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June 29, 2017

Infectious Diseases

Progress against Infectious Diseases, but We Are Not There Yet

Mark Peeples, PhD

Professor, Department of Pediatrics
The Ohio State University College of Medicine
Principal Investigator, Center for Vaccines and Immunity
The Research Institute at Nationwide Children’s Hospital

This weekend thousands of Americans will be walking in the streets of more than 400 cities around the world to show their support for science. Dubbed the ‘March for Science’, this historical event is intended to draw attention to the important role that science plays in our lives. The truth is that science has been quietly marching ahead for hundreds of years by creating technologies, enhancing our food supply, protecting our environment, and eradicating diseases.

The ‘march of science’ has greatly accelerated over the past century, moving faster with each decade, particularly beginning in the 1950s and 60’s when our government realized that a relatively small amount of funding for scientists and universities could provide jet fuel for our progress, including the training of scientists and engineers that would drive corporate innovation.

During my own lifetime, in my field of infectious diseases, our progress has been staggering. I was infected by measles virus, and rubella virus, and mumps virus as a child but kids born 10 years after me weren’t -- because they were vaccinated. I was vaccinated with the polio vaccine, actually both polio vaccines, when they first became available, because my parents did not want what happened to my father to happen to us. A decade later, no kids in the US were infected with poliovirus and none had poliomyelitis, like my father had. Unfortunately that is not true for everywhere on the planet, but we are getting ever closer (1). By the time I finished college, smallpox had been eradicated from the earth (2). And now children are protected from chickenpox, rotavirus, hepatitis B virus, and from many bacterial diseases, too, by vaccination.

This story of humanity’s ability to conquer many infectious diseases is one of our true successes. So, it is surprising that these achievements are now in danger of being ignored and lost (3). Some well-educated parents are refusing vaccinations because, as they say, “that disease isn’t here anymore” and “vaccines are dangerous.” Neither is true.

If we don’t use the extremely effective vaccines we have developed to keep our population immune, these diseases will creep back. In the past three years, Ohio has seen a large measles outbreak in Holmes County (4) and an even larger mumps outbreaks (5), including one on the OSU campus. The problem is that if vaccination rates fall below 90%, the frailest among us are the first to be infected: those too young to be vaccinated and those with a compromised immune system. This year in Ohio, 158 schools had less than 70% of their students starting school without being fully vaccinated (Columbus Ledger-Enquirer April 16, 2017), well below the 90% threshold necessary for group immunity.

We have new pathogens now, such as Ebola and Zika, and old foes such as HIV, influenza, dengue and respiratory syncytial virus. My colleagues and I are working diligently to develop effective vaccines to protect us against them. Government support is essential to our efforts to battle these infectious diseases at the CDC, the NIH, and many universities around the country. Recently proposed funding reductions would cripple the research and testing efforts needed for the next vaccines and the control of so many other diseases such as cancer, diabetes, heart disease and on and on.

As a country, we are better than this. The belief that what we learn from a scientific approach to problems can simply be ignored has been growing in strength in many communities. It is an alarming trend that threatens to erase hundreds of years of progress. As fond as they may seem, those were not the good old days.

Science has given us the luxury of health and prosperity that enables these debates today, but we cannot afford to become complacent or cynical. Our historical scientific achievements stand as a testament to the benefits of investing in research. We must resist the urge to go back by continuing to march forward.

 

References:

1.         Pagliusi S, Ting CC, Lobos F, Group DEC. Vaccines: Shaping global health. Vaccine 2017;35:1579-1585.

2.         Henderson DA, Fenner F. Recent events and observations pertaining to smallpox virus destruction in 2002. Clin Infect Dis 2001;33:1057-1059.

3.         Mammas IN, Theodoridou M, Kramvis A, Thiagarajan P, Gardner S, Papaioannou G, Melidou A, Koutsaki M, Kostagianni G, Achtsidis V, Koutsaftiki C, Calachanis M, Zaravinos A, Greenough A, Spandidos DA. Paediatric virology: A rapidly increasing educational challenge. Experimental and therapeutic medicine 2017;13:364-377.

4.         Gastanaduy PA, Budd J, Fisher N, Redd SB, Fletcher J, Miller J, McFadden DJ, 3rd, Rota J, Rota PA, Hickman C, Fowler B, Tatham L, Wallace GS, de Fijter S, Parker Fiebelkorn A, DiOrio M. A measles outbreak in an underimmunized amish community in ohio. N Engl J Med 2016;375:1343-1354.

5.         Sifferlin A. Rise of the mumps. What's behind the new cases. Time 2014;183:24.

 

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