Public Health

National Infant Immunization Week: Spotlight on Rotavirus and Pertussis

Transmission electron micrograph of intact rotavirus particles. National Infant Immunization Week is April 23-30 this year. This week, the History of Vaccines blog features posts about several diseases that can be prevented by vaccination of infants.

Although its name is not as well known as those of diseases like chickenpox or measles, rotavirus is the most common cause of severe diarrhea in children and infants worldwide. Before a vaccine was introduced in the United States, the disease caused more than 400,000 doctor's visits and 200,000 emergency room visits each year, causing as many as 60 deaths annually in U.S. children younger than five.

The virus spreads easily among children, and can also be passed from children to those with whom they're in close contact. Rotavirus spreads via the fecal-oral route -- that is, from the waste of an infected person to the mouth of another individual. This can occur via contamination on hands or objects like toys.

Rotavirus can be prevented by vaccination. The first dose of the vaccine series is recommended at two months of age. More

National Infant Immunization Week: Spotlight on Diphtheria

Diphtheria is still endemic in these countries. (Click on the image to view it at full size.) National Infant Immunization Week is April 23-30 this year. This week, the History of Vaccines blog will feature posts about several diseases that can be prevented by vaccination of infants.

Diphtheria, now nearly unknown in the United States, was once a common childhood affliction. In 1921 the country recorded more than 200,000 cases and more than 15,000 deaths, with the highest percentage of fatal cases among children younger than five. Although the last recorded case in the United States was in 2003, diphtheria remains endemic in many countries.

The disease is caused by a bacterium, Corynebacterium diphtheria, although the actual damage is not done by the bacterium itself. Instead, it secretes a toxin that damages the body's tissues. The most unique symptom of diphtheria is a thick gray substance that can spread over the nasal tissues, tonsils, larynx, and/or pharynx. This substance, called a pseudomembrane, can block the airways; in fact, diphtheria was known in Spain as "el garatillo" -- "the strangler." The toxin produced by the bacterium can also travel through the bloodsteam and damage other organs. More

Cholera Outbreak in Haiti May Reach Almost Double Predicted Cases

Dr. Jaime Ferrán Inoculating for Cholera in Spain, 1885. Image courtesy National Library of Medicine. In October 2010, cholera broke out in Haiti for the first time in decades, devastating the country while it was still recovering from the 7.0 magnitude earthquake that killed hundreds of thousands and left millions homeless just nine months earlier. In typical conditions, cholera can be treated easily with an oral rehydration solution or, in severe cases, via intravenous fluids to replace what is lost to vomiting and diarrhea. With quick treatment, nearly all patients recover. Left untreated, however, the dehydration and shock caused by the disease can kill within a matter of hours.

In Haiti, the country’s already-poor infrastructure had been additionally damaged by the earthquake, leaving conditions ripe for water- and food-borne diseases; within a month’s time, the cholera outbreak had spread across the country and killed almost 1,000 people. By the end of the year the death toll in Haiti had passed 3,000, and the Haitian government predicted that there would be more than 400,000 cases by the end of October 2011. Now, researchers at the Harvard School of Public Health and the University of California San Francisco have found that the number may reach almost twice that, predicting 779,000 cases of cholera and 11,100 deaths by the end of November. More

Interview with Paul Offit and Seth Mnookin

On March 1, The History of Vaccines hosted "Vaccine Science, Realities, and Fears in the Popular Mind" at The College of Physicians of Philadelphia. Paul Offit, MD, an infectious disease physician and vaccine developer, and Seth Mnookin, a contributing editor at Vanity Fair, discussed their new books as well as the past and future of vaccination as depicted in the media, among parents, and in the medical world. More

Comments (3)Posted in:

Candidate Malaria Vaccine Effective for 15 Months in Clinical Trial

Magnified photomicrograph of Plasmodium falciparum parasites that cause malaria, in a growing stage. CDC/Dr. Mae Melvin. Despite global efforts to disrupt malaria transmission using mosquito nets and drug therapies, the disease remains widespread: hundreds of millions of cases occur each year, causing hundreds of thousands of deaths. While these measures can help to control the disease, an effective vaccine against malaria would be a major contribution to global public health.

