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1.
Anthropogenic land use changes drive a range of infectious disease outbreaks and emergence events and modify the transmission of endemic infections. These drivers include agricultural encroachment, deforestation, road construction, dam building, irrigation, wetland modification, mining, the concentration or expansion of urban environments, coastal zone degradation, and other activities. These changes in turn cause a cascade of factors that exacerbate infectious disease emergence, such as forest fragmentation, disease introduction, pollution, poverty, and human migration. The Working Group on Land Use Change and Disease Emergence grew out of a special colloquium that convened international experts in infectious diseases, ecology, and environmental health to assess the current state of knowledge and to develop recommendations for addressing these environmental health challenges. The group established a systems model approach and priority lists of infectious diseases affected by ecologic degradation. Policy-relevant levels of the model include specific health risk factors, landscape or habitat change, and institutional (economic and behavioral) levels. The group recommended creating Centers of Excellence in Ecology and Health Research and Training, based at regional universities and/or research institutes with close links to the surrounding communities. The centers' objectives would be 3-fold: a) to provide information to local communities about the links between environmental change and public health; b) to facilitate fully interdisciplinary research from a variety of natural, social, and health sciences and train professionals who can conduct interdisciplinary research; and c) to engage in science-based communication and assessment for policy making toward sustainable health and ecosystems.  相似文献   

2.
The emergence and reemergence of infectious diseases, as the result of recent and ongoing social and environmental changes, urgently calls for a global surveillance system, so that unusual outbreaks can be recognized and controlled at an early stage. ProMED, an international non-governmental group of infectious disease experts, was organized by the Federation of American Scientists to promote the establishment of a global Program to Monitor Emerging Diseases. ProMED proposes the establishment of a demonstration program by prioritizing a small number of strategically-located institutions in the developing world, mainly those least in need of upgrading, for development as sentinel centers. In this way a functional, although limited, network with capabilities for monitoring both endemic and emerging diseases could be rapidly established at minimal cost. The network would serve as an experimental model for future expansion. Initially, each center would develop its own local/regional network with which it would exchange information and assistance, and through which it would collect clinical data and specimens for monitoring the emergence of a limited number of defined syndromes. A central program office would provide protocols, assistance, training, quality assurance, communications, etc. and would coordinate fundraising and program activities. If successful, the syndromes monitored would be expanded and additional institutions strengthened to become new network centers.  相似文献   

3.
Public health authorities are now increasingly concerned by changes in the epidemiology of infectious diseases which may have an adverse impact on their budget plans and control strategies. Rapid increases in population and urban migration, various ecological changes, increasing poverty, and a rise in international travel have contributed to the worldwide vulnerability of human populations to the emergence, recurrence or spread of infectious diseases. In the rapidly growing city of Djibouti in East Africa, public health priorities have been altered during the last 10 years by diseases which were unknown or under control until the early 1980s. These diseases, including malaria, AIDS, tuberculosis, dengue fever and cholera, are consuming considerable resources. This article on Djibouti illustrates the epidemiological changes in the region. Besides the specific ecological and behavioural changes, which accompany rapid population growth, poverty seems to be a major cause for the emergence and recurrence of infectious diseases.  相似文献   

4.
Discussions on diseases of wildlife have generally focused on two basic models: the effect of disease on wildlife, and the role that wildlife plays in diseases affecting people or domestic animal health, welfare, economics and trade. Traditionally, wildlife professionals and conservationists have focused on the former, while most human/animal health specialists have been concerned largely with the latter. Lately, the (re-)emergence of many high-profile infectious diseases in a world with ever-increasing globalisation has led to a more holistic approach in the assessment and mitigation of health risks involving wildlife (with a concurrent expansion of literature). In this paper, the authors review the role of wildlife in the ecology of infectious disease, the staggering magnitude of the movement of wild animals and products across international borders in trade, the pathways by which they move, and the growing body of risk assessments from a multitude of disciplines. Finally, they highlight existing recommendations and offer solutions for a collaborative way forward.  相似文献   

