued in the US in 2016 because of poor sales
  • Vaxchora is approved to in 2016 for adults traveling to cholera-affected areas

More Information About Vaccine Timelines

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Are Immigrants and Refugees Spreading Disease in the United States?

Neither the tired, poor, huddled masses yearning to breathe free, the wretched refuse of your teeming shore, nor the homeless, tempest-tossed, are not spreading diseases on our shores or anywhere else.
Neither the tired, poor, huddled masses yearning to breathe free, the wretched refuse of your teeming shore, nor the homeless, tempest-tossed, are not spreading diseases on our shores or anywhere else. (Photo by Vincent Iannelli, MD)

Why do some folks think that immigrants and refugees are spreading disease in the United States?

It certainly doesn’t help that Lou Dobbs once pushed the false idea that “illegal aliens” were fueling outbreaks of disease in the United States:

“The invasion of illegal aliens is threatening the health of many Americans. Highly-contagious diseases are now crossing our borders decades after those diseases had been eradicated in this country.”

Lou Dobbs Tonight

He warned, on his show in 2005, that “there are rising fears that once eradicated diseases are now returning to this country through our open borders. Those diseases are threatening the health of nearly every American as well as illegal aliens themselves.”

The once “eradicated diseases” he was talking about was leprosy. Of course though, he was wrong – leprosy has never been eradicated and it has not been increasing. Since 1985, there have been about 100 to 300 cases a year in the United States – no where near the “7,000 in the past three years” that Dobbs reported.

Immigrant Disease Spreading Propaganda Blitz

More recently, “as the taxpayer funded refugee resettlement industry launches a propaganda blitz about the so-called World Refugee Day” in 2016, Breitbart News reported that “six diseases that were recently near eradication are making a comeback in the United States.”

Of these six diseases, three – measles, mumps, and whooping cough – are vaccine-preventable and have very little to do with immigrants or refugees. Often, they have to do with unvaccinated United States citizens traveling out of the country, getting sick, and coming home to start an outbreak.

There was an outbreak of measles among a Somali community in Hennepin County, Minnesota in 2011, involving 14, mostly unvaccinated people. But they were unvaccinated because the anti-vaccine crowd (Wakefield) scared them away from being vaccinated over fears of autism, not because they were recent refugees.

Another Breitbart disease, scarlet fever, is simply the rash that you get when you have a strep infection, like strep throat. It is very common in kids and the incidence hasn’t changed over the years in the United States. For an unknown reason, the UK is seeing higher rates of scarlet fever though.

The last two Breitbart News warns about are bubonic plague and tuberculosis.

While there were 16 cases of plague in the United States in 2015, that is not unusual. The CDC reports that “in recent decades, an average of seven human plague cases have been reported each year (range: 1–17 cases per year).”

“The bacteria that cause plague, Yersinia pestis, maintain their existence in a cycle involving rodents and their fleas.”

CDC – Plague ecology in the United States

Anyway, you get bubonic plague from infected fleas and flea bites, not other sick people. You can get pneumonic plague from a sick person, but that hasn’t happened in the United States since 1924.

What about tuberculosis? That must be increasing because of new immigrants and refugees, right?

Nope. After years and years of decreasing, the number of cases and incidence rate has leveled off at its lowest level, about 9,500 cases since 2013. That’s compared to just over 14,000 cases in 2005. While that’s not to say that more work has to be done in working to eliminate tuberculosis, it is not making any kind of comeback.

Other Breitbart articles warned that “Syrian Refugees Spreading Flesh-Eating Disease, Polio, Measles, Tuberculosis, Hepatitis” and “EXCLUSIVE – Syrian Refugees Bringing Flesh-Eating Disease into U.S.?”

The “Flesh-Eating Disease” Breitbart is talking about isn’t the flesh-eating bacteria. It is a parasite that isn’t even spread from person to person. It is spread by sand fleas.

And rates of tuberculosis are actually lower in Syria than in most of Europe.

“In spite of the common perception of an association between migration and the importation of infectious diseases, there is no systematic association.”

