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A significant proportion of Americans believe it is perfectly all right to put other people at risk of the costs and misery of preventable infectious diseases. These people are your friends, neighbors, and fellow citizens who refuse to have themselves or their children vaccinated against contagious diseases.

There would be no argument against allowing people to refuse vaccination if they and their families would suffer alone the consequences of their foolhardiness. It would be their right to forego misery-reducing and life-preserving treatments. But that is not the case in the real world.

The University of Pittsburgh's Project Tycho database, launched last week, quantifies the prevalence of infectious disease since 1888 in the United States. Drawing on Project Tycho data, a November 28 New England Journal of Medicine article concluded that vaccinations since 1924 until now prevented 103 million cases of polio, measles, rubella, mumps, hepatitis A, diphtheria, and pertussis. While the NEJM article did not calculate the number of deaths avoided as a result of vaccination, one of the study's authors estimates that number is between three and four million.

People who don't wish to take responsibility for their contagious microbes will often try to justify their position by noting the fact that the mortality rates of many infectious diseases had declined significantly before vaccines came along. And it is certainly true that a lot of that decline in infectious disease mortality occurred as a result of improved sanitation and water chlorination. A 2004 study by the Harvard University economist David Cutler and the National Bureau of Economic Research economist Grant Miller estimated that the provision of clean water "was responsible for nearly half of the total mortality reduction in major cities, three-quarters of the infant mortality reduction, and nearly two-thirds of the child mortality reduction." Improved nutrition also reduced mortality rates, enabling infants, children, and adults to fight off diseases that would have more likely killed their malnourished ancestors.

But vaccines have played a substantial role in reducing death rates too. An article in the Journal of the American Medical Association compared the annual average number of cases and resulting deaths of various diseases before the advent of vaccines to those occurring in 2006. Before an effective diphtheria vaccine was developed, for example, there were about 21,000 cases of the disease each year, 1,800 of them leading to death. No cases or deaths from the disease were recorded in 2006. Measles averaged 530,000 cases and 440 deaths per year before the vaccine. In 2006, there were 55 cases and no deaths. Whooping cough saw around 200,000 cases and 4,000 deaths annually. In 2006, there were nearly 16,000 cases and 27 deaths. Polio once averaged around 16,000 cases and 1,900 deaths. No cases were recorded in 2006. The number of Rubella cases dropped from 48,000 to 17, and the number of deaths dropped from 17 to zero.

With the latter disease, the more important measure is the number of babies, born to rubella-infected mothers, who suffered from disease-induced birth defects, such as deafness, cloudy corneas, damaged hearts, and stunted intellects. Some 2,160 infants were afflicted with congenital rubella syndrome as late as 1965. In 2006 it was one.

The risk that infectious diseases will kill innocent bystanders is not the only issue. Sheer misery counts too. The fevers, the sweats, the incessant coughs, the runny noses, the itchy rashes, and the lost days at work must be taken into account, too. And, of course, many people end up in the hospital as a result of infectious disease.

Before a chicken pox vaccine became available, upwards of four million kids got the disease every year, of which 11,000 were hospitalized and 105 died. In 2004, the estimated number cases had dropped to 600,000, resulting in 1,276 hospitalizations and 19 deaths. Before the measles vaccine was introduced in 1962, some 48,000 were hospitalized and 450 died of that infection each year. So far this year there have been 175 cases and three hospitalizations. A 1985 study by Centers for Disease Control and Prevention epidemiologist in the journal Pediatrics estimated that the first 20 years of measles vaccination in the U.S. had prevented 52 million cases, 5,200 deaths, and 17,400 cases of mental retardation.

In rich countries, few children die of rotavirus diarrheal disease, but it does kill some 500,000 kids living in poor countries annually. Prior to 2006, when vaccines against rotavirus became available, about one in five kids under the age of five in the United States annually came down with it, of which 57,000 were hospitalized. Subsequent to widespread vaccination, hospitalization rates have dropped by 90 percent. Interestingly, rotavirus hospitalizations among older children and young adults who are not immunized have also fallen by around 10,000 annually. Why? Because they are no longer are exposed to the disease in infants who would otherwise have infected them.

