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PubMed1998

A tuberculosis hotline in Tyler: a Texas resource for primary health care providers for the control of infectious diseases.

The Center for Pulmonary and Infectious Disease Control (CPIDC), located on the campus of The University of Texas Health Center in Tyler, manages a toll-free infectious disease consultation hotline advertised to public and private physicians and to health care agencies throughout the state. From January 1994 through December 1996, as part of a statewide initiative to curb an unprecedented increase in the incidence of tuberculosis observed since 1985, a concentrated effort was made to solicit health care providers for consultation requests that involved the diagnosis and management of tuberculosis, in particular, drug-resistant varieties. During that period, 3447 calls were made to the CPIDC by 1682 physicians and nurses. While most of the calls originated from 4 major urban areas plus health care facilities along the border, calls were received from more than half of all the counties in Texas. The value of providing an infectious disease consultation service, readily available, without charge, to all members of the health care community is discussed.

Communicable Disease Control↗

PubMed1991

Improving surveillance of infectious diseases in New South Wales.

OBJECTIVE: To determine the feasibility of laboratory reporting of infectious diseases and to compare the value of this system with the existing medical practitioner notification system. DESIGN: A sample of notifications was selected from medical practitioner notifications and was compared for both completeness and timeliness of notification with a sample of notifications obtained through the Laboratory Infectious Diseases Surveillance Project. SETTING: The New South Wales Health Department and the Public Health Unit of the Eastern Sydney Area Health Service. PARTICIPANTS: Medical practitioners forwarding notifications of infectious diseases to the New South Wales Health Department and laboratories participating in the Laboratory Infectious Diseases Surveillance Project. MAIN OUTCOME MEASURES: We counted the number of infectious diseases reported by medical practitioners and participating laboratories and estimated the proportion of these diseases which were common to both sources of data. We also estimated the time taken between the diagnosis of a notifiable infectious disease and the receipt of the notification by the Medical Officer of Health. RESULTS: There was substantial underreporting of notifiable infectious diseases by medical practitioners. During the study there were 461 cases of a notifiable disease reported by either medical practitioners or by participating laboratories. Of these cases, 75% were reported only by laboratory staff, 20.2% were reported by medical practitioners alone and 4.8% of cases were reported by both laboratory staff and medical practitioners. The Medical Officer of Health received the reports from the participating laboratories within a significantly shorter time than the notifications from medical practitioners. CONCLUSION: The use of infectious disease notifications by laboratories can substantially improve the surveillance of infectious diseases.

Communicable Disease Control↗

PubMed2005

Meeting the challenge of epidemic infectious disease outbreaks: an agenda for research.

Challenges arising from epidemic infectious disease outbreaks can be more effectively met if traditional public health is enhanced by sociology. The focus is normally on biomedical aspects, the surveillance and sentinel systems for infectious diseases, and what needs to be done to bring outbreaks under control quickly. Social factors associated with infectious disease outbreaks are often neglected and the aftermath is ignored. These factors can affect outbreak severity, its rate and extent of spread, influencing the welfare of victims, their families, and their communities. We propose an agenda for research to meet the challenges of infectious disease outbreaks. What social factors led to the outbreak? What social factors affected its severity and rate and extent of spread? How did individuals, social groups, and the state react to it? What are the short- and long-term effects on individuals, social groups, and the larger society? What programs can be put in place to help victims, their families, and affected communities to cope with the consequences--impaired mental and physical health, economic losses, and disrupted communities? Although current research on infectious disease outbreaks pays attention to social factors related to causation, severity, rate and extent of spread, those dealing with the "social chaos" arising from outbreaks are usually neglected. Inclusion, by combining traditional public health with sociological analysis, will enrich public health theory and understanding of infectious disease outbreaks. Our approach will help develop better programs to combat outbreaks and equally important, to help survivors, their families, and their communities cope better with the aftermath.

Attitude to Health↗

PubMed2003

Secular trend in medical education regarding infectious disease.

