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PubMedDate not supplied

Health protection: Surveillance and control of infectious diseases.

Although pneumonia and influenza are the only infectious diseases remaining among the 10 leading causes of death in this country, more than 290 million infectious illnesses occur annually--more than one for every person. These diseases have a significant impact on the population when measured in terms of increased social costs, including quality of life, decreased work productivity, and increased health care costs. During the next decade, no dramatic changes are anticipated in infectious disease trends; however, diseases may be newly recognized, epidemiologic patterns will be defined, antibiotic resistant patterns will change, and changing immigration patterns and refugee migrations may affect disease trends in the United States (e.g., tuberculosis). These factors will require the development and application of effective prevention methods, including disease surveillance, sanitation, casefinding and control, and development and use of vaccines and drugs. In addition, efforts to improve the rapidity and accuracy of diagnosis as well as the appropriateness of therapy are also important activities.

Communicable Disease Control↗

PubMed2006

[Consultations with infectious disease specialists for patients in a teaching hospital: Adherence in 174 cases].

OBJECTIVES: In a teaching hospital where infectious disease specialists were routinely consulted for infections in patients in other departments, we sought to assess adherence to the specialists' recommendations, identify the factors influencing adherence, and measure the proportion of nosocomial infections among these consultations. METHODS: We collected data from intrahospital consultations with infectious disease specialists over a 4-week period. Afterwards (48 hours later), a physician and pharmacist collected all prescriptions for anti-infectious agents (dose, drug, combinations) and other orders (laboratory tests, radiology examination, isolation) for each patient. RESULTS: There were 174 infectious disease consultations requested for 143 inpatients during the study period. Anti-infectious agents were prescribed for 52.4% of patients, modified for 22.4%, and stopped for 9.1%; 16.1% neither had nor required such treatment. The rate of adherence to the specialists' recommendations was 84.6% for anti-infectious prescriptions and 77.4% for other orders. The factors associated with adherence were a bedside consultation (p = 0.04) and a recommendation to stop rather than modify anti-infectious treatment (p = 0.02). Roughly 40% of the patients (n = 57) had a nosocomial infection, most often during hospitalization for surgery (53.1% versus 29.1%, p < 0.01). Consultations were requested for 20% of the nosocomial infections observed at Grenoble University Hospital (based on annual prevalence in 2005). CONCLUSIONS: The specialist's presence at the patient's bedside has an impact on staff adherence to recommendations. These specialists play a vital role in managing nosocomial infections, which account for more than a third of these intrahospital' consultations.

Adolescent↗

PubMed2006

Stochastic modeling of empirical time series of childhood infectious diseases data before and after mass vaccination.

The goal of this paper is to analyze the stochastic dynamics of childhood infectious disease time series. We present an univariate time series analysis of pertussis, mumps, measles and rubella based on Box-Jenkins or AutoRegressive Integrated Moving Average (ARIMA) modeling. The method, which enables the dependency structure embedded in time series data to be modeled, has potential research applications in studies of infectious disease dynamics. Canadian chronological series of pertussis, mumps, measles and rubella, before and after mass vaccination, are analyzed to characterize the statistical structure of these diseases. Despite the fact that these infectious diseases are biologically different, it is found that they are all represented by simple models with the same basic statistical structure. Aside from seasonal effects, the number of new cases is given by the incidence in the previous period and by periodically recurrent random factors. It is also shown that mass vaccination does not change this stochastic dependency. We conclude that the Box-Jenkins methodology does identify the collective pattern of the dynamics, but not the specifics of the diseases at the biological individual level.

Journal Article↗

PubMed2001

Community well being and infectious diseases among Alaska Native communities in the Chugach Region.

OBJECTIVES: This study sought to examine how Native people of the Chugach Region of Alaska perceive their own communities' health and well being, particularly in regard to infectious diseases. STUDY DESIGN: Prospective focus group interview survey. METHODS: During September to December 1999, 12 focus groups were conducted in seven communities in the Chugach Region of Alaska with 97 participants. Using a set of eight questions, information gathered provided insights into the participants' health-related perceptions and provided previously nonexistent baseline data pertaining toTB and hepatitis. RESULTS: Participants showed a good working knowledge of common infectious diseases. There were misconceptions and a potential for increased knowledge in highly prevalent diseases, but more recently delineated infections in rural Alaska, e.g., respiratory syncvtial virus (RSV), Helicobacter pylori, and less prevalent diseases, e.g., Acquired Immunodeficiency Syndrome (AIDS). The participants expressed a desire for further infectious disease information and dialogue. CONCLUSIONS: This process can be used to develop a risk assessment tool for medical and clinical providers' use in an effort to increase testing for such infectious diseases as HIV, TB, Hepatitis C, and sexually transmitted diseases (STDs). In this case the authors also produced a STD prevention video for rural Alaska Natives, entitled, Summer Sun Winter Moon.

