9 infections tamed by vaccines
Today the need for vaccination is the subject of heated debate in society. Opponents of immunization usually cite the fact that vaccines can cause severe allergic reactions. Such cases do happen. However, it makes sense to pay attention to the main positive effect that preventive vaccinations provide: they not only protect a particular person from dangerous diseases and their complications, but also sharply reduce the likelihood of widespread infection.
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It is difficult for a modern person to imagine that in the 19th century infectious diseases were the main cause of death in the world. It is thanks to immunization that the terrible epidemics that affected entire regions have become a thing of the past. Today we will remind you of the diseases that we managed to defeat thanks to the mass vaccination of the population.
Smallpox
The name "vaccine" (from Latin vacca - cow) was given to the drug containing the pathogen of cowpox, which poses no threat to human life. It was with the help of such a substance that the English physician Edward Jenner proved in 1796 that the introduction of a weakened pathogen into the body subsequently protects against infection with real smallpox, a serious disease that was widespread at that time, annually claiming hundreds of thousands of lives and the same amount of mutilation.
In the early 19th century, compulsory smallpox vaccination was introduced in Great Britain and several other European countries. In Russia, since 1815, a special committee functioned, one of the tasks of which was to keep track of children who had not received the vaccine. As a result, the annual smallpox epidemics in Europe subsided, but they continued to rage in Africa, Asia and America. After an outbreak of the disease in 1967 killed more than 2 million people, the World Health Organization (WHO) introduced mass vaccination against smallpox, and the incidence worldwide began to decline. Smallpox is now considered extinct: since 1978, not a single case of the disease has been recorded in the world.
Polio
The causative agent of poliomyelitis affects the nervous system, causing paralysis. As a rule, children under the age of 5 fall ill (of whom about 10% die). Among adults and adolescents, mortality from the disease is about 30%. By the middle of the 20th century, more than 350 thousand people were infected with polio every year.
The problem was not only the widespread spread of the infection, but also the fact that polio was virtually untreatable. In 1988, the Global Polio Eradication Initiative (GPEI) was established. The results of mass vaccination of children turned out to be very impressive: out of 125 countries whose inhabitants suffered from the disease, only 2 remained by 2015. Today, cases of poliomyelitis are recorded mainly in Afghanistan and Pakistan. However, experts do not consider the disease completely defeated: as long as there are people who do not have strong immunity to polio, the risk of an epidemic remains real. This is why most countries continue to implement vaccination programs for all newborns.
Mumps (mumps)
The viral nature of mumps was proven in 1934. In the pre-vaccination era, up to 6% of the world's population was infected with this disease every year (mainly children aged 3 to 15 years). Despite the fact that the mortality rate from mumps is quite low, the disease is considered dangerous because of the complications it causes. Mumps in childhood can cause infertility (especially in men), unilateral hearing loss, pancreatitis and some other pathologies.
The drug that protects against mumps, rubella and measles was invented in 1963. Since the introduction of mass vaccination, the incidence of mumps has decreased by almost 99%. In most countries of the world, by 2014, from 100 to 1000 cases of infection were recorded per 100 thousand population. For Russia, this figure is much less: only 2 cases per 1 million people.
Measles
Measles vaccination became widespread only in 1980. Before that, the disease was called the childhood plague: more than 2.5 million people died from it every year. The massive vaccination campaign has resulted in measles deaths falling by almost 75%. In 2014, there were 114,900 deaths worldwide.
Nonetheless, the likelihood of measles outbreaks remains a concern in many developed countries. Experts believe that the danger of epidemics arises when vaccination coverage of the population falls below 85%. Most of the sick are not vaccinated.
Rubella
In children, rubella is carried as a minor malaise. In adults, the disease is more severe, but deaths from it are not known. The danger lies elsewhere: women infected with rubella in the early stages of pregnancy risk losing a fetus in 15% of cases. In addition, 9 out of 10 babies born to infected mothers are born with congenital rubella syndrome, which is characterized by severe damage to the cardiovascular system, organs of vision and hearing, and sometimes mental retardation.
In the middle of the 20th century, the spread of rubella in some countries took on the character of an epidemic. After mass vaccination, the incidence has decreased hundreds of times. The countries of the Americas have been designated a rubella-free zone by WHO since 2015.
Tetanus
Before the use of the tetanus vaccine (in the middle of the 20th century), the risk of infection existed for any person: the causative agent of tetanus lives in soil and water almost everywhere and can enter the bloodstream with a slight violation of the skin. The disease is extremely dangerous: the probability of death, even with treatment, is about 40%. For newborns, who today account for the bulk of the infected, this risk is even higher - about 80%.
