Why more diseases originating in Africa are taking the West under control: AIDS, polio…

The polio revival in the West. Health authorities of the state of New York (USA) confirmed a case of infection at the end of July. A week later, they warned of the discovery of the virus in sewage, as happened in London. The situation only worsens the health crisis that started with Covid and is now being scrutinized monkeypoxwhich, like polio, had disappeared in much of the world. In this scenario, it is inevitable to ask ourselves the question: why do these diseases reappear and how do they spread?

“They don’t reappear, that’s just the way it is they never disappeared” explains José Muñoz, a doctor in the International Health and Tropical Medicine Service at the Hospital Clínic de Barcelona and an ISGlobal researcher.

Indeed, polio is still endemic in two countries, Afghanistan Y Pakistan. In addition, in 2022 Mozambique declared an outbreak caused by the wild virus, and Malawi confirmed a case. “As long as there is only one infected child, children in all countries are at risk of contracting polio,” warns the World Health Organization (WHO).

The WHO’s warning is in line with the statement of the European Center for Disease Prevention and Control (ECDC): “The alarming emergence of poliovirus outbreaks, which arise and circulate due to the lack of immunity in the population, shows that potential risk from one increased international distribution“. The danger of polio is that it is highly contagious.

forgotten places

While monkeypox remains endemic in African countries: Benin, Cameroon, Central African Republic, Democratic Republic of Congo, Gabon, Ivory Coast, Liberia, Nigeria, Republic of Congo, Sierra Leone, South Sudan and Ghana.

[La mitad de las muertes por cáncer en el mundo en hombres y un tercio en mujeres son evitables]

“There are a few cases of monkeypox in the global north and it seems like the end of the world, but every time we have an outbreak in the global south, nobody talks about it,” said Oyewale Tomori, a member of several WHO health committees. Despite the criticism, he warned: “What we are seeing in Europe is a reinforcement of the African model“.

Speaking of models, the case recalls, saving the magnitude and gravity distances, what happened to AIDS. The first confirmed case of HIV came from a blood sample taken in 1959 from a man in Kinshasa, in Democratic Republic of the Congo. It wasn’t until the virus began to spread around the world that it caught the attention of health authorities. This is also an example of the ‘globalization of disease’.

Muñoz shares Tomori’s words: “We stare at each other’s navels so much that we do not see what is happening in the rest of the planet, but today, with the movement of people and transportation, what happens in China matters to us and what happens in Brazil matters to us”. So the doctor puts the concept of global health on the table. “In Spain there is polio, but in Nigeria there are people who travel by plane to these countries and then come back. We have to look further this is global health“.

The expert has just laid the groundwork for the first response to what’s going on: movements between populations, whether due to work, vacation or migration. Just look at the figure provided by the United Nations High Commissioner for Refugees (UNHCR) on forced movements: 89.3 million people they were forced in 2021 to leave their homes.

Data like these should force health authorities to look beyond their borders. María Tomás, a medical microbiologist at La Coruña Hospital and spokesperson for the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), agrees with Muñoz, globalization This is one of the reasons for the return of these diseases.

Vaccines, the key

The expert, in turn, provides another theory to explain the reproduction, ie low vaccination rate which exists in some countries either because of a lack of resources or, as evidenced by Covid, the spread of anti-vaccine currents.

[Arribas, el sabio del SIDA: “El VIH es una de las historias de éxito más grandes de la medicina”]

The latter may seem residual, but the deniers have enough power and extension in some countries. In addition, at the beginning of this August, the news of the suicide of the Austrian doctor Lisa-Maria Kellermayr, bullied to death by the anti-vaccines in the country, in particular the adherents of the Querdenken theory, became known.

“What needs to be encouraged is vaccination, which is the only way to eradicate these diseases,” insists Maria Thomas, who illustrates with the case of London the problems that can arise if this measure is not implemented: “What happened with polio there is this have a much lower vaccination rateabout 80%”.

The WHO confirms his words. In order to have effective protection against said virus, the percentage must be more than 90%. “If you add to that that it’s a very cosmopolitan city and that probably the people who got oral vaccineWell, here’s the explanation.

Thomas refers to the fact that there are two types of polio vaccine, one is injected, without activated virus; and another oral, with a weakened but not dead pathogen. With the latter, it’s unlikely, but there’s a chance you can infect other people.

In Spain, the formula used is injected. In addition, according to data from the Carlos III Health Institute (ISCIII), the percentage of vaccinated people rose to 95%. “Then, we’re not taking any chances here“, reassures the microbiologist.

“zombie” diseases

Although polio will not be a big problem in our country, it shows the importance of a proper vaccination schedule, something that has been confirmed by the resurgence of other diseases zombies. For example, the UN warned of unusual 79% increase in measles cases in the first two months of 2022. In 2019, it claimed 6,000 lives in Congo alone.

[Guía para saber si me tengo que vacunar del sarampión si tengo entre 40 y 50 años]

In Spain a decade ago this disease was almost eradicated, but in recent years there have been sporadic outbreaks, most of which imported cases. The explanation for the contagion is that systemic vaccination against the triple virus (which includes measles, mumps and rubella) was introduced in 1981. For this reason, the Ministry of Health recommends that those born before this year should also be vaccinated.

“We need to emphasize the importance of vaccines, especially now that climate change this will favor the spread of certain infections,” says Maria Thomas.

The threat of climate change is something Jose Munoz also warns about. What’s more, the doctor admits that they currently are very alert to the spread of dengue. In Perpignan (France) several autochthonous cases have been found, viz. the people who became infected did not travel to a risk area, but rather were bitten by carrying tiger mosquito. “The climate is going to make these diseases have a greater capacity to reproduce, with the tiger mosquito we see it and with some ticks like the one that carries Lyme disease, we have that very clearly.”

According to a report published by ISCIII, between 2005 and 2019, hospitalizations for Lyme increased in Spain by 191%. Until now, the tick that causes it was found in the US.

The Crimean-Congo hemorrhagic fever, also transmitted by a tick bite, is another disease of concern. On August 8, a man died because of it, and Health confirmed another infection.

the next pandemic

At this point, with the ‘globalization of disease’, it is worth asking: Are we close to the next pandemic? “The spectrum of diseases that can, in quotes, threaten the health of our population and that are not in Spain at the moment is relatively wideJose Muñoz answers. “What we need to do is invest in innovation and research to create identification mechanisms that they do not currently exist“.

[El nuevo fármaco que ha acabado con las bacterias resistentes a antibióticos en el laboratorio]

SEIMC, for its part, published a paper last June entitled Infectious diseases in 2050. What will infectious diseases be like in 30 years. The conclusion is quite striking. If nothing prevents it, during this time it is likely to be infectious diseases leading cause of death from disease.

The report addresses the issues presented here, although Maria Thomas describes one of the most troubling as neither coming from outside nor being eradicated: antibiotic resistance.

According to research published in The lancetinfections caused by bacteria resistant to antibiotics kill 1.2 million people a yearmore than AIDS.

“We are immersed in a silent pandemic which it’s cooking right now. If we don’t have weapons to fight, it will become a health crisis,” warns the doctor, who joins her colleague’s cry: “What we need to do is to rely on science and innovation to be prepared.”

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