Massachusetts Medical Society's Physician Focus

June 2014

Common and Emerging Infectious Diseases

PROGRAM HIGHLIGHTS:

  • Mosquito- and tick-borne infectious diseases such as West Nile Virus, Eastern Equine Encephalitis, and Lyme disease, are common threats every year in the U.S.

  • With more global travel, emerging diseases from foreign countries are now reaching the U.S., increasing the threat of infections.

  • For individuals going overseas, a trip to a travel clinic before departure to check on immunizations is a necessary step in preventing infectious disease.

  • Vaccines remain the best protection for many infectious diseases, and the overwhelming scientific evidence shows them to be safe and effective.

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Infectious disease is a major cause of death worldwide and results from viruses, bacteria, and other pathogens that enter the body and multiply. Common methods of infection include skin contact, inhaling airborne particles, or insect bites.

Infectious diseases can range from the inconvenience of the common cold to disfigurement from polio to death from Ebola. Americans, however, with the exception of severe seasonal flu outbreaks, have mostly been protected from epidemics and major outbreaks of infectious disease in recent years. This is due in large part to public health measures at the national, state and local levels; high vaccination rates; state-of-the-art sanitation methods; and high awareness and individual efforts at prevention – measures that are more advanced and frequent than those in many other nations around the world.

Yet such protection is neither permanent nor invincible.

“Global travel,” says George Abraham, M.D., M.P.H., “has brought diseases which were in one part of the world to other parts of the world, including the United States.” Read another way: an outbreak or epidemic can be just a plane ride away from anywhere in the world.

Dr. Abraham, Associate Chief of Medicine at Saint Vincent Hospital in Worcester, Mass. and Professor of Medicine at the University of Massachusetts Medical School, joins program host Dale Magee, M.D. in the June episode of Physician Focus to discuss common and emerging infectious diseases – their origins, how dangerous they are, and what individuals can do to protect themselves.

Dr. Abraham, a Fellow of the American College of Physicians, is an infectious disease specialist. He earned a master’s degree in public health in infectious disease epidemiology from the Johns Hopkins School of Public Health and has served as a World Health Organization fellow in HIV disease in Uganda and as an infectious disease fellow at the Communicable Disease Center in Singapore.

While his discussion begins with an analysis of the familiar mosquito- and tick-borne diseases that local residents face each year - West Nile Virus, Eastern Equine Encephalitis, and Lyme disease – he also notes that new diseases from foreign countries are coming closer to the U.S. Some are already here.

Among them is MERS – Middle East Respiratory Syndrome – a viral, pneumonia-like disease that originated in Middle Eastern countries. Others are dengue and chikungunya, both mosquito-borne, viral diseases from Asia and Africa. Dengue has been reported in Florida, and chikungunya has appeared in the Caribbean, including popular vacation spots like the Virgin Islands and Martinique.

“The worrisome part about these emerging diseases,” says Dr. Abraham, “is that we don’t have specific treatments for them, and people who may have underlying health conditions could be affected with life-threatening complications.” No vaccines, as yet, exist for many of these conditions as well.

Dr. Abraham also raises concern over the resurgence of vaccine-preventable diseases, such as mumps, measles, and whooping cough. Outbreaks of these infections, caused by resistance to immunization and global travel, have been reported across the U.S. These outbreaks, along with introduction of diseases from other countries, is testimony to how small our world has become and how quickly disease can spread. Even polio, eradicated years ago in the U.S. and just a few years ago on the brink of extinction globally, is making a comeback in some countries.

Dr. Abraham’s advice is simple: “Protect yourself as much as possible from mosquito bites. If you’re making overseas trips, assess your need for vaccines. Visit a travel clinic, not only for vaccines, but for food safety and water safety tips. Get vaccines for those things that can be prevented, so you minimize the risk of getting disease when you come back.”

And to those skeptical of vaccines, his message is also clear: “My plea to everyone who says that vaccines are unsafe,” he says, “is to look at the scientific evidence. There’s an overwhelming body of science that supports their benefit and the fact that they are safe to use. Look at the amount of disease we could prevent if we take them as we should.”

View the video above for more conversation, including preventive measures for mosquito- and tick-borne illnesses, characteristics of the emerging diseases, the need for “booster” shots to combat declining immunity, and the value of “herd immunity.”

Text:
MMS/Richard Gulla

ADDITIONAL RESOURCES
Infectious Disease Society of America

World Health Organization

Centers for Disease Control

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"Infectious Diseases" PSA


From left, Dale Magee, M.D., George Abraham, M.D., M.P.H.
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