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Where did our infectious diseases come from? The evolution of infectious disease.

Infectious diseases have been evolving from the earliest days of life on earth. Major factors influencing their developments include the splitting of continents (continental drift), the radiation of early primates into present-day forms, migrations of man around the world, the ending of the Ice Age, the invention of agriculture, the domestication of animals, the increase in populations, and the urbanization of societies. The impact of such basic changes on infectious diseases is reviewed.

Agriculture

[Gonadal load in radiotherapy of benign diseases. II. Infectious diseases and keloids].

The irradiation damages to the gonads caused by the radiotherapy of parotiditis and mastitis and of cheloids was determined partially under different irradiation methods. The measurements were effected with LiF dosimeters in the Alderson phantom with a tube tension of 250 kV for the inflammatory diseases and 55 kV for the cheloids. The gonad dose measured at the surface was within the range of hundreths of permille for the parotiditis, for the mastitis is was between tenths of permille and 2% depending on the therapy method. The gonad dose of the cheloid irradiations showed a clear relation to the distance between radiation source and gonads. The importance of radiological protection is emphasized.

Female

A mathematical model for the epidemiologic study of infectious diseases.

Many infectious diseases have been hypothesized to represent common virus infections in which only small proportions of cases result in clinically recognizable disease. In order to find a method of studying this class of diseases, a mathematical model of the age distribution of clinical disease was developed using poliomyelitis as a prototype. The model is shown to fit the age distribution of reported poliomyelitis in a variety of localities before the use of artificial immunization. The true yearly rate of infection is easily estimated and ranges from .11 in rural Sweden to 1.20 in Chile. The model accounts for several major features of poliomyelitis epidemiology, including the shift to older ages and the high rate of clinically apparent disease which were frequently observed in populations which could be expected to have a comparatively low rate of spread. An examination of the age distribution of other diseases by these methods may provide a method of identifying other common infections which only occasionally result in clinically apparent disease.

Age Factors

Immunization against infectious disease.

Mortality and morbidity from infectious diseases in the United States have declined more than 90 percent since 1900. Factors believed to be responsible for this decline include changes in the natural history of disease, sanitation, quarantine measures, control of nonhuman vectors, antibacterial drugs, and immunization. The contributions of each of these factors differ among the various infectious diseases; except for smallpox and diphtheria control, immunization had little effect until after World War II. The success of present and future immunization programs is endangered by public and physician complacency and by complex legal and ethical problems related to informed consent and responsibility for rare, vaccine-related injury.

Adolescent

CRISPR-Cas and Infectious Diseases: A Decade of Translational Advances in Molecular Biotechnology.

CRISPR-Cas systems have emerged as a versatile tool for diagnosing, treating, and preventing infectious diseases. This review highlights translational advancements in CRISPR-Cas-based applications, concentrating on the past decades in diagnostics, therapeutic genome editing, and vaccine development. The article highlights key platforms like DETECTR and SHERLOCK, which enable rapid, sensitive pathogen detection, and explores CRISPR-Cas9 systems in therapeutic strategies for directly targeting viral genomes and combating antimicrobial resistance. It also examines the role of CRISPR-Cas9 in engineering live-attenuated and personalized neoantigen vaccines. Principal findings demonstrate a clear progression from experimental proof-of-concept to preclinical applications primarily in CRISPR-based diagnostics and the engineering of live-attenuated vaccine candidates, whereas translation in CRISPR-based therapeutics and personalized neoantigen vaccines for infectious diseases remains at earlier, more exploratory stages. CRISPR-based diagnostics have progressed further toward clinical evaluation than therapeutics due to delivery and safety constraints, while personalized neoantigen vaccines are included mainly as an emerging, comparative concept for infectious diseases rather than a mature application. This review uniquely integrates CRISPR-based diagnostics, therapeutics, and vaccine development within a single infectious disease framework, critically assesses their current maturity, and systematically highlights technical, regulatory, and ethical barriers alongside realistic future priorities. The review concludes that while CRISPR-Cas holds transformative potential for infectious disease management, significant challenges in delivery efficiency, off-target effects, and ethical regulation must be addressed to ensure safe and equitable clinical translation.

Humans

Physician manpower needs and research training in infectious diseases.

As a result of recent and continuing studies of internal medicine manpower, data are now becoming available on training and manpower, data are now becoming available on training and manpower in infectious diseases. In 1976-1977, there were 121 training programs graduating a total of about 180 infectious disease specialists each year. Most funding for these fellowship programs comes from the federal government and hospital revenues. It is conservatively estimated that 2300 medical subspecialists in infectious diseases will be practicing in 1986-1987. About 55% of graduates of infectious diseases training programs plan careers in academic medicine. Information from manpower studies should be of value in the development of a national policy on the training of infectious disease specialists.

Education, Medical, Graduate

Epidemics of infectious diseases in newborn nurseries.

The newborn nursery is a frequent site of epidemics of infectious disease. The unique susceptibility of neonates to colonization, their intimate exposure to hospital personnel, and their frquent contact with possibly contaminated inanimate objects are major factors contributing to the risk of nursery epidemics. Most of the epidemics described have been caused by bacteria; the role of viruses in nosocomial infections is not well defined but is undoubtedly greater than presently appreciated. All bacteria implicated in nursery epidemics have the capacity to survive or even multiply in the environment or on human skin or to cause gastrointestinal disease. Analysis of the etiologic bacteria, the epidemiology of outbreaks studied, and extensive clinical research indicate that bacterial transmission in this setting occurs primarily by manual contact and very infrequently by the respiratory route. The cornerstone of a program to prevent infectious diseases in the nursery consists of active, disease-oriented surveillance by specially trained personnel; microbiologic surveillance is important only when specifically indicated. Practical technical considerations for prevention of infectious diseases in nurseries are available. Programs to eradicate an ongoing epidemic must be individualized.

Cross Infection

Epidemics of non-infectious disease.

Epidemics of non-infectious disease are often caused by exposure to industrial products, intermediates or by-products, either in the work-place or as a result of the contamination of a wider environment. Although the prime objective of research must be the recognition of the hazard and the evaluation of its magnitude so that illness may be prevented, close collaboration of clinicians, epidemiologists and toxicologists should lead to the acquisition of much knowledge of the mechanisms by which disease is caused. Catastrophes, though always regrettable, must be seen as experiments demanding careful analysis and exploitation. Many examples of different types of problem will be selected from the numerous epidemics from the time of the Schneeberg and Joachimsthal miners to the recent concern with contamination of the environs of Seveso by dioxin.

Asbestos

[Recent developments in the field of infectious diseases].

A résumé is presented of recent developments in the field of infectious diseases of particular interest of practising physicians. Examples are given to illustrate recent discoveries concerning the frequent misuse of antibiotics, the problem of infections developing in hospitalized patients, the biology of microbial infection, the etiology of well-known illnesses, new infectious diseases, and the development of vaccines. It is evident that the rate at which new and important information is evident that the rate at which new and important information is being reported demands particular effort in medical school teaching to ensure that students learn how to acquire and evaluate new information as well as how to discard ideas which are no longer valid.

Anti-Bacterial Agents

An overview of public policy and infectious diseases.

Major problems face this nation's health care system; infectious disease and their management are a major and growing part of these problems. It is clear from available information that 40 years after the introduction of the sulfonamides, infection and its management remain an enormously important cause of morbidity and mortality. We are far from being in the "post-infectious-disease era." Unless society and the medical profession understand this and take vigorous remedial steps, our problems may intensify, despite the availability of a remarkable effective group of therapeutic agents.

Economics, Medical