Saturday, November 17, 2012

Diseases that wouldn't die: Why are so many Victorian killer illnesses making a comeback?

Cases of measles, gout and syphilis are soaring, while new figures reveal we are in the grips of the biggest ­whooping cough outbreak for decades. Rickets and consumption epidemics sound like plotlines from ­Downton Abbey but doctors are reporting a rise in ­19th-century illnesses we thought were a thing of the past.

Cases of measles, gout and syphilis are soaring, while this month new figures reveal we are in the grips of the biggest ­whooping cough outbreak for decades. So why is this happening? “Before routine vaccinations and our understanding of how infections spread, diseases like these affected thousands of people every year in the UK,” says the Health Protection Agency. “Now, their impact has significantly ­reduced, but this doesn’t mean they’ve been eradicated.”

The reason for the increase is that some conditions are linked to lifestyle – children are getting less ­sunlight ­leading to ­rickets, or a rise in risky sexual ­behaviour ­is pushing up syphilis numbers. Other comebacks are down to reduced rates of vaccines, sometimes because routine jabs were stopped when cases fell, as with TB, or due to public anxiety as we saw with the MMR jab. Modern measures, ­including national health campaigns, vaccination programmes and ­effective treatments means ­outbreaks are contained before they become the uncontrollable killers they used to be. But it’s still frightening to see these ­forgotten diseases hitting the ­headlines. Here’s how to reduce your risk.

This childhood bone disease, caused by vitamin D deficiency, reached epidemic proportions when smog-filled Victorian cities blocked natural sunlight.
There are no exact figures but cases of rickets are rising. Dr Benjamin Jacobs, consultant paediatrician at the Royal National Orthopaedic Hospital, London, says it was unheard of when he qualified in 1988. Now he sees one case a month.

Why? As many as one in four UK children could be lacking in vitamin D, which aids calcium absorption, due to them getting less ­outdoor activity, widespread use of sunscreen and a fall in the intake of cod liver oil – a standard supplement used 50 years ago. The rise in breast-feeding is also a factor, as breast milk is low in the ­vitamin, as is the rise in immigrants from hotter climes because ­darker skin needs more sun to make enough D.

Spot the symptoms: Soft skull bones, bow legs, painful bones and breaks, ­muscle ­weakness, slowed growth and ­dental problems are all signs.

Reduce your risk: This year the Government changed its recommendations, saying under-fives should take daily ­supplements that contain 7-8.5mcg of vitamin D.
P­regnant and breast-feeding women should take 10mcg, and a family should aim for 15-20 ­minutes daily sun without sunscreen.

Tuberculosis is an ­infectious lung disease that killed one in four people during its peak in Victorian times.
The ­discovery of antibiotics in the 1940s and the BCG vaccine brought rates so low it was deemed ­almost eradicated.
But HPA figures show more than 9,000 UK cases were diagnosed last year, the highest since 1979.

Why? The ageing population, and an increase in poverty and immigration from areas where TB is a problem, such as Eastern Europe, are both factors.
In 2005, it was decided infection rates were so low we no longer needed to give the BCG vaccine to all children, but ­vaccines are now being targeted at ­high-risk groups, including babies in London.

Spot the symptoms: A cough that lasts longer than three weeks, tiredness, night sweats, weight loss and ­appetite loss.

Reduce your risk: “Know the symptoms, as diagnosis is often delayed because TB awareness is low these days”, says ­charity TB Alert, ­
Babies in areas with high rates are offered the vaccine – speak to your GP. Quitting smoking reduces your risk.

Hospital admissions for the condition, which causes swollen joints, have doubled in the past decade. Known as the disease of kings, as it afflicted Henry VIII and was linked to overindulgence, it is now being seen in 30 and 40-somethings.

Why? Experts blame eating and drinking to excess for the illness, which is caused by a build-up of uric acid in the blood, a waste product formed by the breakdown of food, beer and wine. Other risk factors include obesity and high cholesterol.

Spot the symptoms: Pain and swelling in the joints, often the big toe, but also larger joints such as the knee.

