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PubMed1996

Surveillance of disease and health with particular reference to infectious disease in Israel.

This paper examines the concept and scope of surveillance in relation to health and disease with special reference to infectious disease in Israel. The methodology of surveillance is reviewed with particular consideration of legal notification. The need for selectivity in relation to notification of infectious disease is outlined and the Canadian approach set out. A brief account is given of infectious disease patterns in Israel and of how this is reflected in notification obligations. A review is strongly suggested. The need to restate the importance of infectious disease control is emphasized, as is that of cooperation with those engaged in surveillance in other fields.

Communicable Diseases↗
PubMedDate not supplied

A disease management case study in infectious disease.

One of the earliest attempts at risk sharing between a managed-care organization and a pharmaceutical company is the infectious disease management program developed since late 1993 by Intergroup of Arizona and Eli Lilly and Company (Indianapolis, Indiana) in conjunction with the Center for Pharmaceutical Economics at The University of Arizona (Tucson, Arizona) and other entities. In the first phase of the program, protocols were built around eight infectious disease states, and it was recognized that second-line antibiotics were often prescribed when more economical first-line antibiotics would be equally effective. The second phase of the program emphasized developing treatment algorithms focused on patient outcomes, using merged medical and pharmacy claims databases to determine the effects of the antibiotic changes. To implement the program successfully, some significant shifts in corporate, medical, and patient mind-sets had to be addressed. A primary goal was to encourage a movement from a rebate, volume-driven, cost structure to a shared-risk, appropriate-use, reimbursement method in which both managed-care and the pharmaceutical company incentives could mesh as far as possible. Over the long term, it is hoped that this project will lay the groundwork for other disease management programs for high-impact, frequently occurring diseases.

Anti-Bacterial Agents↗
PubMed2001

Revisiting emerging infectious diseases: the unfinished agenda.

Infectious diseases present a formidable threat to the world today. Not only are new infectious diseases emerging, but those presumed to be contained or eradicated are re-emerging. Developing nations, with the least resources to respond, bear the greatest burden of this threat. However, with the potential to spread rapidly and ubiquitously, infectious diseases present a significant risk to the health and development of all nations. No country or population is immune, and geographic and political barriers offer little protection. Many factors facilitate the spread of infectious diseases, including globalization of travel and trade, weakening of national and international public health infrastructure, deterioration of socioeconomic conditions, and heightened political and civil strife in some developing nations. These conditions render populations more vulnerable to infections and provide an environment conducive to the transmission of infectious diseases. Compounding these risk factors is the emergence of another threat: antimicrobial resistance. Antimicrobial drugs are rapidly losing their effectiveness because of their misuse. As a result, the global health community is confronted with the daunting task of combating more offenders with fewer defenses.

Communicable Disease Control↗
PubMed2003

Morbidity in Swedish dairy calves from birth to 90 days of age and individual calf-level risk factors for infectious diseases.

The health of 3081 heifer calves born in 122 dairy herds in the south-west of Sweden from 1 January to 31 December, 1998, was monitored from birth until 90 days of age. The calves were kept either in individual pens (n=2167), in group pens, with 3-8 calves to a pen and manual feeding of milk (n=440), in group pens with 6-30 calves per pen and an automatic milk-feeding system (n=431), or with their dams (n=43). Disease incidence was recorded by farmers and project veterinarians, who clinically examined the calves and auscultated their lungs every 2-3 months. A disease was graded as 'severe' if the general loss of condition or of appetite in the calf continued for >2 days or if the animal suffered severe weight loss due to the disease. The effects of season, breed, housing, and type of colostrum feeding, and time, place and supervision of calving on the incidences of diarrhea, severe diarrhea, respiratory disease, other infectious disease and moderately to severely increased respiratory sounds, were analyzed by logistic-regression models (with herd as a random effect). The total morbidity rate was 0.081 cases per calf-month at risk. Incidence rates of arthritis, diarrhea, omphalophlebitis, respiratory disease and ringworm were 0.002, 0.035, 0.005, 0.025 and 0.009 cases per calf-months at risk, respectively. The odds ratios for diarrhea and severe diarrhea were increased in Swedish Red and Whites (OR: 1.6, 2.3) and in calves that received colostrum from first-lactation cows (OR: 1.3-1.8), and for severe diarrhea in calves born in summer or that received colostrum through suckling (OR: 1.7, 1.8). The odds ratios for respiratory disease and increased respiratory sounds were increased in calves housed in large-group pens with an automatic milk-feeding system (OR: 2.2, 2.8). Supervision of calving was associated with a decreased odds ratio for respiratory disease (OR: 0.7) and birth in individual maternity pen or tie stalls with a decreased odds ratio for increased respiratory sounds (OR: 0.5-0.6). Cross-breeds with beef breeds were associated with increased odds ratios for increased respiratory sounds (OR: 2.1-4.3) and colostrum from second-lactation cows and birth during night for other infectious disease (OR: 1.6, 1.5).

Aging↗
PubMed1997

Health outcomes and infectious disease control.

