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PubMed1991

Infectious diseases and drug abuse. Prevention and treatment in the drug abuse treatment system.

Several communicable infectious diseases, including AIDS, hepatitis B infection, gonorrhea, syphilis, and tuberculosis, are increasing among drug abusers. Drug abuse treatment programs may be ideal sites to identify those infections and initiate and maintain appropriate medical management. This paper reviews the epidemiology of those infections among drug abusers in the USA, presents rudimentary aspects of medical management of selected infectious diseases, and discusses the need to integrate infectious diseases, drug abuse treatment, and public health approaches if we are to reverse, or at least stabilize, the trends of those diseases.

Communicable Disease Control↗

PubMed2001

Models of infectious diseases in spatially heterogeneous environments.

Most models of dynamics of infectious diseases have assumed homogeneous mixing in the host population. However, it is increasingly recognized that heterogeneity can arise through many processes. It is then important to consider the existence of subpopulations of hosts, and that the contact rate within subpopulations is different than that between subpopulations. We study models with hosts distributed in subpopulations as a consequence of spatial partitioning. Two types of models are considered. In the first one there is direct transmission. The second one is a model of dynamics of a mosquito-borne disease, with indirect transmission, and applicable to malaria. The contact between subpopulations is achieved through the visits of hosts. Two types of visit are considered: a first one in which the visit time is independent of the distance travelled, and a second one in which visit time decreases with distance. There are two types of spatial arrangement: one dimensional, and two dimensional. Conditions for the establishment of the disease are obtained. Results indicate that the disease becomes established with greater difficulty when the degree of spatial partition increases, and when visit time decreases. In addition, when visit time decreases with distance, the establishment of the disease is more difficult when the spatial arrangement is one dimensional than when it is two dimensional. The results indicate the importance of knowing the spatial distribution and mobility patterns to understand the dynamics of infectious diseases. The consequences of these results for the design of public health policies are discussed.

Animals↗

PubMed1975

"Transfer factor" therapy in infectious diseases.

The world literature on transfer factor treatment in infectious diseases was examined. Even with the limits due to the incomplete knowledge of the substances, its use is worthy of further study in the field of infectious diseases.

Candidiasis, Cutaneous↗

PubMed1995

Survey to assess dental practitioner's knowledge of infectious disease.

The prerequisite to understanding the need for infection control practices in dentistry is a sound knowledge of infectious disease and the potential for its transmission in the dental setting. To assess the infectious disease knowledge-base of dental practitioners, a questionnaire was developed and distributed to dentists in British Columbia. The survey results showed that many of the mechanisms, routes and risks for the transmission of viral pathogens in the dental setting are not clearly understood by dentists. Continuing education is needed to ensure that compliance with current infection control recommendations, and the provision of appropriate patient care, continues to be based on a clear understanding by dentists of the mechanisms of infection. By identifying the current infectious disease knowledge-base of dentists, this survey may permit more specifically-directed continuing education programs to be offered.

Adult↗

PubMed2000

Hospital-treated infectious diseases in Western Pomeranian region in a 5-year surveillance: importance for travellers.

Retrospective analysis of the incidence of infectious diseases in the five-year period 1994-1998 as recorded by the Department of Infectious Diseases of the Pomeranian Medical School, has been presented. In this period contagious diseases were diagnosed in 3,863 adults with mean age of 42.8 +/- 33.5 y. Most patients still had viral liver diseases, but we observe some major changes in the epidemiology of infectious diseases in our region. There is an increased number of hospitalisations due to chronic hepatitis and liver cirrhosis as well as due to symptomatic HIV infections, whereas some acute diseases namely acute hepatitis B and infectious intoxication show decreasing tendency.

Adult↗

PubMed1979

Epidemics of infectious diseases in newborn nurseries.

The newborn nursery is a frequent site of epidemics of infectious disease. The unique susceptibility of neonates to colonization, their intimate exposure to hospital personnel, and their frquent contact with possibly contaminated inanimate objects are major factors contributing to the risk of nursery epidemics. Most of the epidemics described have been caused by bacteria; the role of viruses in nosocomial infections is not well defined but is undoubtedly greater than presently appreciated. All bacteria implicated in nursery epidemics have the capacity to survive or even multiply in the environment or on human skin or to cause gastrointestinal disease. Analysis of the etiologic bacteria, the epidemiology of outbreaks studied, and extensive clinical research indicate that bacterial transmission in this setting occurs primarily by manual contact and very infrequently by the respiratory route. The cornerstone of a program to prevent infectious diseases in the nursery consists of active, disease-oriented surveillance by specially trained personnel; microbiologic surveillance is important only when specifically indicated. Practical technical considerations for prevention of infectious diseases in nurseries are available. Programs to eradicate an ongoing epidemic must be individualized.

