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4 Diseases That You May Have Thought Were Gone

In the United States, we enjoy relatively good health. Medical breakthroughs and our public health infrastructure have discovered treatments for or have controlled, diseases and conditions that have plagued humanity. However, despite all of the work done by the world medical community, there are diseases that you may have thought were eradicated yet still exist.

Measles

Measles (or Rubeola) is a highly contagious virus in the paramyxovirus family that spreads by direct contact or in the air through coughing and sneezing by infected persons.[1],[2] Additionally, the virus can remain active and contagious on surfaces or in the air for up to two hours.[3] The first symptom is a high fever that lasts four to seven days, as well as a runny nose, red eyes, sore throat, and a rash that spreads over the whole body.[4],[5] Measles is only known to occur in humans, and most measles-related deaths occur due to complications such as blindness, encephalitis (brain swelling), severe diarrhea and dehydration, ear infections, or severe respiratory infections.[6]

While there is no antiviral treatment, there is a safe and cost-effective vaccine. In the decade before 1963 when the vaccine became available, almost all children contracted measles by the time they were aged 15, and an estimated 3 to 4 million people in the U.S. were infected each year.[7] Between 2000 and 2014 alone, measles vaccinations resulted in a 79% drop in measles deaths worldwide.[8] Yet, despite the availability of the vaccine, measles remains one of the leading causes of death among young children.[9] In 2014, there were 114,900 global measles deaths, predominantly children under the age of five.[10] In developing countries, measles is still common. About 95% of measles deaths occur in countries with low per capita incomes and weak health infrastructures.[11] Just this month, a measles outbreak killed 40 people, mostly children, in remote villages of Myanmar, where there have been more than 200 measles cases reported since mid-July.[12] Although documented as eliminated in the U.S. in 2000, measles is still present nationally. From January 2nd to 22nd, 2016, 48 people from 13 states were reported to have measles – a majority of these patients were unvaccinated.[13]

In 2012, the World Health Organization (WHO) launched the Global Measles and Rubella Strategic Plan 2012-2020, which aims to achieve measles elimination in at least 5 WHO regions by the end of 2020.[14] This plan highlights the necessity of high vaccination coverage, disease surveillance, outbreak preparedness, public engagement, and research to address measles worldwide.[15]

Tuberculosis

Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis, has been present in human populations since the time of ancient civilizations.[16] Evidence of tubercular decay has even been found in the remains of ancient Egyptian mummies.[17] To this day, TB is one of the top infectious disease killers worldwide.[18] In 2014, 9.6 million people fell ill with TB, and 1.5 million of these cases were fatal.[19]

TB bacteria can be spread in the air when an infected person coughs, speaks, or sings. TB is not spread through shaking hands, sharing food or drink, touching bed sheets or toilet seats, or kissing.[20] Not everyone that is infected with TB becomes ill, they may have what is called a latent TB infection. These individuals will not show symptoms or feel sick, and cannot spread the disease, but may develop the disease at some point in his or her life. About 5-10% of patients with latent TB that do not receive treatment will develop the TB disease.[21] Left untreated, TB can be fatal, and those with a compromised immune system, such as those living with HIV, are particularly vulnerable.[22]

The TB bacteria usually attack the lungs, causing a cough, pain in the chest, and coughing up of blood or sputum.[23] Other symptoms include weakness or fatigue, weight loss, lack of appetite, fever, chills, and night sweats.[24] There is not a vaccine widely used in the U.S., but TB is treatable and curable with a six-month course of four antimicrobial drugs.[25] Between 2000 and 2014, the WHO estimates that 43 million lives were saved as a result of TB diagnosis and treatment.[26] However, multidrug resistance is widespread, often due to inappropriate treatment methods. Therefore, ending TB by 2030 has become one of the newly adopted Sustainable Development Goals, and there is an emphasis on integrated patient-centered care, supportive health systems, and intensified research to ensure proper treatment and effective diagnostic methods.[27]