Adolescent↗

PubMed1994

The relationship of schizophrenic births to 16 infectious diseases.

BACKGROUND: Recently, several investigators have reported an association between influenza epidemics and increased birth rates of 'preschizophrenic' individuals some four to six months later. Here we examine whether maternal exposure to other infectious diseases can also predispose the foetus to later schizophrenia. METHOD: Two independent sets of dates of birth of first admission schizophrenic patients, born between 1938 and 1965 in England and Wales, were obtained from the Mental Health Enquiry in England and Wales. Data on the number of deaths per month from 16 infectious diseases between 1937 and 1965 in England and Wales were also collected. We used a Poisson regression model to examine the relationship between deaths from infectious diseases and schizophrenic births. RESULTS: In the two separate data sets, increased national deaths from bronchopneumonia preceded, by three and five months respectively, increased numbers of schizophrenic births. We did not find any other significant associations between schizophrenic births and any of the other 15 infectious diseases. CONCLUSIONS: The association between deaths from bronchopneumonia and increased schizophrenic births some months later may be a reflection of the fact that bronchopneumonia deaths increase markedly during influenza epidemics.

Adult↗

PubMed1999

Secular trends in the epidemiology of major infectious diseases among Israeli soldiers.

BACKGROUND: Army personnel, albeit in general young and healthy, are at greater risk for infectious morbidity owing to higher crowding, compromised hygienic conditions, and exposure to new geographic and climatic factors. We describe the changing trends in the incidence of major infectious diseases of public health importance in the Israeli military: hepatitis A, measles, meningococcal disease, and diarrheal diseases. METHODS: Departments of Epidemiology and Medical Statistics of the Israel Defense Forces Medical Corps monitor the incidence of infectious diseases within the military. Notifiable diseases are predefined and their reporting is mandatory. RESULTS: The incidence of hepatitis has declined significantly since the introduction of prophylaxis with immune serum globulin in the 1970s, and complete control of outbreaks has been achieved. Outbreaks of diarrheal diseases have decreased, probably as a result of intensive control measures begun in the last decade. However, sporadic diarrheal morbidity continues to rise. The vaccination of recruits against Neisseria meningitidis was begun in 1994, following an increase in cases caused by serogroup C bacteria. So far, the program has proved efficacious in reducing morbidity. Measles morbidity in the military was much higher than in the civilian sector over the years. It has become negligible since 1995, when the first cohorts with 2 vaccination doses began their service. CONCLUSION: Despite improvements in personal and environmental health measures, immunization remains the most efficient means for preventing infectious diseases in the military.

Adult↗

PubMedDate not supplied

[Use of antibiotics in general practice and at the Clinic for Infectious Diseases].

INTRODUCTION: Optimal pharmacotherapy includes utilization of the right drug, at the right time, right duration of therapy and adequate dosage. This study analyzed utilization of antimicrobial drugs at the Clinic of Infectious Diseases of the Clinical Center Novi Sad and in outpatients of the Outpatient General Service of the Health Center Novi Sad-Liman. MATERIAL AND METHODS: Utilization of anti-infective agents was examined according to Anatomic-Therapeutic-Chemical Classification (group J). Drug utilization data were presented in Defined Daily Doses at the Clinic of Infectious Diseases of the Clinical Center Novi Sad in Defined Daily Doses per 100 bed-days, and in the Outpatient General Service of the Health Center Novi Sad-Liman in Defined Daily Doses/1000 inhabitants per day. RESULTS: At the Clinic of Infectious Diseases of the Clinical Center Novi Sad penicillins susceptible to beta-lactamase were established as most frequently used (39.33%) namely: benzylpenicillin (32.18%), quinolone antibacterial agents, ciprofloxacin (12.44%) and cephalosporins, cephalexin (8.25%). In the Outpatient General Service of the Health Center Novi Sad-Liman most frequently used were extended-spectrum penicillins (24.20%) namely: tetracyclines, doxycycline (18.98%), amoxicillin (18.27%), macrolides, roxithromycin (17.56%). At the Clinic of Infectious Diseases of the Clinical Center Novi Sad the decision on using antibiotics and establishing whether it was bacterial or virus infection in 92.13% cases was made on the basis of following analyses: throat and nasal swabs, urine culture, virus complement-binding reaction. In Outpatient General Service of the Health Center Novi Sad-Liman it was done only in 18.46%. CONCLUSION: Although treatment performed based on clinical picture and experience usually proves to be correct, antibiotic prescription policy should include antibiograms to provide optimal treatment and decrease the degree of resistance. Thus, medicine would be considered an exact science and it should be one of its goals of the 21st century.

