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Saturday, April 1, 2017

Learn from the past, look to public health for the future

Dr. Lena Derie-Gillespie
AHS South Zone Medical Officer of Health Dr. Lena Derie-Gillespie - I do a lot of media interviews every year on influenza and outbreaks of illness in the South Zone. I am continually surprised by how people seem shocked to hear that influenza can kill people. Deaths from influenza continue to make headlines, despite the fact that the seriousness of influenza and other infectious diseases are not a medical mystery.

Prevention should always trump treatment, and yet so much focus is placed on the newest and shiniest medical equipment or treatment breakthrough that plain-old prevention often gets pushed to the sidelines. Really the question is as simple as: would you rather get sick and face the potential consequences of treatment; or would you rather not get sick at all?

When faced with trying to explain why we focus so much attention on preventative care such as immunization, hand washing and good hygiene, I find it most useful to reflect on the past. The Spanish Influenza pandemic of 1918 killed between 20 and 50 million people worldwide - many of them otherwise young, healthy people. It is tempting to think that such an event could never happen in modern times, but such an idea may be false. Although medical science has come a long way, there is still no cure for influenza and the preventative measures we employ, like influenza immunization, only work if people actually do them. Antibiotics are ineffective against influenza and many modern environmental factors, like urbanization and easy travel, may actually lead to an increased spread of viruses compared to 1918.

Another example of an old disease that is making a comeback is syphilis. Although syphilis can be treated with antibiotics, it has the potential to do significant damage, especially to unborn babies, before it is diagnosed and treated. So why are both syphilis and gonorrhea rates increasing in Alberta? One hypothesis is that people are letting prevention (I’m looking at you, condoms) lapse. In the early 1980s, HIV was a new and terrifying virus and safer sex became a topic of conversation. Amazing advancements have been made in the treatment of HIV and now many people live well with HIV. However, safer sex should not be a relic of the past and despite treatment advancements, the prevention of STIs should remain our goal. Communicable diseases like syphilis are a great example of how treatment of one patient can equal prevention in future patients. However, we as a society need to remain vigilant and not let prevention get pushed aside in favor of ’I just want a pill to treat it.’

Modern society may have a preoccupation with the new, the easy and the convenient, but when it comes to your health, sometimes lessons learned from the past are the best. Prevention not only makes good common sense but is also financially smart; an important factor when health-care resources are both fixed and shared. Public health may not be flashy but immunization, safe water, general hygiene and environmental safety have saved countless lives and will continue to do so in the future. I have been trying throughout this article not to lean on the old standby of ’an ounce of prevention is worth a pound of cure’ but really, my point is that the simple and the established knowledge, like good old fashioned hand washing, will stand the test of time and may even save your life.

Dr. Lena Derie-Gillespie is Medical Officer of Health in the South Zone.

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