Vaccines do not produce immunity in some people, so a percentage of those who took the responsibility to be vaccinated remain vulnerable. This brings us to the important issue of herd immunity. Herd immunity works when most people are immunized against an illness, greatly reducing the chances that an infected person can pass his microbes along to other susceptible people, such as infants who cannot yet be vaccinated, immunocompromised individuals, or folks who have refused the protection of vaccination.

People who refuse vaccination for themselves and their children are free-riding off herd immunity. Anti-vaccination folks are taking advantage of the fact that most people around them have chosen the minimal risk of vaccination, thus acting as a firewall protecting them from disease. But if enough refuse, the firewall comes down and other people get hurt.

Oliver Wendell Holmes articulated a good libertarian principle when he said, "The right to swing my fist ends where the other man's nose begins." Holmes' observation is particularly salient in the case of whooping cough shots.

Infants cannot be vaccinated against whooping cough, so their protection against this dangerous disease depends upon the fact that most of the rest of us are immunized against it. Unfortunately, whooping cough incidence rates have been increasing along with the number of people refusing immunization for their kids. The annual number of pertussis cases fell to a low of 1,010 in 1976. Last year, the number of reported cases rose to 48,277, the highest number since 1955. Eighteen infants died of the disease in 2012, and half of the infants who got it were hospitalized.

In 2005, an intentionally unvaccinated 17-year-old girl brought measles back with her from a visit to Romania and ended up infecting 34 people. Most of them were also intentionally unvaccinated, but a medical technician who had been vaccinated caught the disease as well and was hospitalized. Despite the medical technician's bad luck, the good news is that the measles vaccine is thought to protect 99.8 percent of who get the shot. Similarly, in 2008 an intentionally unvaccinated seven-year-old boy sparked an outbreak of measles in San Diego. The boy, who caught the disease in Switzerland, ended up spreading his illness to 11 other children, all of whom were also unvaccinated, putting one infant in the hospital. Forty-eight other kids who were too young to be vaccinated were quarantined.

To borrow Holmes' metaphor, people who refuse vaccination are asserting that they have a right to "swing" their microbes at other people. There is no principled libertarian case for their free-riding refusal to take responsibility for their own microbes.

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Refusing Vaccination Puts Others At Risk

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A significant proportion of Americans believe it is perfectly all right to put other people at risk of the costs and misery of preventable infectious diseases. These people are your friends, neighbors, and fellow citizens who refuse to have themselves or their children vaccinated against contagious diseases.

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This past Monday - April 7th - marked the celebration of World Health Day, sponsored by the World Health Organization. The 2014 focus was on the spread of diseases around the globe.

The first World Health Day was celebrated in 1950, back when world population was 2.5 billion. Since the day's inception, our global family has added an additional 4.5 billion individuals. Let's take a moment and consider some of the ways population growth has impacted the ability of diseases to spread.

1. Population density and urbanization - Diseases spread more quickly among people who live in close proximity to each other. Currently, over 50% of the global population lives in urban areas. With more people living in dense conditions, there is more frequent contact between more individuals, allowing disease transmission to easily occur.

2. Migration and global travel - As it becomes more common for people to travel throughout the world, it also becomes easier for diseases to travel with them. An outbreak in one region that would have otherwise been contained can move into other uninfected regions when infected people travel or relocate to these areas.

3. Environmental degradation - Environmental challenges such as changing climate, can lead to the spreading of diseases, especially those that are vector-borne (or carried by a host). For example, the West Nile Virus is spread by mosquitoes (the vector). As the climate changes, the disease carrying mosquitoes are able to move into regions where they previously could not survive, thus affecting new areas. Additionally, as global temperatures increase, so do the conditions under which many of these carriers flourish.

