Adam Morris: Forgotten diseases in sickening return

THEY are conditions that many of us have only heard about from elders, or read about in history books. We recognise names such as tuberculosis and dysentery, but to what extent do they apply to modern life in the Lothians and Scotland?

The answer, worryingly, is increasingly. While the health sections of modern bookshops or the online medical question and answer forums are dominated by conditions like swine flu, MRSA and asthma, other "forgotten" ailments are creeping up the inside track.

Experts are now warning about a resurgence of hepatitis C – an illness synonymous with the 1970s and 80s; mumps – a classic childhood illness of old; and even syphilis.

Together with these retro diseases, a general increase in overseas travel is also bringing back infections health workers here have rarely had to face.

There are many reasons for this, and Dr Lyndsey Myskow, a leading sexual health expert and founder of Edinburgh private doctor Medicalternative, highlighted the return of syphilis – jokingly referred to as a nasty disease of the past, but one that saw more than 70 people diagnosed last year in the Lothians, compared to four in 2000.

"There was a time when HIV first appeared when there were lots of campaigns and people started becoming very careful sexually," she said.

"As a result they became less exposed to other diseases because they were less likely to have unprotected sex. But then another generation comes along and become complacent because they haven't heard the messages.

"Certainly the trend of groups of young men and women going abroad on stag weekends is also causing this to come back."

Both increased foreign travel and migration from the third world to the UK are raising the chances of new diseases coming to these shores.

Dr Myskow continued: "People are a lot more wide-ranging in their travel now. If they are one place, they might then say 'let's go over the border', and not have the proper jabs for that."

But as Health Protection Scotland travel medicine nurse consultant Fiona Genasi points out: "Many of the problems experienced by travellers cannot be prevented by vaccinations. Other preventive measures need to be taken."

These include making safe choices with regards to eating and drinking, and protecting against insects.

It is the increased migration that has caused record highs of TB cases in the Lothians. There were 86 last year, and in the past five years there have been ten instances of the disease being passed onto health workers from patients.

However, we are far from the days where specialist TB hospitals were the norm, and now the chances are a person treated for it will survive.

Oliver Blatchford, a consultant in public health and specialist in TB control for NHS Scotland, explains: "The numbers (of new TB cases] in Scotland had been stable for almost a decade but recently we have seen the numbers increasing again.

"There are many dimensions to that, one of which is migration. There has been an increase in cases from abroad, whereas those that have emerged in the country itself have been stable.

"During the 20th century as a whole, the incidence of TB in Scotland showed a steady reduction as a result of many factors. These included better social conditions including improved nutrition and housing, along with the introduction of modern treatments for TB."

The prospects for Hepatitis C are not so strong. The main problem is the 3,000 people in Edinburgh who don't know they have it.

Again, while modern treatments can work if caught soon enough, experts have warned that the knock-on effect from the epidemic of the 1980s could lead to a hike in liver-related deaths. Professor David Goldberg, a consultant epidemiologist for HPS, added: "The majority of people in Scotland who are infected with Hepatitis C remain undiagnosed. However, there are good signs that initiatives to promote awareness and testing are making a real impact."

Mumps is another condition which has seen a big rise, largely because of young people missing out on the MMR vaccine. Nationwide there was a 50 per cent rise last year.

Bacillary dysentery, a water-borne disease brought in from the third world, has become so common among immigrants that HPS doesn't even release weekly updates about it, as it used to.

Other unusual illnesses imported to Scotland in the past year include cholera, typhoid fever and rubella. Anthrax poisoning has also appeared among heroin users, killing 13.

While the increase of rare, unusual or "retro" diseases may be on the rise, advances in medical technology mean that they are significantly more treatable now than ever before.