5.
The frequent and swift emergence of new and devastating infectious diseases has brought renewed attention to health as an issue of international importance. Some states and regional organizations, including in Asia, have begun to regard infectious disease as a national and international security issue. This article seeks to examine the Vietnamese government's response to the epidemics of avian influenza and Human immunodeficiency virus. Both diseases have been recognized at different times as threats to international security and both are serious infectious disease problems in Vietnam. Yet, the character of the central government's response to these two epidemics has been starkly different. How and why this disparity in policy approaches occurs depends largely on the epidemiological, economic and political context in which they occur. Although epidemiological factors are frequently explored when discussing disease as a security issue, seldom are the political, social and economic characteristics of the state invoked. These dimensions, and their interaction with the epidemiology of the disease, are central to understanding which diseases are ultimately treated by states as security issues. In particular, the role of economic security as a powerful motivator for resistance to control measures and the role that local implementation of policies can have in disrupting the effect of central government policy are explored. In exploring both the outcomes of securitization, and its facilitating conditions, I suggest some preliminary observations on the potential costs and benefits of securitizing infectious disease and its utility as a mechanism for protecting health in Asia.  相似文献   

6.
《Global public health》2013,8(6):663-675
Abstract

The objective of the SARSControl Delphi study was to develop options for national and international emerging infectious diseases policies. The aim of this paper is to present the results of the study, which gathered expert opinions on gaps and inconsistencies concerning preparedness and response planning for Severe Acute Respiratory Syndrome (SARS) and SARS-like diseases. The Delphi technique was employed, which comprised a pilot round, two written rounds and a face-to-face meeting. The Delphi panel consisted of 38 experts from 22 countries, who highlighted the necessity to test plans and stressed the importance of surveillance measures for the swift containment of communicable disease outbreaks and the inclusion of detailed triage plans in national pandemic plans. The experts also suggested a need to define criteria for testing pandemic preparedness plans at different regional levels. New policy alternatives were identified, such as the need for generic plans on pandemics and universal access to healthcare during an outbreak. The usefulness of some non-medical interventions, such as bans on travel, could not be established and need further research. Dissemination of the findings will help to bridge gaps and rectify inconsistencies in current pandemic planning and response strategies for SARS and SARS-like diseases, as well as add valuable knowledge towards the development of national and international emerging infectious disease policies.  相似文献   

7.
Increasing infectious disease deaths, the emergence of new infections, and bioterrorism have made surveillance for infectious diseases a public health concern. Medical examiners and coroners certify approximately 20% of all deaths that occur within the United States and can be a key source of information regarding infectious disease deaths. We hypothesized that a computer-assisted search tool (algorithm) could detect infectious disease deaths from a medical examiner database, thereby reducing the time and resources required to perform such surveillance manually. We developed two algorithms, applied them to a medical examiner database, and verified the cases identified against the opinion of a panel of experts. The algorithms detected deaths with infectious components with sensitivities from 67% to 94%, and predictive value positives ranging from 8% to 49%. Algorithms can be useful for surveillance in medical examiner offices that have limited resources or for conducting surveillance across medical examiner jurisdictions.  相似文献   

8.
从20世纪90年代起, 全球不断发现新发传染病暴发流行。2003年严重急性呼吸综合征(sever acute respiratory syndrome, SARS)后, 我国也先后发生和出现了多起本地和输入性新发传染病疫情, 新发传染病应对形势不容乐观。新发传染病的发生和出现受到生物学、自然和社会等多种因素的影响或驱动。世界卫生组织及国际社会着重建立有效的区域和国际监测与应对体系。2003年SARS疫情后, 我国新发传染病应对能力自得到了系统性提高, 但防治体系尚存短板, 面对当前新发传染病疫情形势, 我国新发传染病应对需要明确重点, 提升和强化相关监测预警与应对处置能力。  相似文献   

9.
Malaysia's global, regional and bilateral international health relations are surveyed against the historical backdrop of the country's foreign policy. Malaysia has always participated in multilateral agencies, most notably the World Health Organization, as such agencies are part of the longstanding fabric of "good international citizenship". The threats of infectious diseases to human health and economic activity have caused an intensification and an organizational formalization of Malaysian health diplomacy, both regionally and bilaterally. Such diplomacy has also established a basis for developing a wider set of cooperative relationships that go beyond responding to the threat of pandemics. As Malaysia approaches "developed" status, its health sector is becoming increasingly integrated into the global economy through joint research and development ventures and transnational investment. At the same time, it will have the technological, financial and human resources to play an expanded altruistic role in global and regional health.  相似文献   

