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Emerging infectious diseases and pathogens.

Emerging infectious diseases are caused by old, new, and mutant microorganisms. Emergence of these pathogens can be attributed to changes in the characteristics and risk factors of patients, the widespread use of antibiotics, changes in the environment, the role of xenotransplantation, and international travel. In the United States, the incidences of C. difficile, cyclosporiasis, enterohemorrhagic E. coli gastroenteritis, Hantavirus, hepatitis C virus infection, and Lyme disease have increased significantly over the past two decades. Malassezia pachydermatis, extended spectrum beta lactamase (ESBL), Gram negative bacilli, and antibiotic resistant Enterococci, S. aureus, S. pneumoniae, and M. tuberculosis have also emerged prominently. Although not yet seen in the United States, variant Creutzfeldt-Jakob disease has made a great emotional impact on this country. Identifying, treating, and controlling emerging infectious disease and pathogens have created enormous challenges.

Animals↗

Residents' perspectives on the use of the Internet to improve infectious disease reporting.

Reports of infectious diseases to local and state public health agencies are often delayed and incomplete. Some of the clinicians charged with the responsibility for making notifications encounter various difficulties in reporting. These may include heavy patient loads that make it easy to forget to file reports, or cumbersome disease reporting mechanisms and systems. For some percentage of practitioners, knowledge of what and when to report infectious diseases is less than optimal. However, it is not clear how reporting methods or systems could be designed or improved, owing to lack of data on physicians' knowledge and views about them. We conducted a survey of resident physicians at three university teaching hospitals in Pennsylvania to ascertain their knowledge about reporting timeframe and responsibility, as well as their attitudes toward various methods to enhance disease reporting.

Attitude of Health Personnel↗

Prenatal testing for infectious disease.

Prenatal testing for infectious diseases is performed frequently and for a variety of indications. The purpose of this article is to review the maternal and fetal infections that pose diagnostic concerns. Recent advances in diagnostic testing (such as avidity testing) is included. Testing issues focus on the diagnosis of maternal and fetal infection.

Adult↗

Infectious diseases and day care.

Infectious diseases often occurring in epidemics, are to be expected in group day care because of the susceptibility of infants and toddlers to infection and the ready transmission of infection in the day care setting. Children in day care have more respiratory and gastrointestinal infections and are at higher risk for meningitis due to Haemophilus influenzae than are children in home care. Infections acquired by the child in the day care center may spread to members of the household and to the community. Illness in the child in day care may necessitate care at home and a change in plans of the parents; family stress may result. Infections in the day care center can be limited by appropriate use of the physical facilities, education of personnel in standards of hygiene, and maintenance of recommended immunizations of children and adult care givers. Simple techniques of infection control, such as hand washing, are the most effective.

Child↗

Infectious diseases on the World Wide Web.

Infectious diseases are a critically important topic in medicine. Although several of the most dangerous infectious diseases have been controlled or eliminated by modern medicine, many others continue to plague mankind. Old pathogens reappear, sometimes in drug-resistant forms, and new diseases such as SARS have emerged. The World Wide Web provides a plethora of information on infectious diseases; unfortunately, not all of it is reliable. This article lists the best Web sites on infectious diseases to help health professionals and consumers find current, accurate information on the topic.

Communicable Diseases↗

The infectious diseases impact statement: a mechanism for addressing emerging diseases.

The use of an Infectious Diseases Impact Statement (IDIS) is proposed for predictive assessments of local changes in infectious diseases arising from human-engineered activities. IDIS is intended to be analogous to an Environmental Impact Statement. The drafting of an IDIS for specific activities, particularly in developing nations, would provide a formal mechanism for examining potential changes in local health conditions, including infected and susceptible populations, diseases likely to fluctuate in response to development, existing control measures, and vectors likely to be affected by human activities. The resulting survey data could provide a rational basis and direction for development, surveillance, and prevention measures. An IDIS process that balances environmental alterations, local human health, and economic growth could substantially alter the nature of international development efforts and infectious disease outbreaks.

Communicable Diseases↗

[Heck cattle in the Oostvaardersplassen: risk for infectious diseases or not?].

