Claudia Böesser | MADRID/EFE/CLAUDIA BÖESSER//HENAR FERNÁNDEZ Monday 19.08.2019
There are people who currently have an infectious disease and don't know it. Most of these infectious diseases are asymptomatic or have such mild symptoms that they can go unnoticed. Because the patient is undiagnosed, the risk of transmitting the infection to their contacts increases dramatically. We examine four of these diseases: tuberculosis, viral hepatitis, sexually transmitted infections, and HIV.
Photo EFE/ Ulises Rodríguez
In the 'Map of Diseases' section of our radio program "The Scalpel", doctors from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) Jaime Esteban, Federico García, Jordi Casabona and Esteban Martínez talk to us about four infectious diseases with high incidence and some medical advances.
Tuberculosis, the deadliest in the world
Tuberculosis remains the world's deadliest infectious disease, causing more than 4,500 deaths daily and more than one million deaths annually.
According to the latest report from the World Health Organization (WHO), the incidence in Spain is about 15 cases per 100,000 inhabitants, one of the highest within the European Union.
“Sometimes we think that tuberculosis is dying out and that it doesn’t exist in our country. But it is a public health problem and there is still much to be done,” says Dr. Jaime Esteban, attending physician in the Department of Clinical Microbiology at the Jiménez Díaz Foundation and secretary of the Board of Directors of the SEIMC.
Is there a cure?
Despite its high mortality rate, tuberculosis is a preventable and curable disease. “If diagnosed early and treated properly, it is cured in virtually 99% of cases,” the doctor explains.
“These cure rates drop dramatically, to as low as 70%, when it comes to multidrug-resistant tuberculosis,” he adds.
The WHO indicates that tuberculosis could be eradicated by 2050. Dr. Jaime Esteban considers it a “difficult, but achievable” goal.
“It is a problem of political will that requires a coordinated effort at the international level,” the doctor concludes.
Viral hepatitis, another infectious disease
These hepatitis infections are caused by viruses that, when they infect liver cells, cause inflammation of the liver.
Each viral hepatitis has different transmission mechanisms and routes, so its spread depends on the type of virus and how susceptible a person is to contracting it. The classic hepatitis viruses are hepatitis A, B, C, D, and E.
“Advances in diagnosis and treatment have been very important. Highly effective treatments have been achieved, especially for hepatitis C, which cure 98% of patients,” notes Dr. Federico García, head of the Clinical Microbiology service at the San Cecilio University Hospital in Granada and member of the SEIMC viral hepatitis study group.
Combat underdiagnosis
In most cases, hepatitis is a disease that progresses without symptoms and may initially go unnoticed.
“The number of people who are unaware they have viral hepatitis is very high; that is the main problem. The challenge is to reach and diagnose this pool of patients who are unaware they have the disease,” concludes Dr. Federico García.
STIs: a silent and dangerous epidemic
Every day more than one million people contract a sexually transmitted infection (STI), according to the latest data provided by the WHO, an organization that warns about figures that have not decreased since 2012.
There are more than 30 types of viruses, bacteria, and parasites that are transmitted through sexual contact.
The main problem is that STIs are often asymptomatic or have very mild symptoms. As a result, a large proportion of the 376 million infected people are unaware that they have the virus.
“This increases the risk of them transmitting the infection to other people. That's why much more training is needed for professionals and more information for the general population,” points out Dr. Jordi Casabona, scientific director of the Center for Epidemiological Studies on Sexually Transmitted Infections and AIDS in Catalonia (CEEISCAT).
Comprehensive sex education, an unfinished task
According to Dr. Casabona, the remaining challenge regarding STIs is to improve and promote comprehensive sex education.
“In Spain, we have a historical deficit in sex education in general, especially compared to other northern European countries. We have talked a lot about AIDS, but there are other infections, such as chlamydia, which, although less serious and treatable, also have significant adverse effects,” the doctor points out.
The doctor proposes to address sex education in a "broad and cross-cutting" way, educating not only about infectious diseases but also about "contraception, accepting different sexual orientations, and the mental health associated with these issues."
“Furthermore, screening programs must be accessible services,” he concludes.
An illustration depicting sex between humans. EFE/EPA/Friso Gentsch
HIV: major medical advances
Thirty years ago, it seemed unthinkable to talk about HIV the way we do today. The idea that HIV, the virus that causes AIDS, is synonymous with death is a thing of the past.
“HIV is an example of the great medical advances that have taken place. Thirty years ago, we had no weapons to combat it. Those who suffered from it, apart from the social stigma, knew they were facing certain death. Today this has changed,” points out Dr. Esteban Martínez, consultant in the infectious diseases service of the Clinical Institute of Medicine and Dermatology at the Hospital Clínic of Barcelona and president of the SEIMC AIDS Study Group.
Today, with the help of available treatments, HIV can be controlled but not eradicated.
“The treatment is maintained indefinitely and the patient will have to get used to the idea that they will have to attend medical check-ups for the rest of their life,” adds Dr. Martínez, who points out that there are many infected people without knowing it.
Chemsex: an open door for HIV
Chemsex is a practice that is becoming increasingly popular.
It consists of organizing sexual encounters, usually in groups, and combining sex with chemical drugs.
Participants consume drugs and have sex during encounters that can last for hours or even days. Altered risk perception due to substance use can have dangerous consequences.
“Drugs help reduce stigma, generate disinhibition, and lead to multiple sexual relationships, which are a risky opportunity for the transmission of different infectious diseases,” the doctor warns.
In: https://www.efesalud.com/enfermedades-infecciosas-avances-desaf%C3%ADos/