Disease Management through Treatment and Immunization

Abstract

In the developed world, our perception of infectious disease in humans has changed dramatically within the past century, as a result of advances in chemotherapy and the advent of mass immunization. Many diseases that occurred regularly in endemic or epidemic form only a few decades ago, and which were feared greatly, are now so uncommon that they are viewed almost as medical curiosities. Most of these changes have occurred within my lifetime. For instance, my maternal grandmother died of tetanus at about the time I was born; this disease is now prevented through routine immunization. I distinctly remember school being cancelled and the holiday beginning early one summer because of an outbreak of poliomyelitis. This was the last epidemic of poliomyelitis in the area, but I vividly recall attending the funeral of a classmate victim of the disease that summer. Poliomyelitis has virtually disappeared as a clinical entity in Canada because of routine prophylactic immunization. Other diseases are now dealt with routinely by antibiotic treatment or other chemotherapy. For example, I was pleased to find that the case/fatality rate in chlamydiosis (psittacosis) had declined significantly from the preantibiotic era, when I acquired the disease a few years ago.

“There exists a discrepancy between our knowledge of how to treat an individual and how to control the infection within a community” (Anderson, 1982).