This article discusses risk analysis of infectious diseases in a cattle population. Heck cattle living in nature reserve 'De Oostvaardersplassen' were studied as an example of the risk analysis approach. Twenty-five adult cattle were tested for every infectious disease agent that the risk analysis indicated might be prevalent. All sampled cattle tested positive for Bovine Herpesvirus 1, whereas the prevalence of antibodies against other infectious disease agents was below the level that was assumed to be the threshold for spread of the disease to cattle in the surrounding areas. Risk management of infectious diseases was expressed in a so-called 'low-risk profile'. The risk of introduction or spread of infectious diseases was estimated to be very low as long as the population was kept strictly enclosed.

Animals↗

Infectious disease surveillance in China.

A national system of infectious disease surveillance was established in 1959 in China. Now it consists of three subunits, namely, national disease reporting system (NDRS), nationwide disease surveillance points (DSPs), and surveillance network for specific infectious diseases. There are 35 notifiable infectious diseases, which are divided into Classes A, B, and C. The functions of the surveillance include explaining the natural history of infectious diseases, describing the distribution of case occurrence, triggering disease-control effort, monitoring epidemic of infectious diseases during natural disasters, predicting and controlling epidemics and providing the base of policy adjustment.

China↗

Major factors affecting the emergence and re-emergence of infectious diseases.

The diversity of infectious disease threats currently facing humanity is unprecedented because of the remarkable emergence and reemergence of pathogens worldwide. Because of population mobility, globalization of commerce and the food supply, and the effects of the HIV/AIDS pandemic, infections in the developing world must be addressed to prevent infections in industrialized countries. Because pathogens do not recognize national boundaries, the rapidity with which individuals can circumnavigate the globe incubating infections makes the control of communicable diseases an enormous challenge for governments as well as for the public and primary health care systems. A global strategy for dealing with infectious disease threats must be developed and implemented as soon as possible.

Communicable Disease Control↗

[Respiratory infectious diseases in horses].

Among all infectious diseases affecting horses, respiratory disease pose the greatest threat to horses kept in stables, horses used for breeding and race horses. Here a distinction should be made between the so-called monocausal infectious diseases (so-called Henle-Koch postulates) and multicausal infectious diseases which are the result of the synergistic interaction of different processes, that alone do not lead to disease. There is no clearcut distinction between the two groups. The most important monocausal respiratory infections of horses are caused by equine influenza virus (subtypes 1 and 2), equine rhinopneumonitis virus (equine herpes-virus type 1), equine arteritis virus and partially by Reoviruses. In addition, streptococcus equi (strangles, adenitis equorum, coryza contagiosa equorum) and mycobacteria tuberculosis can cause monocausal diseases. In multicausal infections, the first step usually is a virus infection. This is the basis for secondary infection by widespread, opportunistic agents such as bacteria, mycoplasms or fungi which lead to clinical disease. The method of choice for controlling monocausal respiratory infections of horses is prophylactic vaccination and chemotherapy. Measures to control multicausal infections include: vaccination with functional-synergistic combined vaccines; the use of herd-specific vaccines; medical stimulation of the non-specific part of immunity (immunmodulation, paramunization). Paramunization is a new concept in the prophylaxis and therapy of respiratory infections of horses and can be combined with prophylactic vaccination as well as with chemotherapy. In severe cases of respiratory disease paramunization can also be combined with corticosteroids.

Animals↗

[More information on infectious diseases provided by a national information system].

The Infectious Diseases Information System (ISIS) was established to improve the exchange of information about infectious diseases among those combating these diseases. Information about infectious diseases is obtained from municipal health services by means of a data processing system elaborated by the National Institute for Public Health and the Environment. After adjustment to the new Act on Combating and Tracing of Infectious Diseases it will be introduced nation-wide in 1998. Information about pathogens is obtained from medical microbiological laboratories (MMLs) through automatic storage of positive and negative results in a central data bank. After a pilot project had shown that the data from one MML, Arnhem, were complete and reliable, the MMLs of Roermond and Tilburg were also connected. For feedback of information to medical microbiologists and infectious diseases specialists, but also to, for instance, GPs, data from the whole country are presented daily on a public Internet site (http:/(/)www.isis.rivm.nl).

Communicable Diseases↗

Prevention of infectious diseases in aquaculture.

Infectious diseases remain one of the most important limitations to the successful propagation of aquatic animals. Most of the losses caused by pathogens in aquaculture could be prevented by health inspection, adequate environment and sound management practices. Effective control measures, mainly based upon 1) avoidance of pathogens 2) modification of the environment 3) improvement of host resistance 4) vaccination and 5) chemoprophylaxis are described.

