Dealing with epidemics

Ralph Tapping takes a closer look at two relatively recent epidemics that generated fear and apprehension, but also led to vital medical breakthroughs  

In our last column, we discussed the rather terrifying “Plague Doctor” who aimed to treat plagues in Europe in the 16th and 17th centuries.

The ‘Plague Doctor’ face mask on display in the Collection of Medical Artefacts in Hobart serves as a grim reminder of the many epidemics that have swept through the populations of the world over past centuries and the need for constant vigilance.

It seems that the only effective protection from such outbreaks is social distancing, until such time as an effective antidote or vaccine is developed.

In my lifetime I have witnessed two other earlier outbreaks that have caused considerable apprehension: Tuberculosis and Poliomyelitis.

The curse of TB

Tuberculosis has been around for centuries. In the 1800’s many a death certificate ascribed the cause of death to be “Consumption”, as TB was known in those times.

In the 1940’s there were many “Sanitariums” around Australia, which were hospitals devoted to the treatment of TB through rest, clean air and good nutrition, together with whatever medication was prescribed. 

The development of Streptomycin was a major advance and a system of compulsory chest X-rays was introduced to identify sufferers in the community. Together with BCG vaccine ( bacilli Calmette-Guerin ) that was administered from the 1950’s tuberculosis was virtually eliminated in Australia, although it still exists in some parts of the world.

BCG is an attenuated live vaccine no longer routinely administered in Australia.

A crippling condition

Around the same era there was an outbreak of poliomyelitis that attacked the population, particularly the young, who because of nerve damage suffered severe muscle degeneration, resulting in what was called “Infantile Paralysis”. 

Many a child could be seen wearing steel callipers attached to a sturdy boot that enabled them to walk. It was effectively a permanent disability. 

Adults were not immune from the disease, which also attacked the lungs. Because of this the “Iron Lung” was developed, which took the form of a steel cylinder with a padded bench inside, the patient lying prone with just the head exposed.  It was described as a “Negative Pressure Ventilator” in that it provided a partial vacuum within the cylinder thus making it easier for the patient to breathe.

Hospitals sometimes had wards having tens of these machines lined up. Lucky patients managed to be released after a few weeks, but some with severely damaged lungs spent decades living this way until the end of their lives!

Eventually vaccines were developed that eliminated Polio in Australia. Initially, Jonas Salk designed an injectable (killed virus) vaccine, followed later by the Sabin (attenuated live virus) oral vaccine. In recent times there has been a world-wide effort, lead by Rotary International, to eliminate polio completely through vaccination of every child. 

Great advances have been made, but pockets in various parts of the world have defied the final step. The hurdles have been many, but the objective is still being pursued. After all, success was achieved in eliminating smallpox from the world, so it is possible

The Covid19 coronavirus outbreak we have been experiencing is a wake-up call to us all. In just a few short weeks this virus has brought the world to its knees, far more effectively than any military conflict could have done. 

In future we must be prepared to act promptly on any outbreak, as history tells us that it will assuredly happen again, maybe not for many years, but plans need to be in place to act with alacrity whenever it does.

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