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PubMed2000

Genetic susceptibility in infectious diseases.

The outcome of infectious disease varies tremendously between individuals due to a number of factors and may therefore be viewed by the geneticist as complex traits. The identification of genes which influence disease outcome is, at present, a resource-intensive project and therefore should not be undertaken without clear evidence, preferably from twin studies, that the genetic contribution is significant. Although three principal techniques are available for the identification of disease susceptibility alleles, they are not applicable to all infectious diseases for logistical reasons. Whether a candidate polymorphic gene is identified through allele sharing studies, from interspecific crosses or taken from the currently available candidate list, the final evaluation will require carefully conducted disease association studies. As we move into the post genomic era, the identification of candidate polymorphisms and the characterization of their functional significance will rapidly increase, which will make the analysis of disease susceptibility in infectious diseases steadily more tractable.

Alleles↗
PubMed2003

A brief history of the prevention of infectious diseases by immunisations.

Infectious diseases have always been a terrible scourge for humans. The appearance of these plagues, as they were called without distinction, was generally connected to various conditions: asters, climatic changes or religious reasons. The concept of contagious, and then infectious, diseases came slowly. Variolation, i.e. transmission of 'virulent' matter to induce a natural disease and the immunity against it, was brought from Constantinople to England by Lady Montague, in 1721. This 'variolation' technique was also often performed in veterinary medicine against diseases like sheep-pox or pleuropneumonia. As 'vaccination' is the term generally accepted for 'immunisation', variolation can be the word designating such a technique. The second period of the history of immunisation began, in 1880, with the studies of Pasteur and his collaborators. A great number of bacterial vaccines were developed: dead, live but attenuated or only parts of pathogens. The viruses were produced in animals, then in eggs and at last, in tissue cultures. Second generation vaccines appeared with genetic engineering: recombinant vaccines, vector vaccines, nucleic acids vaccines, and markers vaccines, among others. These novel technologies can permit the development of new ones and improve the quality of the vaccines already existing.

Bacterial Infections↗
PubMed1999

Control of infectious diseases.

Deaths from infectious diseases have declined markedly in the United States during the 20th century. This decline contributed to a sharp drop in infant and child mortality and to the 29.2-year increase in life expectancy. In 1900, 30.4% of all deaths occurred among children aged <5 years; in 1997, that percentage was only 1.4%. In 1900, the three leading causes of death were pneumonia, tuberculosis (TB), and diarrhea and enteritis, which (together with diphtheria) caused one third of all deaths. Of these deaths, 40% were among children aged <5 years. In 1997, heart disease and cancers accounted for 54.7% of all deaths, with 4.5% attributable to pneumonia, influenza, and human immunodeficiency virus (HIV) infection. Despite this overall progress, one of the most devastating epidemics in human history occurred during the 20th century: the 1918 influenza pandemic that resulted in 20 million deaths, including 500,000 in the United States, in <1 year-more than have died in as short a time during any war or famine in the world. HIV infection, first recognized in 1981, has caused a pandemic that is still in progress, affecting 33 million people and causing an estimated 13.9 million deaths. These episodes illustrate the volatility of infectious disease death rates and the unpredictability of disease emergence.

Anti-Bacterial Agents↗
PubMed2005

Antibodies as delivery vehicles for radioimmunotherapy of infectious diseases.

The field of infectious diseases is in crisis and there is a need for strategies that can facilitate the rapid development of new antimicrobial agents. Radioimmunotherapy (RIT), a therapeutic modality originally developed for cancer treatment, has recently been suggested as a novel therapy for the treatment of a variety of infectious diseases. Because specific antibodies are used in RIT as delivery vehicles of cytocidal radiation, their molecular weight influences the nonspecific accumulation in infectious foci and blood clearance, and their affinity-specific accumulation of antibodies in infectious foci. Like the problems encountered in oncology, relevant variables in the development of RIT of infectious diseases include target antigen-shedding; delivering radionuclides to infectious foci in organs, abscesses, granulomas, heart and brain, and potential safety concerns. Dadachova and Casadevall anticipate that RIT can be developed for many types of infectious diseases, including microbes resistant to conventional antimicrobial therapy and agents of biological warfare.