10.
Avian influenza and oseltamivir; a retrospective view   总被引:3,自引:0,他引:3  
The outbreak of avian influenza A due to an H7N7 virus in Dutch poultry farms turned out to have public-health effects for those who were involved in the management of the epidemic and who were thus extensively exposed to contaminated excreta and dust. An outbreak-management team (OMT) of experts in virology, infectious diseases and public health advised the Dutch government with respect to the potential health effects on humans. Strict hygiene measures were advised. Moreover, vaccination against human influenza was advised to prevent emergence of a new pandemic virus in humans. Since the human influenza virus H3N2 circulated at the same time, a double infection and emergence of a new human virus was the main fear on which prevention was focused. Conjunctivitis was observed in about 10% of the people involved. The conjunctivitis was sometimes accompanied by mild flu-like symptoms and incidental transmission between humans occurred as well. Because of the unexpected high incidence of symptomatic infections, proven to be caused by the H7N7 strain, oseltamivir was advised as an additional control measure, both for the treatment of symptoms and prophylactically for those with prolonged occupational exposure. After the unfortunate death of a veterinarian due to pneumonia caused by the avian virus, the preventive policy was further extended to people with short and incidental exposure to infected flocks. It is concluded that the policy was adequate, in spite of the unforeseen victim.  相似文献   

11.
传染病新特点与口岸卫生检疫应对   总被引:1,自引:1,他引:0  
目的提高国境口岸应对传染病的新特点的能力。方法分析传染病新近出现新的特点和趋势,提出国境口岸卫生检疫的应对措施。结果应对传染病出现全球化、卷土重来的新特点,口岸卫生检疫工作任重道远,加强国际、国内、区域间及人医与兽医的合作,调整卫生检疫模式及内容,建立有效的防控体系。结论在传染病全球化和增多的情况下,建立有效的卫生检疫模式。  相似文献   

12.
目的 通过对兰州自来水局部苯指标超标事件的卫生应急处置工作进行分析,系统分析其应急处理方法、流程与效果,为政府、卫生和疾控等相关部门制定相应应急对策提供科学依据,对应急工作中采取的诸多应急处置措施进行归纳总结,分析应急处置工作取得的成效和存在的主要问题及建议.方法 收集兰州市政府、兰州威立雅水务集团公司及兰州市疾控中心统计数据、公告、报表和会议纪要等,采用描述分析应急处置措施、处置效果和存在问题及建议.结果 此次自来水局部苯指标超标事件,造成饮用水危机,兰州市政府采取了应急措施,及时公开信息、免费限量供应成品饮用水和治理污染,动态监测水质、实时公开检测结果,经过紧急处置,饮用水各项指标符合国家标准,解除应急状态.结论 有效的多部门联动机制和开展动态监测、信息实时公开和共享,多途径采取应急处置措施可有效、迅速控制饮用水污染事件.  相似文献   

13.
Pauly BM  Varcoe C  Storch J 《HEC forum》2012,24(1):1-11
Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight key insights from the symposium and the papers in the series, propose to redefine moral distress, and outline directions for an agenda for action on moral distress in health care.  相似文献   

14.
The threat of climate change and global warming is now recognised worldwide and some alarming manifestations of change have occurred. The Asian continent, because of its size and diversity, may be affected significantly by the consequences of climate change, and its new status as a 'hub' of livestock production gives it an important role in mitigating possible impacts of climate variability on animal health. Animal health may be affected by climate change in four ways: heat-related diseases and stress, extreme weather events, adaptation of animal production systems to new environments, and emergence or re-emergence of infectious diseases, especially vector-borne diseases critically dependent on environmental and climatic conditions. To face these new menaces, the need for strong and efficient Veterinary Services is irrefutable, combined with good coordination of public health services, as many emerging human diseases are zoonoses. Asian developing countries have acute weaknesses in their Veterinary Services, which jeopardises the global surveillance network essential for early detection of hazards. Indeed, international cooperation within and outside Asia is vital to mitigating the risks of climate change to animal health in Asia.  相似文献   

15.
With the development of improved health systems, antibiotics and vaccines throughout the 20th century, the prospects of control of infectious diseases improved. During the same time-frame, an approach to disease control was developed which used the health outcomes resulting from various interventions to choose, guide and modify those interventions. Despite these major advances in the control of diseases, infectious diseases have (with occasional exceptions) not only continued to occur but in many instances the situation had deteriorated with the emergence and re-emergence in recent years of a range of infectious diseases. In this paper we consider why infectious disease control has not benefited from the move towards a health outcomes approach, why infectious disease control might benefit from such a move, and the differences between infectious and non-infectious diseases when considering health outcomes. We follow-up with some practical approaches to the use of health outcomes. We argue that appropriate use of health outcomes when planning and evaluating infectious disease control programs will improve human health.  相似文献   

