Volume 196 - Issue 5
The case for herd immunity
Author: Bart J Currie
Med J Aust 2012; 196 (5): 359. || doi: 10.5694/mja11.11165
Published online: 19 March 2012
Published online: 19 March 2012
Gone viral. The germs that share our lives.
Frank Bowden. Sydney: University of New South Wales Press, 2011 (216 pp, $32.95). ISBN 978174223273.
FRANK BOWDEN tells a good story. As a sexual health physician and professor of medicine at the Australian National University Medical School he is well placed to provide an informative account of 15 “germs that share our life”. The anecdotes from his years of clinical and public health work in Australia make for interesting reading for both health professionals and the public.
Fairfield Hospital for Infectious Diseases was, indeed, a “beautiful anachronism” in the 1980s, remembered fondly by generations of Victorian medical students who rotated through there, especially by the registrars who had the good fortune to be mentored in the science and art of general medicine and infectious diseases by Fairfield’s legendary infectious diseases physicians. Bowden provides a poignant account of his training at Fairfield during the early years of the AIDS epidemic: “There were 16 patients with AIDS on Ward 4. They were all men, all homosexual, and they were all dying”.
Indigenous health has been an important part of Bowden’s career and many of the organisms he bases his stories on remain major causes of morbidity in Australia’s Indigenous population. Several controversial aspects are raised. The author is for an aggressive approach to screening and treatment of sexually transmitted infections (STIs). He laments that the success of the national donovanosis eradication campaign, which he was centrally involved in, has not been matched with similar results for other STIs, and that historically there has been opposition to the concept of mass treatment as a means to address the high rates of infectious diseases in Indigenous communities.
The argument has been that a “sheep-dip approach” fails to address the primary issues of socioeconomic disadvantage, housing, health hardware, and access to health services and education. Nevertheless, the stars may be aligning finally to include the possibility of population-based treatment for infections such as syphilis, scabies, trachoma and chlamydial genitourinary infections in the setting of improved primary health care.
Having to reach for the dictionary often when reading can be annoying; or it can be amusing, or even enlightening. Bowden takes the reader along from the role of necromancy in WHO decision making to the adverse impact of HIV misinformation by a pulchritudinous female surgeon. I remain baffled, however, by his allusion to the “metaphorical cojones” of cardiologists!
Not Gone but Often Forgotten: Action Needed to Address Tuberculosis in Aboriginal and Torres Strait Islander Communities
Nikkita Joshua, Emma L. Smith, Eunice (Cheeky) Love, Christopher P. Lowbridge, Nicole Tukana, Amy Bowden, Megan A. Campbell, Dawn Casey, James Ward
Newborn Screening: Equity for Aboriginal and Torres Strait Islander Families in the Context of Emerging Genomics
Gail Garvey, Sarah Norris, Joanne Scarfe, Louise Lyons
Forty Years in the Making: Reporting on the Co-Creation of a National Roadmap for Birthing on Country Services for the Best Start to Life
Res McCalman, Anneka J. Bowman, Roianne West, Kristie Watego, Jyai Allen, Claire Clack, Sue Kildea, Sue Kruske, Melanie Briggs, Cleone Wellington, Rebecca Coddington, Yu Gao, Isabella Garti, Sascha Kowalenko, Sarah Ireland, Catherine Austin, John D. Boffa, Marah Prior, Kelsie Kahl, Bettina Chaseling, Sarah Khaw, Emily Armstrong, Donna Hartz, Yvette Roe
Watchful Waiting Compared With Immediate Antibiotics for Urban Aboriginal and Torres Strait Islander Children With Uncomplicated Acute Otitis Media (WATCH): A Non-Inferiority Randomised Controlled Trial
Jennifer S. Reath, Hasantha Gunasekera, Sanja Lujic, Amanda J. Leach, Letitia Campbell, Robyn Walsh, Tim Usherwood, Geoffrey K. Spurling, Claudette A. Tyson, Deborah A. Askew, Kelvin Kong, Chelsea J. Watego, Peter Morris, Wendy Hu, Penelope A. Abbott
Beds Still Burning: Suicide Should Not Be in the Vocabulary of Children
Rudi Louis Taylor-Bragge
Weight Loss Medication Marketing and First Nations People: Disease Awareness or Corporate Profit?
Troy Walker, Simone Sherriff, Jennifer Browne