The diseases that can take our breath away
Respiratory illnesses are still a significant danger, despite new treatments
MANY PEOPLE alive today will remember the fear associated with the infectious respiratory diseases that were responsible for large numbers of deaths in the relatively recent past.
At the beginning of the 20th century, the major causes of death were tuberculosis, pneumonia, influenza and polio.
These conditions still have an impact on health today when the major contemporaryrespiratorydiseasesarelung cancer, chronic obstructive pulmonary disease (COPD) and asthma.
The epidemic of tuberculosis (TB) reached a peak in the UK in the 1940s but the dreadful mortality of the previous century had already begun to decline because of the sanatorium movement and other public health measures.
The introduction of effective antimicrobial chemotherapy in the 1960s saw the rates decline further.
In the less developed world, TB remains a devastating disease.
However, it has not gone away in this country and many people would be surprised to learn that in the last decade the incidence rate in Britain had started to rise again, to about 8,000 cases per year.
The majority of these cases arise from reactivation of the disease in people who have originally contracted it abroad.
For a while this was particularly worrying because we had begun to relax the public health controls. Fortunately, NHS England and Public Health England have now introduced a new national strategy for TB that focuses on the identification of latent disease in new immigrants and the offer of preventative treatment. The figures already suggest that this strategy is having an effect.
Around 100 years ago, pneumonia was as common as cancer and cardiovascular disease as a cause of death. This was particularly true during influenza epidemics when young people were especially vulnerable.
Although the death rates from pneumonia are no longer of the same epidemic proportions, the condition is still responsible for approximately 35,000 deaths per year. This is a reminder of how important the influenza immunisation campaign is in reducing the risk for the vulnerable categories.
Nevertheless, large numbers of people are still admitted to hospital with pneumonia with a 10 per cent risk of death. Hopefully, these days patients get prompt diagnosis and early antibiotic treatment to reduce the possibility of complications. In the western world the scourge of polio largely ended in the 1950s with the introduction of effective immunisation. Before that, polio killed people by paralysis of the respiratory muscles leaving them to suffocate slowly.
The chances of survival were greatly enhanced with the introduction of artificial ventilation in the form of the tank ventilator known as the iron lung. This device saved many people and there are even people alive today who contracted