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Infectious diseases in persons of leadership.

A reference source listing the significant infectious diseases affecting over 500 persons of leadership is presented. The credibility of biographical diagnoses is discussed, and the historical perspective of these diseases is outlined. The impact of infectious diseases on the lives of individual leaders in many fields has modified history many times.

Europe↗

[Infectious diseases among military personnel in the catchment area of the United Nations Interim Force in Lebanon hospital, from 1993 to 2000].

In the study the incidence of infectious diseases among military personnel of the United Nations Interim Force in Lebanon and local civilian population is examined. Additionally, the authors investigate the potential risk factors, including environmental conditions, influencing the incidence of infectious diseases. Epidemiological analysis was conducted based on the medical records of patients treated in the Internal and Surgical Ward of the UNIFIL Hospital from 1993 to 2000. The patients with infectious diseases accounted for 5.84 % of all patients hospitalized during the analyzed period. The most frequent infectious diseases treated during that time were salmonellosis and staphylococcal food poisoning.

Adult↗

Development of antimicrobial agents in the era of new and reemerging infectious diseases and increasing antibiotic resistance.

During the past 2 decades, new infectious diseases have appeared and old ones previously thought to be controlled have reemerged. New and reemerging infectious agents will continue to pose serious threats well into the 21st century. The prediction that the threat of infectious disease may not diminish is supported by evidence that infectious agents cause many chronic diseases and cancer of previous unknown etiology. Moreover, the utility of existing antimicrobial agents is rapidly eroding, tipping the balance in favor of multidrug-resistant pathogens, and there appear to be few, if any, new classes of drugs currently in clinical development. The need for research directed toward development of new antibiotics has never been greater. Advances in research technologies and microbial genome sequencing in the past decade have led to identification of a large number of new targets. Functional genomics and integrative biology should validate these targets and provide the best opportunity for developing effective new therapies, improved diagnostic techniques, and better tools to understand host-pathogen interactions.

Animals↗

Bone and joint manifestations of systemic infectious diseases.

Bone and joint infections can occur as the consequence of a wide variety of systemic diseases. Disseminated fungal and mycobacterial infections, hepatitis, syphilis, gonorrhea, Lyme disease, and AIDS can all have osteoarticular manifestations. A thorough knowledge of the wide range of potential pathogens is key to establishing a correct diagnosis and instituting appropriate treatment.

Bone Diseases, Infectious↗

Statistical analysis and prediction on incidence of infectious diseases based on trend and seasonality.

We proposed a prediction methodology for the incidence of infectious diseases using incidence data on measles and influenza for forty years in Japan. We also proposed a diagram that makes it possible to convey information on infectious disease incidence more attractively to a wider audience. This can be a useful tool for health promotion in the community. The obtained results are as follows: 1. It was advantageous to use data transformed by logarithm in statistical analysis of infectious disease incidence. 2. The incidences of measles and influenza exhibited strong seasonality. Measles was most frequent in June and influenza in February. 3. Long-term trends were extracted from the derived data obtained by eliminating seasonal effects from the original data. For measles, a decline was accelerated by the introduction of vaccination program in 1978. Influenza also showed a decline for these thirty years. 4. The observed incidence data were quite well predicted by only the trend and the seasonality. The squares of multiple regression coefficients of measles and influenza were 0.84 and 0.58, respectively. The analysis of the residuals suggested there was a possibility of improvement in prediction. 5. The improvement in prediction was attained by incorporating an autoregressive component of the residuals. As a result, the squares of multiple correlation coefficients of measles and influenza increased to 0.97 and to 0.79, respectively. 6. We finally proposed the TS-decomposition diagram to facilitate practical use of incidence data. In this diagram, current incidence data and predicted values for the near future are plotted on the plane where the trend and the seasonality are superimposed.(ABSTRACT TRUNCATED AT 250 WORDS)

Forecasting↗

Basic Surveillance Network, a European database for surveillance data on infectious diseases.

