What is SARS viruses ?
What is Leishmania ?
What is Staphylococci ?
What is trypanosoma ?
What is ascaris lumbricoides ?
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Despite enormous advances in medical sciences and their applications in public health, infectious diseases remain a central challenge for public health in the twenty-first century. Of particular concern are human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis (TB), malaria, severe acute respiratory syndrome (SARS), avian flu, and antibiotic-resistant infections (superbugs), among others. Globalization has facilitated the spread of many infectious agents to all corners of the globe. Mass travel, economic globalization, and climate change, along with accelerating urbanization of human populations, are causing environmental disruption, including global warming. There are and will be more consequences in the international transmission of infectious diseases that are now known, in humans and wildlife, as well as domestic animals in the food chain.
This chapter describes communicable and infectious diseases and programs for their prevention, control, elimination, and eradication. Eradication refers to the total elimination of the organism from nature; elimination designates a stop in the circulation of the organism locally, and control means reducing the disease as a public health problem. All of these require a systems approach using available resources, conducting research and effectively mobilizing environmental measures. This must be carried out in conjunction with strengthening primary care and the overarching health care framework. Rapid transportation and communication make a virus outbreak in any part of the world an international concern, both for health professionals and for the general public. With rapid changes in our understanding of basic sciences, and in vaccine research, production, and associated measures, it is incumbent upon all medical and allied professionals, educators, policymakers, and students entering the field to have a working understanding of the exciting and dynamic advances. Here, the interesting overlap between communicable diseases and non-communicable diseases (NCDs) becomes evident and imperative. Furthermore, it is crucial to be aware of the social environment in which the risk and exposure of vulnerable groups and individuals cause greatly varying degrees of morbidity and mortality in populations.
The material presented in this chapter is intended to provide an introduction to the student or a review for the public health practitioner, with an emphasis on the applied aspects of communicable disease control. The authors have relied for the content of this chapter on several standard references, especially Heymann’s Control of Communicable Diseases Manual, 19th edition (2008), WHO Vaccine-Preventable Diseases Monitoring System: 2007 Global Summary, and Jawetz, Melnick and Adelberg’s Medical Microbiology, 26th edition (2012). Regular access to the Centers for Disease Control and Prevention (CDC) publication Morbidity and Mortality Weekly Report (MMWR), the European Union’s Eurosurveillance, and the World Health Organization’s (WHO’s) Weekly Epidemiological Record (WER) provides continuing sources of information on communicable diseases, and these are available free online. ProMed, a highly effective Harvard University-based website, is a frequently-updated source of current infectious disease outbreaks around the world. The authors have also relied on electronic sources such as PubMed, the American Academy of Pediatrics, WHO, and United Nations Children’s Fund (UNICEF) websites, as well as library-access journals. The references listed will augment the limited discussion possible in this text. A recommended standard reference text is Plotkin, Orenstein, and Offit’s Vaccines, 5th edition (2008).
Each disease has its characteristic organism and natural history from onset to resolution. Many infectious diseases may remain at a presymptomatic or subclinical stage without progressing to clinical symptoms and signs but maybe transmissible to other people. Even a subclinical disease may cause an immunological effect, producing immunity. The drama of infectious disease is exemplified in the tragic event of the plague in the fourteenth century and its periodic recurrence, as in the epidemic of 1665 in London, described by Daniel Defoe (Box 4.1 ).
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