Personal Health, 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:

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.

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.