Advice to a Modern-Day Rip Van Winkle: Changes in State and Local Public Health Practice During the MMWR Era at CDC

October 7, 2011
by David W Fleming, MD & Melvin A Kohn, MD
Morbidity and Mortality Weekly Report (MMWR)

1. There are some "old" diseases about which you no longer have to worry much and some "new" ones you do.

Buy yourself an up-to-date infectious disease textbook. Vaccines have driven rates of many diseases that were common in 1961 to very low levels today in the United States. Polio, measles, invasive Haemophilus influenzae disease, and diphtheria are rarities, and smallpox has been eradicated (Table). In fact, it has become a challenge to get health practitioners to recognize these old diseases when they do occur and to mount a rapid, competent public health response to them unless a "senior" epidemiologist happens to be around. After your experiences with controlling polio in the United States during the 1950s, you might be amazed at the increasing problem of "vaccine hesitancy" (2). The rarity of many of the old diseases has made it difficult to convince a growing subset of parents to vaccinate their children against them.


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