Diseases Are Often Just a Plane Ride Away
May 13, 2011

Like it or not, global health impacts us all.
For all the complaining we do as Americans, it’s easy to see that, by comparison to other nations, we have it pretty good. 
Sure, we still have a lot of national health issues that could be improved upon, but generally speaking, we have an abundance of choices that provide us with good nutrition, plenty of opportunity to exercise and advanced medical care.  We have options that the majority of people in this world will never have.   And while socio-economic status and regional location may limit our individual choices, our overall public health is still far better than most other places around the globe.
I guess that’s why it is not surprising to hear some parents question the need for vaccines.  They often wonder why we need to immunize against diseases which are rarely seen.  Some go so far as to argue that a healthy diet, adequate exercise and access to clean water and proper sanitation will provide their children with a healthy immune system that will naturally protect them from disease without the need for immunizations.  While being healthy can help prevent disease, the concern here is that many diseases we currently immunize for are highly contagious.  They don’t discriminate based on income, sanitation or diet.  Otherwise healthy individuals can, and do, fall victim to these diseases.  Sometimes these diseases even result in death.  Though these diseases are somewhat rare in the US, they still threaten the lives of millions of people throughout the world.  The concern is that many other countries continue to experience outbreaks of vaccine preventable diseases.  Today, more than ever, it’s evident that these diseases are often just a plane ride away.  
Fortunately, in the United States, diseases like measles, Haemophilus influenza type b (Hib), and even pertussis are not nearly as common as they were some 30-40 years ago.  In the US, the incidence of measles has been reduced 99.95% during the time in which the vaccine was introduced in the 196o’s through the year 1997.  The prevalence of Hib has decreased by 98.62% between the year 1991 and 1997.  Even pertussis has declined 97.56% since 1950, shortly after the vaccine was introduced, and the year 1997.
Sadly, when you consider the global burden of vaccine preventable diseases, the picture is not so bright.  In the year 2002, the World Health Organization (WHO) estimated that 1.4 million childhood deaths, or 14% of global mortality in children under the age of 5, resulted from vaccine preventable diseases predominately from measles (38%), Hib (27%) and pertussis (20%).    That doesn’t even take into account how many more children suffered or were hospitalized as a result of these diseases.
While there are many organizations who have taken the initiative to improve global health and reduce the occurrence of vaccine preventable diseases worldwide, (such as The Gates Foundation , the GAVI Alliance, the Measles Initiative  and it’s Partners, among many others), the prevalence of disease in other countries continues to impact the health of us all.
Take for instance the recent measles outbreaks we have witnessed in the past few months in places like Massachusetts, New Mexico, Minnesota and Utah, to name just a few.  Many of these cases originated from patients who had been exposed to the disease overseas.  In Boston, one case began in February with an unvaccinated French consulate worker.  And this week, Boston saw five new cases.  In New Mexico, an unvaccinated resident  returning from a trip to Europe, exposed thousands of other travelers in VA, MD, Colorado, DC and New Mexico.   In Minnesota, there have been 23 confirmed cases of measles, twenty of which were linked to a case that was acquired by an unvaccinated child who had traveled to Kenya.  Five cases in Utah were linked to a family’s travels to Poland.
These examples, all within the past few months, illustrate the fact that many US measles cases often originate as a result of overseas exposure.  According to Dr. Rebecca Martin, who heads the Vaccine Preventable Diseases program for the WHO’s European Region, at least 6,500 cases of measles have been reported in a dozen European countries so far this year.  Nearly 5,000 of those cases were in France alone.
This may explain why the United States seems to be on track to have more measles cases this year than any year in more than a decade.  Already this year, The Centers for Disease Control and Prevention reports 98 cases in 23 states, which is double the average number for an entire year.
While we’ve been criticized for making too much of a “fuss” about the resurgence of measles and other vaccine preventable diseases, it is important for people to realize that these diseases are still circulating in the population.  Just because most of us have been fortunate enough not to experience these diseases first hand, doesn’t mean they don’t represent a continued threat to the health of their children. If you are a parent questioning the need for vaccines, it is important to realize that global diseases impact to us and immunizations offer an effective preventive measure.
I believe Alex Palacios, a special representative of the GAVI Alliance sums it up in a recent Science Daily article by stating, “It is important that vaccine-preventable diseases are kept under control no matter where they crop up, whether it be in Texas or in Kenya. Diseases don’t recognize borders.”
Anna Dragsbaek, President and CEO of The Immunization Partnership, also explains our concerns with global outbreaks of vaccine-preventable diseases.  “As long as there is polio and other vaccine-preventable diseases in the world, outbreaks are only a plane flight away,” she said. “It may seem like it’s safe to be complacent. But in actuality, diseases such as whooping cough and measles arise only because we have been complacent. We are still all at risk because not enough people are immunized worldwide.”
Dr. Martin offered her explanation about the French measles outbreak, stating that it is probably attributable to a lack of vaccination since most of the people who got the disease were either not immunized with the measles vaccine, or infants too young to be vaccinated.  In the example of France, and several other European countries, though vaccines are widely available, they are sometimes declined.  In these cases, the consequences seem to be determined by choice.  However, let us not forget that in other areas of the world, low immunization rates are often due to a lack of availability, accessibility or affordability of vaccines.
By supporting organizations that are committed to improving immunizations worldwide, we will not only improve global health, but we can potentially save millions of lives.  It is ambitious for sure, but entirely possible.  If you represent one of these organizations, perhaps you will consider letting us know just how our readers can support your efforts.

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