World Health Organization

Tragically, while there have been some outbreaks of measles, polio, and other diseases in Syria, refugees are not spreading these diseases to Europe or the United States.

Of course, Breitbart isn’t the only  one participating in the immigrant disease spreading propaganda blitz these days.

“Likewise, tremendous infectious disease is pouring across the border. The United States has become a dumping ground for Mexico and, in fact, for many other parts of the world.”

Donald Trump (2015)

From politicians spreading misleading information about “tremendous infectious disease” to everyone else spamming each other with tales of immigrants spreading everything from Ebola and EV-D68 to worms, the net result is folks being scared of immigrants and refugees for no good reason.

Mychal Massie, in an Invasion USA report for WND recently wrote about a briefing given to the Arizona State Senate warning about a “Medical Ticking Time Bomb” warning that “illegals” were bringing scurvy, pernicious lice, and worms, etc. into the US.

Now unless immigrants are stealing all of our vitamin C, I don’t think that we have to worry that we will start see epidemics of scurvy any time soon.

We might have to worry about even larger outbreaks of measles and other vaccine-preventable diseases, but it won’t be immigrants or refugees causing them. It will be because more folks are skipping out on getting vaccinated and protected.

For More Information on Immigrants and Refugees

Eradicated Diseases

Once a vaccine-preventable disease is eradicated, the worldwide incidence of the disease is reduced to zero so that intervention, including immunizations, are no longer needed.

Eradicated Diseases

Only one vaccine-preventable disease has actually been declared eradicated in the world – smallpox in 1979.

Rinderpest was also eradicated with vaccines, but unlike smallpox,  rinderpest was a disease of livestock.

The second vaccine-preventable disease to be eradicated will likely be polio.

Guinea worm disease may be eradicated first, but not with the help of vaccines.

Eliminated Diseases

Many more vaccine-preventable diseases have been eliminated, especially in developed countries.

Similar to eradication, when a disease is eliminated, the incidence of disease is reduced to zero, but only in a particular geographic area. Unlike eradication, since the disease is still around in other areas, people must continue to get vaccinated so that the disease doesn’t come back in that area.

To be more clear, when an epidemiologist says that a disease is eliminated in an area, what they are really saying is that the endemic form of the disease has been eliminated – someone has to reintroduce the disease from outside the area for outbreaks to occur. So you can still have cases and even big outbreaks, like we continue to see with measles in the United States, however, they always start with someone who initially got infected from outside the country.

In the United States, endemic yellow fever, polio, measles, rubella and respiratory diphtheria have all been eliminated. So have neonatal tetanus and congenital rubella syndrome:

  • endemic yellow fever (1905), spread by mosquito bites, was the first diseases to be eliminated
  • endemic polio was declared eliminated in 1979
  • endemic measles was declared eliminated in 2000
  • neonatal tetanus was declared eliminated before 2000
  • endemic rubella and congenital rubella syndrome were declared eliminated in 2004
  • endemic respiratory diphtheria was declared eliminated in 2009 and the last big outbreak was in the 1970s

Again, even though these diseases have been eliminated in the United States, that doesn’t mean that you can’t get them anymore. If you are not vaccinated or have a problem with your immune system and travel to an area of the world where these diseases are still common, you are at risk to get sick and bring that disease home with you, infecting others.

Disease Control

Unfortunately, not all diseases can be eliminated and eradicated.

This may have nothing to do with how well a vaccine works or whether or not people get their kids vaccinated though.

In some cases, an infection might not be contagious and is simply found in the environment, like Ascariasis (roundworms) or tetanus. To eradicate tetanus, we would have to get rid of the tetanus bacteria at its source – soil!

Other reasons that a disease might not be able to be easily eliminated or eradicated could include that:

  • it can also infect animals – rabies, yellow fever, Chagas’ disease
  • the disease causes infections without symptoms – Amebiasis
  • the presence of asymptomatic carriers – diphtheria
  • natural infection doesn’t provide life-long immunity – malaria
  • the disease doesn’t always have obvious symptoms – polio
  • people are contagious before they have obvious symptoms – measles

Hopefully these challenges will soon be overcome for more diseases though, especially vaccine-preventable diseases like polio and measles.

