Geography Reference
In-Depth Information
Islamists preventing vaccinations. Others, such as increasing cases of tuberculosis
in cities such as London, seem to come from immigrants arriving with the infection
from countries where the disease is still endemic. This means that more effective
screening of the health background of immigrants is probably needed. Also, there is
always the threat of new outbreaks of many of the diseases largely controlled, be-
cause of increasing numbers of people refusing to accept vaccinations. So vigilance
to spot new outbreaks and their source, as well as mass vaccination programmes
are still needed. There is also the threat of new, previously unknown diseases ap-
pearing, with the case of the acquired immunodeficiency virus (AIDS) and (Severe
Acute Respiratory Syndrome (SARS) providing opposite examples of early fail-
ure and success in coping with the problems. In the former case Holt ( 2014 ) has
described how the growth of the disease caused by a virus, spread through sexual
contact and contaminated blood, which quickly mutates and was difficult to treat. It
led to a high of 2.2 million annual deaths. Originally unrecognized from its origin in
infected monkeys in Africa its spread from the 1980s was helped by governments,
such as South Africa, which refused basic treatment to victims. Today antiretroviral
drugs can halt its progression, allowing people to lead an active life, although they
are not cured. So since 35.3 million are infected worldwide, the virus is still esti-
mated to be the sixth most common cause of death in 2030 (Table 13.1 ) and remains
as a major threat. By contrast, the respiratory disease, SARS that spread between
November 2002 and July 2003 provides an example of the dangers that can quickly
emerge in our connected world (Enserink 2013 ). It originated from a species jump
of the virus to a Chinese farmer from its host in bats and civets and then to others in
local markets and Hong Kong. In this case it was relatively quickly diagnosed when
travellers from Hong Kong brought it back to North America due to vigilance of
doctors in major hospitals in Canada and the United States, alerted to a new disease
in southern China, and its rapid identification by Canadian researchers and The U.S.
Centre for Disease Control and Prevention. Victims were isolated in special wards,
with their contacts being tracked and warned (Enserink 2013 ). In addition, civets in
the southern Chinese markets that acted as hosts were destroyed. The use of masks
and other protective clothing by carers, and the careful cleaning and sanitation of
all surfaces near infected people, also reduced the spread of the infections. In the
longer term, the search for cures is vital. What the example also shows is the need
to have large numbers of wards or places available to be turned into isolation rooms
if a similar major outbreak occurs—a scale of resources which may still be rare in
most urban centres, even in the developed world. In the past, separate quarantine
hospitals, and even areas, were set aside in or near cities for people with infectious
diseases. For example, North Brothers Island in New York fulfilled this role, espe-
cially for immigrants, although it is now abandoned and its buildings are decaying.
If infectious diseases cannot be controlled by vaccines and drugs this type of separa-
tion may again have to be practiced. The history of the SARS outbreak shows the
need for rapid genome typing of a suspected new disease and the ability to quickly
create large numbers of isolation wards to quarantine victims. It illustrates how a
multipronged and international effort is needed to prevent the spread of new com-
municable diseases. Yet there is little doubt that there are many diseases that are
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