EXPERT > Doctor In The House

Immunization Against Disease

By Dr. Willis Chang
Interviewed by Melissa Moniz
Wednesday - August 04, 2010
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Dr. Willis Chang
Infectious diseases specialist

Where did you receive your schooling and training?

I was born and raised here in Hawaii. I went to Saint Louis High School and then went to the University of Southern California for four years. Then I came back home to attend the University of Hawaii John A. Burns School of Medicine, which was a very good choice because it’s an excellent school. I also did my internal medicine residency here. From there I went back to California, this time to the UCLA-based hospital system for my infectious diseases fellowship, which lasted two years. Then I came home and started practice in 1992.

Can you talk more about your specialty, specifically the different types of infectious diseases?

An infectious disease is an illness caused by some kind of infectious organism. Most commonly, people think of bacterial or viral infections, and a lot of times people confuse the two. But there are major differences between the two. It also includes fungal infections, infections from parasitic organisms, and organisms in between bacteria and viruses that aren’t quite either, which have their own category. So there are all types of organisms that can cause infection, and also pretty much any part of your body can get an infection.

Which types of infections are the hardest to treat?

The hardest to treat are fungi and parasites. A lot of times the way we treat infections is by basically giving them a poison. The trick is finding a poison that kills the parasite or fungi but doesn’t kill the host human. The reason is that fungi and parasites on a cellular level are closer to humans than bacteria and viruses, so they are just harder to kill. With viruses, it’s kind of hard to say whether you kill it or not because you’re pushing the limits to what is really alive, because a virus can’t do anything on its own. It has to be within a cell. From there, it will use the machinery in the cell to produce itself. With viruses, the term that is commonly used is “inactivate.” That’s what they do with vaccines, they inactivate the virus. So with viruses what we do is disrupt their ability to reproduce and allow the body’s immune system to get rid of it.

The H1N1 virus was a big scare for a while. Are there any updates? Is it under control?

I haven’t seen or heard anything real major about it. It seems to have died down. I’m sure that they are still keeping a close eye on it, but as far as everyone having to get vaccinated, that has cooled down. I think there’s still a lot of vaccine still available, if needed.

Since August is National Immunization Month, can you discuss the importance of getting vaccinated?

Immunization in general is important for two reasons: 1) to protect the individual from acquiring these diseases and 2) to protect the general population. If we can prevent a good number of people from getting infected, then we can prevent the infection from spreading. That concept is called herd immunity. That’s one of the reasons why we’ve been seeing outbreaks of things like pertussis and measles. And this is because too many parents get scared because they hear all these things about autism being allegedly connected to vaccinations and they refuse to get their kids vaccinated.

So this causes the diseases to spread. That’s why it’s very important for parents to vaccinate their children.

Are there any diseases right now about which the public should be concerned?

The most recent scary one was H1N1 and that wasn’t as bad as we thought it would be. I was worried about that becoming a big, big problem for the world. Fortunately it didn’t turn out that way.

Is it realistic in this day and time for an infectious disease to show up and kill thousands of people because no one can find a cure for it?

It is possible, but highly improbable. There were times that we had major epidemics in disease that wiped out huge numbers of people. The biggest one I can think of is the plague. I know that happened in the dark ages, but it really set human civilization back and wiped out a huge percentage of the population.

The whole reason why the H1N1 virus was such a huge panic is that influenza did kill thousands and thousands of people back in the earlier part of the 20th century. The worry was that something similar would happen.

What has been the biggest advancement in your field that has changed the way you treat patients?

There are always new antibiotics becoming available. Antibiotics are important treating infectious diseases. But what people need to know is that, for viral infections, an antibiotic will not help. The public is gradually learning this, but there are still so many people who come in requesting an antibiotic for a viral infection. We have some anti-viral medicines, but most of those are geared toward HIV, hepatitis B and C, and also for herpes.

Are there infectious diseases that can’t be treated?

Most infections can be treated or your body will get rid of it. It’s very common that I get called in to look at a patient with a fever, because while it’s very common that a fever may be caused by an infection, that isn’t always the case. Usually, the longer someone has a fever, the less likely it’s an infection. The reason is because there are very few infections that keep going on and on in the body. For the most part, the body either gets rid of the infection or the infection gets rid of you.

So, usually, if someone has a fever for several weeks or months, then the chances of them having an infection is much lower.