Cross Infection↗

PubMed2002

[Movies as a teaching resource for infectious diseases and clinical microbiology].

Since its inception, the cinema has constantly provided a reflection of infectious diseases because of their omnipresence in life and their importance to individuals and society. Few infectious diseases escape its eye, to the extent that the cinema constitutes an authentic treatise on these phenomena. The cinema is a very valuable educational resource, able to supplement classical teaching methods and to encourage critical thinking among students. The enormous flow of information, images, sounds, consequences, situations, and points of view that it provides should not be wasted and can be of great use, both in the spread of ideas and in training in infectious diseases and clinical microbiology.

Drama↗

PubMed2002

Rapid diagnosis in pediatric infectious diseases: the past, the present and the future.

The focus of rapid diagnosis of infectious diseases of children in the last decade has shifted from variations of the conventional laboratory techniques of antigen detection, microscopy and culture to that of molecular diagnosis of infectious agents. Pediatricians will need to be able to interpret the use, limitations and results of molecular diagnostic techniques as they are increasingly integrated into routine clinical microbiology laboratory protocols. PCR is the best known and most successfully implemented diagnostic molecular technology to date. It can detect specific infectious agents and determine their virulence and antimicrobial genotypes with greater speed, sensitivity and specificity than conventional microbiology methods. Inherent technical limitations of PCR are present, although they are reduced in laboratories that follow suitable validation and quality control procedures. Variations of PCR together with advances in nucleic acid amplification technology have broadened its diagnostic capabilities in clinical infectious disease to now rival and even surpass traditional methods in some situations. Automation of all components of PCR is now possible. The completion of the genome sequencing projects for significant microbial pathogens, in combination with PCR and DNA chip technology, will revolutionize the diagnosis and management of infectious diseases.

Bacteria↗

PubMedDate not supplied

Labelled leukocytes for diagnosis of infectious diseases. Our experience in labelling and clinical usefulness.

BACKGROUND: To review our experience in infectious diseases diagnosis, using a simple labelling technique. METHODS: We made 101 scans in 91 patients with suspected infectious diseases confirmed by clinical, histologic or cultural specimens; a clinical or instrumental follow-up was available for every patient. Patients were divided into four subgroups: A: Inflammatory Bowel Diseases; B: Septic Syndromes; C: Bone diseases; D: Others. We used 99mTc-HMPAO in 80 scans and 111In in 21. In 20/80 frozen and stored HMPAO was used. RESULTS: 99mTc-HMPAO frozen and stored labelling yield was: 60%(SD15%), 99mTcHMPAO: 62(12)(p n.s.), 111In 75%(10%), (p < 0.05). Frozen-stored HMPAO was sterile and apyrogen. 27 had positive scan without leukocytosis or neutrophilia. No correlation between leukocytosis or neutrophilia and yield was observed. Transit lung times ranged between 14-16 min without differences among three radiopharmaceuticals. In each Group and in the sample as a whole True Positive, False Positive, True Negative, False Negative, Sensitivity, Specificity and Accuracy, were calculated. In Group B and in the sample as a whole Predictive Positive Value and Negative Predictive Value were also evaluated. CONCLUSIONS: Labelling yields and "viability" were good using the three radiopharmaceuticals; labelling procedure was simple and safe. Accuracy PPV, NPV, cost-effectiveness were good; 111In is the choice for diagnosis of bone and joint infections. Frozen-stored HMPAO should be introduced as a cost-saving labelling procedure in practice.

Adolescent↗

PubMedDate not supplied

Risk for transfusion-transmitted infectious diseases in Central and South America.

