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61
SECTION III
PREVALENCE OF, AND CONTROL-OVER. INFECTIOUS
AND OTHER DISEASES
By definition, epidemiology is concerned with the occurrence
and distribution of all diseases but, until recently, it had acquired
a narrower concept linking it, fortuitously, with infectious disease.
But, now that recent advances in pharmacology, chemotherapy
and immunology have rendered the conquest of infectious disease
all but complete, other non-communicable diseases are assuming
relatively greater prominence and are providing a new challenge.
This will need to be resolved by the re-orientation of the preventive
services, changes in clinical and laboratory techniques and greater
emphasis on health education.
However, we must not blind ourselves to the fact that inherent
in the speed of modern travel is the danger of the importation
from abroad of the more serious infectious diseases such as
tuberculosis, smallpox, leprosy, enteric infections and perhaps
other unfamiliar complaints which, conceivably, could threaten
our standards of public health so painstakingly built up over a
number of years. Such a situation brooks of no relaxation on
the part of health authorities, for the price of public health is
constant local and national vigilance.
Moreover, complacency with our efforts in preventive
medicine so far must not lead us to forget that, in infections of viral
origin, measles can still cause significant and serious illness in
young children and influenza is notorious in its ability, on occasions,
to disrupt the life of the community. Rubella, so often dismissed
as a trivial complaint, continues to threaten the unborn child,
while mumps persists in producing its infrequent but grave effects
on the nervous system or gonads of adults. Furthermore, viral
hepatitis, for which there are no specific laboratory tests nor
vaccines available, is becoming increasingly recognised as a serious
menace in European countries.
It is reasonable to assume that all diseases are the outcome
of interactions of environmental and genetic factors. If this view
is sustained and it is accepted that, as yet, the genetic aspects are
beyond our control, then present prevention or alleviation must
lie in influencing environments which are disease precipitating.
In this respect, diseases (other than those of the infectious type)
such as cancers of the lung and bladder, respiratory disabilities
such as silicosis, pneumoconiosis, etc., saturnism, salmonellosis, all
with their own particular associations, immediately spring to mind