Public health measures

E. J. Largent, "MetaboHsm of Inorganic Fluoride" ia Fluoridation as a Public Health Measure, American Association for the Advancement of Science, Washiagton, D.C., 1954, pp. 49—78. 

A new coronavirus was quickly identified after the outbreak of an atypical pneumonia in southern China early in 2003. The new virus eventually caused 8,000 infections with approximately 800 deaths in 29 countries. The condition was named Severe Acute Respiratory Syndrome, SARS, and the causative coronavirus named SARS-CoV. The zoonotic nature of the infection came with the identification of a similar virus in bats (Poon et al. 2005), although it is possible that the bat virus passed through other animal hosts and recombined with other SARS-like coron-aviruses prior to infecting humans (Hon et al. 2008). SARS-CoV is not currently circulating in the human population however, the mysterious appearance and rapid spread of this virus emphasized how vulnerable the human population is to such respiratory infections. This has spurred interest in the development of antivirals that could be used either in treatment or as prophylaxis to complement public health measures in curbing future outbreaks. 

For those infectious diseases that are transmitted to humans via insect vectors the onset and decline phases of epidemics are rarely observed other than as a reflections of the seasonal variation in the prevalence of the insect. Rather, the disease is endemic within the population group and has a steady incidence of new cases. Diseases such as these are generally controlled by public health measures and environmental control of the vector with vaccination and immunization being deployed to protect individuals (e.g. yellow fever vaccination). 

More recently, standard tuberculosis has become a common infection in AIDS patients. TB was largely eradicated in Western countries through public health measures and antibiotic treatments. However, recently there has been a resurgence of TB, due to a combination of several factors (1) immigration from areas where TB infection is still common (Asia and Latin America) (2) decline in public health funding and (3) AIDS patients, who are highly susceptible to TB infection and who in turn can transmit the bacterium. 

Research will be important in providing biomedical solutions to the disease itself. Research in such areas as the virology of HIV and the immune system will provide clues for possible therapies and cures. Epidemiological research may give us more information about how the virus spreads in populations and what kind of public health measures might be effective in controlling the disease. Finally, clinical research will test and validate new therapies for the disease. 

Proper planning is a delicate process because public health measures are rarely noticed or appreciated (like buried utility pipes, they are often hidden functions) except when they fail—then they are very visible. Consumers are particularly upset by unsafe (contaminated) environmental media (water, air, and/or soil) because they are often viewed as entitlements—and indeed, it is reasonable for consumers to expect a high-quality, safe environment. Public health failures during response to contamination threats often take the form of too much or too little action. The results of too little action, including no response at all, can have disastrous consequences potentially resulting in public injuries or fatalities. On the other hand, a disproportionate response... 

Life expectancy in the United States increased markedly during the twentieth century, from about 46 years old in 1900 to about 76 years old in 2000. There are many reasons for the addition of three decades to the average duration of life. Among them are better public health measures, healthier lifestyles (better diets, more exercise, avoidance of tobacco, moderation in the intake of alcohol), availability and use of vaccines. 

The focal point of this chapter is antibiotics, specifically antibacterials. There are two principal ways that science attempts to deal with infections diseases vaccines that prevent or reduce the frequency and/or severity of infections diseases and antibiotics that are usually employed as an aid in achieving a cure once an infections disease has been acquired. In addition, public health measures such as clean water, clean air, and pathogen-free food are critically important in limiting infectious diseases. ... 

The state of public health measures in the United States and beyond leaves a lot to be desired. See L. Garrett, Betrayal of Trust The Collapse of Global Public Health, Hyperion, New York, 2000. 

J.W. Stamm, Milk fluoridation as a public health measure, J. Can. Dent. Assoc. 38 (1972) 446-448. 

But to retain the proper perspective here, let s remember that chlorination is probably the most important public health measure in the history of the world. Chlorine was first used to disinfect water at Maidstone, England, in 1897, during an outbreak of typhoid fever. People had known about the pale green gas since 1774, when the German scientist Scheele generated it by treating salt (sodium chloride) with sulfuric acid and man-... 

The value of insecticides in controlling human and animal diseases spread by insects has been dramatic. It has been shown that between 1942 and 1952, the use of DDT in public health measures to control the mosquito vectors of malaria and the human body louse vector of typhus saved five million lives and prevented 100 million illnesses (4). Insecticides have provided the means to control such important human diseases as filariasis transmitted by Culex mosquitoes and onchocerciasis transmitted by Simulium blackflies. 

One other early public health measure we were able to take was a daily bottle sanitizing station. We had many infants on bottle feeding and were fortunate enough to have a side kitchen with a sterilizer installed. With RN training in proper washing, rinsing, and sterilizing technique, teams of non-health care volunteers quickly took over that area of responsibility and served very conscientiously. 

Microbial adaptation and change Human susceptibility to infection Climate and weather Changing ecosystems Human demographics and behavior Economic development and land use International travel and commerce Technology and industry Breakdown of public health measures Poverty and social inequality War and famine Lack of political will Intent to harm... 

Define algorithms that trigger further epidemiological investigation. Apply appropriate science-based public health measures to ensure continued population protection appropriate to the biological threat involved, including follow-up of those exposed, vaccinated, or quarantined. 

Which antiviral drugs work or how the disease is dealt with in terms of public health measures, depends, in part, on the type of virus. The DNA viruses are relatively stable in form since mutations are internally corrected, and here it is often more effective to use vaccination than chemotherapy. By these means smallpox has been eradicated. For some RNA viruses, vaccination is also effective, including poliomyelitis, rubella, measles and mumps, and some rabies strains. Other viruses mutate so rapidly that vaccination is more difTicult, e.g. influenza, the common cold, HIV. 

Contrary to popular opinion, governments and health services develop almost no drugs and discover very few. In the developed world, almost all of the therapeutic advances of the last half-century have been the result of the efforts of the pharmaceutical industry. This is actually also true in the underdeveloped parts of the world, although public health measures in those regions may also have greater scope for improving the human condition. 

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