Scarlet Fever

Scarlet Fever results from a group A streptococcal infection, and the bacteria can live in an individual’s nose and throat.[28] Infections are typically spread through droplets from a person’s cough or sneeze, and most often affect children between 5 and 15 years old.[29] While there is no vaccine, scarlet fever is treatable with antibiotics, and symptoms are usually mild. Nevertheless, treatment is necessary to prevent any serious, long-term health conditions. Common symptoms include sore throat, fever, whitish coating on the tongue, swollen glands, nausea and vomiting, head or body aches, and a red rash with a rough, sandpaper-like feel.[30] The rash is the most recognizable scarlet fever symptom, but not all people infected will develop this rash.[31] Potential long-term health complications from scarlet fever consist of rheumatic fever (inflammatory disease), kidney disease, otitis media (ear infections), skin infections, abscesses of the throat, pneumonia (lung infection), or arthritis (join inflammation).[32]

Historically, scarlet fever has been responsible for disastrous epidemics, especially during the 19th century.[33] Since the invention of antibiotics, scarlet fever has become much less common, but cases have been on the rise in Britain and in parts of Asia.[34] The disease is also exhibiting signs of antibiotic resistance. Although penicillin is still effective, there are concerns that scarlet fever may develop additional resistance to this antibiotic in the future.[35]

Bubonic Plague

Plague is caused by the bacterium Yersinia pestis, with bubonic being the most common form.[36],[37] Bubonic plague is an infection of the lymph nodes (buboes), but, left untreated, the infection can spread in the bloodstream and to the lungs to cause the much more deadly septicemic and pneumonic plagues.[38] Plague can affect rodents and humans, so most individuals acquire plague when they are bitten by a flea that has had the blood of an infected animal, or through inhalation of infected respiratory droplets.[39] People usually become ill two to six days after being infected, and illness onset begins with “flu-like” symptoms such a fever, headaches, chills, weakness, head and body aches, and vomiting and nausea.[40] There is no plague vaccine, so it is important to begin antibiotic treatment as soon as possible.[41]

Bubonic plague has also been known as the “Black Death,” infamous for its 14th century outbreak, during which it claimed 60% of the European population.[42] The most recent epidemics were reported in India during the first half of the 20th century, and in Vietnam in the 1960s and 1970s, but now 95% of cases are found in sub-Saharan Africa and Madagascar.[43] Worldwide, between 1,000 and 2,000 cases are reported to the WHO each year, but the true case number is believed to be much higher.[44] In the U.S., there are an average of seven cases per year.[45] However, in 2015, there were 15 cases of bubonic plague and four deaths.[46] The reason for this increase is unknown. Plague has a case-fatality ratio of 30-60%, consequently it is important to maintain global surveillance and control in order to break the plague cycle, and to limit the disease spread through environmental management programs.[47]

Although these may not be diseases that you will regularly encounter, it is important to recognize that these conditions still exist, and continue to be serious problems for some populations. A global effort is needed to completely eradicate any disease, as well as constant surveillance to monitor trends and incidence. Furthermore, there is a lot we can learn from outbreaks to prepare ourselves for the future. For more information about current outbreaks both nationally and internationally, you can check the Center for Disease Control’s Current Outbreak List or the World Health Organization’s Disease Outbreak News Page.

References

[1] “Measles,” World Health Organization, reviewed March 2016, accessed August 8, 2016, http://www.who.int/mediacentre/factsheets/fs286/en/.

[2] “Measles (Rubeola),” Centers for Disease Control and Prevention, last updated August 10, 2015, accessed August 8, 2016, https://www.cdc.gov/measles/.

[3]“Measles,” WHO.

[4] “Measles,” WHO.

[5] “Measles (Rubeola),” CDC.

[6] “Measles,” WHO.

[7] “Measles History,” Centers for Disease Control and Prevention, last updated November 3, 2014, accessed August 8, 2016, http://www.cdc.gov/measles/about/history.html.

[8] “Measles,” WHO.

[9] “Measles,” WHO.

[10] “Measles,” WHO.

[11] “Measles,” WHO.