The Basic Surveillance Network was started in 2000 and is one of the networks on infectious diseases funded by the European Commission. The network collects and makes readily available basic surveillance data on infectious diseases from all the 'old' (pre-2004) European Union member states. The aim is to provide easy access to descriptive data that already exist in national databases, so that it is possible to monitor and compare incidence trends for infectious diseases in the EU member states. The list of diseases covered by the network has recently been expanded from 10 initial 'pilot' diseases to over 40 diseases listed by the EU to be under surveillance. In the near future, the new member states will be invited to participate in the network. Data are case-based and comprise date of onset of disease, age and sex. Only a very short list of disease specific additional variables, such as country of infection or immunisation status, is collected. Classification of cases (possible, probable, confirmed) is specified according to EU case definitions. The participants of the network have access to an internal web site were all the data is presented in tables and graphs. An open website is available for the public at https://www.eubsn.org./BSN/

Communicable Diseases↗

The Croonian Lecture, 1994. Populations, infectious disease and immunity: a very nonlinear world.

The interaction between the variables that determine the typical course of infection in an individual patient and those that determine transmission in communities of people is often complex and very nonlinear in form. Mathematical models of infection and immunity are used to study the interaction in a wide variety of problems including the role of antigenic variation in pathogen persistence in the host, the design of vaccination policies for the control of childhood viral infections, the role of heterogeneity in sexual behaviour as a determinant of the epidemiology of sexually transmitted diseases and the demographic impact of infectious disease on human population growth. The themes of dynamical complexity in outcome deriving from simple biological assumptions, the evolution of the parasite under selection by the immune system, heterogeneities in the interacting systems, and the necessity of comparing prediction with observation reoccur in each problem. It is argued that much is to be gained from the use of mathematics in biology, concomitant with experiment and observation, in providing precision in interpretation and in facilitating the formulation and testing of hypotheses to explain observed pattern. Special emphasis is placed on the need for interdisciplinary research on the epidemiology of infectious diseases that combines molecular, immunological, field study and theoretical approaches.

Adult↗

Oculo-renal disorders in infectious diseases.

BACKGROUND: The aim of this article is to review the potential ocular and renal disorders in infectious diseases to which humans are susceptible and to determine prevalence of these diseases. METHODS: Published cases of oculo-renal disorders associated with various infectious diseases were collected from the international literature by searching the MEDLINE database (PUBMED 1970-2004) for original reports and review articles published in English. Citations from papers retrieved were screened and retrieved papers were evaluated. RESULTS: Based on the screened data, we propose a practical, structure-oriented checklist of such lesions divided into bacterial, viral, parasital, and fugal infections. CONCLUSION: The oculorenal manifestations of infectious diseases may be flagrant or subtle. Awareness of the signs and symptoms of infections allows early recognition and prompt, appropriate management. The clinical presentation and relative frequency of those manifestations are reviewed.

Anti-Bacterial Agents↗

[Research results on sensitivity of surveillance on the infectious diseases of PSSE Zwoleń].

The aim of the paper was to evaluate sensitivity of surveillance of infectious diseases in 2005, in comparison to 2000-2004 (i.e. after taking the measures to improve notification of infectious diseases). In the first half of 2005 significant improvement was noticed, mainly in the group of diseases, which had been to be reported obligatorily since 2002 (e.g. helminthiasis). The improvement of notification and registration was short-lasting. In the second half of the year the drop of notification and registration was reported. There is a need of active and permanent monitoring of notification and registration of infectious diseases and renewed consideration of the list of diseases which are subjected to be obligatorily notified.

Communicable Disease Control↗

Infectious diseases following major disasters.

A recent surge in the general awareness of the extent of disasters has increased concern over the adequacy of our state of preparedness for these events. Outbreaks of infectious disease after a disaster may have significant societal impacts. In preparation, rescuers must anticipate and identify infectious risks, isolate and treat the individuals with infections, and institute measures that will prevent the further spread of infectious diseases. Epidemiological factors may contribute to the spread of infectious disease after a given disaster. A simple microbiological laboratory in the field may be helpful in attempting to direct therapy at specific infectious etiologies. Prior post-disaster experience suggests that mass immunization may not always be valuable in protecting against disease spread acutely, although immunizations may be considered in a limited number of situations. Disaster medical personnel should prepare themselves with appropriate vaccinations and remain in good health; new pathogens must not be brought in by well-meaning relief personnel. Disasters often occur in a Third-World setting where resources are limited and often compromised. Complete recovery from infectious disease outbreaks and restoration of infection control practices may take years when a Third-World population has suffered a major disaster.

