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1.
Rev. méd. Chile ; 125(4): 474-82, abr. 1997. tab, ilus
Artículo en Español | LILACS, MINSALCHILE | ID: lil-196294

RESUMEN

The emergence of old and new communicable diseases is becoming an importanty public health problem in industrialized and developing countries worldwide. Chile experienced at the end of the seventies and during the eighties, epidemics of several emergent communicable infectious diseases whose relevance as public health problems had steadily decreased in the previous 25 years. The most strinking of these epidemics was a severe outbreak of typhoid fever that lasted at least 10 years. The majority of the cases ocurred in the urban setting of Santiago. Several investigators suggested, in light of apparently good sanitation statistics, that factors responsible for this outbreak of typhoid were an increase in the number of chronic carriers of salmonella typhi, the lack of microbiological food controls and the consumption of vegetables irrigated with waste water contaminated with S typhi. However, there is a dearth of epidemiological information and field work confirming the role of these factors in this typhoid outbreak. Moreover, the sudden, massive and urban characteristics of this epidemic, coupled to contemporary information regarding shortcoming on the preparation of drinking water and on decreased availability of drinking water to the population in Santiago regardless of good sanitation statistics, suggest that this outbreak may have been partially waterborne. The beginning of this typhoid outbreak also coincided with increased rain fall, with rapidly deteriorating economic and social conditions manifested in high rates of unemployment, and with decreased government investment on social services, including sanitation and health. Al these factors are known to influence the epidemiology of typhoid and other emergent diseases worldwide


Asunto(s)
Humanos , Fiebre Tifoidea/epidemiología , Pobreza/estadística & datos numéricos , Verduras , Agua Potable/análisis , Calidad del Agua/análisis , Control de Enfermedades Transmisibles , Brotes de Enfermedades/estadística & datos numéricos , Causalidad , Saneamiento Básico
2.
Rev. méd. Chile ; 125(1): 74-84, ene. 1997. tab, graf
Artículo en Español | LILACS | ID: lil-194528

RESUMEN

During recent years the world has experienced the reemergence of old communicable diseases and the emergence of new ones caused by novel pathogens such as the HIV virus and Borrelia burgdorfei. The problem consists mostly in the reemergence of old diseases but specially in industrialized countries new pathogens have also been described. Although the emergence of these infections in rare instances is due to genetic changes of pathogens to more virulent forms, most commonly they are due to changes in the environment and the host. Rapidly deteriorating living standards, desintegration of sanitation and public health infrastructure, cultural changes, migration and variations in behavior are some of the factors involved in the worldwide increase of infectious diseases. The degradation of natural habitats including forests and marine niches accompanied by climatic changes, are also playing an increasing role in the detrimental evolution of these diseases. The global emergence of these diseases calls into question the doctrine of epidemiological transition and directs us to scrutunize the paradigm that bases the prevention of this diseases solely vaccination. The current situation also highlights the limitations of classical epidemiology in dealing with unexpected problems and strongly suggests that this discipline should incorporate into its analysis findings from other fields, including ecological, climatological and economical information. As most of the negative social and economical developments that impinge on the detrimental evolution of these diseases are increasing world-wide, it can be predicted that the problems posed by these infections will continue and perhaps worsen in the near future


Asunto(s)
Humanos , Enfermedades Transmisibles/epidemiología , Historia Natural de las Enfermedades , Condiciones Sociales/tendencias , Ecosistema , Cambio Climático , Evolución Cultural , Factores Socioeconómicos , Salud Pública/tendencias
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