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PubMedDate not supplied

Climate change and human health: possible communicable disease consequences in the United Kingdom.

In May 1990 a 'Think Tank' was constituted in order to advise the Director of the Public Health Laboratory Service (PHLS) on the potential effects of global climatic change, and of world population increase and movements, on the epidemiology of infectious diseases internationally and in the United Kingdom, and to consider the implications for the PHLS. This article draws on the Think Tank deliberations and describes the scenario considered, and some of the major issues identified, with particular reference to the UK.

Climate↗
PubMed2002

Determinants of major non-communicable diseases in the elderly: the pilot Freemasons health study.

AIM: To present preliminary results of the pilot phase of the Freemasons Health Study. METHODS: A prospective cohort study, in which determinants of occurrence of stroke and dementia in the elderly will be investigated. RESULTS: The pilot study (n = 507) showed substantial heterogeneity in risk factor levels among participants and suggested outcome rates that would allow a study of 6000 individuals aged 65 years and over to produce statistically reliable results within a few years of follow up. Preliminary results of the pilot study suggest that the demographic (age, sex) and risk factor (namely blood pressure levels and ranges of body mass index) profile of the projected sample of the Freemasons population is similar to that of the general elderly New Zealand population. CONCLUSIONS: The pilot study confirmed that the collection of baseline data from the New Zealand Freemasons population and their spouses is feasible, and that the prevalence of major vascular risk factors in the elderly Freemasons population is similar to that of the general New Zealand population of comparable age. In addition to contributing to our understanding of the aetiology of major non-communicable diseases in the elderly, the proposed major study provides a unique opportunity to investigate the determinants of health and requirements for care in an elderly New Zealand population.

Aged↗
PubMed2005

Changing patterns of under- and over-nutrition in South African children-future risks of non-communicable diseases.

Under- and over-nutrition in children in KwaZulu-Natal, South Africa was investigated comparing data collected from primary school children in a rural district (643 children aged 8-11 years in 1994) with secondary data from the National Schools Study (16,179 children, 4-11 years in 1994), the Vitamin A Consultative Group Study (408 children, 2-5 years in 1994) and the Income Dynamics Study (1,593 children, 2-11 years in 1998). Stunting and wasting (WHO/NCHS guidelines) and overweight and obesity (International Obesity Task Force guidelines) were retrospectively analysed from these studies and compared in the children aged 4-5 and 8-11 years. There was moderate stunting in 10-25%, wasting in 1-6%, 5-24% were overweight and 1-10% obese. Girls in the National Schools Study (p<0.005) and in the primary datasets (p=0.02) had a significantly higher prevalence of overweight than boys; girls (1.4%) were also more obese than boys (0.9%) in the Schools Study (p=0.002), and the boys significantly more stunted (p<0.005) and wasted (p<0.005). An increasing prevalence of overweight and obesity was seen in both the 4-5- and 8-11-year age-groups. The finding that moderate stunting co-exists with overweight and obesity suggests that patterns of under- and over-nutrition in South African children are changing and might indicate the early stages of a complex nutritional transition. Action is required to prevent the future risk of non-communicable diseases.

Age Distribution↗
PubMed1976

Monitoring communicable disease: vaccination programmes.

The success of vaccination as a means of disease prevention depends on its appropriate application and its reputation with the profession and the public. Surveillance, by providing accurate information on effectiveness and the frequency and nature of hazards, is essential to this purpose. Several factors that influence the success and safety of vaccination programmes are discussed. The essential elements of a vaccine surveillance scheme are outlined with special reference to experience derived from monitoring vaccines in current use.

Antibodies, Viral↗
PubMed1986

The future of communicable disease control: toward a new concept in public health law.

The exercise of compulsory public health powers for the common good of the community, though rooted in constitutional authority, involves a potentially massive infringement of individual liberty, autonomy, and privacy. Yet, public health statutes do not reflect modern conceptions in either science or law. Most are structurally obsolete and lack criteria for judicial oversight and impartial decision making. Guidelines for a model statute are proposed to protect both communal and personal interests.

