Tentex Royal


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THE RETURN OF INFECTIOUS DISEASE: WHY IS THERE A REVIVAL IN INFECTIOUS DISEASE?
While medical science is traditionally applauded for having brought about the elimination of infectious disease, the role played by medical measures in the improvement of health is less clear than it once seemed. Although it is true that infectious disease had been virtually eliminated in Western countries by the middle of the twentieth century, we are presently faced, with the revival of tuberculosis, whooping cough and other infectious maladies, the explanation of which in conventional terms is decidedly inadequate.
The basic assumption has been that immunisation and medical therapy have led to the extirpation and continued control of infectious disease. If immunisation and therapy are the key factors to infections disease control, why then are these diseases reoccurring despite systematic programs of immunisation?
The answer lies in the recognition that the decline of infectious disease in the late nineteenth century and the first half of the twentieth century was due neither to immunisation programs nor medical therapies. Indeed, by the time the origins of infectious disease were sufficiently well understood in order to enable vaccines to be developed and administered properly, many infectious diseases had already been robbed of their virility.
In his apparently much ignored or neglected presidential address in 1971 to the British Association for the Advancement of Science, Dr R. R. Porter reported that between I860 and 1965, almost 90 per cent of the total decline in infant mortality among children up to fifteen suffering from infectious diseases, including diphtheria and whooping cough, had occurred prior to the introduction of either the immunisation programs or antibiotics relevant to the eradication and control of these diseases. It was in 1938 that sulphonamides became available for the treatment of whooping cough, by which time the incidence of the disease had already dropped markedly. Equally interesting is the fact that although the sulphonamides and antibiotics were hailed by many doctors as vital for the prevention and control of this disease, the effect of treatment by these drugs on the course of the disease in statistical terms is highly questionable.
The virulence of tuberculosis had also markedly declined prior to the introduction of antibiotics. Non-respiratory tuberculosis, a significant cause of death in the nineteenth century, is a case in point. Although Streptomycin was regarded as the first effective measure against the disease, it is clear that the level of incidence of this form of tuberculosis was already low when the drug made its way onto the market in 1947. The same pattern of reduced virulence prior to the introduction of relevant antibiotics and immunisation can be observed for the majority of other infectious diseases, including typhoid, whooping cough, measles, scarlet fever and diphtheria.
Once we appreciate that medical measures such as immunisation programs and the administration of antibiotics have not necessarily been the key factors in the prevention and control of infectious diseases, it is easier to see why they are reoccurring and that the way to control them is not to reinstitute measures whose effectiveness hindsight has now shown to be questionable. Although it is unlikely that any single factor can be identified which explains the decline in infectious disease by the beginning of this century, and its revival as we approach the end of it, there is considerable evidence to show that the rise and fall in the incidence of infectious diseases has more to do with environmental and social factors, including adequate nutrition, than anything else.
The major conditions which provide the context for the spread of infectious disease are poor hygiene, overcrowding, insufficient or inadequate food supplies, and poor sanitation, conditions which only a few decades ago were better in many ways for many people in Western countries than they are today. The once crystal-clear waters of our Australian beaches, especially those located near large cities, all too often carry the stench of the wastes they contain. When we swim or bathe in polluted seas, lakes or rivers, we expose ourselves to the very conditions and worse which led to a degradation of health for our ancestors a century or so ago.
Men’s HealthIn the United States, cities have witnessed the deterioration of the superb living standards which once characterised them. Overpopulation has led to overcrowding; overcrowding has led to intolerable sanitary conditions and unemployment has led to an army of homeless persons, predominantly male, who experience these conditions in the extreme. Those of the homeless who are infected with tuberculosis spread the disease as they move from place to place. They often seek shelter in places unfit for human life and optimally suited to the spread of infectious disease. Some well-intentioned makeshift hostels for the homeless provide hundreds of beds for them, all under the same roof and in the same room or hall. Is it any wonder that the disease is spreading at an exponential rate?
The rising incidence of AIDS only complicates the problem. Given the weakened immune systems of AIDS sufferers, they readily become carriers of the tuberculosis virus. Since many AIDS sufferers come from upper socioeconomic backgrounds and mix with people from those same backgrounds, the tuberculosis epidemic will not be confined to the poor. From possible exposure in the crowded streets in our cities, to our airports, trains, subways and buses, from our crowded cafes, restaurants, entertainment centres, arenas, gyms and sporting grounds, to our schools, universities, clubs and churches, we become vulnerable — whatever our social status — to the highly infectious tuberculosis virus.
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