We report the potential risk for an infectious disease through tainted transfusion in 10 countries of South and Central America in 1993 and in two countries of South America in 1994, as well as the cost of reagents as partial estimation of screening costs. Of the 12 countries included in the study, nine screened all donors for HIV; three screened all donors for hepatitis B virus (HBV); two screened all donors for Trypanosoma cruzi; none screened all donors for hepatitis C virus (HCV); and six screened some donors for syphilis. Estimates of the risk of acquiring HIV through blood transfusion were much lower than for acquiring HBV, HCV, or T. cruzi because of significantly higher screening and lower prevalence.rates for HIV. An index of infectious disease spread through blood transfusion was calculated for each country. The highest value was obtained for Bolivia (233 infections per 10,000 transfusions); in five other countries, it was 68 to 103 infections per 10,000. The risks were lower in Honduras (nine per 10,000), Ecuador (16 per 10,000), and Paraguay (19 per 10,000). While the real number of potentially infected units or infected persons is probably lower than our estimates because of false positives and already infected recipients, the data reinforce the need for an information system to assess the level of screening for infectious diseases in the blood supply. Since this information was collected, Chile, Colombia, Costa Rica, and Venezuela have made HCV screening mandatory; serologic testing for HCV has increased in those countries, as well as in El Salvador and Honduras. T. cruzi screening is now mandatory in Colombia, and the percentage of screened donors increased not only in Colombia, but also in Ecuador, El Salvador, and Paraguay. Laws to regulate blood transfusion practices have been enacted in Bolivia, Guatemala, and Peru. However, donor screening still needs to improve for one or more diseases in most countries.

Central America↗

PubMed2002

Diversifying animal models: the use of hispid cotton rats (Sigmodon hispidus) in infectious diseases.

The hispid cotton rat (Sigmodon hispidus) has been a longstanding laboratory animal model of infectious diseases. In this review, the most common usage of hispid cotton rats as models of infectious diseases is discussed in detail and all organisms, which have been shown to infect cotton rats, are listed. A state of the art overview is given on handling and maintenance of hispid cotton rats as well as experimental techniques such as narcosis and blood withdrawal. Most importantly, through the development of new reagents, the hispid cotton rat can be used to study immune responses against the respective pathogen. Hispid cotton rat cytokine and chemokine genes have been sequenced and cotton rat specific antibodies and cell lines have been produced which in connection with the establishment of immunological methods should facilitate the use of hispid cotton rats as animal models in the pathogenesis of infectious diseases.

Animal Husbandry↗

PubMed2006

Emerging infectious diseases at the beginning of the 21st century.

The emergence and re-emergence of infectious diseases involves many interrelated factors. Global interconnectedness continues to increase with international travel and trade; economic, political, and cultural interactions; and human-to-human and animal-to-human interactions. These interactions include the accidental and deliberate sharing of microbial agents and antimicrobial resistance and allow the emergence of new and unrecognized microbial disease agents. As the 21st century begins, already new agents have been identified, and new outbreaks have occurred. Solutions to limiting the spread of emerging infectious diseases will require cooperative efforts among many disciplines and entities worldwide. This article defines emerging infectious diseases, summarizes historical background, and discusses factors that contribute to emergence. Seven agents that have made a significant appearance, particularly in the 21st century, are reviewed, including: Ebola and Marburg hemorrhagic fevers, human monkeypox, bovine spongiform encephalopathy, severe acute respiratory syndrome (SARS), West Nile virus, and avian influenza. The article provides for each agent a brief historical background, case descriptions, and health care implications.

Animals↗

PubMed1994

Infectious disease surveillance during emergency relief to Bhutanese refugees in Nepal.

OBJECTIVE: To implement simplified infectious disease surveillance and epidemic disease control during the relocation of Bhutanese refugees to Nepal. DESIGN: Longitudinal observation study of mortality and morbidity. SETTING: Refugee health units in six refugee camps housing 73,500 Bhutanese refugees in the eastern tropical lowland between Nepal and India. INTERVENTIONS: Infectious disease surveillance and community-based programs to promote vitamin A supplementation, measles vaccination, oral rehydration therapy, and early use of antibiotics to treat acute respiratory infection. MAIN OUTCOME MEASURES: Crude mortality rate, mortality rate for children younger than 5 years, and cause-specific mortality. RESULTS: Crude mortality rates up to 1.15 deaths per 10,000 persons per day were reported during the first 6 months of surveillance. The leading causes of death were measles, diarrhea, and acute respiratory infections. Surveillance data were used to institute changes in public health management including measles vaccination, vitamin A supplementation, and control programs for diarrhea and acute respiratory infections and to ensure rapid responses to cholera, Shigella dysentery, and meningoencephalitis. Within 4 months of establishing disease control interventions, crude mortality rates were reduced by 75% and were below emergency levels. CONCLUSIONS: Simple, sustainable disease surveillance in refugee populations is essential during emergency relief efforts. Data can be used to direct community-based public health interventions to control common infectious diseases and reduce high mortality rates among refugees while placing a minimal burden on health workers.

Adolescent↗

PubMed1991

Patterns in the effects of infectious diseases on population growth.

