Why is diseases important

A communicable disease is one that is spread from one person to another through a variety of ways that include: contact with blood and bodily fluids; breathing in an airborne virus; or by being bitten by an insect.

Reporting of cases of communicable disease is important in the planning and evaluation of disease prevention and control programs, in the assurance of appropriate medical therapy, and in the detection of common-source outbreaks.

California law mandates healthcare providers and laboratories to report over 80 diseases or conditions to their local health department. Reportable Diseases in California. How these diseases spread depends on the specific disease or infectious agent. Some ways in which communicable diseases spread are by:. Start Here.

Correspondence to David L. The views expressed in this article do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.

This is a partial US Government work. There are no restrictions on its use. There are no financial conflicts of interests among any of the authors. Two of the authors Mark S. Riddle and David L. Blazes are employees of the U. Government and military service members. This work was prepared as part of official duties. Title 17 U. Government work as a work prepared by a military service member or employee of the U. Reprints and Permissions. Blazes, D. The local importance of global infectious diseases.

Trop Dis Travel Med Vaccines 1, 5 Download citation. Received : 15 June Accepted : 16 June Published : 31 July Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Blazes 1 , Mark S. References 1. Article Google Scholar 6. Ryan Authors David L.

Blazes View author publications. View author publications. The field of infectious diseases is kinetic, unpredictable, and layered with surprises that sometime require heroic efforts from a diverse field of scientists and practitioners. On 2 October , a patient with fever and confusion was seen at a Florida medical center by Dr Larry Bush, an infectious disease physician. He examined the cerebrospinal fluid, saw boxcar gram-positive rods, diagnosed anthrax, and predicted bioterrorism [ 1 ].

This was strong stuff at a time no one had thought much of bioterrorism anywhere in decades and especially in an obscure, small town in Florida.

The ensuing epidemiologic investigation showed anthrax spores in this patient's workplace, the local postal service, and a letter received by the patient. This was the index case of the anthrax bioterrorism epidemic that shook the country in The result was a major national preparedness response to not only bioterrorism, but also preparedness for natural disasters, epidemics, and other major public health threats. In , Dr Alan Steere, a rheumatologist from Yale School of Medicine, led an investigation of an outbreak of arthritis involving 39 children and 12 adults in Connecticut.

Most of the patients had asymmetric swelling and pain of large joints, especially knees, and some also had an erythematous, annular rash [ 2 ]. Dr Steere was convinced it was an infection and moreover, that it was arthopod-born based on epidemiology and clinical features.

His relentless pursuit of the pathogen was finally rewarded with the discovery of the newly recognized spirochete in the blood and in typical skin lesions [ 3 ]. The specific agent was subsequently defined in a another extraordinary effort, this time by Dr Willie Bergdorfer, who had spent much of his career studying the microbiology of the hindgut of ticks; he successfully isolated the pathogen that he considered his last and most important scientific project [ 4 , 5 ].

That agent is named in his honor: Borrelia burgdorferi [ 6 ]. Dr Robin Warren, a pathologist in Australia, made the historic discovery that gastric biopsies from patients with gastritis showed a large burden of curved bacteria. No one paid attention until a young gastroenterologist, Dr Barry Marshall, agreed to study the association. Subsequent studies consistently showed the association between this curved microbe with gastritis and peptic ulcer disease, but there was almost uniform opposition from both gastroenterologists and infectious disease physicians.

Larry Altman, noted medical editor for The New York Times , wrote that never in his experience had he witnessed such fierce opposition from the medical community to the possibility that peptic ulcer disease was caused by a microbe L. Altman, personal communication, 16 May [ 8 ]. This prompted 2 proponents, Drs Barry Marshall and Alan Morris, to perform the ultimate experiment—they swallowed a flask of Helicobacter pylori and suffered from the experience; L.

Altman, personal communication, 16 May [ 9 ]. The long-term result of this unrelenting battle is now well known: H. In early September , Dr April Pettit, an infectious disease physician in Tennessee, saw a patient with Aspergillus meningitis following an epidural steroid injection [ 11 ]. This prompted her to notify Dr Marion Kainer at the Tennessee Health Department, who then set up shop with a sleeping cot in the health department to facilitate a nonstop investigation [ 12 ].

This was the beginning of the infamous national epidemic of Exserohilum rostratum meningitis associated with the contaminated steroids that led to cases and 55 deaths in 18 states.

Credit here is to Dr Pettit for recognition and prompt notification, to Dr Kainer for her aggressive response on behalf of the victims, and to the Centers for Disease Control and Prevention CDC for the hasty intervention. Somewhat disappointing is the fact that compounding pharmacies are still unregulated. This must be now viewed as possibly the most remarkably successful attack on an important infectious disease since Fleming discovered penicillin. In February , severe acute respiratory syndrome SARS was a newly described, severe disease in humans that was often fatal and appeared to travel by air routes, but had no established pathogen or treatment.

Dr Klaus Stohr at the World Health Organization WHO identified the finest virology laboratories in the world and asked them to collaborate to define the pathogen with the condition that all information would be shared on the Internet and there was no ownership of the data. This unselfish collaboration under strong leadership is credited with the rapid solving of a global crisis that eventually showed cases with deaths in 25 countries.

