The city's pediatricians are now seeing about 50 cases of congenital syphilis a year, a disease they only used to read about, said the hospital's pediatric epidemiologist, Dr. Emilia Bashenova. And a steep increase in hepatitis B, which is far more contagious than H.I.V., has been ascribed to increasing intravenous drug use and sexual transmission of the infection. Diphtheria cases soared nationwide in the early 90's, the combined result of declining childhood vaccination rates and the vulnerability of adults who had received shoddy Soviet vaccines as children. Since a new vaccination campaign backed by international aid, diphtheria is now rare again. But the low numbers don't tell an accurate story, Dr. Bashenova said.
Immunity is down among our children here.
It comes from poverty, from too little food, not enough vitamins, from more difficult access to health care - the children are sick more often, and more seriously sick. Doctors have been alerted that cholera, polio and the plague from that region may soon start showing up as well. Dr. Bashenova shook her head doubtfully.