After the start of large-scale vaccinations, tetanus has practically disappeared in developed countries. A very important fact was noted: babies born to mothers who received a double or triple vaccination did not get sick when the pathogen got into the blood. Now in Russia, 30-35 cases of tetanus infection are registered annually, and the majority of those infected are the older age group that has not been vaccinated.
Whooping cough
Whooping cough is most dangerous for children under 5 years of age. In babies under one year old, the mortality rate from this disease is 4%. The disease often causes the development of bronchopneumonia (in 10% of cases), and in newborns it can be complicated by emphysema, cerebrovascular accident and the addition of a severe secondary infection.
Before the mass vaccinations organized in developed countries in the 1950s – 1960s, the incidence of pertussis in children was almost universal. Now outbreaks of the disease are observed periodically, with peaks every 4-5 years. According to WHO estimates, in 2008, when more than 80% of children in the world were vaccinated twice, about 700 thousand people escaped death from whooping cough. In recent years, the coverage of the population with pertussis vaccinations has decreased. In some countries, it fell to 30% and there was a risk of the incidence returning to the pre-vaccination level.
Diphtheria
Bacillus Leffler, the causative agent of diphtheria, secretes an active toxin that affects the cardiovascular, nervous and excretory systems. The disease is accompanied by edema of the upper respiratory tract, and often there is a mechanical blockage of dense fibrin films. Before the invention of diphtheria toxoid, more than half of the patients died from the disease itself and its complications.
Despite the fact that the first attempts to vaccinate against diphtheria were carried out at the end of the 19th century, a massive vaccination campaign was initiated by WHO only in 1974. Since then, the incidence of this disease has dropped by almost 90%. Subsequently, it turned out that childhood vaccination does not provide lifelong protection against diphtheria, as immunity to it fades over time. Ignorance of this feature caused a serious epidemic that struck European countries in 1994-1995. In 1994 Russia began to implement a new mass vaccination program, which includes re-immunization of adults. As a result, the incidence of diphtheria in our country has greatly decreased: since 2011, no more than 1 case per 10 million population has been recorded annually.
Hepatitis A (Botkin's disease)
The hepatitis A virus affects the liver and bile ducts. In a fulminant form, which is more common in older people, the disease causes the development of acute liver failure, from which up to a third of those infected die. In patients who have not reached advanced years, hepatitis A often lasts for a long time, periodically exacerbating (chronic recurrent course). The disease is manifested by inflammation of the liver and bile ducts, yellowness and itching of the skin, fever, vomiting, cramps and abdominal pain. Hepatitis A does not cause chronic disorders and, with adequate treatment, the outcome is favorable. The older the infected person, the higher the likelihood of a severe course of the disease and the development of complications.
The risk of contracting hepatitis A is directly related to social conditions: the virus lives in soil and water and is very resistant to aggressive influences (boiling, treatment with chlorine-containing drugs, formalin, etc.). In developing countries, where the majority of the population does not have access to clean drinking water and personal hygiene products, 90% of children are infected with the virus.
In unsanitary conditions, it can spread widely. For example, Botkin's disease caused the loss of 10% of the number of British troops, who conducted an operation in the Middle East in 1941-1942. During the 1988 epidemic, more than 300,000 people fell ill in Shanghai.
Each state implements the vaccination program against hepatitis A in its own way, depending on the current epidemic situation. In the United States, Israel, Turkey, China and Argentina, such vaccinations are included in the mandatory immunization system for children. In Russia, the anti-hepatitis vaccine is administered to people who have an occupational risk of infection (employees of treatment facilities and sewerage networks, medical workers, people employed in food production, etc.). In addition, people who travel to areas with a high prevalence of the disease are subject to immunization.
A single injection of the hepatitis A vaccine provides 95% protection against the virus, and a repeated procedure, carried out 6–12 months later, creates persistent immunity for 10 years. Children can be vaccinated after they reach the age of 1 year.
Vaccination is aimed at performing two main tasks: teaching the body of a particular person to fight against the causative agent of the disease and reducing the total number of infected in the population. The programs of mass immunization against the most dangerous infectious diseases, which are being implemented in most developed countries, have made it possible to leave in the past the monstrous epidemics that brought death to millions. It is worth remembering this and taking a balanced approach to the decision on vaccination or refusal from it.
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
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