Disease control

Clinicians have always intuitively understood the value of disease control and prevention. Early intervention in the course of a disease or even before disease develops has saved the lives of millions of people. Although immunization and screening tests remain important for controlling and preventing diseases, the most promising role for disease control may lie in educating people and changing the personal health behaviors before clinical disease develops.

Screening tests such as the Pap smear (for cervical cancer), mammography (forbreast cancer), and the Prostate Specific Antigen (PSA) level (for prostatecancer) have all been successful in dramatically reducing the incidence of many cancers. Routine physical examinations and screening for hypertension andother risk factors for heart disease have significantly brought down the mortality from stroke and heart attacks. Similarly, because of very rigid rules for childhood immunizations, once-common childhood infections (e.g. diphtheria, pertussis, measles) have now become a rare thing in the USA.

Besides controlling and preventing chronic diseases and childhood diseases, infectious diseases can also be controlled by educating people about the riskfactors and giving them information on steps they can take to prevent it. TheCenters for Disease Control (CDC) and many institutions such as the NationalInstitutes of Health (NIH) distribute fact sheets on several infectious diseases. These fact sheets give information about the symptoms of the disease, the causative agent, the mode of disease transmission, drugs used to treat thedisease and how the disease can be prevented.

In order to control the spread of food and water borne infections, such as cholera, typhoid, and amebiasis, the following precautions can be taken. When visiting areas where these infections are prevalent, drink only bottled water,carbonated water, and canned or bottled sodas. Boiling water for 1 minute will kill parasites, bacteria, or viruses that may be present. E. histolytica is not killed by low doses of chlorine or iodine; do not rely on chemical water purification tablets, such as halide tablets to prevent amebiasis. Food should be cooked thoroughly to kill parasites, bacteria, or viruses that may bepresent. If you plan to eat raw vegetables that may be contaminated, they should first be washed with a strong detergent soap and then soaked in vinegar for 10-15 minutes. Do not eat fruit that already has been peeled or cut. Drinkonly pasteurized milk or da! iry products. Avoid eating dairy products or drinking raw milk. They can be contaminated with unclean water.

In order to prevent African trypanosomiasis and other insect bites, wear protective clothing, including long-sleeved shirts and pants. The tsetse fly canbite through thin fabrics, so clothing should be made of thick material. Wearkhaki or olive colored clothing. The tsetse fly is attracted to bright colors and very dark colors. Use insect repellant. Though insect repellants have not proven effective in preventing tsetse fly bites, they are effective in preventing other insects from biting and causing illness. When sleeping, use bednets. Inspect vehicles for tsetse flies before entering. Do not ride in the back of jeeps, pickup trucks, or other open vehicles. The tsetse fly is attracted to the dust that moving vehicles and wild animals create. Avoid bushes. The tsetse fly is less active during the hottest period of the day. It rests in bushes but will bite if disturbed.

Similarly, the spread of all types of invasive group A streptococcal infections may be reduced by good handwashing, especially after coughing and sneezing, before preparing foods and before eating. All wounds should be kept clean and watched for possible signs of infection: increasing redness, swelling, drainage, and pain at the wound site. A person with signs of an infected wound,especially if fever develops, should seek medical care.

Group B Streptococcal (GBS) infections can be detected during pregnancy by taking a swab of both the vagina and rectum for special culture. A positive culture result means that the mother carries GBS--not that she or her baby willdefinitely become ill. Carriage of GBS, in either the vagina or rectum, becomes important at the time of labor and delivery--when antibiotics are effective in preventing the spread of GBS from mother to baby.

In order to control hospital-induced (nosocomial) infections such as Legionnaire's diseases, diagnostic tests for legionellosis should be used in patientswith nosocomial pneumonia who are at high risk of developing the disease. Inaddition, an investigation for a hospital source of Legionella spp. should be initiated immediately. Routinely maintaining cooling towers and using onlysterile water for filling and terminal rinsing of nebulization devices is also advised.

HIV and AIDS are also preventable. The prevention strategies include practicing abstinence or monogamy (with an uninfected partner), and use of barrier protection (condoms). People who use IV drugs should try to get off drugs. If they cannot they should always use new needles or should clean needles and works with bleach and water. People who use IV drugs should try to get off drugs. If they cannot, they should always use new needles or should clean needleswith bleach and water. It is recommended that people who have HIV or AIDS should discuss their serostatus with their doctors and dentists, and inform their sex and needle-sharing partners. Women who are pregnant or planning a pregnancy are encouraged to talk with their doctor about being tested for HIV. Ifa mother is known to be infected with HIV, treatment is available to decreasethe baby s chance of infection. Practices called Universal Precautions and Standard Precautions such as the use of gloves, goggles, gowns, etc., are usedby health care practitioners for prevention of transmission of any communicable disease including HIV.

Getting vaccinated against diseases is another way through which one can prevent diseases. If you are traveling to a country where typhoid is common, youshould consider being vaccinated against typhoid. Visit a doctor or travel clinic to discuss your vaccination options. Remember that you will need to complete your vaccination at least 1 week before you travel so that the vaccine has time to take effect. Some vaccines may lose effectiveness after several years; if you were vaccinated in the past, check with your doctor to see if itis time for a booster vaccination.

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