Inthe early 20thcentury, infectious disease like diphtheria was highly dreadful. Itclaimed more than 10,000 lives in 1920s. Subsequently, in 1940s and50s, polio killed and paralyzed thousands of children. Smallpox wasdeclared eradicated in 1977 from the world while polio in 1991 fromthe USA and the Western Hemisphere. Before polio vaccine wasdiscovered, there were almost 13,000, to 20,000, cases reported everyyear, but in 2000, there was no single case of that ailment whilediphtheria that caused 12,230 deaths in U.S in 1921 was only reportedonce in 1998. Additionally, death from infectious diseases havedeclined remarkably during the 20thand 21stcentury decreasing the mortality rate and increasing the lifeexpectancy by 29.2% in years. In the early 1900s, 30.4% of childrenless than 5 years died as a result of infectious diseases. This ratehas drastically dropped with only 1.4% deaths reported in 1997.Likewise, according to CDC, about 20,000, children aged <5 yearsare hospitalized as a result of influenza every year in the USA. InMaryland, the highest rate of hospitalization was recorded in infantsbelow six months with a range of 9 to 30 cases per 10,000 childrenper annum. Interventions that are evidence based should be used inending the disparities that exist in administering vaccinations.People that are pregnant, obese and chronically ill, are at anincreased risk for influenza complications. CDC noted that there waslower coverage for influenza vaccination among Hispanics andnon-Hispanics blacks during the 2009-2010 season.
Keywords:infectiousdiseases, mortality, influenza, disparity
Infectiousdiseases are maladies caused by bacterial, viral, parasites andfungal organisms (American Academy of Pediatrics, 2015). It isimportant to note that some of these organisms that are found in ourbodies are harmless, but in certain conditions they might causediseases. The infectious diseases are transmitted through variousagents or venues these can be insects, saliva, water, sweat, blood,food, and animals among other many factors. The symptoms forsicknesses caused by these organisms vary, but mainly include fatigueand fever. It is important that you seek medical advice once you haveany symptoms. Moreover, some infectious diseases such as chickenpoxand measles among others are preventable through immunization.
Thedesire to change the standards of living by prolonging lifeexpectancy and increasing the mortality rate of children has been thegoal of many nations. In the early centuries, babies used to becomeill, disabled, and die due to lack of immunization. In the early 20thcentury, infectious disease like diphtheria was highly dreadful(Morbidity and Mortality Weekly Report, 1999). It claimed more than10,000 in 1920s. Subsequently, in 1940s and 50s, polio killed andparalyzed thousands of children. Also, there was a time in the U.Sthat measles affected more than a half-million children, but todaypeople live healthier and parents have become concerned aboutinfectious diseases than they were in the past after greatdevelopment in vaccines. For instance, smallpox was declarederadicated in 1977 from the world while polio in 1991 from the USAand the Western Hemisphere. A notable fact is that before poliovaccine was discovered, there were almost 13,000 to 20,000 casesreported every year, but in 2000 there was no single case of thatailment while diphtheria that caused 12,230 deaths in U.S in 1921 wasonly reported once in 1998 (Morbidity and Mortality Weekly Report,1999).
Additionally,death from infectious diseases have declined remarkably during the20thand 21stcentury decreasing the mortality rate and increasing the lifeexpectancy by 29.2% in years. In the early 1900s, 30.4% of childrenless than 5 years died as a result of infectious diseases. This ratehas drastically dropped with only 1.4% deaths reported in 1997(Morbidity and Mortality Weekly Report, 1999). The causes of deathsin the 20thcentury was influenza, pneumonia, tuberculosis, and diarrhea. Theworst deaths were caused by the influenza epidemic which killed morethan 20 million people inclusive of 500,000 in the USA (Morbidity andMortality Weekly Report, 1999). Thus,as a result of immunization and various breakthrough in vaccination,the mortality rate has greatly reduced today compared to the earlycenturies.
Itis important to note that there is a need for masses to be sensitizedabout immunization and infectious diseases as they do not stop atgeopolitical borders. What makes this issue important is the factthat despite infectious diseases being preventable, the health caresystem focuses its efforts on treatment. It is thus important thatthe health care provides a culturally appropriate preventive care asthere is a shift in the demographic. Infectious agents need to belooked at from a global context due to the increase in migration,international travel, bioterrorism, and the importation ofagricultural products. Thus, prevention and treatment processesremain important, but creating awareness is an essential componentfor reducing infectious disease transmission because children arestill suffering from infectious diseases, which are avoidable throughimmunization.
Surprisingly,today children continue to get diseases that are vaccine-preventablein a developed country like the United States. These are diseasessuch as viral hepatitis, tuberculosis, and influenza that remain tobe among the principal causes of illnesses and deaths, and accountfor significant spending in the health care budget. Childhoodimmunization programs have provided a great investment return in theUnited States “saving 33,000 lives, preventing 14 million cases ofdiseases, reducing direct and indirect health care cost by $9.9 and$33.4 respectively,” (Healthy People Org, n.d). Despite thatprogress, about 300 children and 42,000 adults die each year in theUnited States from vaccine-preventable diseases (healthy People Org,n.d).
