[Lymphadenosis benigna cutis as a transmissible infectious disease. II. Transmission to the skin of the body].
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OBJECTIVE: This paper examines whether or not topography is a contextual variable that indirectly influences the transmission of infectious diseases. Age, gender, race/ethnicity, education level, economic status, injection drug use, and high-risk sexual behavior are known to influence infectious diseases transmission, but the effects of topography are often overlooked. DESIGN: A sample of 395 drug users were chosen from census tracts based upon a target profile of drug use behavior and demographics for the city of Houston. HIV was chosen as the infectious disease used to test this hypothesis. SETTING: Residents of 16 census tracts in Houston, Texas participated in this study. RESULTS: The findings revealed that census tracts that were 'isolated' by topographic barriers, such as bayous, parks, railroad tracks, railway yards, major thoroughfares, freeways, and unique street grids had fewer cases of HIV than census tracks that were more accessible to thru-traffic. CONCLUSION: The research findings suggest that future research studies should consider topography as being contextually related to infectious disease transmission.
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A variety of infectious diseases can be transmitted during competitive sports. Modes of transmission in athletic settings include person-to-person contact, common-source exposures and airborne/droplet spread. This paper reviews the most commonly reported infectious diseases among athletes and discusses the potential for transmission of bloodborne diseases in sports. Guidelines are provided regarding measures to prevent transmission of infectious diseases in athletic settings, including hygiene and infection control practices, vaccination, and education of officials, coaches, trainers and sports participants.
Therapeutic acts often surgically practised in the dental office can lead to the transmission of infectious diseases such as A.I.D.S. To prevent this, the authors propose guideline base acts for antisepsis and asepsis. In conclusion, the authors exhort for an integration of these antiseptic acts in the efficient working of the dental office for an effective prevention of these infectious diseases in the area.
We present a regression modelling framework to analyse infectious disease transmission during a time period where extensive exposure data are available, but where the outcome data are sparse. A latent variable model is used for each exposure time, allowing a straight-forward accumulation of risk for a collection of exposures for which outcome data are available. We describe an analysis of HIV infection from blood products among a cohort of haemophiliacs in Ireland between 1980 and 1985. The analysis provides estimates of the time pattern and batch effects; we show how analytical complexity such as smoothly varying coefficients or random coefficient models can be accommodated by the model. Finally, we discuss other problems where the model is applicable.
OBJECTIVES: To review studies defining risk factors for infectious disease transmission in correctional settings, to determine target objectives, and to assemble recommendations for health promotion in prisons and jails. METHODS: Electronic databases were searched, using a specific search strategy, from 1993 to 2003. RESULTS: The principal risk factors in correctional facilities are proximity, high-risk sexual behaviour and injection drug use. Based on the type of disease transmissions and epidemics reported in the literature, four diseases were targeted for which preventive measures should be implemented: tuberculosis, human immunodeficiency virus, hepatitis and sexually transmitted diseases. Knowledge of risk factors helps define effective preventive measures along five main themes of action: information and education, screening, limiting harm from risk behaviour by distributing condoms and exchanging syringes, treatment and vaccinations. CONCLUSIONS: The effectiveness and feasibility of each of these actions have to be assessed in relation to the specificities of the correctional setting.
Infectious disease within outmigrant juvenile salmon in the Columbia River Basin is modulated, in part, by abiotic stressors that influence host-susceptibility. Through the application of a dose-structured population dynamic model, we show that chemical (both in the river and in the estuary) and in-river (e.g., dams and/or predation) stressors influence host-susceptibility, increasing the mean force of infection (defined as the per capita acquisition rate of infection) by a factor of 2.2 and 1.6, respectively. Using Listonella anguillarum as a model pathogen, nonchemical in-river and chemical stressors contribute equally to a cumulative incidence of delayed disease-induced mortalities in Chinook salmon that range from 3% to 18% for estuary residence times of 30-120 days, respectively. Mitigation of environmental stressors that increase host-susceptibility could represent a significant component in future management strategies to recover listed stocks.
