Fueled by outbreaks in raccoons, foxes and bats, the disease has “clearly reestablished itself as a major public health concern in New York,” according to the state health department. The current epidemic started in Florida in 1977, among raccoons, and has crept steadily northward. Infected raccoons are now turning up in the densely populated New York New Jersey area, where health officials worry they will transmit the virus to domestic animals. Unvaccinated dogs or cats could spread the disease to people.
Despite the rise among animals, rabies is still rare among humans; the number of cases has held steady at a few dozen a year since the 1950s, according to Dr. George Baer of the federal Centers for Disease Control. Untreated, the disease is fatal, but a series of five postexposure vaccinations can save an infected person.
Seven years ago TB was well on its way to obscurity. Thanks to antibiotics and a rising standard of living, the number of afflicted Americans had dropped from 84,000 in 1953 to 22,000 in 1984. Today, because of a convergence of social ills, the disease is rebounding as fast as it once fell. The U.S. caseload rose by 5 percent in 1989 and nearly 10 percent last year, due mainly to inner-city outbreaks.
A bacterial lung infection, TB spreads from person to person through coughing and sneezing. Since a strong immune system can keep the responsible microbe in cheek, most of the 10 million to 15 million Americans who carry it never suffer any symptoms. Even when the microbe does cause illness, antibiotics can usually bring it under control. The problem is that a growing number of Americans - the poor, the homeless, the drug-addicted, the HIV-infected-lack either the immune response to subdue the bacterium or the means to pay for treatment. In 1988, the most recent year on record, an estimated 1,970 Americans died of the illness.
This old childhood menace nearly vanished in the 1960s, with the advent of effective vaccines, but has lately returned with alarming fury. The number of U.S. measles cases burgeoned from a record low of 1,500 in 1983 to more than 25,000 last year, and the problem is still growing. New York City reported more measles cases during the first three months of 1991 than in all of 1990.
During the 1970s and early ’80s, measles struck mainly in older children or adults, after a vaccine failed or wore off. The disease now preys increasingly on young innercity kids, many of whom receive no vaccinations until they reach school age. And because measles is especially hard on such small patients, the consequences are growing more serious. Nearly one sufferer in five was hospitalized last year, and 97 died.
After three decades of successful vaccination, paralytic polio is little more than a bad memory. New cases are virtually unheard of in the United States. Yet earlier epidemics are still producing shock waves. Over the past decade, thousands of people who overcame the disease as children have found themselves back on crutches or in leg braces, weakened by a condition known as post-polio syndrome. The problem, doctors say, stems from the burdens put on undamaged spinal-cord neurons forced to compensate for those destroyed by the disease. The condition isn’t contagious, of course, but it’s spreading nonetheless. “I keep getting calls from new cases,” says Dr. Lauro Halstead, director of the post-polio program at the National Rehabilitation Hospital in Washington. “Our clinic is backed up for three months.”