Communicable Disease Control↗

Notification of infectious diseases by junior doctors in accident and emergency departments.

OBJECTIVE: To assess the knowledge about notifiable infectious diseases by accident and emergency (A&E) senior house officers. METHODS: A telephone questionnaire of senior house officers was carried out over a one week period at the end of their six month attachment in A&E departments in Northern Ireland. RESULTS: 81 (91%) of the senior house officers participated in the study; 23 (29%) realised that the doctor diagnosing the notifiable disease had a statutory duty to notify that disease; nine (11%) were aware there were three statutory lists in the United Kingdom. Knowledge about which infectious diseases require notification varied from 79/81 (98%) for meningococcal disease to 15/91 (19%) for methicillin resistant S aureus. Seventy nine (98%) of the doctors thought that a poster displayed in the A&E department would be helpful. There was no significant difference between duration of qualification and performance on the questionnaire (p = 0.2). CONCLUSIONS: Despite varying experience, junior doctors in A&E do not know which infectious diseases are notifiable by statute. They felt that it would be helpful to have a poster in the A&E department listing the notifiable diseases of that region. To encourage accurate reporting, interregional variation between the statutory lists should be abolished and replaced by one nationally agreed list.

Communicable Diseases↗

Selection bias in epidemiological studies of infectious disease using Escherichia coli and avian cellulitis as an example.

In epidemiological studies of infectious disease, researchers often rely on specific cues of the host, such as clinical signs, as surrogate indicators of pathogen presence. A selection bias would manifest if the specific visual cues used in sampling for the pathogen were not representative of the full range of signs caused by the strains of that pathogen. In our molecular epidemiological studies of Escherichia coli associated with avian cellulitis in broilers, we collect carcasses at the processing plant based on visual cues of lesion morphology. Therefore, the objectives of this study were to: (1) explore the potential impacts of selection bias in an application of infectious disease epidemiology, and (2) utilize a validation protocol to assess the potential for selection bias in our molecular epidemiological studies of E. coli and avian cellulitis. In two different trials, E. coli DNA fingerprints were compared between birds that our observers collected and the birds that the observers missed. Using Fisher's exact tests and simulation models, we determined that the isolates collected by the observers were not significantly different from the isolates missed by the observers (P > 0.60 in both trials). Our method of selecting birds suspected of having cellulitis did not significantly bias our inferences about the population of E. coli associated with cellulitis in the flock. We encourage more investigators to critically assess the relationship of the sample to the target population in epidemiological studies of infectious disease.

Animals↗

[Emergency care for infectious disease patients].

Urgent critical condition during acute course of infectious diseases can be developed in early terms and suddenly with fast irreversible changes in vital organs and systems. In connection with generality of pathogenesis of many groups of infectious diseases the critical conditions characterized by stereotyped clinical syndromes. They include infective toxic shock, infective toxic encephalopathy and cerebral hypertension, acute dehydration, acute respiratory, cardiac, hepatic, adrenal and renal insufficiency. Urgent therapeutic measures can be standardized with reference to that or other syndromes of critical conditions. In their number--prescription of glucocorticosteroids, diuretics, neuroleptics, antipyretic preparations, solutions of various applicability. Application of antimicrobic preparations and specific antitoxic serums, antimalarial preparations requires care in connection with possible development of complications of toxic or allergic character.

Acute Disease↗

[Bacteria seen in acute otitis media in children hospitalised for infectious diseases].

The authors draw the following conclusion on the basis of 85 cases of children hospitalised for infectious diseases : -amongst childhood infectious diseases, measles between the ages of 7 and 14 is most commonly associated with complications in the form of otitis (50 as against 19 other diseases). -Staphylococcus aureus was the dominant organism in measles otitis, but in addition to a particular affinity of this organism for measles, it is also necessary to bear in mind contamination by hospital flora, amongst which staphylococci are especially representative, in view of the late development of the otitis and the multiresistance of staphylococci isolated after the 4th day of admission. -Bacteria seen in other exanthematous fevers were more varied but if there is not rapid cure of the otitis, the generally sensitive flora is replaced by a multiresistant hospital flora, once again dominated by staphylococcus aureus and Gram negative bacilli. - The role played by such flora was seen to occur particularly on the 4th day of hospitalization, implying a twofold increase in the period of hospitalisation when compared with cases where paracentesis was performed before this time.

