History indicated that infectious diseases have had an ever-changing problem for public health. The paper tries to analyze the trend of infectious diseases prevalent in the developed and developing countries of the world in the early twentieth century and further addresses the emerging infectious diseases of the twenty - first century and how they can be prevented and controlled. THE GLOBAL
SCENARIO
The early twentieth century saw the growth of infectious diseases across the world resulting in 54 million deaths worldwide every year (World Health Organization, 1998). In United States alone, infectious diseases like tuberculosis, diarrhea and pneumonia led to 30 per cent of deaths. The infectious disease scenario in the developing countries was almost similar to the developed countries. Most of the reported cases were infected by tuberculosis, diarrhea and pneumonia.
The deaths were around 13 million which is one quarter of the total deaths. With the development of science and technology, development and success of antibiotics and immunization and decrease in mortality from infectious diseases due to better nutrition, safer food and water, hygiene and sanitation, housing helped in reducing the impact of infectious diseases. This resulted in the eradication of infectious diseases. General Surgeon William H.
Stewart told the United State Congress that there is a need to ‘close the book on infectious diseases’ mainly in the developed counties of the world. Thus, there was a shift in focus in terms of research and prevention and control from infectious diseases to non-infectious diseases like heart attacks, strokes and cancer which were reported to be 62 per cent of the total deaths in the developed countries of the world.
The re-emergence of infectious diseases along with the emergence of new infectious diseases like HIV/
AIDS, malaria, dengue, yellow fever, cholera, measles, ebola, ‘mad cow disease’, food borne viruses like E. coli O157:H7 and ‘flesh eating’ bacteria became an eye opener for the public health practitioners, academicians, government and general public who were under the impression that infectious diseases no longer exist. Globally, the new and the old infectious diseases were being recognized as they have been a cause of concern.
The number of cases increased because of a number of reasons like lower mortality rate leading to more ageing population who are more susceptible to infectious diseases, migration from one region to other or even cross boundaries and international travel and commerce, behavioural change such as unsafe sex or the use of alcohol and drug, unnecessary use of anti-microbial agents which has resulted in developing resistance to antibiotics, poor public health system, change in environmental and land use pattern etc.
Even though the developed and the developing countries were able to prevent and control the diseases to some extent, but the world experienced important health problems in the emergence of new and ones controlled infections. Societal and technological changes also accounted for both the control and the emergence of infectious diseases. One lesson learnt is that change leads to the continued emergence of infectious diseases, and there is a need to address this problem. The twenty – first century thus needs to focus mainly on the food-borne diseases and the resistance to antimicrobial agents.
CONCLUSION Looking at the rising pattern of infectious diseases, there is a need to develop flexible strategies and detect and respond to such problems. There is therefore a need to put in place adequate plans as done by Centers for Disease Control and Prevention which identifies four major strategies: (i) enhancing surveillance and response, (ii) encouraging rapid research, (iii) strengthening the infrastructure for public health and providing training opportunities and (iv) developing, implementing, and evaluation strategies for prevention and control.
The importance of each of the strategies varies from problem to problem and whether the country is a developed or a developing country. To address these problems effectively, there is a need to generate awareness, flexibility, resources and long term commitment so that the improvements of the twentieth century can be extended to the developing world and preserved in the developing world.