OBJECTIVE: The paradigm of global medical health has been re-characterised by a shift in its major focus from infectious disease to chronic illness. Opinions vary as to the declining emphasis on infectious disease. This paper provides clinicians with an understanding of a secular trend in medical education regarding the topic of infectious diseases over a period of 26 years. METHODS: A survey was carried out to evaluate coverage of infectious disease topics within recent general medicine textbooks and journals. RESULTS: The percentage of content dedicated to infectious disease has remained static in 2 major medical textbooks, whereas a trend towards decreasing coverage was shown in 4 major medical journals. Of 901 original articles published in 2000, 16.4% covered certain aspects of infectious disease, as compared with 20.9% of 790 articles published in 1985. Increasing rates of infectious disease mortality in developing countries were not consistently matched with the trend in coverage of infectious disease topics in either medical textbooks or journals. CONCLUSIONS: Our data demonstrate that coverage of infectious disease topics in publications issued in developed countries was more indicative of global trends in disease mortality rather than those of developing countries. Medical education and knowledge, which are usually delivered by the rich nations where influential medical textbooks and journals are published, place less emphasis on infectious disease relative to the burden infectious disease places on the developing world.

Bibliometrics↗

PubMed1997

[A brief discussion on ancient Chinese Infectious Hospital and setting down for the patients with infectious diseases].

The medical care and treatment of patients with infectious diseases began in the Yin-Sang dynasty is the earliest in Chinese character, indicating an idea of patients with infectious diseases kept in isolation ward. This character was found in Bronze inscriptious dated 3350 years ago. In the Spring and Autumn period, isolation ward for infectious disease patients was mentioned in Lun Yu. In the Qin dynasty, isolation ward for leprosy patients was mentioned by Qinjian from Yunmeng (Cloudy Dreams of Sleeping Tiger) in Hubei provice, which was called Liqiansuo. In the Eastern Han dynasty, infectious army hospital was set up --Yanlu. From the Six dynasties period to the Sui-Tang dynasties, clinical wards in the temples, and after the song dynasty--An Le Fang, An Ji Fang, Bao Shou Cui He Guan, Jiang Li Yuan, Yang Ji Yuan, Fu Tian Yuan etc, though not specifically set up for infectious diseases patients, all played an important role for the isolation, setting down and treatment of infectious diseases patients.

China↗

PubMed2004

Fatal infectious disease surveillance in a medical examiner database.

Increasing infectious disease deaths, the emergence of new infections, and bioterrorism have made surveillance for infectious diseases a public health concern. Medical examiners and coroners certify approximately 20% of all deaths that occur within the United States and can be a key source of information regarding infectious disease deaths. We hypothesized that a computer-assisted search tool (algorithm) could detect infectious disease deaths from a medical examiner database, thereby reducing the time and resources required to perform such surveillance manually. We developed two algorithms, applied them to a medical examiner database, and verified the cases identified against the opinion of a panel of experts. The algorithms detected deaths with infectious components with sensitivities from 67% to 94%, and predictive value positives ranging from 8% to 49%. Algorithms can be useful for surveillance in medical examiner offices that have limited resources or for conducting surveillance across medical examiner jurisdictions.

Algorithms↗

PubMed1998

Emerging and reemerging infectious diseases: a multidisciplinary perspective.

Predictions that infectious diseases would be eliminated as a major threat to human health have been shattered by emerging and reemerging infections, among them acquired immunodeficiency syndrome (AIDS), hemorrhagic fevers, marked increases in infections caused by antimicrobial-resistant bacteria, and the resurgence of tuberculosis and malaria. Understanding the dynamics of emerging and reemerging infections is critical to efforts to reduce the morbidity and mortality of such infections, to establish policy related to preparedness for infectious threats, and for decisions on where to use limited resources in the fight against infections. In order to offer a multidisciplinary perspective, 23 infectious disease specialists, epidemiologists, geneticists, microbiologists, and population biologists participated in an open forum at Emory University on emerging and reemerging infectious diseases. As summarized below, the group addressed questions about the definition, the identification, the factors responsible for, and multidisciplinary approaches to emerging and reemerging infections.

Acquired Immunodeficiency Syndrome↗

PubMed2001

Infectious diseases: considerations for the 21st century.

The discipline of infectious diseases will assume added prominence in the 21st century in both developed and developing nations. To an unprecedented extent, issues related to infectious diseases in the context of global health are on the agendas of world leaders, health policymakers, and philanthropies. This attention has focused both on scientific challenges such as vaccine development and on the deleterious effects of infectious diseases on economic development and political stability. Interest in global health has led to increasing levels of financial support, which, combined with recent technological advances, provide extraordinary opportunities for infectious disease research in the 21st century. The sequencing of human and microbial genomes and advances in functional genomics will underpin significant progress in many areas, including understanding human predisposition and susceptibility to disease, microbial pathogenesis, and the development new diagnostics, vaccines, and therapies. Increasingly, infectious disease research will be linked to the development of the medical infrastructure and training needed in developing countries to translate scientific advances into operational reality.

