Prevention of infectious diseases

Much of the decline in the incidence and fatality rates of infectious diseases is mainly due to public health measures- especially immunization, improved sanitation, and better nutrition.

Immunization remains the best means of preventing many infectious diseases. In developed nations, a childhood immunization has resulted in near eradication of measles, mumps, rubella, poliomyelitis, pertussis and tetanus. Haemophilus influenza type b is reduced to 95%since the introduction of the first conjugate vaccines. However, substantial vaccine preventable morbidity and mortality continuous to occur among adults from vaccine-preventable diseases such as Hepatitis A, Hepatitis B, influenza and pneumococcal infections. Current protocol recommends that clinicians should review each adult immunization status at age 50

Strategies to enhance vaccinations in general include increase community demand for vaccinations; enhancing access to vaccination services; and provider or system based interventions such as reminder systems.

As, tuberculosis remains the leader of infectious diseases in the developing nations, skin testing for tuberculosis  and treating selected patients reduce the risk of reactivation tuberculosis. Strategies like DOTS (directly observed treatment short-course ) can help in patients who already develop tuberculosis. Patients with HIV are at an especially high risk for tuberculosis. So, follow-up is important in such patients.

HIV infection is now a major disease problem in the world. Since sexual contact is a common mode of transmission, primary prevention relies on eliminating unsafe sexual behavior by promoting abstinence, later onset of first sexual activity, decreased number of partners, and use of latex condoms. Appropriately used, condoms can reduce the rate of HIV transmission by nearly 70%. Unfortunately, as many as one-third of HIV positive individuals continue unprotected sexual practices after learning that they are HIV-positive. With regard to secondary prevention, many HIV-infected persons receive the diagnosis at advanced stages of immunosuppression. On the other hand highly active antiretroviral therapy (HAART) reduces the risk of clinical progression or death in patients of advanced immunosuppression.

Whenever possible, immunizations should be completed before procedures that require or induce immunosuppression (organ transplantation or chemotherapy) or that reduce immunogenic responses (splenectomy)

The current epidemic of highly pathogenic H5N1 avian influenza within duck and poultry in Southeast Asia raises serious concerns that genetic ressortment will result in a human influenza pandemic. To prevent and prepare for an increase in human cases, public health officials are working to improve detection methods and to stockpile effective antivirals.

While vaccines are the mainstay for the prevention of infectious diseases WHO in collaboration with regional health officials working on strategies to further improve the outcomes.

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