We thought they were relegated to the past, yet they resurface with sometimes worrying incidence: measles, whooping cough, syphilis, tuberculosis… diseases of the past are returning thanks to a lack of vaccination or insufficient prevention.
– Forgotten diseases that come back –
+ Whooping cough is making a comeback in France. Since the start of the year, it has killed 14 children, the vast majority of them newborns. Public Health France speaks of a “very significant circulation of the bacteria” which is intensifying at the moment.
+ The number of measles cases is exploding. In 2023, 117 cases (including 31 imported) were reported in France, compared to 15 in 2022. This highly contagious viral disease is often benign but can lead to serious respiratory and neurological complications, sometimes fatal in babies.
+ Tuberculosis, while remaining at a low level, has seen a rebound in cases in France in 2023 after three years of health crisis, with 4,728 reported cases. Transmitted through the air, it is a highly contagious bacterial infection most often affecting the lungs, but can spread to the brain.
+ Syphilis, a sexually transmitted infection infamous throughout the world for having infected artists like Baudelaire or Schubert, has long been relegated to the background of public policies, particularly in the face of the HIV epidemic. It saw its incidence jump by 110% between 2020 and 2022.
– Had they really disappeared? –
“Never really, but they have transformed, spaced out over time,” emphasizes Mikael Askil Guedj, doctor of medical sciences and eye surgeon, who has looked at all the diseases of the century in a book “Médecins malgré vous, Portraits des maladies du XXIe siècle” (Grasset, 2023). “It’s the epidemic genius: there are cycles of a few years, sometimes a few decades where diseases are forgotten, mutate a little, then reappear without warning.”
These diseases “have always been latent”, also notes Philippe Sansonetti, professor emeritus at the Pasteur Institute and the Collège de France.
“We saw syphilis flare up with AIDS and then fall back at the same time as preventive measures; tuberculosis had diminished enough for vaccination to stop; as for measles and whooping cough, we live with irregular outbreaks,” he explains.
– How can we explain their current resurgence? –
As with other germs, scientists see this as a consequence of the end of barrier measures against the Covid pandemic, or a drop in collective immunity.
But it is often insufficient vaccination coverage that is to blame.
The MMR vaccine in particular (measles-mumps-rubella) had been the victim of strong mistrust among parents due to false reports attributing cases of autism to it. Cases soared in the 2000s that this vaccination went from recommended to mandatory for all infants in 2018 in an attempt to stem the phenomenon.
But “there are measles in adults and adolescents among those who are not or poorly vaccinated (a single injection instead of the obligatory two)”, underlines Mikael Askil Guedj.
For tuberculosis, which mainly affects people in very precarious situations, “there is a vaccine, BCG, which is no longer found anywhere in pharmacies”. And which, moreover, “does not protect very well”, he adds.
Concerning whooping cough, it would be necessary to “revaccinate in adulthood, particularly pregnant women” to protect future babies, because “the current vaccine does not protect against infection for life”, stresses Philippe Sansonetti.
As for syphilis, its return can be explained by the reduced use of condoms, since antiretrovirals have reduced the fear of AIDS.
“Many people carry it without knowing it, and continue to spread syphilis because the first symptoms are quite discreet or poorly identified,” adds Dr. Guedj.
– Recommendations for getting rid of it –
“Some countries have a more robust vaccination policy than France,” notes Philippe Sansonetti, who has high expectations for the future digital vaccination health record.
“Today, there are holes and vagueness in the actual vaccination coverage” of adults, he notes.
Without necessarily advocating compulsory vaccination for all, as is the case in pediatrics, the researcher questions the implementation of a better vaccination policy among adolescents and adults.
For syphilis “the diagnosis is difficult, but as soon as there is doubt, serological tests must be carried out”, adds the scientist, who also advocates for “major information and awareness campaigns”.
