infectious disease

U.S. Cases per 100,000 Population

Diphtheria:

• 1950: 3.83
• 1960: 0.51
• 1970: 0.21
• 1980: 0.00
• 1990: 0.00
• 2000: 0.00
• 2005: -

Hepatitis A:

• 1950: ---
• 1960: ---
• 1970: 27.87
• 1980: 12.84
• 1990: 12.64
• 2000: 4.91
• 2005: 1.53

Hepatitis B:

• 1950: ---
• 1960: ---
• 1970: 4.08
• 1980: 8.39
• 1990: 8.48
• 2000: 2.95
• 2005: 1.78

Lyme disease:

Current Testing in Infectious Diseases

If Robert Koch or Christian Gram should suddenly reincarnate and wander through a modern microbiology laboratory, they’d feel right at home. Koch, who invented culture media, and Gram, developer of the stain that bears his name, would note little difference in methods from their heyday in the 1880s. Despite the innumerable advances in our knowledge of infectious diseases, we still streak our plates and stain our smears much as they did. But despite the stability in the core technology, there are many ways that the microbiology laboratory has evolved.

West Nile Virus

West Nile virus, a mosquito-borne flavivirus, was initially isolated in Uganda in 1937. The first human cases of West Nile virus infection transmitted in the western hemisphere were recognized in New York City in late August 1999 in a cluster of encephalitis cases. A total of 59 hospitalized cases and seven deaths were recorded. Since that time the virus has been found in mosquitoes (the vector), birds, horses, humans, and other mammals.

Immunizations

The evidence clearly supports their use. The recommendations are very straightforward, and the patients generally understand the need for them. So why are immunizations such a challenge to deliver? Despite the availability of an unprecedented number of vaccines for both children and adults, many people fail to benefit from them because of barriers to immunization delivery — some real and some perceived.

H1N1 (Swine Flu)

The world was rocked in late March 2009 when a new strain of Influenza A virus was first detected in Mexico, followed by cases in the United States. It is unknown whether humans have natural immunity. This novel strain consisted of genetic elements from four different viruses: North American swine influenza, avian influenza, human influenza, and swine influenza typically found in Asia and Europe. Infected pigs act as a mixing pot in which re-assortment occurs between flu viruses of several species, in this case pig and human.

Bad Bugs and Fewer Drugs

In the pre-antibiotic era, what today is considered a relatively “simple” infection could wipe out an entire family, village, or even countryside. Similarly, surgical mortality (from infection) averaged 40 percent. Today, infectious diseases are responsible, annually, for more than 13 million deaths and greater than 25 percent of mortality. Infections caused by antibiotic-resistant bacteria — often contracted by patients in hospitals — are a consistent problem.

The SDCMS GERM Commission

The San Diego County Medical Society’s GERM Commission was created by SDCMS in 1996 in order to bring together a group of infectious disease specialists, public health officers, infection control practitioners, and pharmacists to assist and advise SDCMS about issues related to infectious diseases.

The name GERM (Group to Eradicate Resistant Microorganisms) was adopted with the full understanding that, in reality, eradication was unlikely to be an attainable goal but its pursuit a worthy enterprise.

MRSA and MDROs

We devote this issue of San Diego Physician to infectious disease (ID), the medical topic we once thought we had conquered. As the first cases of HIV/AIDS emerged in the early 1980s, we soon realized that “bad bugs” were here to stay and that our coexistence with them remains precarious.

June 2009 "San Diego Physician" • Infectious Disease

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Features MRSA and MDROs Joseph E. Scherger, MD, MPH General Acute Care Facilities Kim Delahanty, RN, BSN, MBA, CIC, and Shannon Oriola, RN, CIC, COHN Current Testing in Infectious Diseases Daniel Keays, MS, and Carla Stayboldt, MD West Nile Virus Michele Ginsberg, MD, and Azi Maroufi, MPH Immunizations Mark H. Sawyer, MD H1N1 (Swine Flu) Robert E. Peters, PhD, MD Bad Bugs and Fewer Drugs Robert E. Peters, PhD, MD The SDCMS GERM Commission Ramon E. Moncada, MD, FIDSA (Ret.) and Gonzalo R. Ballon-Landa, MD Consumer Health Resources Mary Wickline, MLIS, MEd, Karen Heskett, MSI, Susan M. McGuinness, PhD Skin Cancer Dean E. Sidelinger, MD, MSEd EMAN Transitioning to CAHAN Bruce Even Lawyers Requesting Medical Record • Gynecology Exam Handout • DEA Agents Marisol Gonzalez U.S. Cases per 100,000 Population