Animals↗
PubMed2004

[Survey among local health departments concerning the implementation of the new infectious disease reporting system].

The Infectious Disease Control Act enacted in Germany in January 2001 led to the establishment of a new reporting system for infectious disease. The implementation of this system was evaluated to identify opportunities for further improvement. In a survey of all German local health departments the following criteria were analyzed: resources (staff and technical equipment), information needs (satisfaction with current offers/further training requirements), data analysis (extent of local data analysis/feedback of national data), and acceptability (case definitions/electronic reporting). In local health departments, 11% of the staff were assigned to the infectious disease reporting system. Data were processed mainly by nonmedical staff (78.4%). A computer work-station is available for most staff members. One-third of the local health departments uses the RKI software "SurvNet@rki" for data transmission. All others use commercial software. Experience with the electronic reporting system was rated as very good/good by 47.1% of local health departments, as satisfactory by 44.5%, and as problematic by 8.4%. Most of the local health departments were satisfied with the offers of information provided by RKI (96.4%) and state health departments (83.7%), respectively. However, 49.1% of the local health departments saw a need for further education and training. The implementation of case definitions was supported by 95% of the local health departments, but transmission criteria were criticized. In summary, the new infectious disease reporting system in Germany was successfully implemented. However, the system could be improved through reduction of software problems concerning electronic data processing and transmission, expansion of current offers of in-formation and provision of special staff training programs, and revision of the case definitions concerning clearness and simpler handling.

Communicable Disease Control↗
PubMed1998

Current outlook of infectious diseases in Taiwan.

The "emerging" infectious diseases have received global attention. Taiwan is a country which is going through the process of becoming "developed" from being "developing". If we compare five leading causes of death in 1952 and in 1993, three were infectious diseases in 1952 and there was none in 1993. And yet today, infectious diseases remain a major problem in this country as well in every country in the world, whether developing or developed. Some of the problems Taiwan faces are old problems with old faces. They have never been adequately solved because the societal and environmental sanitary infrastructure does not ensure proper sewage disposal, safe potable water and freedom from dangerous vectors. Examples are the diarrheal diseases, parasitic diseases, scrub typhus and Japanese encephalitis. Some of the Taiwan's problems are caused by old agents which present a new face. Mortality from tuberculosis took a dramatic and gratifying plunge in the last fifty years. Yet tuberculosis is ever present and a constant public health threat. Dengue has become a problem again because of a world breakdown in the control of the mosquito, Aedes egypti, and it is partly contributed to by increased urbanization and world travel. The problem of antibiotic resistant bacteria causing hospital acquired and community acquired infections is probably the most serious "new" problem. The most important cause is excessive and indiscriminate use of antibiotics in the community and in hospitals. We propose the establishment of "Bacterial Infections Reference Laboratory" at the National Health Research Institutes to be a national facility to study the epidemiology and control of antibiotic resistance. All infectious diseases require a rigorous system of surveillance, and precise etiological diagnosis before they can be treated or prevented. This should be kept clearly in mind when one considers the changing role of the infectious disease physician in Taiwan in the face of unsolved disease problems and a new health care system. There is inadequate attention to precise microbiological definition of most infectious diseases in Taiwan. The community of infectious disease specialists may well redirect its attention to improving the competence and utilization of microbiological laboratory diagnosis.

Clinical Laboratory Techniques↗
PubMedDate not supplied

[The diagnostic problems of systemic diseases in an infectious disease clinic].

Results are reported of a study of 46 patients with systemic diseases: connective tissue, inflammatory granulomatous processes, lymphoid tissue lesions and blood diseases treated in the clinic of infections diseases. Difficulties and errors in their clinical diagnosis, and their causes are shown. It is emphasized that these patients are hospitalized in infections clinics and that the incidence of systemic diseases rises in conditions of radiation environment.

Adult↗