Bioterrorism↗

PubMed2005

Social, behavioural and environmental factors and their impact on infectious disease outbreaks.

The microbes that cause infectious diseases are complex, dynamic, and constantly evolving. They reproduce rapidly, mutate frequently, breach species barriers, adapt with relative ease to new hosts and new environments, and develop resistance to the drugs used to treat them. In their article "Meeting the challenge of epidemic infectious diseases outbreaks: an agenda for research", Kai-Lit Phua and Lai Kah Lee clearly demonstrate how social, behavioural and environmental factors, linked to a host of human activities, have accelerated and amplified these natural phenomena. By reviewing published and non-published information about outbreaks of Nipah virus in Malaysia, severe acute respiratory syndrome (SARS) and avian influenza in Asia, and the HIV pandemic, they provide a series of examples that demonstrate the various social, behavioural and environmental factors of these recent infectious disease outbreaks. They then analyse some of these same determinants in important historical epidemics and pandemics such as plague in medieval Europe, and conclude that it is important to better understand the social conditions that facilitate the appearance of diseases outbreaks in order to determine why and how societies react to outbreaks and their impact on different population groups.

Communicable Disease Control↗

PubMed2006

Association between infectious diseases and type 1 diabetes: a case-crossover study.

BACKGROUND: To investigate the role of infectious diseases in the development of type 1 diabetes, this study estimated the relative risks of type 1 diabetes immediately after infectious diseases. RESEARCH DESIGN AND METHODS: A case-crossover design was employed. Information on infectious diseases during 407 d before the onset of type 1 diabetes was collected from medical records and parents' interviews for 260 patients in Chinese type 1 diabetes registry. The frequency of infectious diseases in 42 d before the onset of type 1 diabetes was compared with either the usual frequency of infectious diseases over the past year or the actual frequency of infectious diseases in a comparable 42-d control period. RESULTS: Forty-eight (18%) patients were reported to have infectious diseases during this period based on medical records and interviews with parents. The relative risk of type 1 diabetes onset was markedly elevated to 10.1 (5.6, 17.9) immediately after infectious diseases, suggesting the role of infections as a precipitator. The relative risk decreased gradually before and after 42 d and was similar between male and female patients. CONCLUSION: The results showed that infectious diseases are associated with a large and transient increase in the risk of type 1 diabetes during 42 d after the infection.

Causality↗

PubMed2004

[Analysis of infectious disease mortality in Italy].

Our research aimed to describe infectious disease mortality in Italy between 1969 and 1999, with particular emphasis on sex, age, and geographic differences. Using mortality data provided by the Italian Central Institute for Statistics (ISTAT), we evaluated all codes of the ICD8 and ICD9 classifications to identify each cause of death attributable to infectious agents. Deaths for HIV/AIDS were excluded. Infectious diseases accounted for 1.7% of overall mortality between 1969-1999, and our approach identified 57.5% of all deaths from infections not included in the ICD8 and ICD9 infectious disease codes. Up to 1994, the mortality for all infectious diseases showed a very strong downward trend, with a 6-fold decline. This trend levelled off in 1995-1999, mainly due to increasing deaths due to septicaemias, heart infections and hepatitis. An increasing proportion of deaths due to infectious diseases occurred in the elderly, from 48.1% in 1969-1979 to 77.3% in 1990-1999. Mortality rates were consistently higher in men than in women and showed a substantial geographic heterogeneity. In the newborn, mortality rates declined 10-fold and an inverse north-south geographic gradient persisted during the study period. This exhaustive methodological approach to identifying infectious causes of deaths allows us to better define the burden of infections on mortality and register downward trends similar to those found in other industrialized countries.

Adolescent↗

PubMed1999

Host genes and infectious diseases. HIV, other pathogens, and a public health perspective.

