After that read the text aloud, trying to imitate the intonation. A. There is also another factor directly related to the increased incidence of allergy in the twentieth century

A. There is also another factor directly related to the increased incidence of allergy in the twentieth century. And this matter is much less spoken about. But if we omit the discussion of this factor here, it can be interpreted as lack of proper medical self-criticism. The generations worldwide, which grew up allergic or inclined to hypersensitivity disorders, are those that have been subjected to mass national programs of cohort immunization.

B. The authors of this text are staunch supporters of vaccination and serotherapy. Since E. Jenner[17] in 1796 proposed active immunization [18] against smallpox, this disease has been universally eradicated. The annals of history keep the name of the last smallpox patient infected and recovered in 1977 – Ali Maow Maalin, a hospital cook and WHO vaccination team volunteer from Somalia. The effective vaccines are routinely and effectively used in many WHO countries for the prevention of poliomyelitis, measles, mumps, rubella, whooping cough, diphtheria, tetanus, Haemophilus influenzae type b meningitis. In some countries there is obligatory immunization with BCG vaccine against tuberculosis. In endemic regions of the world there is also mass immunization for prevention of abdominal typhus, cholera, yellow fever, hepatitis B, Japanese encephalitis and some other infections. Everyone is aware of the saving role of anti-rabies boosts. The means of active immunization – vaccines and toxoids (e.g. titanic one) and the means of passive immunization [19] – antisera and specific g-globulins (anti-diphtheria, anti-tetanic, anti-gangrenous, anti-hepatitis etc.) – virtually saved millions of lives and changed the history of civilization. Their creators, beginning from the inventor of anti-diphtheria serum E. von Behring [20] are listed in Nobel annals. In early post-Soviet Russia, as a result of a non-professional campaign against vaccination organized by medically ignorant journalists, a lot of parents refused to accept anti-diphtheria boosting for their children, misinterpreting mandatory vaccination as “violation of human rights”. As a result, big cities saw an immediate revival of diphtheria previously not observed by Russian doctors for many decades. Some developing countries regularly modernizing their armies but still not performing mass anti-tetanus vaccination, allow tetanus to plunder about 1 million victims annually. This can clearly demonstrate how catastrophic the results of infectious diseases could have been but for the great achievements of practical immunology – sera and vaccines. An anticipated breakthrough in the field is the elaboration of vaccines against Protozoan diseases and viral infections without the use of infectious agents, based on anti-idiotypic principle.

C. Now, let us turn to “the dark side of the Moon”. On the reverse of the coin world medicine could be awarded for the control over infections, one can read a sad word in bold letters: “ ALLERGY ”.

D. In order to be effective, any vaccine must be accepted by the immune system seriously. Although vaccination does not provoke the disease it is aimed at, immunization with DTP, for example, must be an equivalent of d iphtheria, t etanus and p ertussis developing in one body at the same time. Quite a substantial challenge! A challenge of this kind gives the immune system a chance to display all its abilities, not excluding the hidden predisposition to allergy. Not only natural, but also iatrogenic methods of protection against diseases are imperfect. That is why immunization is a weapon for cautious use in experienced hands.

E. Besides vaccination, during the last 80 years there has been rapid progress in the medical application of different antigenic preparations, injected via the parenteral[21] route (blood and blood products, parenteral nutrition, peptide drugs etc). Avoiding the gastrointestinal tract, they are not inactivated in the gut and carry antigenic epitopes.

F. There has been a wave of allergies accrued in parallel with these medical changes. It is quite characteristic that both anaphylaxis and immune complex reactions in clinical conditions were first described as adverse effects of serotherapy in children treated with anti-diphtheric sera (C. von Pirquet, B. Schick[22], 1902). Therefore, one practical conclusion drawn from this is the necessity to be very meticulous about observing all restrictions, precautions and counterindications which are recommended by the Advisory Committee on Immunization Practices and other authorities concerned. “Boosting for boosting” is not the correct way of prophylaxis.

G. To meet these recommendations, medical doctors need broad knowledge in Immunopathology. It is essential to know the great variance of autoimmune and allergic disorders, and it is for this purpose that we have included in our Pathophysiology textbooks not only the general description of allergic mechanisms but also multiple concrete examples of immunopathological disorders in various organs and systems.