RESUMO
International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced by global health events.
RESUMO
Background: The objective of the study was to evaluate indirect methods commonly used in the field to decontaminate water as follows: boiling for 5-10 minutes and heating until "too hot to touch." Water perceived to be "too hot to touch" is defined as water in which a subject is unable to bear having the right index finger fully immersed for 5 seconds. Methods: Five flasks of water at 25 degreesC, 50 degreesC, 60 degreesC, 70 degreesC, and 100 degreesC were inoculated with 1.82 3 106 Escherichia coli bacteria. At the time of inoculation, and at 1 minute, 5 minutes, and 10 minutes, samples were withdrawn from each flask. The samples were plated and incubated for 18 to 24 hours. The numbers of colonies were then counted. Finally, subjects attempted to immerse, fully, their right index fingers into water at 50 degreesC, 55 degreesC, 60 degreesC, and 65 degreesC for 5 seconds. Subjects were normal, healthy individuals who worked at a microbiology laboratory. The main outcome measures were the number of colonies and the subjects' intolerance to heat. Results: Results showed that water at 50 degreesC has no effect on the number of bacteria, whereas water maintained at 60 degreesC for 5 minutes and at 70 degreesC and 100 degreesC for any time period effectively kills E. coli bacteria. The majority of subjects found 60 degreesC or cooler to be "too hot to touch." Conclusions: For travelers or campers, water is safe to drink if heated to boiling, but heating water until it is "too hot to touch" is inadequate for safe drinking purposes.
