Infectious disease, and Vaccinations

Epidemics have been a major and recurring part of human history. The Bubonic plague killed three quarters of Europe's population in the fourteenth century. Epidemics of such diseases as smallpox, yellow fever, and tuberculosis routinely swept through US cities prior to the twentieth century. As recently as 1919, a fatal form of influenza spread through much of the world, killing as many as 20 million people worldwide, including a half-million Americans.

Edward Jenners' 1798 discovery that cowpox inoculation prevented later infection with smallpox was the start of a new science, which is the basis for medicines programmes for preventing disease (Coulter 1990).The advent of modern medicine, the discovery and invention of vaccines and antibiotics, and the establishment of public health agencies - promised to make recurring epidemics a thing of the past.

After cowpox came vaccines against rabies (1885), typhoid (1911), TB (1921), diphtheria and tetanus (1925), yellow fever (1937) and polio (1954). Vaccination campaigns have helped eradicate most of these diseases in the societies that could afford the vaccine. Public health policy in 90s would suggest the war against infectious diseases has been won, and resources are being concentrated on chronic non-infectious diseases such as cancer and heart disease.

Nevertheless, disease epidemics have remained a significant and growing problem in the world. According to a recent report on infectious diseases by WHO, every hour 1,500 people die from infectious diseases, mostly they are malnourished. Inner cities are densely populated, poverty, poor sanitation, unsafe water, are ideal breeding grounds for disease. Illich (1976) stated diarrhoea and upper respiratory tract infections occur more frequently, last longer and lead to higher mortality where nutrition is poor, no matter or how much or how little medical care is available. The potential threat diseases pose does not respect national boundaries in this era of global travel, migration, and commerce. According to the Centres for Disease Control and Prevention (CDC), the US death rate due to infectious diseases rose 58 percent between 1980 and 1992.

A major factor in the persistence - and resurgence - of infectious disease has been antibiotic resistance. "We are threatened with a resurgence of diseases which were once thought to be under control, TB and other infectious diseases are making a dramatic comeback." (Hook 1997). Increase of drug resistance and emergence of new bacteria and viruses make the control of infectious diseases scientifically and uneconomically unlikely in future.

In the 1950's physicians began directing their attention to the common diseases of childhood. A vaccine for measles was developed in 1960, for rubella in 1966, for mumps in 1967 and a vaccine against chicken pox is now available. The benefit of immunising is clear, fewer people develop the disease and so fewer people suffer from serious illness or die as a result of it. (Elliman 1998). Diseases such as diphtheria and polio are now extremely rare, and measles is much less common that it was only five years ago. Nevertheless, many questions remain unanswered about the effect of vaccines on health and many authors (Koren 2000, McTaggart 2000, Neustaedter 1996, Scheibner1993, Miller 1992, Coulter and Fisher 1991 and Mendelsohn 1984) have questioned the apparent health benefits of vaccination campaigns.