Infectious diseases in human populations are seldom seen as part of a permanently occurring phenomenon in natural ecosystems. Their relationships to predator-prey or host-parasite systems are not evident. The conceptual relationships between these systems is established through a basic deterministic model in this note, with special reference to populational fluctuations and epidemic recurrence.
Prevalence and incidence measures are the common way to describe epidemics. The reproduction number supplies information on the potential for growth or decline of an epidemic. We define an actual reproduction number for infectious disease transmission that has taken place. An estimator is suggested, based on the number of new infections observed in a given time-interval, the number of those infected at the start of the interval, and the length of the infectious period. That estimator is applied to HIV among men having sex with other men over the period, 1977-1995, in Scandinavia. The actual reproduction number was estimated with acceptable certainty from the period, 1981-1982, yielding a value of 15 secondary cases. A value of less than one secondary case was assessed for the period, 1988-1995, in Denmark and Sweden. The actual reproduction number gives us some additional understanding of the dynamics of epidemics, compared with prevalence and incidence curves.
The incidence of cell transplant-transmitted infection is unknown and can only be inferred from prospective studies--that have not yet been performed and reported. The possibility of donor-to-recipient disease transmission through cell transplant therapy can be considered by reviewing the risk associated with other transplanted tissues and organs. Viral, bacterial, and fungal infections have been transmitted via transplantation of organs, tissue allografts such as bone, skin, cornea, and heart valves, and cell such as islets, hematopoietic stem cells, and semen. Several types of protozoan and worm parasites have been transferred via organ transplants. Bone allografts have transmitted hepatitis, tuberculosis, and human immunodeficiency virus (HIV-1). Corneas have transmitted rabies, Creutzfeldt-Jakob disease (CJD), hepatitis B (HBV), cytomegalovirus (CMV), herpes simplex virus (HSV), bacteria, and fungi. Heart valves have been implicated in transmitting tuberculosis and hepatitis B. HIV-1 and CMV seroconversion has been reported in patients receiving skin from seropositive donors. CJD has been transmitted by dura and pericardium transplants. Over the past several years, improvements in donor screening criteria, such as excluding potential donors with infection and those with behaviors risky for HIV-1 and hepatitis infection, and introduction of new donor blood tests have greatly reduced the risk of HIV-1 and hepatitis and may have nearly eliminated the risk of tuberculosis and CJD. Prior to use, many tissues are exposed to antibiotics, disinfectants, and sterilants, which further reduce or remove the risk of transmitted disease. Because organs, cells, and some tissue grafts cannot be subjected to sterilization steps, the risk of infectious disease transmission remains and thorough donor screening and testing is especially important.
This paper analyses the situation in countries comprising the WHO South-East Asia Region with respect to water supply and sanitation services, hygiene and the epidemiology of related infectious diseases. Recently, published data from the WHO/UNICEF Global Water Supply and Sanitation Assessment 2000 report was reviewed to depict the situation with respect to consumers' access to improved water supply and sanitation services. It was shown that access to improved drinking water supplies is among the lowest in the world, and that sanitation coverage in this region is below all others. The paper also reviews selected surveys of hygiene behaviours in several countries of the region. Associations are suggested between access to services, hygienic practices and specific infectious diseases. The need is acknowledged to improve the evidence base on linkages between infectious diseases and water, sanitation and hygiene, and specific recommendations are made in this regard. There is a need now and for the foreseeable future to promote low-cost household-level interventions, including behaviour change strategies, that mitigate the health consequences of the current situation with respect to water supply, sanitation and hygiene. The role of health authorities in meeting this challenge, and as advocates for accelerating development of the water and sanitation sector, is highlighted.