AIDS Serodiagnosis↗
PubMed2001

[The worldwide challenges of "new" or reemerging communicable diseases at the dawn of the 21st century].

In the first part of this review, AIDS, prion diseases, Hantavirus and arbovirus infections, Ebola hemorrhagic fever, legionellosis, hepatitis C, enterotoxigenic Escherichia coli infections, Lyme disease, tuberculosis have provided alarming examples of emerging or reemerging infectious diseases. In this second part, the stress is placed on the reemergence of diphtheria and of serious streptococcal infections, on bartonelloses, Chlamydia infections, fungal infections, while malaria and cholera are still prevalent in several areas. The increasing resistance of too many pathogens to antimicrobial agents is a major source of concern, directly related to the challenge of nosocomial infections. An infectious cause has been demonstrated (or strongly suspected) for various diseases and the scope of infectiology keeps widening, while the threat of bioterrorism cannot be neglected. The causes of the emergence or reemergence of infectious diseases are multiple and diverse, often in direct relation with human activities (population migrations, changes in husbandry or farming practices, worldwide exchanges of goods and foods, inadequate uses of antibiotics) but also with climatic variations in several areas. The challenge represented by this unexpected comeback of infections to the forefront of human and animal pathology can only be met with a significant improvement of hygienic practices, cessation of certain dangerous behaviors and also, of course, with the development of novel antimicrobial molecules (acting on original targets) as well as of a whole series of new specific vaccines.

Anti-Bacterial Agents↗
PubMed1993

Communicable diseases in the CCEE/NIS.

The European Region is passing through a period of rapid transition with the most dramatic changes in the CCEE and NIS. The provision of adequate vaccine supplies has become a priority for many Member States in their efforts to sustain immunization activities. The Regional Office has therefore launched a special programme on vaccines for CCEE/NIS. New operational targets for the Expanded Programme on Immunization (EPI) in Europe in the 1990s were established by the European Advisory Group in 1993. These operational targets highlight the steps countries need to follow to achieve the European target 5. Immunization coverage generally remains high and stable in the Region. In 1990-1992 pockets of non-immunized individuals in different countries led to out-breaks of disease. Currently, the low coverage with DPT(DT vaccines in many provinces of the Russian Federation is one of the reasons for the epidemic of diphtheria that has affected the country since 1990. Despite the difficulties experienced by many CCEE and NIS, progress has been observed. Morbidity from poliomyelitis declined during 1990-1993. There remain only a few hot spots with endemic transmission of wild poliovirus: the Balkans, trans-Caucasus and central Asia. The diphtheria situation deteriorated in 1990, becoming increasingly dramatic in 1992 and 1993. Almost all cases have been reported from the Russian Federation and the Ukraine. Increasing diphtheria morbidity has been observed in Belarus, Kazakhstan and Uzbekistan.

Adult↗
PubMed2000

A method for active surveillance of selected communicable diseases.

In 1991, an initiative was launched in the Western Pacific Region of WHO to eradicate poliomyelitis by the year 2000. Confirmation of eradication requires a certification process, in which specific criteria must be met. A hospital-based surveillance system was developed. It was sensitive enough to detect, at least one case of acute flaccid paralysis (AFP) per 100,000 children under age 15 per year, which is considered the "background rate" of AFP. This system was instituted in 1997 in most countries in the Pacific, and included measles and neonatal tetanus as well as AFP. By mid-1998, 53 hospitals in the Pacific were submitting monthly forms indicating whether or not AFP, suspect measles, or neonatal tetanus had been seen in the preceding month. Compliance was excellent, with over 80% of forms submitted to WHO in 1998, thus meeting the certification standard. In 1999 a proposal was made to expand this method, in selected countries, to encompass most conditions presenting with acute fever plus rash, thus including, for example, cases of rubella and dengue. Important aspects of such surveillance include the capacity to confirm diagnoses in the laboratory, and to take effective public health action. A coordinated laboratory network had been established previously for virological analysis of stool specimens for conditions causing AFP, but laboratory support for other conditions is currently the responsibility of individual hospitals to arrange.

Communicable Disease Control↗