Goals for Global Elimination and Eradication of Diseases

Tragically, we have a long history of not meeting our goals for disease elimination and eradication.

Still, a lot of progress has been made over the years, millions of lives have been saved, and many more deaths will be prevented if we meet our current goals to eradicate or eliminate these diseases:

  • polio – since the initial war on polio was started by President Franklin D Roosevelt in 1938 and the development of the first polio vaccines in the 1950s to the creation of The Global Polio Eradication Initiative in 1988, eradicating polio has been a priority for health experts. Unfortunately, we missed the first goal of eradicating polio by 2000, but are certainly getting close, as only three countries still have endemic polio – Afghanistan, Nigeria and Pakistan – and worldwide cases are at all time lows. The new goal is to have a polio-free world by 2018!
  • measles – We have missed a lot of the goals on the way to eradicating measles, including the goal to eliminate measles in the United States by 1982 (wasn’t met until 2000), the goal of global eradication of measles by 2010 which was first set in 1996, and the goal of reducing global measles mortality by 90% by 2010 over 2000 levels (there was a 74% decrease though!). We will hopefully meet the latest goals of the Global Measles and Rubella Strategic Plan 2012-2020.
  • maternal and neonatal tetanus – while many people associate tetanus with stepping on a rusty nail, tetanus can also affect mothers and their newborn babies, especially when hygienic practices aren’t available when the baby is delivered or when they care for the baby’s umbilical cord. Although the target dates have been postponed from the initial goals of 1995, 2000, 2005 and 2015, eliminating maternal and neonatal tetanus is still a goal. Considering that at least 34,000 newborns died of neonatal tetanus as late as 2015, which is down from 787,000 in 1988, significant progress continues to be made by the Maternal and Neonatal Tetanus Elimination partnership.
  • Guinea worm disease – although not usually life-threatening, Guinea worm disease is still a serious disease that causes suffering for those who become infected with the Guinea worm larvae that can grow to become adults that are 2 to 3 feet long. Fortunately, Guinea worm disease should be the next disease that is eradicated, with cases at an all time low thanks to the efforts of The Carter Center.
  • lymphatic filariasis (Elephantiasis) – transmitted by infected mosquitoes, lymphatic filariasis is another disabling condition that has been targeted for elimination using insecticidal bed nets and drugs donated by Merck and GlaxoSmithKline, hopefully by 2020.
  • taeniasis/cysticercosis (tapeworms) – eating undercooked pork that is infected with larval cysts of the tapeworm Taenia solium can cause intestinal tapeworms (taeniasis). Swallowing the eggs of these intestinal tapeworms (located in an infected persons feces) can lead to getting cysticercosis, in which the larval cysts can infect brain (neurocysticercosis) and muscle tissue, etc. Although thought to be potentially eradicable, cysticercosis is considered to be of several major neglected tropical diseases.
  • mumps – a vaccine-preventable disease that is thought to be potentially eradicable.
  • leprosy – using expanded multi-drug therapy regimens, leprosy is now in the final push phase of elimination.
  • river blindness (onchocerciasis) – a parasitic infection that is spread through the bite of small black flies, river blindness is targeted for eliminated in select regions using a drug donated by Merck.
  • trachoma – another eye infection that is spread by flies and which can lead to blindness, blinding trachoma is targeted for global elimination by 2020. In addition to health education and corrective eye surgeries, the effort has been aided by Pfizer donating an antibiotic to fight trachoma.
  • rubella – rubella is also also targeted for elimination from at least five WHO regions by 2020.

Unfortunately, even as we make progress to control, eliminate, and eradicate these diseases, some are beginning to make a comeback.

And no, it is not just because of parents choosing to intentionally not vaccinate their children. In many parts of the world, in addition to the humanitarian crisis and health challenges posed by natural disasters, children are getting sick in war zones and refugee camps and simply can’t be vaccinated.

What to Know about Eradicated Diseases

Vaccines work well and have helped control, eliminate, and in the case of smallpox, eradicate diseases.

More on Eradicated Diseases