People have forgotten what infectious diseases can do

Medicine now has the opportunity to focus much of its research on the chronic diseases of aging: cancer, heart disease and dementia, to give some examples.

This has become possible only because of the great success in eliminating infections as the major cause of death.

To put this in perspective, epidemics are suspected to have killed 90 per cent of the population of the Americas when Europeans introduced new infectious diseases in 1492. Smallpox and measles were the major killers.

Switch to today. Smallpox has been eradicated; measles is now almost 100-per-cent preventable. All this because of vaccination.

Nonetheless, there were 145,000 measles deaths in 2013 in developing countries where vaccination is not widespread. There is still no cure for measles, only prevention.

In Canada, many have forgotten the past. Quebec grappled recently with a measles outbreak outside Montreal that infected 136 people, all members of a religious community, none of whom were vaccinated.

The Quebec outbreak has been linked to a larger outbreak in the United States, which began at Disneyland in California. Ontario has recorded 18 cases of the measles so far this year. Closest to us geographically was a toddler in Elliot Lake.

Ontario’s Immunization of School Pupils Act allows for certain exemptions for children from being immunized: for medical reasons, or, because of religious or personal beliefs.

Some parents believe that vaccines can cause illness, even though a widely publicized study that linked the measles vaccine to autism was discredited in 2010. The research physician had falsified his results. He lost his medical licence as a consequence.

Sadly, the parents who sign these forms object to all vaccinations for their children. These are the provincially funded vaccines for children in Ontario: diphtheria, tetanus, whooping cough, polio, H influenza (a bacterial infection, not the flu), measles, mumps, German measles, pneumococcus, meningococcus, hepatitis B and human papillovirus.

More than 48,000 cases and 20 deaths from whooping cough were reported in the U.S. in 2012. Confined to his wheelchair, President Franklin D. Roosevelt is the most famous image of what polio can do to the nervous system. He caught polio at the age of 39, prior to the development of a vaccine.

In the instance of an outbreak in Ontario, the Medical Officer of Health can order children to be excluded from school. There are no such provisions as it relates to day care. Sudbury’s Health Unit receives 40 to 60 objection forms per year. Few are for medical reasons. Only Ontario and New Brunswick makes proof of vaccinations a requirement for attending school during outbreaks.

Some Canadian provinces are achieving high vaccination rates. Newfoundland is the leader at 95 per cent. New Brunswick has 69-per-cent coverage, just ahead of Nova Scotia at 66 per cent, the lowest rates among the provinces. Ontario is at 91 per cent. Sudbury’s rate is an excellent 94 per cent.

Consider that your unvaccinated child becomes ill with a preventable infectious disease, and then goes to school. He may put at serious risk children who can never be vaccinated because they have a vulnerable immune system.

Think about your child growing up into a fine adult. She decides to do volunteer work in a developing country with a poor vaccination record. And then catches a preventable, infectious disease.

What does work is legislation. The highest vaccination rate in the U.S. is in Mississippi, a state with an otherwise dismal set of health statistics. It allows people to opt out of vaccines only for medical reasons.

Thanks to Lisa Schell of the Sudbury and District Health Unit for all the help she provided for this column.

Dr. Peter Zalan is president of the medical staff at Health Sciences North.