The Population Education activity, Catch it if You Can, from Earth Matter's Health unit can bring the challenge of disease transmission to light in your classroom. Students take part in a simulation that starts with a single individual being "infected" and the disease spreading throughout the room. After the simulation, you'll discover how many students have become "infected" and challenge the class to figure out who was the original carrier.

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Population Growth and the Spread of Diseases

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This past Monday - April 7th - marked the celebration of World Health Day, sponsored by the World Health Organization. The 2014 focus was on the spread of diseases around the globe. The first World Health Day was celebrated in 1950, back when world population was 2.5 billion.

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Outbreak: is a term used in epidemiology to describe an occurrence of disease greater than would otherwise be expected at a particular time and place.

Mortality Rate: Proportion of people who die of the condition in a period of time.

Epidemiology : branch of science that deals with the spreading of diseases.

endemic: the habitual presence of a disease within a given geographic area

epidemic: the presence in a location of a group of diseases of similar nature, clearly in excess of normal expectancy, and derived from a common of propagated source

Pandemic: a worldwide epidemic

Etiology : The cause of a disease or abnormal condition

Prognosis: The expected course of a disease and patients chance of recovery.

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Antibiotics: Are you misusing them?

Find out how overuse of antibiotics has increased the number of medication-resistant germs - and what you can do to help stop this health threat.
By Mayo Clinic Staff
Antibiotics are important medications. It would be difficult to overstate the benefits of penicillin and other antibiotics in treating bacterial infections, preventing the spread of disease and reducing serious complications of disease.

But some medications that used to be standard treatments for bacterial infections are now less effective or don't work at all. When an antibiotic no longer has an effect on a certain strain of bacteria, those bacteria are said to be antibiotic resistant. Antibiotic resistance is one of the world's most pressing health problems.

The overuse and misuse of antibiotics are key factors contributing to antibiotic resistance. The general public, doctors and hospitals all play a role in ensuring proper use of the medications and minimizing the development of antibiotic resistance.

What causes antibiotic resistance?

A bacterium resists a medication when the bacterium has changed in some way. The change either protects the bacterium from the action of the medication or neutralizes the medication.

Any bacterium that survives an antibiotic treatment can multiply and pass on its resistant properties. Also, some bacteria can transfer their medication-resistant properties to other bacteria - as if passing along a cheat sheet to help each other survive.

The fact that bacteria develop resistance to a medication is normal and expected. But the way that medications are used affects how quickly and to what extent resistance occurs.

Overuse of antibiotics

The overuse of antibiotics - especially taking antibiotics even when they're not the appropriate treatment - promotes antibiotic resistance. According to the Centers for Disease Control and Prevention, up to one-third to one-half of antibiotic use in humans is unnecessary or inappropriate.

Antibiotics treat bacterial infections but not viral infections. For example, an antibiotic is an appropriate treatment for strep throat, which is caused by the bacterium Streptococcus pyogenes. But it's not the right treatment for most sore throats, which are caused by viruses.

Other common viral infections that don't benefit from antibiotic treatment include:

Cold

Flu (influenza)

Bronchitis

Most coughs

Some ear infections

Some sinus infections

Stomach flu

Taking an antibiotic for a viral infection:

Won't cure the infection

Won't keep other people from getting sick

Won't help you or your child feel better

May cause unnecessary and harmful side effects

Promotes antibiotic resistance

If you take an antibiotic when you actually have a viral infection, the antibiotic attacks bacteria in your body - bacteria that are either beneficial or at least not causing disease. This misdirected treatment can then promote antibiotic-resistant properties in harmless bacteria that can be shared with other bacteria, or create an opportunity for potentially harmful bacteria to replace the harmless ones.

Taking antibiotics responsibly

It's tempting to stop taking an antibiotic as soon as you feel better. But the full treatment is necessary to kill the disease-causing bacteria. Failure to take an antibiotic as prescribed can result in the need to resume treatment later and may promote the spread of antibiotic-resistant properties among harmful bacteria.

