The Changing Outlook Toward Infectious Diseases

FROM THE LECTURE SERIES: An Introduction to Infectious Diseases

By Barry C. Fox, M.D., University of Wisconsin

The mid-1900s saw the rise of several infectious diseases that had the potential to start an epidemic. In the 1970s, however, the outlook for emerging infectious diseases appeared good, thereby giving the people a chance to relax a bit. How did this happen?

Image showing a pharmacist holding medicine.
In the 1970s, America took several steps to prepare itself against any outbreak of infectious diseases. (Image: i viewfinder/Shutterstock)

American Optimism to Handle Infectious Diseases

In the 1970s, the United States was optimistic that it could handle any infectious disease that may arise. It took several steps toward handling infectious diseases, some of which included improved sanitation, increased vaccination programs, and ample antibiotics.

The tide, however, dramatically changed when the end of the 1970s brought the Legionnaires’ disease and the early 1980s brought us the recognition of a silent sexually transmitted disease—genital herpes. Along with these diseases came the slow discovery of the human immunodeficiency virus, or HIV.

Genital Herpes: The New Sexual Leprosy

Image showing a 3D illustration of the herpes virus.
Genital herpes is a form of sexually transmitted disease that was discovered in the 1970s. (Image: Kateryna Kon/Shutterstock)

After genital herpes was recognized, it received significant national media attention, even appearing on the cover of Time magazine in 1982, calling it the ‘New Sexual Leprosy’ and later deeming it the ‘New Scarlet Letter’.

The big problem with this infection is that only about 10 percent of the people that have the virus realize that they are infected. It meant that the other 90 percent might continue to infect other people unknowingly over time. There are over 700,000 new cases of herpes simplex virus 2 in the United States every year, and over 24 million people in the United States have been infected so far.

Learn more about viruses.

HIV Crisis of the 1980s

In the early 1980s, healthcare providers were unable to recognize the new illness that seem to infect gay men. The Centers for Disease Control (CDC) reported in its weekly journal summary on five cases in previously healthy, young gay men with unusual infections whose immune systems were dysfunctional. Within the next six months, 270 cases had been reported, and there were 121 deaths. Thus, the beginning of the AIDS epidemic can be seen.

Although the HIV infection started out in gay men, it found its way into the blood bank supply, and later into young women by infected heterosexual partners. The discovery of HIV as the cause for AIDS, and the subsequent blood test that was developed for HIV in 1985, were major achievements in medicine in a very short time.

The Epstein-Barr Virus or EBV

There were a couple of medical developments in the 1990s, such as chickenpox vaccines and new anti-viral drugs to treat both hepatitis and HIV. On the other hand, the world also learned about a viral illness that has infected hundreds of individuals today—the Epstein-Barr virus or EBV.

This virus got its name in 1964 when Sir Michael Epstein and Yvonne Barr discovered it. A few years later, the virus was linked to infectious mononucleosis and was named the ‘kissing’ disease, since it is usually transmitted by saliva. Sharing cups or glasses or athletic team water bottles also mimic the ‘kissing’ part of contagion.

It was found that this disease mostly infected teenagers. They often complained of general fatigue lasting for more than a few weeks, accompanied by a persistent sore throat that tests negative for streptococcus. They also had fevers and, on closer examination, it was found they had enlarged lymph nodes and, in many cases, an enlarged spleen.

This is a transcript from the video series An Introduction to Infectious Diseases. Watch it now on The Great Courses Plus.

Does the Epstein-Barr Virus Ever Go Away?

A fact about the Epstein-Barr Virus or EBV was that 90 percent of the patients had a short clinical illness before the age of five with EBV, and neither they nor their parents ever knew that they were ill from EBV.

This major discovery in the 1990s about EBV was true for all herpes viruses—the ability to establish a dormant or latent infection, similar to chickenpox coming back as shingles. EBV was also found to have the ability to cause cancer, a trait that is called oncogenic. There have been several malignant tumors linked to EBV, including Burkett’s lymphoma, nasopharyngeal carcinoma, and Hodgkin’s lymphoma.

Respiratory Syncytial Virus or RSV

Image of a young child receiving medication through an inhalation mask.
Respiratory syncytial virus or RSV is very fatal to infants and young children. (Image: Blanscape/Shutterstock)

The new millennium saw a major achievement of modern medicine—an anti-viral medicine against the respiratory syncytial virus, or RSV.

Premature infants had virtually no immune system of their own, which made them vulnerable to many infectious germs, especially to a virus known as RSV. The RSV is an RNA virus known to cause giant conglomerations of virus particles.

The lungs of the premature newborns had immature airways, making them vulnerable to RSV attacking the lungs and closing off the airways, thereby leading to death. Eventually, an antiviral medication, ribavirin, was used for the treatment of this infection and an immune serum was given weekly for prevention that helped saved many infants.

Learn more about antibiotics.

Norovirus Infection: A Viral Nemesis

A viral infection of epic magnitude in the present times is the norovirus infection. Noroviruses are the most common cause of foodborne diseases and intestinal illness, especially in the United States. They produce nausea and vomiting and often a rapid onset of diarrhea. Fever is common for 24 hours.

Fortunately, the illness lasts for only about 48 to 72 hours, with a rapid and full recovery. However, without any long-lasting immunity, one may get this disease again.

Norovirus causes an estimated 1 in 15 U.S. residents to become ill each year, resulting in almost 2 million primary care visits. Deaths can actually occur in young children and the elderly, due to severe dehydration. It is extremely contagious, as it can survive on surfaces for days, especially in freezing temperatures and cooking temperatures above 140 degrees.

This has led the CDC to recommend that paid sick leave be offered as an incentive to stay home and be symptom-free for 48 hours before returning to work.

Common Questions about the Changing Outlook of Infectious Diseases

Q: Identify the main problem with genital herpes.

The main problem with genital herpes is that only about 10 percent of the people that have the virus realize that they are infected.

Q: How did the Epstein-Barr virus or EBV get its name?

The Epstein-Barr virus or EBV got its name in 1964 when Sir Michael Epstein and Yvonne Barr discovered it.

Q: What are noroviruses?

Noroviruses are viruses that are the most common cause of foodborne diseases and intestinal illness

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