Anotherdata from Healthy People 2020 organization shows that there are56,000 deaths annually resulting from acute respiratory infectiousdiseases such as influenza and pneumonia. Averagely, in the UnitedStates, there are more than 36,000 deaths and 200,000 hospitalizationcases while in Maryland the mortality rate is at 15.5% per 100,000each year, as a result of influenza. Furthermore, in 2010, there werean estimated 12,270 deaths in the world and 270,000 hospitalizationsas a result of H1N1 influenza with 1270 deaths were from peopleyounger than eighteen years (Healthy People Org, n.d).
Likewise,according to CDC, about 20,000 children aged <5 years arehospitalized as a result of influenza every year in the USA (Johnson,Hayes, Brown, Hoo, & Ethier, 2014). In Maryland, the highest rateof hospitalization was recorded in infants below six months with arange of 9 to 30 cases per 10,000 children per annum (NationalVaccine Information Center, 2015). Moreover, 2009-2010 was the firstinfluenza season for which all children aged between 6 to 17 monthswere recommended for annual vaccination. Since then, it becamenecessary that pregnant women be vaccinated for influenza due to therisks of its complication. In 2012, 50.5% of pregnant women wereimmunized from influenza (Johnson et al., 2014). On the other hand,in Maryland, it is not mandatory that a child is vaccinated if aguardian or parent objects to it due to religious beliefs, but deathsthat result due to lack of immunization have dropped by 30% (NationalVaccine Information Center, 2015).
Infectiousdiseases, in this case influenza, usually affects people who areyoung or aged (Markland & Durand, 1976). This is because theimmune system of this population is not developed or is low, as aresult, they become susceptible to infectious diseases. The immunesystem is usually affected by various factors such as HIV/AIDS,cancer treatments, corticosteroids and anti-rejection drugs.Furthermore, living conditions also influence the rate of contractinginfectious disease for instance, people living in barracks andnursing homes are at a high probability of contracting influenza(Markland & Durand, 1976).
Ithas also been noted that people that are pregnant, obese andchronically ill, are at an increased risk for influenzacomplications. Furthermore, it has been noted that disparities inaccessing health care also influences the rate at which influenzavaccinations are covered. According to CDC, it was noted that therewas lower coverage for influenza vaccination among Hispanics andnon-Hispanics blacks during the 2009-2010 (Johnson et al., 2014). Theorganization also noted that there was an improvement in childhooddisparity vaccination coverage compared to people above 65 years,which has persisted. This disparity has been caused by lack ofawareness and surveillance system, which keeps a record ofvaccination progress.
Asa result, it is necessary that interventions that are evidence basedbe used in ending the disparities that exist in administeringvaccinations. This is because only those interventions that haveworked before in reducing disparities will be effective ineliminating the discrimination that exists in delivering vaccinationcoverage. Also, it would be effective if immunization registries,recall systems, regular assessment of vaccination coverage levels,and standing orders for vaccination are used. This will increasesurveillance, reporting, and analysis, which will help in eliminatingdisparities and promoting health equity.
Tohandle these disparities, there is a need that the federal governmentworks in collaboration with local government in increasing awarenessand equipping medical facilities with necessary medical personnel,equipment, and medicine that will be used in handling the issue ofinfectious diseases (Markland & Durand, 1976). Also, it isimportant to note that infectious diseases are closely related toliving conditions.
Thus,it is mandatory that the local government does all it can to improvethe level of living standards by providing social amenities thatfavor good health such as clean water, better housing structures,treatment and intervention procedures for other ailments thatincrease the risk for infectious diseases. The better the livingstandards of people, the better the ability to afford a good lifethat is necessary to have proper diet and medical help. This in turn,will have the effect of people having high immune levels reducing therisk for infectious diseases.
Theintroduction of vaccines have been transformational in improving themortality rate of children not only in Maryland, but also in the U.S.These rates have dropped significantly with only 300 cases ofmortality rate reported per year as a result of infectious diseases,which is a significant progress despite lack of awareness anddisparities in the health care system. Therefore, it is importantthat the health care provides culturally appropriate preventive careas there is a shift in the demographic.
AmericanAcademy of Pediatrics. (2015, November 21). History of Immunizations- HealthyChildren.org. Retrieved fromhttps://www.healthychildren.org/English/safety-prevention/immunizations/Pages/History-of-Immunizations.aspx
HealthyPeople 2020. (n.d.). Immunization and Infectious Diseases | HealthyPeople 2020. Retrieved fromhttps://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases
Johnson, N. B.,Hayes, L. D., Brown, K., Hoo, E. C., &Ethier, K. A. (2014). CDC National Health Report: LeadingCauses of Morbidity and Mortality and Associated Behavioral Risk andProtective Factors—United States, 2005–2013. Retrieved fromhttp://www.cdc.gov/mmwr/preview/mmwrhtml/su6304a2.htm
Markland, R. E.,& Durand, D. E. (1976). An investigation ofsocio-psychological factors affecting infant immunization. AmericanJournal of Public Health,66(2),168-170. doi:10.2105/ajph.66.2.168
Morbidityand Mortality Weekly Report (MMWR). (1999). Achievements in PublicHealth, 1900-1999: Control of Infectious Diseases. JAMA,48(29),621-629. Retrieved fromhttps://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm
NationalVaccine Information Center. (2015, April 5). Maryland State VaccineRequirements – National Vaccine Information Center. Retrieved fromhttp://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/maryland.aspx