Ambulatory Care↗

PubMed1995

Recurrence and emergence of infectious diseases in Djibouti city.

Public health authorities are now increasingly concerned by changes in the epidemiology of infectious diseases which may have an adverse impact on their budget plans and control strategies. Rapid increases in population and urban migration, various ecological changes, increasing poverty, and a rise in international travel have contributed to the worldwide vulnerability of human populations to the emergence, recurrence or spread of infectious diseases. In the rapidly growing city of Djibouti in East Africa, public health priorities have been altered during the last 10 years by diseases which were unknown or under control until the early 1980s. These diseases, including malaria, AIDS, tuberculosis, dengue fever and cholera, are consuming considerable resources. This article on Djibouti illustrates the epidemiological changes in the region. Besides the specific ecological and behavioural changes, which accompany rapid population growth, poverty seems to be a major cause for the emergence and recurrence of infectious diseases.

Adult↗

PubMed2000

Infectious disease morbidity in the US region bordering Mexico, 1990-1998.

The United States and Mexico share an international boundary approximately 3000 km long. This border separates 2 nations with great differences in health status. The objective of this study was to assess morbidity due to infectious diseases in the US region bordering Mexico. The incidence between 1990 and 1998 of 22 nationally notifiable infectious diseases was compared between border and nonborder regions. Disease rates, reflected as rate ratios, were higher in the border region for botulism, brucellosis, diphtheria, hepatitis A, measles, mumps, rabies, rubella, salmonellosis, and shigellosis than in either of 2 nonborder comparison regions. These data indicate that incidence rates for a variety of infectious diseases of public health importance are significantly higher in the United States along the Mexican border than in nonborder regions. These results suggest that an inadequate public health infrastructure may contribute to excess morbidity due to infectious diseases in the border region.

Adolescent↗

PubMed1991

Nebraska dental professional's procedures and opinions related to infectious diseases.

Based on the findings of this study, the following specific strategic recommendations are offered: 1. Offer continuing education courses throughout the state at reasonable fees. The courses should emphasize recognition of AIDS related lesions and infectious diseases, aseptic techniques/infectious disease control, AIDS, Hepatitis B, and infections/antibiotics. In addition, continuing education courses in the area of medical history taking methods should be offered to teach methods of inquiring about sexual and drug-use histories. 2. Establish a state resource center for information regarding infectious diseases. This could, perhaps, be a cooperative venture with the Department of Health, the Nebraska Dental Association, and the College of Dentistry. There is a need to gather, interpret and disseminate periodic updates on infectious disease research. This venture should also focus on developing literature for practitioners with consistent information about infection control regulations and guidelines. 3. Either through continuing education courses or through the information resource center, provide instruction on realistic assessment of the risk of infectious disease transmission in dentistry. 4. Develop a public relations campaign to educate the public about infection control policies in dentistry, what is being done to protect the public. 5. A research effort should be undertaken to determine the discrepancy between self-reported infection control practices and observed infection control practices. This could be accomplished through patient and dentist surveys, interviews, and/or observations. 6. Establish a confidential HIV blood screening program for health care providers.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Infectious disease and dermatologic conditions in evacuees and rescue workers after Hurricane Katrina--multiple states, August-September, 2005.