With the development of improved health systems, antibiotics and vaccines throughout the 20th century, the prospects of control of infectious diseases improved. During the same time-frame, an approach to disease control was developed which used the health outcomes resulting from various interventions to choose, guide and modify those interventions. Despite these major advances in the control of diseases, infectious diseases have (with occasional exceptions) not only continued to occur but in many instances the situation had deteriorated with the emergence and re-emergence in recent years of a range of infectious diseases. In this paper we consider why infectious disease control has not benefited from the move towards a health outcomes approach, why infectious disease control might benefit from such a move, and the differences between infectious and non-infectious diseases when considering health outcomes. We follow-up with some practical approaches to the use of health outcomes. We argue that appropriate use of health outcomes when planning and evaluating infectious disease control programs will improve human health.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Infectious diseases - a global challenge.

Infectious diseases represent a continuous and increasing threat to human health and welfare. Due to emerging diseases, increasing resistances, international travelling, and the risk of bioterroristic attacks, infectious diseases concern the whole world and can only be combated by internationally coordinated and interdisciplinary approaches. When assessing the worldwide publication activities on infectious diseases in the years 1994-2004 accessible via the ISI Science Citation Index Expanded, an overall increase by 24% can be monitored. Furthermore, it becomes evident that highest research priorities are given to HIV/AIDS, hepatitis C, tuberculosis, respiratory infections, and sepsis. Ten countries - including the USA, the UK, France, Germany, and Japan - contributed to more than 80% of these publications; nation-specific research priorities focusing on the current problems in the respective country can be estimated. Countries with the highest disease burdens are still not given the opportunity to contribute adequately to the scientific field. Based on our data, relatively increasing publication activities include those on respiratory infections, tuberculosis, malaria, hepatitis, and sepsis, whereas decreasing activities were determined for AIDS, diarrhoea, meningitis, schistosomiasis, and other diseases. Accordingly, the prevalence of many infectious diseases occurring in tropical countries is not clearly reflected in the worldwide publication activities.

Bibliometrics↗
PubMed2005

Sacred disease of our times: failure of the infectious disease model of spongiform encephalopathy.

BACKGROUND: Public health and agricultural policy attempts to keep bovine spongiform encephalopathy out of North America using infectious disease containment policies. Inconsistencies of the infectious disease model as it applies to the spongiform encephalopathies may result in failure of these policies. METHODS: Review of historical, political and scientific literature to determine the appropriate disease model of spongiform encephalopathy. PRINCIPAL FINDINGS: Spongiform encephalopathy has always occurred sporadically in man and other animals. Hippocrates may have described it in goats and cattle. Transmission of spongiform encephalopathy between individuals is too uncommon for it to be usefully considered an infection. Spongiform encephalopathy is a somatic disorder whose dissemination within a host or transmission between individuals is more like cancer than infectious disease. Spongiform encephalopathy transmission within a species is facilitated in comparison to transmission between species so that cannibalism may amplify the prevalence of the disease. CONCLUSION: Agricultural policy should be directed toward an absolute prohibition on occult cannibalism and away from surveillance, quarantine and slaughter, the principal measures of infectious disease containment used to control bovine spongiform encephalopathy.

Animals↗
PubMed1996

Immunization: protecting older patients from infectious disease.

Prevention of infectious disease is an important component of primary care medicine. One goal of Healthy People 2000 is to reduce the rate of complications and death from infectious diseases by increasing the rates of immunization. Influenza and pneumococcal vaccines are indicated for high-risk groups, including all persons age 65 or older. Influenza immunization should be offered during routine office visits from September through November. Pneumococcal vaccine may be repeated after 6 years and may be given concurrently with the influenza vaccine. Other vaccines to consider--depending on the patient's perceived level of risk--include hepatitis B, tetanus toxoid, measles-mumps-rubella, hepatitis A, and varicella.

Age Factors↗
PubMed2003

The history of Pediatric Infectious Diseases.

The history of Pediatric Infectious Diseases closely parallels the history of Pediatrics at least until the last century, because historically infections comprised the major causes of childhood morbidity and mortality, as they still do in the developing world. This history reviews developments in the field through the centuries and is written so that it does not overlap the contribution to this series by Baker and Katz entitled 'Childhood Vaccine Development in the United States.' Remarkable descriptions of selected pediatric infections existed long before the invention of printing, and early pediatric texts included many chapters devoted to various infections. Coincident with the establishment of pediatric organizations in America in the late 19th and early 20th Centuries, major attention was focused on diphtheria, infant diarrheal illnesses, tuberculosis, streptococcal infections and their complications, and other pediatric infections, and substantial progress was made. The American Pediatric Society (1888), the American Academy of Pediatrics (1930), the Society for Pediatric Research (1931), and the American Board of Pediatrics (1933) all contributed to the evolution of the discipline of Pediatric Infectious Disease, and numerous leaders of these organizations had significant infectious diseases interests. The establishment of the Pediatric Infectious Diseases Society, the Pediatric Infectious Diseases sub-board, and an accreditation process for training programs, as well as sub-specialty textbooks and journal, further validated the development of this specialty, particularly in North America. The many remaining challenges related to infectious diseases in children (including HIV, emerging infections, antimicrobial resistance, opportunistic infections, and infections in the developing world) insure the future of the specialty. The genomic era of medicine and the tools of molecular biology will lead to new insights into pathogenesis, diagnosis, and treatment of infections. Pediatric Infectious Diseases physicians can celebrate the past triumphs of the discipline and future achievements, all contributing to improved health for children.

Child↗