Consequences of antibiotic resistance

For many years, the introduction of new antibiotics outpaced the development of antibiotic resistance. In recent years, however, the pace of medication resistance has contributed to an increasing number of health care problems.

Approximately 2 million infections from antibiotic-resistant bacteria occur in the United States each year, resulting in 23,000 deaths.

Other consequences of medication-resistant infections include:

More-serious illness

Longer recovery

More-frequent or longer hospitalization

More doctor visits

More-expensive treatments

Antibiotic stewardship

The appropriate use of antibiotics - often called antibiotic stewardship - can help to:

Preserve the effectiveness of current antibiotics

Extend the life span of current antibiotics

Protect people from antibiotic-resistant infections

Avoid side effects from using antibiotics inappropriately

Many hospitals and medical associations have implemented new diagnostic and treatment guidelines to ensure effective treatments for bacterial infections and reduce inappropriate use of antibiotics.

The public also plays a role in antibiotic stewardship. You can help reduce the development of antibiotic resistance if you:

Avoid pressuring your doctor to give you an antibiotic prescription. Ask your doctor for advice on how to treat symptoms.

Practice good hygiene, to avoid bacterial infections that need antibiotic treatment.

Make sure you and your children receive recommended vaccinations. Some recommended vaccines protect against bacterial infections, such as diphtheria and whooping cough (pertussis).

Reduce your risk of getting a foodborne bacterial infection. Don't drink raw milk, wash your hands, and cook foods to a safe internal temperature.

Use antibiotics only as prescribed by your doctor. Take the prescribed daily dosage, and complete the entire course of treatment.

Never take leftover antibiotics for a later illness. They may not be the correct antibiotic and would not be a full course of treatment.

Never take antibiotics prescribed for another person.

See more In-depth

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Find out how overuse of antibiotics has increased the number of medication-resistant germs - and what you can do to help stop this health threat. By Mayo Clinic Staff Antibiotics are important medications. It would be difficult to overstate the benefits of penicillin and other antibiotics in treating bacterial infections, preventing the spread of disease and reducing serious complications of disease.

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Bacteria are single-celled organisms usually found all over the inside and outside of our bodies, except in the blood and spinal fluid. Many bacteria are not harmful. In fact, some are actually beneficial. However, disease-causing bacteria trigger illnesses, such as strep throat and some ear infections. Viruses are even smaller than bacteria. A virus cannot survive outside the body's cells. It causes illnesses by invading healthy cells and reproducing.

Viral infections that should not be treated with antibiotics include:

Colds

Flu

Most coughs and bronchitis

Sore throats (except for those resulting from strep throat)

Some ear infections

Antibiotics, also known as antimicrobial drugs, are drugs that fight infections caused by bacteria. Alexander Fleming discovered the first antibiotic, penicillin, in 1927. After the first use of antibiotics in the 1940s, they transformed medical care and dramatically reduced illness and death from infectious diseases.

The term "antibiotic" originally referred to a natural compound produced by a fungus or another microorganism that kills bacteria which cause disease in humans or animals. Some antibiotics may be synthetic compounds (not produced by microorganisms) that can also kill or inhibit the growth of microbes. Technically, the term " antimicrobial agent" refers to both natural and synthetic compounds; however, many people use the word "antibiotic" to refer to both. Although antibiotics have many beneficial effects, their use has contributed to the problem of antibiotic resistance.

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antibiotic resistance questions & answers food bacterial  health antibiotic kinds virus resistant to  penicillin prevention side effects medical medicine different type fda

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Antibiotic Resistance: Questions & Answers

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Bacteria are single-celled organisms usually found all over the inside and outside of our bodies, except in the blood and spinal fluid. Many bacteria are not harmful. In fact, some are actually beneficial. However, disease-causing bacteria trigger illnesses, such as strep throat and some ear infections. Viruses are even smaller than bacteria.