It is noteworthy that all started with strong leadership and came to closure with either elimination or successful management. Epidemics of infections are predictable to occur, but largely unpredictable in time, place, microbe, and consequences. The following highlights some of the recent epidemic records and surprises in this category:.

Coccidioidomycosis: The total number of reported cases increased fold in 13 years, from in to 22 in [ 16 ]. Malaria reported in US travelers reached a record high of cases in [ 17 ]. This pathogen is highlighted because global warming is expected to make it endemic in the southern United States and because of its substantial morbidity with possible long-standing arthritic complications [ 19 ].

Measles: The largest number of annual reported cases in the United States in 17 years was noted during — It now appears that will be worse [ 20 ].

Measles was declared eradicated in but has now become a problem, primarily in those refusing vaccination, but also in some with documented vaccination [ 21 ]. Pertussis: This infection is resurgent in the United States and Europe, with increased cases including epidemics in children and adults and involving both vaccinated and unvaccinated individuals [ 23 ].

This is thought to reflect waning immunity to the acellular vaccine and the need for a new vaccine [ 24 ]. Meningitis: — reporting showed 4 outbreaks of Neisseria meningitidis meningitis, 2 on college campuses and 2 among gay men in New York City and Los Angeles [ 25 ]. Influenza: This is a continual concern based on the ever-present threat of pandemics with devastating consequences —, —, —, —, — that seem difficult to predict or control [ 26 , 27 ].

Limitations of current expertise were illustrated with influenza A H1N1 swine flu, as the standard concept based on historic precedent is that new influenza epidemics come from Asia in the wintertime, but this one came in the eastern hemisphere in the summertime [ 27 ].

Both show high mortality rates, but little evidence so far of that single critical mutation permitting attachment to the hemagglutinin antigen to permit sustained person-to-person transmission [ 26 ]. Middle East respiratory syndrome MERS coronavirus: This coronavirus is a major global concern with analogies to the SARS coronavirus in terms of its perceived potential to become a global epidemic with high mortality and no apparent treatment [ 31 , 32 ].

Of immediate importance in the United States is recognition of risk with appropriate diagnostic testing, isolation, and management of persons with severe, unexplained pneumonia associated with recent travel to the Arabian Peninsula MERS [ 32 ]. Foodborne disease: Widespread foodborne epidemics are now a common consequence of the massive food distribution system that permits contaminated beef or lettuce from Mexico to reach stomachs in distant multistate areas, with medical consequences involving hundreds or thousands of people.

This includes the more recent emergence of the GII. These outbreaks seem likely to continue, with unpredictable pathogens in unpredictable places [ 33—35 ]. Heartland virus: A recently encountered tick-borne disease in Tennessee and Missouri with 10 cases and 2 deaths [ 36 ]. Polio-like virus infection with extremity paralysis has been recently reported in 5 and possibly 25 children in California [ 37 ].

Ebola virus: WHO has reported an outbreak in Guinea involving a new clade of this usually fatal infection [ 38 ]. This listing could continue almost indefinitely. The point is that epidemics are the domain of infectious diseases and public health, with the expectation for management or prevention of outbreaks with requirements for detection, reporting, isolation, and case management.

The listing here includes diverse pathogens, some life-threatening diseases, infections with important public health implications, an upsurge of pediatric infections in adults, many travel-related infections, multiple public health threats, and the continuous concerns for influenza and foodborne disease.

The major weaponry of the infectious disease catalog includes antibiotics, vaccines, and public health. These categories are remedial reading, but some facets are worthy of emphasis. The value of antibiotics seems obvious.

She received penicillin intravenously starting 14 March , promptly recovered, and survived to age 90 years [ 39 ]. The more recent experience with bacterial resistance and sparse pipeline threatens this miracle, but antiviral development is quite different, primarily for HIV and hepatitis C virus HCV.

It now appears that patients with HIV can achieve near-normal longevity [ 41 ]. HCV infection is even more impressive in terms of speed of progress and ability to cure.

The HCV treatment story reflects the efficiency of basic science to define targets, pharmaceutical skills of industry, well-organized trial networks, and a regulatory agency US Food and Drug Administration [FDA] that facilitated product development [ 42 ]. The impact of vaccines is also impressive. A recent report concluded that the global total for lives saved by vaccines exceeds million [ 43 ].

The impact could be substantially greater with more global access, fewer refusals, and a better pertussis vaccine. This illustrates the challenge and the priorities [ 44 ]. The epidemic was finally halted, but the toll was 18 cases and 6 fatalities over 6 months [ 45 , 46 ].

Another KPC epidemiologic investigation showed widespread distribution of this microbe from a long-term acute-care facility in the Chicago area [ 47 ], and others have demonstrated distribution of KPC by air travel from India to Europe [ 48 ].

There is no specialty field in medicine that demonstrates shifting priorities like infectious diseases. Note that the year interval resulted in a completely new agenda for what was considered timely and important in the field based on rapid changes in topical microbes, new epidemics, and new diagnostics, but not new antimicrobials. It is impossible to predict the menu for It is now known that genes for resistance to antimicrobial agents were well established in bacteria at least 3 million years before evidence of human life [ 49 ].

The use of antibiotics has selected for these genes by Mendelian laws, making it increasingly difficult to control previously treatable infections.