INTRODUCTION: The global impact of infectious diseases is tremendous. In 1996, the 17 million deaths from infectious diseases accounted for one third of all deaths worldwide, while the acute and chronic morbidity from infectious diseases adds an additional great burden on global health. Multiple factors, host and nonhost, influence the susceptibility of individuals and populations to infectious diseases, as well as the severity of the illness once infected. METHODS: We review the influence of host genes on the susceptibility to and severity of viral, bacterial, parasitic and fungal infectious diseases, on vaccine responsiveness and on treatments for infections. HIV/AIDS is discussed in detail because it is an example of an infectious disease influenced by multiple host genes and because of its impact. Although the HIV/AIDS pandemic dates only since the late 1970s, it has claimed the lives of 11 million people worldwide and, today, more than 30 million people are estimated to be HIV infected. CONCLUSION: Our greater understanding of the genetic factors that influence morbidity and mortality of infectious disease leads to new avenues of prevention and treatment that can improve the health of individuals and populations.

Communicable Disease Control↗

PubMed2004

[Immune response to Engerix-B vaccine in employees at the Clinic for Infectious Diseases in Tuzla].

The adults died more frequents from the diseases that could be prevented by vaccinae. To data from WHO HBV infection numbers the nineth place on the list for causes of death. The paper from 1980 proved that chronic HBV carriers have 5-100 folds higher risk for liver carcinoma than noninfected persons lived in the same areas and had the same occupations. In the group of higher risks for HBV infection the medical employees are on the first place. The aim of our paper was to show the high risk of HBV diseased at the Clinic of infectious Diseases and to point HBV vaccina in relation to prevention of HBV infection and HBV chronical carriers. During 2002 we've tested on markers of HBV et HCV all employees of the Clinical Center and among them 84 persons of the Clinic of Infectious Diseases in Tuzla. Tests were done by ELISA in the Department of Transfusiology in University Clinical Center in Tuzla. From total 84 persons 41 (56.9%) were vaccinated before and at 17 (23.6%) the seroconversion weren't done. They most receive 1 booster-dosis. The others with negative markers of HBV were 30 (35.7%) vaccinated by "Engerix B" vaccina (GlaxoSmithKline), that we're had in the beginning of our project. 27 persons (32.0%) have been in contact with HBV virus during the long term duty in the Clinic. They've had HBs antibodies. At 3 (4.1%) members of medical employees that were recovered from severe HBV diseases after accidental injury by winkles the seroconversion HBsAg to HBs antibodies were happened. Among the to have been in contact with HBV virus proved the true of high risk of diseased from hepatitis in the Clinic of Infectious Diseases.

Hepatitis B↗

PubMed2003

[Elderly patients presenting with fever and respiratory problems in an intensive care unit. Diagnostic, therapeutic and prognostic impact of a systematic infectious disease consultation].

OBJECTIVE: To measure the impact of an infectious disease consultation on the morbidity and mortality in patients aged over 75 presenting with fever and respiratory signs and treated with antibiotics in an intensive care unit. METHOD: Retrospective study comparing two groups of patients having been seen or not by an infectious disease specialist within the first 24 hours of hospitalisation. The data available before prescription of the antibiotherapy by the intensive care physician were collected, together with the diagnostic and therapeutic proposals of the infectious disease specialist. Morbidity and mortality were assessed from the medical files and nurses charts and included: duration of fever and hospitalisation, complications with antibiotherapy and venous catheters and the cause or causes of death. RESULTS: 169 patients were included, 115 of whom had been seen (study group) and 54 who had not bee seen (control group) by an infectious disease specialist. Sixty-six percent of the infectious disease specialists (76/115) proposed a differential diagnosis, although a diagnostic re-assessment was effective for only 22% of the patients in the control group (p< 0.01). A 50% reduction in antibiotic prescriptions was observed in the study group. The duration of hospitalisation was greater in the study group than in the control group (a mean of 10 versus 7 days, p<0.01), but was unrelated to the consultation with a specialist. The same result was observed with the complications of venous catheterism (16 versus 2 cases, p =0.04). The rate of mortality was of 13% in both groups. CONCLUSION: The over-zealous diagnoses of infection are the primary cause of over-prescription of antibiotics. Despite the population studied, considered as fragile, the 50% reduction in antibiotics is without any negative prognostic impact.

Aged↗

PubMedDate not supplied

ABO system of blood groups in people and their resistance to certain infectious diseases (prognosis).

