Returning epidemic: Is cause for concern necessary?

Returning epidemic: Is cause for concern necessary?

In the ever-evolving world we live in, the re-emergence of infectious diseases poses a significant public health challenge, impacting various regions across the globe. This article explores the commonality of this phenomenon and the contributing factors that have led to the return of previously controlled diseases.

## Commonality of Disease Re-emergence

From measles, which was declared eliminated in the U.S. in 2000, to tuberculosis (TB), polio, and whooping cough, numerous diseases have resurfaced, primarily due to declining vaccination rates and vaccine hesitancy[2]. Over 300 confirmed cases of measles were reported in 2024, primarily among unvaccinated children[2].

## Factors Contributing to Disease Re-emergence

Several factors contribute to the comeback of these diseases.

1. **Vaccine Hesitancy**: The decline in vaccination rates due to misinformation and lack of perceived risk has led to outbreaks of diseases like measles, polio, and whooping cough[2].

2. **Misinformation and Social Media**: The spread of false information about vaccines can significantly impact public perception and vaccination coverage[2].

3. **Inadequate Surveillance and Infrastructure**: Weak surveillance systems and insufficient public health infrastructure hinder early detection and effective response to outbreaks, allowing diseases to spread further[1].

4. **Antimicrobial Resistance (AMR)**: The rise of drug-resistant infections complicates treatment and increases the likelihood of disease resurgence, as seen with TB[1][4].

5. **Global Mobility and Travel**: The increased ease of international travel can facilitate the rapid spread of diseases across borders[1].

6. **Economic Constraints**: The economic burden of re-emerging diseases strains healthcare systems, diverting resources away from other essential health services[1].

Other factors include conflict areas, where diseases spread due to closer contact with animals, and environmental degradation, such as in Madagascar, where a big outbreak of plague occurred due to rats coming into contact with infected animals[1].

The resurgence of diseases is a pressing issue, with one or two significant emergences or re-emergences of infectious diseases occurring each year[1]. Many of these diseases, which seem to re-emerge, have likely been present in certain regions for a long time[1].

The US is currently experiencing its largest measles outbreak in two decades, with over 1,300 cases confirmed by the Centers for Disease Control and Prevention (CDC)[1]. International travel is a significant threat for spreading antibiotic-resistant organisms, which are considered emerging infections[1].

Furthermore, it is difficult to eradicate infections when people who can spread them are well before showing symptoms[1]. Sex tourism and medical tourism contribute to the spread of antibiotic-resistant organisms[1].

While the bacterial infection causing the plague has not significantly changed, the plague remains a concern, particularly in Ukraine and Gaza[1]. A person has died from pneumonic plague in Arizona[1]. In the US, cases of plague have been reported in people who are hunters or get too close to prairie dogs[1].

Smallpox is the only disease that has been eradicated, but it is unlikely that most infections will be eradicated[1]. Another big influenza pandemic, like the Spanish Flu in 1917, could cause the most fatalities[1]. Spanish Flu tends to kill younger people, whereas COVID-19 tends to affect older populations[1].

Small outbreaks of dengue fever are starting to occur along the Mediterranean coast in Europe due to warming[1]. Climate change is causing infectious diseases to spread into areas where they have never or rarely been seen before[1].

In conclusion, disease re-emergence is a significant public health concern worldwide, requiring continuous monitoring, effective vaccination programmes, and strong public health infrastructure to prevent and control outbreaks.

1. Science and medicine have a crucial role to play in addressing the commonality of disease re-emergence, furthering our understanding of contributing factors such as vaccine hesitancy, misinformation, and antimicrobial resistance.
2. The evolution of health-and-wellness practices, including comprehensive vaccination campaigns, debunking misinformation, and strengthening public health infrastructure, are essential to mitigate the impact of re-emerging diseases like measles, TB, polio, and whooping cough.
3. Research into climate change and its effects on the environment is also crucial, as warming temperatures have been linked to the re-emergence of tropical diseases, such as dengue fever, in regions never before affected.
4. Looking towards the future, the medical-conditions exacerbated by climate change pose a significant threat, especially with the potential for another Spanish Flu-like pandemic to emerge.
5. In the face of increasing global mobility, it's important to establish strong border controls and international cooperation to prevent the spread of antibiotic-resistant organisms and other infectious diseases.
6. Nature provides a reminder of the interconnectedness of all living things, highlighting the importance of treating health, environment, and science as intertwined facets of our collective future.

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