In 1965, Dr William Stewart was appointed US Surgeon General. These were challenging times in Public Health. A year earlier, Stewart's wonderfully-named predecessor, Luther Leonidas Terry, had overseen the publication of a report on the links between smoking and lung cancer. This in turn followed a landmark report published in the UK in 1962, which stated clearly that smoking was a cause of lung cancer and bronchitis. These were the first steps in a long struggle between public health doctors and the tobacco industry, a fight which goes on today despite the advantage having clearly shifted from the latter to the former camp.
In 1967, William Stewart, realising that chronic diseases such as cancer, cardiovascular disease and diabetes would soon take over as the leading causes of mortality, infamously stated that it was "time to close the book on infectious disease" (well, maybe he didn't; some claim he was misquoted - perhaps he mis-spoke?). To be fair to him, antibiotics had recently revolutionised the treatment of communicable diseases, and immunisation programs were gathering pace in most developed countries. Polio was on the way out. Polio! There was obviously cause for optimism.
Well, the 1960s weren't just tough in the corridors of the Center for Disease Control and Prevention. The magnitude of the conflict in Vietnam was becoming plain for all to see - Stewart was actually under a lot of pressure to reduce public health expenditure because of the cost of the war. Yet Vietnam also offered good evidence that the book of infectious diseases was nowhere near its final chapter. In 1965, Cho Quan hospital in Saigon was building a new contagious diseases ward and a new operating room for leprosy patients. The hospital was already over 100 years old by then, and has kept on growing since - in 1979, it became the first hospital in Vietnam specialising in infectious diseases. Today it is called the Centre for Tropical Diseases, and it lies just outside the centre of Ho Chi Minh City.
A brief meeting this morning with Dr Chinh, Director of the hospital, reminds me that while infectious diseases seem quite small-print when you are in Oxford, they are very much the bread and butter of medicine in many parts of the world. At any one time there are at least 10 patients in the hospital suffering from tetanus. Then there's the TB, the dengue, the HIV. Oh, and malaria's thinking of making a comeback in Vietnam.
They're nowhere near extinction. Infectious diseases are here to stay and may well become an even greater problem as climate change exerts its effects. I expect the next few weeks will help drive the point home for me. If there are any interesting stories along the way (and I'm sure there will be), I'll let you know.
In 1967, William Stewart, realising that chronic diseases such as cancer, cardiovascular disease and diabetes would soon take over as the leading causes of mortality, infamously stated that it was "time to close the book on infectious disease" (well, maybe he didn't; some claim he was misquoted - perhaps he mis-spoke?). To be fair to him, antibiotics had recently revolutionised the treatment of communicable diseases, and immunisation programs were gathering pace in most developed countries. Polio was on the way out. Polio! There was obviously cause for optimism.
Well, the 1960s weren't just tough in the corridors of the Center for Disease Control and Prevention. The magnitude of the conflict in Vietnam was becoming plain for all to see - Stewart was actually under a lot of pressure to reduce public health expenditure because of the cost of the war. Yet Vietnam also offered good evidence that the book of infectious diseases was nowhere near its final chapter. In 1965, Cho Quan hospital in Saigon was building a new contagious diseases ward and a new operating room for leprosy patients. The hospital was already over 100 years old by then, and has kept on growing since - in 1979, it became the first hospital in Vietnam specialising in infectious diseases. Today it is called the Centre for Tropical Diseases, and it lies just outside the centre of Ho Chi Minh City.
A brief meeting this morning with Dr Chinh, Director of the hospital, reminds me that while infectious diseases seem quite small-print when you are in Oxford, they are very much the bread and butter of medicine in many parts of the world. At any one time there are at least 10 patients in the hospital suffering from tetanus. Then there's the TB, the dengue, the HIV. Oh, and malaria's thinking of making a comeback in Vietnam.
They're nowhere near extinction. Infectious diseases are here to stay and may well become an even greater problem as climate change exerts its effects. I expect the next few weeks will help drive the point home for me. If there are any interesting stories along the way (and I'm sure there will be), I'll let you know.
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