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Communicable disease control: an introductory course for MPH students.

Persons preparing for careers in public health practice need a solid academic grounding in the principles of communicable disease control before arriving on the job. We have developed an introductory course in infectious disease control for the Master of Public Health program in Jerusalem, which includes instruction in the following broad areas: How do micro-organisms spread and cause disease? How do we investigate and control an outbreak? What are the basics of primary prevention by immunization and what can mass immunization accomplish? What is the importance of routine ongoing communicable disease surveillance? What are the essentials of Travel Medicine? How can public health officials provide useful information to a concerned citizenry by intelligent cooperation with the media? How can immunization programs and other programs for infectious disease control be kept current with the help of expert advisory committees? What are the best resources available to the public health practitioner in the area of infectious disease control? Armed with the essentials, the practitioner will have the tools to approach communicable disease problems in an orderly and rational way even in an atmosphere of public and professional ignorance and apprehension.

Communicable Disease Control↗

Policies for control of communicable disease in day care centres.

A survey was carried out to identify the availability and quality of guidelines for the prevention and control of communicable disease and procedures in use in child day care centres within the South West Thames Regional Health Authority. A sample of 50 day care centres was investigated including those funded by social services and privately funded day care centres. Policies for the prevention and control of communicable disease for children and staff showed a wide variation between different centres. Exclusion criteria were unclear especially in relation to carriers of the hepatitis B virus and HIV positive children. Channels for reporting and seeking advice were inconsistent. It is recommended that clear and up to date written guidelines on the prevention and control of communicable diseases should be available in all day care centres with clear indications of good practice and channels for reporting and advice. It is desirable that guidelines are agreed by the different health and local authorities throughout the region.

Child Day Care Centers↗

Evolution of the Control of Communicable Diseases Manual: 1917 to 2000.

For 84 years, The Control of Communicable Diseases Manual has provided public health practitioners with relevant and timely information on infectious diseases. An examination of the contents of the Manual's 17 editions provides insight into the changes in medical understanding of infectious diseases. This article provides an evolution of the manual and examines the diseases described in each edition.

Communicable Disease Control↗

Evidence base of incubation periods, periods of infectiousness and exclusion policies for the control of communicable diseases in schools and preschools.

BACKGROUND: The optimal control of communicable diseases requires accurate information on incubation periods, periods of infectiousness and the effectiveness of exclusion. We collected the available evidence for a wide range of infections and infestations and produced evidence-based guidelines for their control in schools and preschools. METHODS: A thorough MEDLINE literature search was conducted on the incubation period, period of infectiousness and effectiveness of exclusion for 41 infections. The quality of the information obtained was indicated by levels of evidence. The information was used to produce guidelines on exclusion, and the recommendations were graded according to the levels of evidence available. Grades A, B and C represented strongly, reasonably and poorly evidence-based recommendations, respectively. RESULTS: The quality of data obtained was highly variable. Information on incubation periods was obtained for all 41 infections and was generally of good quality. Information on periods of infectiousness and effectiveness of exclusion was of a lesser quality and was found for only 11 and 4 conditions, respectively. There were 3 Grade A, 17 Grade B and 21 Grade C recommendations on exclusion. Examples of exclusion periods include: 5 days for chickenpox, measles, mumps, rubella, pertussis and scarlet fever; and 24 h from the cessation of diarrhea for most gastrointestinal diseases In contrast to existing guidelines exclusion was not recommended for school age children with hepatitis A. CONCLUSIONS: We have been able to present the best available data on the incubation periods and periods of infectiousness of 41 childhood infections. It was possible to produce strongly or reasonably evidence-based guidelines on exclusion periods for approximately one-half of the infections.

Child↗

Globalisation and the prevention and control of non-communicable disease: the neglected chronic diseases of adults.

The growing global burden of non-communicable diseases in poor countries and poor populations has been neglected by policy makers, major multilateral and bilateral aid donors, and academics. Despite strong evidence for the magnitude of this burden, the preventability of its causes, and the threat it poses to already strained health care systems, national and global actions have been inadequate. Globalisation is an important determinant of non-communicable disease epidemics since it has direct effects on risks to populations and indirect effects on national economies and health systems. The globalisation of the production and marketing campaigns of the tobacco and alcohol industries exemplify the challenges to policy makers and public health practitioners. A full range of policy responses is required from government and non-governmental agencies; unfortunately the capacity and resources for this response are insufficient, and governments need to respond appropriately. The progress made in controlling the tobacco industry is a modest cause for optimism.

Developing Countries↗

Five-year surveillance of patients with communicable diseases nursed in isolation.

During a five year surveillance program of patients with communicable diseases nursed in isolation, we gathered information on 2880 patients who were nursed in isolation for 28 145 days, from January 1994 to December 1998. The mean number of patients nursed in isolation was 575.4 (range, 427-709) per year. On average 2.4% of patients admitted yearly to the University Medical Center (UMC) were nursed in isolation. The mean number of days nursed in isolation was 9.8 days per patient.1996 was a peak year in isolations due to outbreaks of gentamicin-resistant enterobacteriaceae (GRB) and methicillin resistant Staphylococcus aureus (MRSA). The main reasons for requiring isolation were: GRB, MRSA (proven and suspected cases), Clostridium difficile, viral infections and Mycobacterium tuberculosis. Registration of quantitative data on nursing patients in isolation, as presented in this paper, makes it possible to gain insight into the type and number of isolation indications, the required isolation room capacity on different wards, the workload of healthcare workers resulting from isolation and the trends in incidence of communicable diseases.

Communicable Diseases↗