16.
目的评定浙江省主要传染病的失能权重。方法以全球疾病负担研究中疾病失能权重7级分类标准及22个指标症状为依据,采用德尔菲法,选择10名传染病临床专家和18名公共卫生专家,通过自制的专家咨询表评定浙江省主要传染病的疾病失能权重的最小值和最大值。结果专家咨询表回收率100%,6种主要传染病的疾病失能权重最小值的均数为0.048~0.295,最大值的均数为0.300~0.950。结论对6种主要传染病的疾病失能权重的评定结果与澳大利亚疾病负担研究结果有一定的差异。  相似文献   

17.
目的探讨区域性大型活动的公共卫生突发事件风险,为科学制定公共卫生保障策略提供依据。方法选取2010年江苏省第17届运动会为研究对象,选择30名专家进行2轮Dclphi专家咨询,确定餐饮食品安全事件、公共场所健康危害事件、生活饮用水安全事件、传染病疫情事件和病媒生物引起的5大类及其所含的20种公共卫生突发事件的发生的可能性以及后果的严重性。结果 30名咨询专家的平均工龄为(21.17±7.81)a,2轮的应答率均为100%,权威系数为0.87±0.07,Kendall协凋系数分别为0.583(χ2=856.374,P0.01),0.845(χ2=1 242.280,P0.01),经卡方检验均具有统计学意义;确定了餐饮食品安全事件和公共场所健康危害事件、生活饮用水安全事件、传染病疫情事件和病媒生物引起的5类及其所含的20种公共卫生突发事件发生的可能性以及后果的严重性,其中风险发生可能性结果是餐饮食品安全事件为很有可能发生,传染病疫情为可能发生,生活饮用水安全事件和公共场所健康危害事件及病媒生物引起的公共卫生事例为不太可能发生;风险严重性结果是餐饮食品安全事件、生活饮用水安全事件、传染病疫情事件和公共场所健康危害事件为较小的,病媒生物引起的公共卫生事件为可忽略的。结论 Delphi专家咨询法是评价区域性大型活动公共卫生突发事件发生的可能性以及后果的严重性的有效方法,并将为进一步进行风险水平评估奠定基础。  相似文献   

18.
The use of an Infectious Diseases Impact Statement (IDIS) is proposed for predictive assessments of local changes in infectious diseases arising from human-engineered activities. IDIS is intended to be analogous to an Environmental Impact Statement. The drafting of an IDIS for specific activities, particularly in developing nations, would provide a formal mechanism for examining potential changes in local health conditions, including infected and susceptible populations, diseases likely to fluctuate in response to development, existing control measures, and vectors likely to be affected by human activities. The resulting survey data could provide a rational basis and direction for development, surveillance, and prevention measures. An IDIS process that balances environmental alterations, local human health, and economic growth could substantially alter the nature of international development efforts and infectious disease outbreaks.  相似文献   

19.
Infectious diseases present a formidable threat to the world today. Not only are new infectious diseases emerging, but those presumed to be contained or eradicated are re-emerging. Developing nations, with the least resources to respond, bear the greatest burden of this threat. However, with the potential to spread rapidly and ubiquitously, infectious diseases present a significant risk to the health and development of all nations. No country or population is immune, and geographic and political barriers offer little protection. Many factors facilitate the spread of infectious diseases, including globalization of travel and trade, weakening of national and international public health infrastructure, deterioration of socioeconomic conditions, and heightened political and civil strife in some developing nations. These conditions render populations more vulnerable to infections and provide an environment conducive to the transmission of infectious diseases. Compounding these risk factors is the emergence of another threat: antimicrobial resistance. Antimicrobial drugs are rapidly losing their effectiveness because of their misuse. As a result, the global health community is confronted with the daunting task of combating more offenders with fewer defenses.  相似文献   

20.
2019年全球传染病疫情仍不容乐观,刚果(金)埃博拉疫情成为国际关注的公共卫生紧急事件;南美洲、东南亚登革热病例数又创新高;欧美、非洲多国麻疹病例数继续攀升;脊髓灰质炎死灰复燃给全球消灭脊髓灰质炎计划带来阴影;2019年末中国武汉暴发新型冠状病毒肺炎,再次引发全球关注。新发和再发传染病是人类永恒的挑战,人类须时刻做好准备。本文对2019年国内外传染病领域重要事件进行回顾。  相似文献   

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