On August 29, 2005, Hurricane Katrina struck states along the Gulf Coast of the United States. In the days after the hurricane struck, approximately 750 evacuation centers were established in at least 18 states to accommodate more than 200,000 evacuees. State and local health departments, with assistance from CDC, initiated enhanced infectious disease surveillance and outbreak response activities, implemented by teams of public health and rescue workers, including military personnel. Outbreak monitoring included direct reporting of conditions of public health significance to public health agencies; daily contact between CDC and local public health officials; canvassing of reports from CDC, public health departments, and news media for potential infectious disease outbreaks; and investigation of reports of infectious disease with outbreak potential. This report summarizes infectious disease and dermatologic conditions reported during the first 3 weeks after the hurricane, before effective local surveillance was fully implemented. One outbreak of norovirus was reported among evacuees in Texas; no other outbreaks requiring unusual mobilization of public health resources were reported among evacuees or rescue workers.

Communicable Diseases↗

PubMed1973

Surface markers on lymphocytes of patients with infectious diseases.

PERIPHERAL BLOOD LYMPHOCYTES FROM NORMAL SUBJECTS AND PATIENTS WITH VIRAL AND BACTERIAL INFECTIOUS DISEASES WERE EXAMINED FOR THE PRESENCE OF THREE SURFACE MARKERS: (i) surface immunoglobulins, (ii) receptor for C3 complement component (EAC test), and (iii) spontaneous binding of sheep red blood cells (E rosette formation). The first two markers are used to detect bone marrow-derived lymphocytes (B cells); the E rosette formation is dependent on thymus-derived lymphocytes (T cells). We demonstrated these assumptions, as defined by others, by the fractionation of lymphocytes on bead columns coated with immunoglobulin plus anti-immunoglobulin. The peripheral blood lymphocytes of normal individuals consisted of 52% T cells, 23% B cells with EAC receptor, and 21% B cells with membrane immunoglobulin. There was no significant difference in these values from those obtained in viral or bacterial diseases. Only a few cases of infectious mononucleosis had an increase in T cells. These results give us a partial picture of the T- and B-cell frequency in normal subjects and in patients with infectious diseases.

Antibody Formation↗

PubMed2005

Socioeconomic factors and risk of hospitalization with infectious diseases in 0- to 2-year-old Danish children.

Although the association between low socioeconomic status and illness in childhood is well known, the impact of socioeconomic factors on risk and frequency of hospitalizations for infectious diseases, the most frequent disease category, during the first 2 years of life has scarcely been studied. Through linkage of records drawn from public administrative and health registries, we conducted a population-based cohort study of 5024 Danish children born in 1997 to examine the frequency of hospitalization for infectious diseases in very young children. The main exposure variables, adjusted for potential confounding factors, were mother's education level, household income, and cohabitation status. The outcome was number of hospital admissions (0, 1-2, or 3+) for infectious diseases. A total of 737 children (14.7%) were admitted to hospital 1-2 times, and 83 (1.6%) were admitted 3-10 times. The risk of hospitalization was increased in children of mothers with a low level of education compared with vocational education (1-2 admissions: adjusted odds ratio (OR) 1.3 (95% confidence interval [CI]: 1.1-1.6). Children from low-income families had an increased risk of 3 or more admissions (low cf middle income: adjusted OR 2.0 [95% CI: 0.6-6.0]). Children of single mothers had an increased risk of hospitalization (1-2 admissions: adjusted OR 1.7 [95% CI: 1.1-2.6]. We found the highest risk of hospitalization for infectious diseases in children of mothers with only basic schooling, and particularly among those coming from single parent homes with a low income.

Child, Preschool↗

PubMed2001

Hot spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases.

The resurgence of the microbial threat, rooted in several recent trends, has increased the vulnerability of all nations to the risk of infectious diseases, whether newly emerging, well-established, or deliberately caused. Infectious disease intelligence, gleaned through sensitive surveillance, is the best defence. The epidemiological and laboratory techniques needed to detect, investigate, and contain a deliberate outbreak are the same as those used for natural outbreaks. In April 2000, WHO formalised an infrastructure (the Global Outbreak Alert and Response Network) for responding to the heightened need for early awareness of outbreaks and preparedness to respond. The Network, which unites 110 existing networks, is supported by several new mechanisms and a computer-driven tool for real time gathering of disease intelligence. The procedure for outbreak alert and response has four phases: systematic detection, outbreak verification, real time alerts, and rapid response. For response, the framework uses different strategies for combating known risks and unexpected events, and for improving both global and national preparedness. New forces at work in an electronically interconnected world are beginning to break down the traditional reluctance of countries to report outbreaks due to fear of the negative impact on trade and tourism. About 65% of the world's first news about infectious disease events now comes from informal sources, including press reports and the internet.