Natural resistance to many infectious disease which to certain extent depends on the blood group of a person is inherent in people. As is known, human erythrocytes possess the surface antigens A, B, AB that determine the groups of blood. Blood group O erythrocytes do not possess these antigens but blood serum of such people have antibodies to A and B antigens. In people with blood group A there are antibodies to antigen B and vice versa. Human blood of AB group does not contain antibodies to erythrocyte antigens of other blood groups. This determines natural resistance of people to many infectious diseases whose agents have antigens on the surface of their cells that are similar to antigens of one or another group of blood. Thus antigens similar to those of blood group A erythrocytes are localized on the agents' cells, such agents are neutralized by natural antibodies of blood groups O and B. When antigens similar to those of blood group B erythrocytes are localized on the agents' cells, that is the obstacle for them when affecting people with blood group A and B whose serum includes a lot of antibodies to these antigens. Only people with blood group AB are most sensitive to infectious diseases which agents carry antigens A, B or both A and B on their cells, since blood of such people does not contain the corresponding natural antibodies. To illustrate the above said the author gives a prognosis of possible affection of people by most pathogenic mycoplasmas whose cells possess antigens similar to those of erythrocytes of one or another blood group.

ABO Blood-Group System↗

PubMed2004

Clinical nurse specialists and nurse practitioners: complementary roles for infectious disease and infection control.

BACKGROUND: The escalation of infectious diseases worldwide heralds an unprecedented need for nurses with advanced practice graduate preparation. OBJECTIVE: To describe how a graduate program prepares clinical nurse specialists and nurse practitioners in infectious diseases or infection control to provide distinct yet complementary care for patients with contagious disease and potentially antimicrobial-resistant infections. RESULTS: The University of Washington School of Nursing launched a new master of nursing program for infectious disease and infection control to reduce the threat of infectious diseases and multiple-resistant organisms.

Communicable Diseases↗

PubMed2005

[Infectious diseases in Poland in 2003].

The most frequent infectious disease as in the previous years was influenza. 1,216,285 cases were reported (3,184.4/100,000). Number of foodborne infections and intoxications remains high--20,221 cases (52.9/100,000). 81.6% of them were caused by Salmonella. In 15.5% of them etiologic factor was not found. In this number Campylobacter infections, rarely tested in Poland may be hidden. Especially alarming is number of cases of diarrhea among children 0-2. Seasonality of childhood diarrhea indicates domination of viral infections, most probably rotaviral among them. There was noted decrease of incidence of newly diagnosed cases of viral hepatitis B (4.7/100,000) which dropped to the level of the incidence of viral hepatitis C (5.9/100,000). Hepatitis A remains at the low level (0.39/100,000). Level of newly diagnosed cases of AIDS (116 cases, 0.36/100,000) remains relatively stable for last few years. The major problem is decreasing reporting of possible risk factors. Infectious diseases caused 0.75% of deaths. Mortality from infectious diseases was 7.2/100,000 and was significantly higher among men (9.5) then among women (5.0). In urban settings mortality from infectious diseases was higher (7.3/100,000) then in the country (6.9). As in previous years, the highest number of deaths was caused by tuberculosis and its late sequels (34.4%). Attention should be given to the increased number of deaths due to sepsis (32.3%, without neonatal sepsis).

Adolescent↗

PubMed1994

Information management in infectious diseases: survival of the fittest.

Like all physicians, infectious disease practitioners are concerned and uncertain about their future role as the United States undergoes a major reform of its health care system. Managed care has become the dominant type of health care provided to most patients in the United States, and specialists are increasingly threatened as patient referrals decrease, reimbursements decline, and health care organizations preferentially recruit primary care physicians over specialists. These changes may represent a potential shift in responsibilities and duties for many infectious disease practitioners. The primary role of the infectious disease physician has traditionally been consultative, although many practitioners have organized programs in infection control, hospital epidemiology, and antibiotic management. These programs have become more important as managed care organizations understand the implications of their potential cost savings. The value of these programs will also be significantly enhanced by the ongoing revolution in medical information management that is being driven by computerization. This paper outlines the enlarging role of computerized information management in clinical patient care and its impact on infectious disease practitioners who are increasingly involved in infection control, hospital epidemiology, and antibiotic management programs, as well as in the development of computerized clinical information systems.

Communicable Diseases↗