An infectious disease may reduce or even stop the exponential growth of a population. We consider two very simple models for microparasitic and macroparasitic diseases, respectively, and study how the effect depends on a contact parameter kappa. The results are presented as bifurcation diagrams involving several threshold values of kappa. The precise form of the bifurcation diagram depends critically on a second parameter xi, measuring the influence of the disease on the fertility of the hosts. A striking outcome of the analysis is that for certain ranges of parameter values bistable behaviour occurs: either the population grows exponentially or it oscillates periodically with large amplitude.

Birth Rate↗

PubMed1995

Cytokines in the acquired immunodeficiency syndrome and other infectious diseases.

The pathogenesis of several infectious diseases is frequently related not only to their etiological agents of viral, bacterial, or parasitic nature, but also to the host immune response. Both inflammatory responses and specific immune responses to the invading microorganisms are controlled by complex networks of intercellular signalling molecules, namely cytokines. This rapidly growing family of mediators includes lymphokines, interleukins, and molecules such as tumor necrosis factors and interferons. Patterns of cytokine production from antigen- or allergen-specific T lymphocytic cell clones have been identified, firstly in animal models and subsequently in man, and are commonly referred to as TH0, TH1, and TH2 profiles. The predominance of one of these profiles strongly influences the type of immune response (humoral versus cellular) and, at least in some experimental models, whether the immune response is protective or harmful. This is most convincingly demonstrated in models of parasitic diseases, but has also been hypothesized to be involved in the pathogenesis of human immunodeficiency virus infection and the acquired immunodeficiency syndrome. Earlier studies on human immunodeficiency virus infection revealed that the replicative capacity of this retrovirus, like the herpes viruses, is strongly influenced by the cytokine milieu of infected cells. Transcriptional and post-transcriptional regulation of human immunodeficiency virus expression by human cytokines are examples of the complex interdigitation of viruses with the host immune system.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Therapeutic vaccines against infectious diseases.

Therapeutic vaccines against chronic infectious diseases aim at eliciting broad humoral and cellular immune responses against multiple target antigens. Importantly, the development of such vaccines will help to establish surrogate markers of protection in humans and thus will augment the subsequent development of efficient prophylactic vaccines. A combination of synthetic small-molecule drugs and immunotherapeutics is likely to represent a powerful means of controlling chronic infections in the future. Challenges faced in developing therapeutic vaccines include the following: first, overcoming the potential impairment of immune responses due to established infection; second, optimizing schedules of vaccine administration in combination with standard of care chemotherapy; and third, defining what biological and immunological read-outs should be used to infer vaccine efficacy.

Animals↗

PubMed1995

Consultation in university-based and community-based infectious disease practices: a prospective study.

Infectious disease physicians in university and community practices completed a standard data form following each of 1,366 inpatient consultations during a 7-month period. The rate of consultation was higher in the university practice than in the community practice (3.4 vs. 1.8 per 100 discharges, respectively). Known or suspected bacterial pathogens accounted for more than half of all consultations in both practice groups. The three organ systems most commonly affected by infection were pulmonary (20% in university practice vs. 19% in community practice), skin and soft tissue (13% in university practice vs. 20% in community practice), and musculoskeletal (12% in university practice vs. 16% in community practice). Bloodstream infection, pneumonia, unexplained fever, osteomyelitis, urinary tract infection, and cellulitis were the six most common disease processes that led to consultation in both practice groups. The percentage of patients with noninfectious diseases and the percentage for whom a change in antimicrobial therapy was advised was nearly identical in both practice settings. Physicians in private practice performed more consultations on weekends (20% vs. 11% in university practices, P < .001) and between 6:00 P.M. and 7:00 A.M. (15% vs. 6% in university practices, P < .001). The scope and diversity of the work of consultants in community practices are nearly identical to those of their colleagues in university-based practices.

Communicable Diseases↗

PubMed1979

Epidemics of non-infectious disease.

Epidemics of non-infectious disease are often caused by exposure to industrial products, intermediates or by-products, either in the work-place or as a result of the contamination of a wider environment. Although the prime objective of research must be the recognition of the hazard and the evaluation of its magnitude so that illness may be prevented, close collaboration of clinicians, epidemiologists and toxicologists should lead to the acquisition of much knowledge of the mechanisms by which disease is caused. Catastrophes, though always regrettable, must be seen as experiments demanding careful analysis and exploitation. Many examples of different types of problem will be selected from the numerous epidemics from the time of the Schneeberg and Joachimsthal miners to the recent concern with contamination of the environs of Seveso by dioxin.

Asbestos↗