Quantitative guidelines for communicable disease control programs.
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A survey was carried out to identify the availability and quality of guidelines for the prevention and control of communicable disease and procedures in use in child day care centres within the South West Thames Regional Health Authority. A sample of 50 day care centres was investigated including those funded by social services and privately funded day care centres. Policies for the prevention and control of communicable disease for children and staff showed a wide variation between different centres. Exclusion criteria were unclear especially in relation to carriers of the hepatitis B virus and HIV positive children. Channels for reporting and seeking advice were inconsistent. It is recommended that clear and up to date written guidelines on the prevention and control of communicable diseases should be available in all day care centres with clear indications of good practice and channels for reporting and advice. It is desirable that guidelines are agreed by the different health and local authorities throughout the region.
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It is in the interest of developing countries to have combined vaccines in veterinary medicine, not so much because they reduce production costs, but rather because they increase convenience and efficacy concerning the logistics of prophylactic projects in the field, thus lowering the cost of these projects. Their drawbacks are basically due to the biological compatibility of immunogens (possible immunosuppression by some viruses) and to the interaction of the various components when mixed, or when lyophilization is carried out. Some examples of such associations of vaccines are: (1) cattle plague + pleuropneumonia and possibly anthrax, (2) anthrax + blackleg, (3) sheeppox + anthrax, (4) pleuropneumonia + blackleg, (5) Newcastle disease + fowlpox + fowl typhoid, (6) fowl typhoid + chicken pasteurellosis. Practical results have been most positive and include the eradication of cattle plague - a major scourge of almost all of the African continent - and control over peripneumonia as a first step towards its eradication.
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The goals of infectious disease surveillance in war and in peace are the same: the detection of infectious diseases, outbreak identification and control, the assessment of vaccination programs, and the determination of the need for specific preventive measures. In the 1991 Gulf War, Israel's infectious disease surveillance system was utilized to follow the progress of a measles epidemic and to look for evidence of a concealed biological warfare attack. Stepped up mortality and morbidity surveillance, based on a prepared and smoothly functioning notification system, failed to uncover any suggestion that biological agents had been deployed.
Reference is made to the third edition of a handbook published 1800 in which experience in preventing and controlling animal diseases is given in the form of standards together with conclusions, the latter being related primarily to the incidence of cattle plague in the second half of the 18th century. The points made in the handbook are related to the history of veterinary medicine, with particular emphasis being laid on today's national veterinary services and the legal provisions which are now in effect for the prevention and control of high risk. Since production relations and productive forces were on a different level then, both the consequences of high-risk animal diseases and action for protection often had deterimental impact upon agricultural production and led to the ruin of many poorer farmers and dependent peasants. The substance of the prevention and control principles was not only adequate, but to some extent is valid even today, notwithstanding the much higher scientific basis on which many problems are tackled in our days. A set of strict rules had been established, and offenders had to expert severe punishment. Yet, in the class society of that time penalty rules differed for 'masters' and 'inferiors'. The handbook is of enlightening importance as a basisfor deliberate application of codes and standards.
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