Reduce your risk: Lose weight if needed, reduce alcohol to three or fewer units a day with two days a week off, and ­exercise for 30 minutes, five times weekly.


Bordetella pertussis, a bacteria that causes whooping cough
Bordetella pertussis, a bacteria that causes whooping cough

Before a vaccine was introduced in the 1950s, the illness caused more than 1,000 deaths a year. This year, we have had the worse outbreak since 1959, with 5,000 cases and 10 infant deaths. It doesn’t ­usually lead to ­serious complications in older children and adults.

Why? The main rise is in teenagers and adults. Although they have probably been vaccinated, the effect may have waned, making them vulnerable to milder forms.
Parents have also been forgetting to get preschool booster jabs for children.

Spot the symptoms: A runny nose, temperature and dry, irritating cough, which progresses to intense coughing fits accompanied by a “whoop” sound.

Reduce your risk: Get babies vaccinated at eight weeks, followed by boosters at three and four months.
The Government is offering the vaccine to all pregnant women in the hope they will pass on protection to their unborn children.

It was thought this STI, which can cause madness, paralysis and death, had almost been ­wiped out with the advent of penicillin.
But cases have risen tenfold in the past decade.

Why? Our great-grandparents were well aware of the dangers, but adults today are largely ignorant of the condition. The latest figures show men, mostly gay men, in their late 30s and early 40s account for a third of cases. Experts ­suggest many who contract it could be divorcees returning to the dating scene and think that safe sex messages are only directed at teenagers.
Spot the symptoms: It is symptomless initially, but weeping sores on the ­genitalia or ­infected ­areas can appear several weeks later, clearing up in two to six weeks ­before a rash appears on the body.
Swelling of the lymph glands may occur. It can damage the heart, joints and ­nervous system if untreated.

Reduce your risk: ­Unprotected sex puts you at high risk, so ­condoms are vital.

Measles used to be ­almost unstoppable. Cramped living ­conditions allowed the virus to spread ­quickly. Many ­victims died of ­complications such as meningitis or ­pneumonia. The MMR vaccination brought rates down but there were ­almost twice as many ­measles cases in the first six months of 2012 as in the same period last year.

Why? Vaccination rates plunged after now ­discredited claims that the MMR jab was linked to ­autism. Rates are back to 93% but the cases may be in teens and older children who missed ­vaccines during the scandal.

Spot the symptoms: Cold-like ­symptoms appear 14 days after contact. The rash emerges two days later, first as tiny spots on the neck then as blotches on the chest.

Reduce your risk: Ensure kids and teenagers get the MMR jab.
The higher the rates of vaccination, the better the so-called “herd immunity”. If you think your child is infected, keep them at home and call a doctor.


Amy McConville
Recovered: Amy McConville

 Amy McConville, 30, from Ealing, West London, was diagnosed with TB at university. I went to see my doctor for a dry cough. He gave me antibiotics, but it just got worse and I lost a stone. The only person who mentioned TB at this stage was my uncle, but I didn’t take him seriously. When I went home for Christmas, everyone noticed how tired and thin I was. I’d also started having night sweats. I was referred to hospital and had an X-ray, but a missing letter meant it was three months before I had further tests. During that time I dropped even more weight – from seven to ­five-and-a-half stone. I remember thinking I had cancer.

When the hospital did a bronchoscopy, where a telescope views the lungs, and sputum test, I was finally diagnosed with TB. I was so shocked when they told me. I thought it was a Victorian disease that had died out. My treatment involved 13 antibiotic tablets a day. But things were about to get worse – an X-ray showed one of my lungs had collapsed, which meant more time in hospital. Not long after, a TB relapse in the collapsed lung meant the only option was to remove it.

It has been a long road back to health, but I finally have the all-clear. I try not to let having only one lung affect me too much. I just wish I had known what signs and symptoms to look out for, but even the doctors didn’t see me as high risk. Everybody should have TB at the back of their minds to ensure early diagnosis and avoid the complications I had.

Source: Mirror UK 

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