The leading candidate vaccine against malaria is the RTS,S vaccine, which is currently in Phase III trials in seven countries in Africa. (Phase III trials are used to confirm the effectiveness of a drug as determined in Phase II trials, as well as to continue monitoring the drug for safety.) While this vaccine offers only partial protection against malaria—prior data showed it to be 53% effective eight months after vaccination—even this level of protection would be a significant improvement to public health efforts. More

Viral Strains for Seasonal Flu Vaccine Well-Matched with Circulating Strains

Transmission electron micograph (TEM) depicting influenza A virions. Photo credit: CDC/ F. A. Murphy Because influenza viruses frequently mutate, a new seasonal flu vaccine is developed each year in order to keep up with the circulating strains. Each year, the vaccine provides protection against three strains: two influenza A strains and one influenza B. The flu vaccine for the 2010-2011 flu season provides protection against a 2009 H1N1 A strain, H3N2 A strain, and an influenza B strain More

BMJ: Wakefield Paper Alleging Link between MMR Vaccine and Autism Fraudulent

Boy with measles. Photo credit: Centers for Disease Control and Prevention A January 5, 2011 report in the British Medical Journal investigates the 1998 paper that first alleged a link between the MMR vaccine and autism. The author, Brian Deer, presents evidence that the paper resulted from research fraud. The History of Vaccines blog looks at the history of the paper and how it has profoundly affected research, public health, and the public perception of vaccines over the last 12 years.

In the wake of a paper published in the Lancet in 1998, vaccination rates in Britain plummeted. The lead author of the paper, Andrew Wakefield, rose to infamy as a result of his claims that the combination measles, mumps and rubella (MMR) vaccine had caused autism in the 12 children in the study, and frightened parents began to delay or completely refuse vaccination for their children, both in Britain and the United States. Since then, outbreaks of previously eliminated diseases have sickened and killed children in both countries. More

Comments (24)Posted in:

Step Toward Vaccination Against Multiple Influenza Strains

Graphical representation of a generic influenza virus particle's structure. CDC/Douglas Jordan, 2009. Illustrator: Dan Higgins Influenza is a challenging disease for vaccine researchers. At any given time, multiple influenza strains are circulating, and immunity against one strain does not necessarily provide protection against others. In addition, influenza A viruses frequently mutate, so that it is difficult to find a "target" within the virus that will remain stable between various strains and mutations. As a result, the current approach for developing flu vaccines is based on observations of the strains most likely to be circulating in the coming flu season. The seasonal flu vaccine contains three inactivated strains of influenza, but typically can't provide protection against other strains.

Now, the results of a recent study in mice suggest that a new approach may be able to provide long-lasting, cross-strain protection against influenza. More

Library Treasures: Map of Typhoid Fever and Malaria Deaths in D.C. (1888-1892)

Typhoid fever and malaria deaths in Washington, D.C., 1888-1892 Research for new articles about typhoid fever and cholera have kept us busy in The College's Historical Medical Library over the past week, and as usual, we stumbled across some great holdings. One that we particularly wanted to share was this map showing deaths from typhoid fever and malaria in Washington, D.C., from 1888-1892.

Click on the image or click here to be taken to its page in the Gallery, where you can zoom in on the map to see how the diseases affected the city's districts. With red dots representing deaths from typhoid, and blue representing deaths from malaria, the map documents 626 typhoid deaths and 363 from malaria over the five-year period. More

Meningitis Vaccine Project Introduces Meningococcal Vaccine for Africa

Emergency mass vaccination campaigns are difficult to implement quickly and effectively. Photo credit: Monique Berlier/PATH. In the United States, meningitis is thought of as an extremely rare disease. It usually appears in the news when a college student has fallen ill, amid reminders by public health officials that a meningococcal vaccine can protect against diseases caused by Neisseria meningitidis bacteria, including meningitis. In 2008 (the most recent year for which data are available) only about 1,100 total cases of meningococcal disease were reported in the United States, and meningitis cases were only a fraction of that number.

In other parts of the world, however, meningitis takes a much larger toll. In Sub-Saharan Africa, an area that spans from Senegal to Ethiopia is called the “meningitis belt” because of the epidemic waves that occur there, some lasting as long as three years. The largest epidemic wave in history led to more than 25,000 meningitis deaths from 1996 to 1997. In 2009 alone, more than 88,000 cases were reported. Now, a new vaccine developed specifically for use in Africa offers hope that future epidemics may be prevented. More