PURPOSE: Describe the contributions of molecular genetics to our understanding of the molecular epidemiology of infectious diseases caused by bacteria. METHODS: Synthesize the literature, highlighting work on Escherichia coli and Group B streptococcus. RESULTS: 1) Commensal bacteria are genetically and phenotypically diverse. 2) Disease-causing strains of commensal bacteria often have special characteristics than allow them to be distinguished from common inhabitants. 3) Colonization by commensal bacteria is dynamic. 4) Commensal bacteria are transmitted between individuals. CONCLUSIONS: Applications of epidemiologic principles to bacterial populations gives insight into the natural history of colonization and transmission in the human host.
This paper uses commonly available prevalence estimates to bound future incidence. The bounds rely on restricting the fraction of contacts between individuals of different infection statuses. It is argued that these bounds can be further tightened by restrictions of economic models of infectious disease that imply that uninfected individuals have larger incentives to avoid matching with infected individuals than do the infected individuals themselves. This implies that incidence predictions from canonical models of infectious disease are worst-case upper bounds, with the degree to which they overestimate new cases being monotonically related to this type of infection-dependent matching. Evidence in support of the economic type of infection-dependent matching is presented, by using data on the joint distribution of partners' HIV statuses in a random sample of couples from San Francisco in 1988-1989.
To examine the pathogenic roles of HTLV-I in HTLV-I-induced diseases, we developed two models; namely HTLV-I carrier rats and HTLV-I env-pX transgenic rats. Among life long HTLV-I carriers in seven rat strains, only WKAH rats with the RT1k haplotype developed chronic progressive myeloneuropathy, resembling HAM/TSP clinically and histologically in humans, designated as HAM rat disease and after long incubation periods. Apoptosis of myelin forming cells, oligodendrocytes and Schwann cells associated with HTLV-I infection appears to be the primary cause of HAM rat disease. Local activation of the pX gene and TNF alpha gene was evident in these rats. WKAH rats transgenic for HTLV-I env-pX gene were established and at age 5 weeks, swelling of the bilateral ankle joints began to develop and histological features of the affected joints resembled findings in cases of rheumatoid arthritis (RA): high-titers of rheumatoid factors were present in these rats. A series of vascular collagen diseases such as polyarteritis nodosa-like angiitis, polymyositis, myocarditis, and Sjögren's syndrome-like sialodenitis together with RA were present, even in one individual animal. These transgenic rats as well as HAM rats appear to be suitable animal models for elucidating pathogenic mechanisms implicated in HTLV-I-induced diseases and also various demyelinating vascular collagen diseases of unknown etiology.
Recognition of the importance of preventing disease transmission in day care facilities has increased as more mothers of infants join the work force and as evidence of the spread of disease in day care mounts; the effectiveness of licensing agencies has eroded with the shrinking of resources, and limited compliance with current standards exists. Both the staff of child day care facilities and the personnel who are responsible for licensing and regulating such facilities require ongoing training in issues of health promotion and disease prevention. The curriculum of all training programs should include, in addition to child development, topics of general health and safety, such as safety hazards and the risk of infection, knowledge of the infectious diseases likely to be encountered in day care, the use of routine screening tests, the principles of good nutrition, the components of routine health assessment, and the special concerns of disabled, abused, and neglected children. Health professionals in the community and licensing personnel should function as channels for the dissemination of new information as it becomes available; inspection of facilities for the purpose of licensing provides an excellent opportunity for training staff. Monitoring has been found to heighten awareness and improve performance. Employees' compliance with regulations has been shown to increase when staff members are trained as advocates of health.
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Staphylococcus aureus is the single most important bacterial pathogen in infections among drug users. It is responsible for several diseases, ranging from superficial cutaneous abscesses to life-threatening intravascular infections. Although the nature of these infections is well described in published work, there is limited understanding of their epidemiology and pathogenesis. This limitation is in part due to the difficulty of studying disease transmission among drug users in the community, and the limitations of the investigative tools that have so far been used. We review the current understanding of the pathogenesis of staphylococcal disease in drug users and argue for the integration of molecular epidemiological techniques and social network methodology to increase our understanding of the basis for the persistence, distribution, and transmission dynamics of S aureus among drug users. Finally, we propose a framework for investigating the transmission of pathogens in community-based settings.