Acute Disease↗

International efforts to control infectious diseases, 1851 to the present.

Many 21st-century observers explain international efforts to control infectious diseases as a function of globalization and recent transformations in international commerce, transportation, and human migration. However, these contemporary global health initiatives can be more fully understood by also exploring the origins of international health organizations and regulations, which were initially dedicated exclusively to stemming the tide of infectious epidemics. This article reviews 3 eras of international approaches to controlling infectious diseases (1851-1881, 1881-1945, and 1945 to the present) and concludes by assessing how nations have a strong fiscal and humanitarian incentive to invest in infectious disease control programs and infrastructures in and beyond their own borders.

Communicable Disease Control↗

Surveillance of infectious disease occurrences in the community: an analysis of symptom presentation in the emergency department.

OBJECTIVES: To determine the effectiveness of a simulated emergency department (ED)-based surveillance system to detect infectious disease (ID) occurrences in the community. METHODS: Medical records of patients presenting to an urban ED between January 1, 1999, and December 31, 2000, were retrospectively reviewed for ICD-9 codes related to ID symptomatology. ICD-9 codes, categorized into viral, gastrointestinal, skin, fever, central nervous system (CNS), or pulmonary symptom clusters, were correlated with reportable infectious diseases identified by the local health department (HD). These reportable infectious diseases are designated class A diseases (CADs) by the Ohio Department of Health. Cross-correlation functions (CCFs) tested the temporal relationship between ED symptom presentation and HD identification of CADs. The 95% confidence interval for lack of trend correlation was 0.0 +/- 0.074; thus CCFs > 0.074 were considered significant for trend correlation. Further cross-correlation analysis was performed after chronic and non-community-acquirable infectious diseases were removed from the HD database as a model for bioterrorism surveillance. RESULTS: Fifteen thousand five hundred sixty-nine ED patients and 6,489 HD patients were identified. Six thousand two hundred eight occurrences of true CADs were identified. Only 87 (1.33%) HD cases were processed on weekends. During the study period, increased ED symptom presentation preceded increased HD identification of respective CADs by 24 hours for all symptom clusters combined (CCF = 0.112), gastrointestinal symptoms (CCF = 0.084), pulmonary symptoms (CCF = 0.110), and CNS symptoms (CCF = 0.125). The bioterrorism surveillance model revealed increased ED symptom presentation continued to precede increased HD identification of the respective CADs by 24 hours for all symptom clusters combined (CCF = 0.080), pulmonary symptoms (CCF = 0.100), and CNS symptoms (CCF = 0.120). CONCLUSIONS: Surveillance of ED symptom presentation has the potential to identify clinically important ID occurrences in the community 24 hours prior to HD identification. Lack of weekend HD data collection suggests that the ED is a more appropriate setting for real-time ID surveillance.

Central Nervous System Diseases↗

Age-dependent resistance factors in the pathogenesis of foodborne infectious disease.

With increasing age there is an increase in both the incidence as well as the mortality due to many infectious illnesses, and foodborne infectious disease is no exception. A review of the pertinent literature identified studies concerning foodborne disease caused by infectious agents in the elderly, as well as those factors that could account for the increase in morbidity and mortality seen in the elderly due to foodborne infections. The published information suggested that the basis for the increased incidence, severity and risk of death of many foodborne infectious diseases in elderly persons is related to factors such as reduced gastric acidity, a higher prevalence of underlying medical disorders (co-morbidity factors), and immune system changes that result in a less effective host defense against infectious agents. The greater risk of foodborne disease experienced by elderly persons results from the contribution of non-immune and immune mediated factors. Due to the growing number of persons over the age of 65 years in the United States, foodborne disease in this age group will continue to be an important source of illness and death in the population.

Aged↗