The breakdown of public health measures. The breakdown of public health measures has been the result of a series of often unrelated factors. Earlier successes in the war against infectious diseases led to complacency. Thus, coupled with limited resources and competing priorities in public health, often led to the transfer of resources from infectious diseases to other areas or to newly emerging infections.
The impact of the breakdown of public health measures can easily be seen during wars, population movements, and natural disasters. One such example has been the emergence of epidemic shigellosis in Africa. Since 1979, massive epidemics of shigellosis caused by Shigella dysenteriae type 1 have occurred in cities, rural areas, and refugee camps in Central and Southern Africa. The epidemics have affected all age groups, often with case-fatality ratios greater than 10 %. In 1991 alone, the disease caused 60,000 deaths in Burundi and at least 200,000 deaths in the rest of Africa. In contrast to Shigella species, which are more common in parts of the developed world, this organism is essentially resistant to all available oral antimicrobial drugs. Some of the newer fluoroquinolones are the last remaining effective oral agents.
Now even in developed countries approximately for 40 % of adult population tap different imunopathologic states that explains atypical and lingering How even of classic infectious diseases, more often development of mixed-infection, superinfection, continuous, microbe carrying.
The diagnostic of the infectious disease should be as early as possible. Such haste is connected not only with the necessity of assignina the conforming treatment but also with the demand of earring out urgent preventive actions, especially, if the disease has arisen in the collective. The diagnosis is grounded on the combination of symptoms characteristic for this or that infectious process. As in case with other diseases, the symptoms should be collected beginning with the complains of a sick person, anamnestic information of the development of illness symptoms, the nature of the epidemiological situation. Objective data should be taking during the physical examination of the patient, and then at auscultation, percussion and laboratory investigations.
At the identification of the infectious diseases as well as other diseases, anamnesis is of great importance. It is necessary to point out one of the most important peculiarities of the anamnestic data in infectious diseases, it is epidemiological anamnesis. The epidemiological anamnesis should be extremely careful and full. When the patient himself cannot give the necessary data (grave condition, age), the information should be obtained from relatives or the people
Collecting the epidemiological anamnesis is as difficult as obtaining the disease anamnesis, and the skill of its collecting needs to be developed just as the skill of objective examining, the more so as collecting the correct anamnesis is considered to be more difficult to learn than the procedure of the objective
Date: 2014-12-21; view: 1180