Monday, 4 March 2013

The death throes of polio?

So, what do Pakistan, Afghanistan and Nigeria have in common? I guess many things, including religious conflicts and instability, but the answer I'm looking for is that these are the only three countries  where the disease of polio is still endemic. According to a report in last week's Independent there has been a reduction in worldwide cases from 350,000 in 1988 to just 212 in 2012. That is truly wonderful news. But, reaching the goal of polio eradication is proving elusive, not least because of the vast sums of money needed (it is estimated that each case averted cost $2000).

The vast majority of western doctors trained in the last 30 years will probably never have seen a case (at least not in its acute phase, I qualified in 1978 and have only ever seen old cases with residual muscular difficulties). Indeed the workload of the average GP is so different from pervious generations.  Writing in 1927 from his Yorkshire practice, Dr Stanley Sykes put influenza, acute bronchitis, tonsillitis, measles and whooping cough as the commonest problems. He saw more cases of pneumonia than cancer. I guess I see about 4-5 cases of pneumonia each year and something like 30 cases (including minor skin cancers) of cancer.

One of the biggest changes is what medical historian Roy Porter calls, 'the age of the acute yielded to the age of chronic disease.'  So coronary artery disease, stroke, hypertension, diabetes, asthma, COPD, dementia and the challenges of the faulty of old age, take up the bulk of a GP's time. Consequently it's easy to forget just what a scourge infections diseases used to be before widespread vaccination. So thank God for  continued efforts,  such as that by the humanitarian organisation Rotary International which was the first body to take on the global threat of polio. I'm pretty unfamiliar with the work of Rotary although attended my first event last week when I joined friends at the Kempston Rotary quiz night (we were robbed by choosing our joker in the 'wrong' round!).

So it looks like the Summer plaque (as polio used to be known), may be on its last legs. I hope our government continues to support the Global Eradication initiative, and although I'm a Mac man rather than  a PC man these days, I'm grateful for Bill Gates and the vast sums of money he has put in to the polio campaign.
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