The 3 Scourges of Infectious Disease

In 2013, TB developed in an estimated 360,000 Europeans, about 1000 persons each day. The number of TB cases dropped by about 6% compared with 2012, continuing a sustained decline over the past decade.

But rates of multidrug-resistant TB remain at very high levels, particularly in the “18 high-priority countries,” which account for 85% of new TB cases and most of the 38,000 TB-related deaths in 2013. To eliminate TB in the region by 2050, the number of cases would need to be reduced at least twice as fast as the current annual 6% decline.

Measles is a leading cause of death among young children. Worldwide in 2013, there were 145,700 measles deaths, or about 400 deaths per day, mostly children younger than 5 years. In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year. In 2013, about 84% of the world’s children received 1 dose of measles vaccine by their first birthday, up from 73% in 2000.

Accelerated immunization activities have reduced measles deaths significantly. Vaccination prevented an estimated 15.6 million measles deaths worldwide between 2000 and 2013 (a 75% drop).

Measles has been reduced drastically in countries where a vaccine is readily available but is still prevalent in developing countries. However, measles virus continues to be imported into the United States from other parts of the world. The CDC reminds health care professionals that the United States is experiencing a large, multi-state outbreak of measles linked to an amusement park in California that has spread to other states. The CDC urges health care professionals to consider measles when they evaluate patients who have febrile rash and ask about their vaccine status, recent travel history, and contact with persons who have febrile rash illness.

Influenza epidemics have caused millions of deaths worldwide. In 1918, the Spanish influenza outbreak killed more than 500,000 persons in the United States. Influenza currently is less of a public health threat, but it continues to be a serious disease, killing about 20,000 persons in the United States each year. H3N2 viruses predominated earlier in the season, but influenza B viruses have been more common in recent weeks.

The CDC recommends that influenza antiviral drugs be used early to treat patients who are very sick or who have flu symptoms and are at high risk for serious flu-related complications. The flu season has been severe for older persons. The flu-associated hospitalization rate among persons 65 years and older is the highest rate recorded since the CDC began tracking that data in 2005. Children aged 0 to 4 years have the second-highest hospitalization rate this season. For 2015-2016, the CDC recommends annual influenza vaccination for everyone 6 months and older with either LAIV or IIV.

Take-home points: TB has been in decline, but it remains a major public health problem. Accelerated immunization activities have reduced measles deaths significantly. Influenza kills about 20,000 persons in the United States each year.