Communicable Disease Control↗

PubMed1997

Common infectious diseases in a population with low multiple sclerosis and varicella occurrence.

A previous study revealed the rarity of varicella zoster virus (VZV) diseases among 5601 Hutterite Brethren living in a high-risk area for these diseases. The current study was established to determine the frequency of other common infectious diseases. The information was gathered from a population-based study of a unique group of Manitoba citizens and compared with an equal number of their age and sex-matched neighbors. The data were contained in the records of the Manitoba Health Services Commission (MHSC). The MHSC, the sole paying agency for medical diseases in Manitoba, contained 94,383,972 records for all of Manitoba for the years 1985 to 1991 inclusive. From these, the records of a cohort of 5601 Hutterites and an equal number of non-Hutterite age- and sex-matched controls were examined for the frequency of 14 diseases of interest. To be eligible a Hutterite subject must have one of the 22 unique family names and live on a Colony with the precise address. A control must be age (within 10 years) and sex-matched, live in the same or a contiguous postal code, and use the same medical practitioners. There were no interventions or identification of any member of the study. Mumps, acute coryza, and rubella are of the same frequency among the two groups. Only herpes simplex and cellulitis are more common among the Hutterites. All of the other nine common infectious diseases are significantly more common among the controls. The VZV diseases are not exclusively less common among the Hutterite Brethren. Nine other common infectious diseases are also less common but the degree of significant difference does not reach the level of the VZV diseases. The reduction in numbers of these diseases among the Hutterites is not related to the vaccination habits of the group and is not due to physical isolation. The Hutterites appear to have a more effective immune system relative to their neighbors.

Age Factors↗

PubMed1996

Addressing the challenges of emerging infectious disease.

Through the recent examples of diphtheria in the former Soviet Union, plague in India, and trends in pneumonia mortality in the United States, the author, in this article, illustrates issues in emerging infectious diseases. The Centers for Disease Control's plan, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States, is summarized. Initial efforts to implement this plan are described, with particular focus on the development of Emerging Infections Programs, which are conducting epidemiologic and laboratory projects on several infectious diseases, including invasive bacterial diseases, unexplained deaths, foodborne diseases, and ehrlichiosis in four population-based sites in the United States.

Adult↗

PubMed2005

The potential impact of climate change on infectious diseases of Arctic fauna.

Climate change is already affecting Arctic species including infectious disease agents and greater changes are expected. Some infectious diseases are already increasing but future changes are difficult to predict because of the complexity of host-agent-environment relationships. However mechanisms related to climate change that will influence disease patterns are understood. Warmer temperatures will benefit free living bacteria and parasites whose survival and development is limited by temperature. Warmer temperatures could promote survivability, shorter development rates and transmission. Insects such as mosquitoes and ticks that transmit disease agents may also benefit from climate change as well as the diseases they spread. Climate change will have significant impacts on biodiversity. Disease agents of species that benefit from warming will likely become more prevalent. Host species stressed by changing environmental conditions may be more vulnerable to disease agents. Warming could lead to increased agriculture and other economic opportunities in the Arctic bringing people, domestic food animals, pets and invasive species and their disease agents into Northern regions. Climate warming may also favor the release of persistent environmental pollutants some of which can affect the immune system and may favor increased rates of some diseases.

Acclimatization↗

PubMed2006

The need for continuing vigilance: addressing the threat for transmission of blood-borne infectious disease.

As international travel and human encroachment into previously isolated areas have increased, so too has the potential for the emergence of new infectious diseases. Populations likely to be susceptible to new infectious diseases have also increased in size. The past three decades have seen outbreaks of diseases caused by parvoviruses, Nipah virus, circoviruses, and prions. Infectious pathogens such as these are formidable opponents; they can adapt to new hosts or cause variant diseases within new hosts. Many are also resistant to current inactivation techniques. In order to prevent or contain outbreaks, pathogens that emerge must be identified quickly and efficiently; research and ongoing global surveillance are therefore of primary importance. To effectively protect the blood supply and blood-based therapies, this research should include investigations into improved techniques for detection, screening, and viral inactivation, as well as into ways to reduce patient exposure to infectious pathogens via therapeutic agents. The proactive devotion of appropriate resources to infectious disease containment and prevention prior to an epidemic should be perceived as both essential public health policy and cost effective.

Animals↗