Tuesday, June 18, 2019
Home Health While Ebola kills in Africa, vaccinations in the West are complacent Mark...

While Ebola kills in Africa, vaccinations in the West are complacent Mark Honigsbaum | opinion

WWith the possible exception of quinine, which for centuries has been the only treatment for malaria and antibiotics, vaccines have saved more lives than other procedures in the medical history. But from New York's Brooklyn to Camden in north London to Kivu in the Democratic Republic of Congo, there are vaccines that are shunned by populations who seem to feel little about the risks they face with their own or other people's lives.

Why this should be so is one of the puzzles of our time. Is it the fault of social media and anti-Vax propaganda that have established themselves on Facebook, Twitter and YouTube? Or has society become complacent about the risks posed by infectious diseases for previous generations, when it was common for children to be paralyzed by polio or to become deaf or brain damaged by measles?

I will come back to these questions, but first a thought to Kivu in the northeast of the Democratic Republic of the Congo, where in the middle of the official second largest Ebola outbreak in history, the rejection of vaccines has particularly tragic consequences. At first, it was hoped that the epidemic that started in August last year would follow the pattern of a previous Ebola outbreak in the Democratic Republic of the Congo controlled by the use of a "ring vaccine" – the vaccination and monitoring of an infection ring ,

That did not happen. In a region where one in four people is convinced that Ebola is "not genuine" and the medical response is a scam by the rulers to maintain humanitarian aid to the government, the villagers have been hiding from World Health Organization contact doctors Militia Ebola treatment centers have set fire to obstruct the work of the vaccination teams.

The result is that Ebola seems to spread under the radar and it is not known when the outbreak, which has already killed 751 people, could end. Worst of all, WHO reported 20 new cases of Ebola last wednesday, the highest daily total of the outbreak. Two were workers at Butembo Airport, a short flight from Kisangani, the third largest city in the Democratic Republic of Congo, with 1.6 million inhabitants. It is no wonder that WHO held an emergency meeting on Friday to express its "deep concern" that the outbreak may follow the same pattern as that which began in Guinea in 2014 and eventually spread to five countries in West Africa, costing 11,300 Life.

Given that Ebola is one of the most virulent agents in medicine – "a molecular shark," in the words of popular non-fiction writer Richard Preston, it is tempting to dismiss immuno-resistance in the Democratic Republic of the Congo as a product of ignorance. After all, if you face a virus with a 60% mortality rate that gets out of hand and rejects a potentially life-saving vaccine, it's similar to a death wish.

New York mayor Bill de Blasio announces a public health emergency on April 9 after the city's measles outbreak in several zip codes.

New York mayor Bill de Blasio announces a public health emergency on April 9 after the city's measles outbreak in several zip codes. Photo: Erik Pendzich / Rex / Shutterstock

But not only in Africa have we experienced a growing vaccine resistance. This year, in the United States, which eliminated measles in 2000, 465 measles cases were reported in 19 states. The majority occurred in ultra-Orthodox Jewish neighborhoods in Brooklyn and Rockland County, New York, where parents avoided the measles, mumps, and rubella vaccine, apparently influenced by allegations that the vaccine was not "kosher" because it " Pigs DNA "contains. , In fact, the end product is highly purified and most rabbis accept that vaccines are not banned by religious laws.

A similar picture can be seen in Europe, where astonishing 83,000 measles cases were recorded last year, tripling the number in 2017. This is fueled by a similar anti-Vax propaganda and the discredited theorist of the British doctor Andrew Wakefield, who allegedly shows a connection between the MMR-Jab and autism. Countless studies, the last of which was published in the Annals of Internal Medicine in March, the connection was a fiction, but Wakefield's theory continues to have a damaging impact, not least in Camden, north London, where it was found last week that a third of five-year-olds have not yet received MMR jab Has . (In the UK, the MMR coverage rate in the UK is 92%, the lowest in four years.)

Although it's difficult to gauge the impact of Facebook and Google on all of this, there's a suspicion that social media has skewed the game in favor of anti-Vaxx players. But that's just part of the story. Since Edward Jenner stabbed a cowpox-infested milkmaid and introduced the pustular material into a healthy boy's arm in 1796, thereby inducing protection against the associated poxvirus, the vaccine has created fertile ground for metaphorical fears. Hence the images of people sprouting cow heads in James Gillray's 1802 engraving, The cow pock,

What is surprising and requires more explanation is the persistence of these fears given the overwhelming scientific evidence that vaccinations are a blessing to health and, for the most part, safe.

Perhaps the phenomenon can best be explained by our hubris. Since we have not had any experiences with childhood illnesses that have cut or plagued our grandparents' lives, let alone tropical diseases like Ebola and Malaria, we have forgotten that we just do not have to fear infectious disease from vaccines and other medical advances. Instead, it is the remote and undetected risks of vaccines that keep us awake at night.

The idea that keeps WHO awake is that Ebola flees the Democratic Republic of the Congo and causes an international emergency. In 2014, WHO was widely criticized for its complacency with the Ebola threat in West Africa. Determined not to fall into the trap of hubris for the second time, it takes this epidemic so seriously.

Mark Honigsbaum is a medical historian and author of The Century of the Pandemic: One Hundred Years of Panic, Hysteria and Hubris



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