Animals↗

[Demands on surgeons of the Infectious Disease Control Act].

The German Infectious Disease Control Act of 2001 includes a modified regulation for reporting infectious diseases and infectious pathogens and new clauses for surveillance and infection control in medical institutions. For the first time, all health care facilities are obliged to conduct surveillance of nosocomial infections and multiresistant pathogens. This legal regulation including mandatory monitoring by local health departments aims at reducing the rates of nosocomial infection and frequency and dissemination of highly resistant pathogens. This article describes the effect of the Disease Control Act on surgical departments. Surveillance of postsurgical wound infection should lead to better understanding of the cause and effect of nosocomial infection and greater acceptance of high-quality hospital hygiene management.

Communicable Disease Control↗

[Human genetics and infectious diseases (author's transl)].

Infectious diseases, especially the worldwide epidemic diseases such as plague, smallpox, syphilis, tuberculosis have to a great extent selective effects. This is demonstrated inter alia in the different "selection values" in the ABO blood group system. Under present day civilized living conditions O carriers have a preservation advantage over blood group A. The deletion of the selection factor "infectious disease", which entails a decline of immunity, may nevertheless regain importance if environmental changes occur.

ABO Blood-Group System↗

[Tasks, principles and methods of applied infectious disease epidemiology/field epidemiology].

Applied infectious disease epidemiology/field epidemiology involves the application of epidemiologic methods to unexpected health problems when a rapid, on-site investigation is necessary for timely intervention. While field investigations of acute problems share the need of high methodological quality with prospectively planned studies, they may differ in several respects. In particular, because field investigations of ten start without a clear hypothesis, they may require the use of descriptive studies to generate a hypothesis before analytic studies are conducted. There also may be an immediate need to protect the population's health, pressure to intervene may conflict with the need to investigate and publicity may introduce bias. Outbreak investigations are paradigms of the use and methodology of applied infectious disease epidemiology/field epidemiology. The steps of an outbreak investigation include verification, confirming the diagnosis, developing a case definition and case finding, describing the data in terms of time, place and person, risk identification, formulating and testing of a hypothesis, planning for further studies, establishing control measures and communicating the findings.

Communicable Disease Control↗

A multi-antigen print immunoassay for the development of serological diagnosis of infectious diseases.

Serological diagnosis of infectious diseases that generate a highly heterogeneous antibody repertoire, such as tuberculosis, requires tests based on cocktails of antigens. We describe a new method called multi-antigen print immunoassay (MAPIA) for cocktail-based serological diagnosis. The assay entails the application of antigen to nitrocellulose membranes by micro-aerosolization (printing), followed by antibody detection using standard chromogenic immunodevelopment. Cocktails of protein antigens of Mycobacterium tuberculosis tested by MAPIA were found to maintain the serological activity of each of their components. In contrast, the same cocktails tested by enzyme-linked immunosorbent assay (ELISA) had a serological activity that was lower than the sum of the activities of their components. Consequently, cocktail-based MAPIA attained the diagnostic sensitivity expected on the basis of single antigen results, while a significant loss of diagnostic sensitivity was observed with cocktail-based ELISA. Thus, the MAPIA format is superior to conventional ELISA for the serological diagnosis of infectious diseases characterized by heterogeneous antibody responses.

Antibodies, Bacterial↗

Attentional and mnemonic deficits associated with infectious disease in humans.

BACKGROUND: Infectious diseases are accompanied by behavioural and psychological changes that suggest the implication of the central nervous system. Among them, cognitive alterations have been reported, but their specificity and implication in everyday life are still largely unclear. The purpose of the present study was to evaluate and specify the everyday memory disturbances in sick human subjects and to determinate the role of fever in the appearance of these alterations. METHODS: The study was carried out in a military training centre for naval recruits. Ninety-one volunteer subjects, healthy (N = 30) or suffering from flu-like syndrome, with (N = 29) or without fever (N = 32), participated in this experiment and were administered a cognitive test (the ERBMT) according to a cross-sectional design for assessing various aspects of everyday memory. RESULTS: Sick subjects were specifically impaired in daily memory tasks that require the temporary management of a large amount of information. This impairment was similar for the feverish and apyretic sick subjects who both differed from the controls. CONCLUSION: These findings suggest that infectious disease disturbs the complex cognitive processes that might be associated with attentional functions. Moreover, these results show that fever is not a necessary condition for the appearance of these cognitive disturbances.

Adolescent↗