[12] Saw Nang and Richard C. Paddock, “Myanmar Measles Outbreak Kills 40 in Remote Villages,” The New York Times, August 6, 2016, accessed August 8, 2016, http://www.nytimes.com/2016/08/07/world/asia/myanmar-measles-outbreak-kills-40-in-remote-villages.html?_r=0.

[13] “Measles Cases and Outbreaks,” Centers for Disease Control and Prevention, last updated July 20, 2016, accessed August 8, 2016, http://www.cdc.gov/measles/cases-outbreaks.html.

[14] “Measles,” WHO.

[15] “Measles,” WHO.

[16] “Tuberculosis (TB),” Centers for Disease Control and Prevention, last updated May 6, 2016, accessed August 8, 2016, https://www.cdc.gov/tb/.

[17] “Tuberculosis (TB) in History,” National Institute of Allergy and Infectious Diseases, last updated March 12, 2012, accessed August 8, 2016, https://www.niaid.nih.gov/topics/tuberculosis/understanding/history/pages/default.aspx.

[18] “Tuberculosis,” World Health Organization, reviewed March 2016, accessed August 8, 2016, http://www.who.int/mediacentre/factsheets/fs104/en/.

[19] “Tuberculosis,” WHO.

[20] “Tuberculosis (TB),” CDC.

[21] “Tuberculosis (TB),” CDC.

[22] “Tuberculosis (TB),” CDC.

[23] “Tuberculosis (TB),” CDC.

[24] “Tuberculosis (TB),” CDC.

[25] “Tuberculosis,” WHO.

 

[26] “Tuberculosis,” WHO.

[27] “Tuberculosis,” WHO.

[28] “Scarlet Fever: A Group A Streptococcal Infection,” Centers for Disease Control and Prevention, last updated January 19, 2016, accessed August 8, 2016, http://www.cdc.gov/features/scarletfever/.

[29] “Scarlet Fever,” CDC.

[30] “Scarlet Fever,” CDC.

[31] “Scarlet Fever,” Patient.info, last checked May 13, 2014, accessed August 8, 2016, http://patient.info/health/scarlet-fever-leaflet.

[32] “Scarlet Fever,” CDC.

[33] “Scarlet Fever,” emedicinehealth, reviewed September 1, 2015, accessed August 8, 2016, http://www.emedicinehealth.com/scarlet_fever/article_em.htm.

[34] Rachel Feltman, “The return of scarlet fever: Is it too tough to treat?” The Washington Post, November 5, 2015, accessed August 8, 2016, https://www.washingtonpost.com/news/speaking-of-science/wp/2015/11/05/scarlet-fever-a-disease-making-a-comeback-may-be-increasingly-antibiotic-resistant/.

[35] Feltman, “The return of scarlet fever.”

[36] “Plague – Frequently Asked Questions,” Centers for Disease Control and Prevention, last updated September 14, 2015, accessed August 8, 2016, https://www.cdc.gov/plague/faq/.

[37] “Plague,” World Health Organization, updated November 2014, accessed August 8, 2016, http://www.who.int/mediacentre/factsheets/fs267/en/.

[38] “Plague – Frequently Asked Questions,” CDC.

[39] “Plague – Frequently Asked Questions,” CDC.

[40] “Plague,” WHO.

[41] “Plague – Frequently Asked Questions,” CDC.

[42] “History,” Centers for Disease Control and Prevention, last updated September 14, 2015, accessed August 8, 2016, http://www.cdc.gov/plague/history/.

[43] “History,” CDC.

[44] “Plague in the United States,” Centers for Disease Control and Prevention, last updated September 14, 2015, accessed August 8, 2016, https://www.cdc.gov/plague/maps/.

[45] CNN Wire, “CDC: 4 deaths, 15 cases of bubonic plague in U.S. this year,” CBS 4, October 22, 2015, accessed August 8, 2016, http://cbs4indy.com/2015/10/22/cdc-4-deaths-15-cases-of-bubonic-plague-in-u-s-this-year/.

[46] CNN Wire, “CDC: 4 deaths, 15 cases of bubonic plague in U.S. this year.”

[47] “Plague,” WHO.

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