Is our health going backwards?
With measles, Dickensian diseases such as scarlet fever, whooping cough, and tuberculosis making a comeback, and life expectancy rates down, Michele O’Connor asks why our health is getting worse, not better
Measles
In 2018, more than 140,000 people worldwide were killed by measles, despite the fact it is a preventable, but potentially life-threatening disease.
Last August, the UK lost its measlesfree status three years after the virus was eliminated in this country.
Often seen in young children and spread by infected respiratory droplets, symptoms include fever, fatigue, nasal congestion, conjunctivitis, a cough and a rash. But complications can occur, including inflammation of the lungs, brain and liver.
“The main reason is the low take-up of the MMR vaccination, meaning the loss of herd immunity,” explains doctor and author Rosemary Leonard.
Vaccination in at least 95% of us is needed to stop the spread of contagious, infectious diseases. “Herd immunity” protects the vulnerable, such as newborn babies, the sick and the elderly.
But the publication of controversial – and since discredited – research in the late 90s wrongly linking MMR with autism, combined with misleading information on social media, led to a drop in parents taking children for the jab.
“There’s a good reason why we vaccinate yet there is an assumption that measles is ‘not that bad’,” warns Dr Leonard.
“There’s also a misconception it can be treated with antibiotics – but it is a virus so antibiotics have no effect.”
Health Secretary Matt Hancock is now considering not allowing children to start school unless they have had both MMR vaccinations.
Scarlet fever
“Scarlet fever is definitely making a big comeback,” says Dr Leonard. In 2018, there were over 30,000 cases of scarlet fever in England and Wales – the highest number since 1960.
This contagious disease mainly affects children and can lead to meningitis and septicaemia. Treatment is with antibiotics to reduce the risk of complications and the spread to others.
“There may be a link between the increase in cases and the fact GPs no longer prescribe antibiotics for sore throats,” explains Dr Leonard.
Antibiotics have no effect on viruses but are effective against streptococcus bacteria (step throat). And because scarlet fever usually starts with a sore throat, it’s possible early intervention with antibiotics had an impact.
Rickets
This bone disorder – once thought to be eliminated – is also making a comeback. Rickets affects children’s bones and can cause pain, stunted growth, fragile bones and malformation of the bones due to a lack of vitamin D and sometimes calcium.
“With more people covering up for religious and cultural reasons, parents becoming meticulous about sunscreen and fewer children playing outside, it’s unsurprising many of us are low in vitamin D,” explains Dr Leonard. “The Chief Medical Officer now says that everyone should take it between October and April.
“And, although GPs can’t prescribe anything that can be bought over the counter, if parents can’t afford it and the child is at risk, most GPs would do so.”
Whooping cough
“Whooping cough – or pertussis – is a bacterial infection spread by airborne droplets,” says GP Dr Nisa Aslam. There are around 3,000 cases a year, although it can peak every three to four years.
It can cause seizures and pneumonia, especially in children under six months, and is treated with antibiotics with the aim of preventing transmission to others as well as reducing symptoms.
“Cases have increased because vaccinations have dropped,” adds Dr Leonard. Whooping cough vaccines are given to children at eight, 12 and 16 weeks, and also as a pre-school booster.
It is also offered to pregnant women as it can provide passive immunity to the newborn baby.
Tuberculosis
According to the World Health Organisation, TB, a bacterial infection affecting the lungs but sometimes also the bones, joints and kidneys, is still the top infectious killer.
There were 4,672 UK cases in 2018. “London is the TB capital of the West,” warns Dr Leonard. “This is mainly due to the increase in immigrants who have never been vaccinated.”
Symptoms include a persistent cough, fatigue, night sweats, unexplained weight loss and swollen neck glands. As TB is spread by inhaling respiratory droplets from coughs or sneezes of an infected person, it can spread easily in crowded accommodation.
“There is also a significant cohort of people who didn’t have the routine BCG vaccine before it was phased out in 2005.
“Because a ‘heaf test’ needs to be done first, to check immunity, patients need to be referred to a hospital chest clinic so cannot be vaccinated at a doctor’s,” says Dr Leonard.
BCG vaccination is now recommended for babies up to 12 months, born in areas where TB rates are high, such as inner London, or those who have a parent or grandparent born in a country with a high rate of
TB. It’s now rarely given routinely to anyone over 16 – apart from healthcare workers.
Gout
Historically known as an affliction of the wealthy as it is triggered by rich foods, gout is caused by an inflammatory reaction to raised levels of uric acid.
When an attack happens symptoms are painful with areas becoming hot, red and swollen.
But with the obesity epidemic, there are now around one in 40 affected. You can prevent gout via lifestyle measures and drugs.
Scurvy
“It’s astonishing we are seeing a disease known to affect sailors with no access to fruit and veg,” says Dr Leonard.
Caused by lack of vitamin C, symptoms include fever, no appetite, fatigue and aches and pains. It can lead to loose teeth, scaly skin and dry hair.
“Children are at risk if their diet relies on processed foods,” warns Dr Leonard. One large orange, a kiwi or a bowl of strawberries provides the recommended daily amount of vitamin C.
Mumps
Hundreds of students were recently struck down by a severe outbreak of mumps. More than 7,200 cases have been reported since July 2019 – almost triple the same period in 2018. Simon Stevens, CEO of NHS England, says: “The stark rise is a reminder that opting out of jabs like the MMR is dangerous.”
The main reason is the low uptake of the MMR jab and no ‘herd immunity’