Resurgent Diseases: A Warning Sign for Public Health in the 2020s
A quiet alarm is sounding in public health circles. Diseases once considered relics of the past – syphilis, measles, tuberculosis – are making a worrying comeback. Recent data, particularly from Quebec, Canada, paints a concerning picture of declining vaccination rates and the potential for a broader resurgence of preventable illnesses. This isn’t simply a localized issue; it’s a global trend with potentially serious consequences.
The Declining Shield: Why Vaccination Rates Matter
Dr. Caroline Quach-Thanh, National Director of Public Health in Quebec, has voiced strong concerns about the drop in vaccination coverage. “The first thing we see when vaccination rates decline is a resurgence of measles,” she explains. “But if all other vaccines continue to decline, there’s nothing to say we won’t see cases of polio again.” This isn’t hyperbole. The recent detection of poliovirus in German wastewater, despite no reported cases, underscores the virus’s continued presence and the risk of re-emergence in populations with waning immunity.
The principle is simple: vaccines don’t just protect individuals; they create herd immunity, safeguarding those who are too young or medically unable to be vaccinated. When that collective protection erodes, everyone becomes vulnerable. A prime example is pneumococcal disease, where reduced vaccination rates in infancy could lead to a rise in pneumococcal meningitis, potentially causing long-term neurological damage, deafness, and even death.
Did you know? Polio was eradicated in the Americas in 1994, a monumental achievement of public health. Declining vaccination rates threaten to undo decades of progress.
Tuberculosis: An Ancient Scourge Returns
Tuberculosis (TB), a disease with roots stretching back to ancient Egypt (evidence found in 2400 BC mummies), is experiencing a global resurgence. The World Health Organization estimated 10.8 million new cases in 2023, a 2-3% annual increase since 2020. Quebec is not immune. As of December 13, 2025, 493 cases were reported, with a particularly high concentration in Nunavik, where rates are among the highest in the world.
The situation in Nunavik highlights the complex interplay between public health and social determinants of health. Overcrowded housing conditions facilitate transmission, but addressing the issue requires more than just medical intervention. It demands a holistic approach encompassing housing, social support, and economic opportunity.
Measles: Losing Ground on Elimination
Measles, declared eliminated in Canada in 1998, has lost that status due to recent outbreaks, particularly in Alberta and Ontario, with over 2000 cases reported. Quebec experienced two outbreaks in 2025 alone, totaling around 40 cases. To maintain herd immunity, vaccination coverage needs to exceed 95%. Currently, Quebec’s coverage varies significantly by region, ranging from 83% to 96%.
Pro Tip: Check your family’s vaccination records and ensure everyone is up-to-date. Contact your healthcare provider if you have any questions or concerns.
The Rise of Syphilis: A Modern Epidemic
Syphilis, an infection with a history dating back to the 15th century, is also on the rise, particularly among men who have sex with men, but increasingly in heterosexual populations, especially women of childbearing age. The most alarming trend is the increase in congenital syphilis – babies born with the infection due to untreated maternal infection. This is entirely preventable with timely screening and treatment during pregnancy.
Public health officials are exploring strategies to improve prenatal screening, including repeat testing in the third trimester and at birth, to ensure that all infected mothers and infants receive prompt treatment.
Beyond Vaccines: The Role of Globalization and Social Factors
Dr. Karl Weiss, Head of Infectious Diseases at the Jewish General Hospital, points to a shift in societal attitudes. “We’ve become a ‘rich’ society where we have the luxury of debating whether or not to vaccinate our children. Our parents and grandparents lived in a time when these diseases were common, and for them, it wasn’t a choice.”
The COVID-19 pandemic offered a stark lesson in the impact of reduced mobility and social distancing on disease transmission. As travel and social interaction resume, the risk of importing and spreading infectious diseases increases. This underscores the interconnectedness of global health and the need for sustained vigilance.
Looking Ahead: What Can Be Done?
Addressing this resurgence requires a multi-pronged approach. The EMMIE program in Quebec, which provides vaccination counseling to new parents, is a positive step. However, more needs to be done to combat misinformation, build trust in vaccines, and address the social and economic factors that contribute to health disparities.
Ultimately, the fight against infectious diseases is a continuous one. As Dr. Weiss aptly puts it, “These diseases have never been eradicated globally. It’s presumptuous to think we can eradicate infectious diseases altogether, but we can certainly minimize their consequences.”
FAQ
- Why are vaccination rates declining? A combination of factors, including misinformation, vaccine hesitancy, and access to healthcare.
- What is herd immunity? Protection from infectious disease that occurs when a large percentage of the population is immune, either through vaccination or prior infection.
- Is tuberculosis curable? Yes, tuberculosis is curable with a course of antibiotics.
- How can I protect myself and my family? Stay up-to-date on vaccinations, practice good hygiene, and seek medical attention if you experience symptoms of an infectious disease.
Explore further: World Health Organization – Tuberculosis, Centers for Disease Control and Prevention – Measles
What are your thoughts on the declining vaccination rates? Share your perspective in the comments below!
